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Chapter 11. Geriatric Care. 11:1 Myths on Aging. Aging for everyone begins at at birth and ends at death Gerontology: scientific study of aging and the problems of the old Geriatric care: care of the elderly Health care worker must distinguish fact from myth. Myths and Facts .

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chapter 11

Chapter 11

Geriatric Care

11 1 myths on aging
11:1 Myths on Aging
  • Aging for everyone begins at at birth and ends at death
  • Gerontology: scientific study of aging and the problems of the old
  • Geriatric care: care of the elderly
  • Health care worker must distinguish fact from myth
myths and facts
Myths and Facts
  • Myth: most elderly individuals are cared for in institutions (nursing homes), or long-term care facilities
  • Fact: most older people are living at home, with family, or in retirement communities or facilities


myths and facts continued
Myths and Facts(continued)
  • Myth: all elderly people live in poverty
  • Fact: less than 10 percent of people over 65 are living at poverty level
  • Myth: the older generation are unhappy and lonely
  • Fact: many elderly individuals socialize by being involved in charity or volunteer work


myths and facts continued1
Myths and Facts(continued)
  • Myth: anyone over 65 is old
  • Fact: many elderly are active and productive into their 80s and beyond
  • Myth: elderly people are not able to manage their finances
  • Fact: older people have lots of experience and knowledge


myths and facts continued2
Myths and Facts(continued)
  • Myth: elderly individuals do not want to work; their goal is to retire
  • Fact: there are many elderly who prefer to work into their 70s and 80s
  • Myth: retired people are bored and have nothing to do with their lives
  • Fact: retirees are busy with hobbies, church, family, and community
  • There are many myths about aging
  • Needs of elderly individuals vary
  • Even though only 5% of the elderly live in long-term care facilities, this still means that 3 million people will be in these facilities by the year 2020
  • Recognizing normal changes allows the individual to adapt and cope
11 2 physical changes of aging
11:2 Physical Changes of Aging
  • Physical changes are a normal part of the aging process
  • Rate and degree of change varies
  • Usually related to a decreased function of body systems
integumentary system
Integumentary System
  • Production of new skin cells decreases
  • Sebaceous (oil) and sudoriferous (sweat) glands become less active
  • Circulation to skin decreases
  • Hair loses color; hair loss may occur
  • Methods to adapt and cope with changes
  • Measures to slow or decrease changes
musculoskeletal system
Musculoskeletal System
  • Muscles lose their tone, volume, strength
  • Osteoporosis
  • Arthritis
  • Coping with changes
  • Measures to slow or decrease changes
  • Providing a safe environment
circulatory system
Circulatory System
  • Heart muscle becomes less efficient at pushing blood into the arteries
  • Blood vessels narrow and become less elastic
  • Blood flow may decrease to brain and other vital organs
  • Methods used to adapt and cope with changes
respiratory system
Respiratory System
  • Respiratory muscles become weaker
  • Rib cage becomes more rigid
  • Bronchioles lose elasticity
  • Changes in larynx affect voice
  • Methods to cope with changes
  • Measures to slow or decrease changes
nervous system
Nervous System
  • Progressive loss of brain cells
  • Senses diminish
  • Nerve endings are less sensitive
  • Methods to adapt and cope
  • Measures to slow or decrease changes
digestive system
Digestive System
  • Fewer digestive juices and enzymes are produced
  • Muscle action becomes slower; peristalsis decreases
  • Teeth are lost
  • Liver function is reduced
  • Methods that are used to adapt and cope with changes
urinary system
Urinary System
  • Kidneys decrease in size; not as efficient at producing urine
  • Decreased circulation to kidneys
  • Bladder function weakens
  • Methods to adapt and cope with ongoing changes
  • Measures to slow or decrease changes
endocrine system
Endocrine System
  • Increased production of hormones
  • Decreased production of hormones
  • Measures to slow or decrease changes
reproductive system
Reproductive System
  • Female: vaginal walls thin and secretions decrease; uterus can drop; breasts sag
  • Male: sperm decreases; sexual stimuli is slower; ejaculation takes longer; testes become smaller; seminal fluid becomes thinner and less is produced
  • Measures to cope with changes
  • Aging causes physical changes in all body systems; rate and degree vary
  • Adapting and coping means fuller enjoyment of life
  • Health care workers need to assess individuals’ needs
  • Tolerance, patience, and empathy are essential
11 3 psychosocial changes of aging
11:3 Psychosocial Changes of Aging
  • Elderly individuals also experience psychological and social changes
  • Some cope well, while others experience extreme frustration and mental distress
  • Health care workers must be aware of this and assess changes and stresses
work and retirement
Work and Retirement
  • Most adults spend a large portion of their days working
  • Retirement is often viewed as an end to the working years
  • Many enjoy retirement
  • Some feel a major sense of loss
social relationships
Social Relationships
  • Change occurs throughout life
  • In elderly individuals, it may occur more rapidly
  • Some elderly people adjust to changes
  • Some elderly people cannot cope
living environments
Living Environments
  • Changes in living environments create psychosocial changes
  • Many elderly people prefer to stay in their own homes
  • Some individuals leave their home by choice
  • Moving to a long-term care facility often creates stress
  • Most individuals want to be independent and self-sufficient
  • Elderly people learn that independence can be threatened with age
  • Factors that can lead to decreased independence include physical disability, illness, and decreased mental ability


independence continued
  • Individuals may need assistance, but the health care worker needs to allow the elderly maximum independence and personal choice
disease and disability
Disease and Disability
  • Elderly people are more prone to disease and disability
  • Diseases sometimes cause permanent disabilities
  • When functioning is affected, psychological stress is experienced
  • Sick people often have fear of death, illness, loss of function, and pain
  • Psychosocial changes can be a major source of stress
  • As changes occur, individuals must learn to accommodate the changes and function in new situations
  • With support, understanding, and patience, workers can assist individuals as they learn to adapt
11 4 confusion and disorientation in the elderly
11:4 Confusion and Disorientation in the Elderly
  • Most remain mentally alert until death
  • Signs of confusion or disorientation
  • It is sometimes a temporary condition
  • Disease and/or damage to the brain
  • Term used to describe a loss of mental ability
  • Characteristics include decrease in intellectual ability, loss of memory, and personality change
  • Acute dementia
  • Chronic dementia
alzheimer s disease
Alzheimer’s Disease
  • One form of dementia
  • Causes progressive changes in the brain cells
  • Lack of neurotransmitter
  • Frequently occurs in 60s, but can occur as young as 40 years of age
  • Cause is unknown


alzheimer s disease continued
Alzheimer’s Disease(continued)
  • Terminal incurable brain disease; usually lasting 3–10 years
  • Early stage
  • Middle stage
  • Terminal stage
caring for the confused or disoriented patient
Caring for the Confused or Disoriented Patient
  • Provide safe and secure environment
  • Follow the same routine
  • Follow “reality orientation” guidelines
  • Caring for a confused or disoriented individual can be frustrating and even frightening at times
  • Perform continual assessments
  • Design program to maximize function
  • Practice patience, consistency, and sincere caring
11 5 meeting the needs of the elderly
11:5 Meeting the Needs of the Elderly
  • Geriatric care can be challenging but rewarding
  • Elderly people have the same needs as others
  • Cultural needs
  • Religious needs
  • Freedom from abuse
  • Respect patient’s rights
  • Needs of the elderly do not vary that much from needs of others
  • Sensitive to individual cultural and religious differences
  • Important to respect and follow all of the patient’s rights
  • Must ensure that the patient is free from abuse