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Chapter 10
Geriatric Care
Myths on Aging
Aging for everyone begins 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
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

(continues)
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

(continues)
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

(continues)
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

Summary
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

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
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
Muscles lose their tone, volume, strength
 Osteoporosis
 Arthritis
 Coping with changes
 Measures to slow or decrease changes
 Providing a safe environment

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 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
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
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
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
Increased production of hormones
 Decreased production of hormones
 Measures to slow or decrease changes

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

Summary
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

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
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
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
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

Independence
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

(continues)
Independence
(continued)

Individuals may need assistance, but the
health care worker needs to allow the
elderly maximum independence and
personal choice
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

Summary
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

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

Dementia
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
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

(continues)
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
Provide safe and secure environment
 Follow the same routine
 Follow “reality orientation” guidelines

Summary
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

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

Summary
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
