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Chapter 11
Geriatric Care
© 2009 Delmar, Cengage Learning
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
© 2009 Delmar, Cengage Learning
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
© 2009 Delmar, Cengage Learning
Myths and Facts
• 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
© 2009 Delmar, Cengage Learning
Myths and Facts
• 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
© 2009 Delmar, Cengage Learning
Myths and Facts
• 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
© 2009 Delmar, Cengage Learning
• 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
© 2009 Delmar, Cengage Learning
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
© 2009 Delmar, Cengage Learning
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
© 2009 Delmar, Cengage Learning
Musculoskeletal System
Muscles lose their tone, volume, strength
Coping with changes
Measures to slow or decrease changes
Providing a safe environment
© 2009 Delmar, Cengage Learning
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
© 2009 Delmar, Cengage Learning
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
© 2009 Delmar, Cengage Learning
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
© 2009 Delmar, Cengage Learning
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
© 2009 Delmar, Cengage Learning
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
© 2009 Delmar, Cengage Learning
Endocrine System
• Increased production of hormones
• Decreased production of hormones
• Measures to slow or decrease changes
© 2009 Delmar, Cengage Learning
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
© 2009 Delmar, Cengage Learning
• 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
© 2009 Delmar, Cengage Learning
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
© 2009 Delmar, Cengage Learning
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
© 2009 Delmar, Cengage Learning
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
© 2009 Delmar, Cengage Learning
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
© 2009 Delmar, Cengage Learning
• 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
© 2009 Delmar, Cengage Learning
• Individuals may need assistance, but the
health care worker needs to allow the elderly
maximum independence and personal choice
© 2009 Delmar, Cengage Learning
Disease and Disability
• Elderly people are more prone to disease
and disability
• Diseases sometimes cause permanent
• When functioning is affected, psychological
stress is experienced
• Sick people often have fear of death, illness,
loss of function, and pain
© 2009 Delmar, Cengage Learning
• 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
© 2009 Delmar, Cengage Learning
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
© 2009 Delmar, Cengage Learning
• 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
© 2009 Delmar, Cengage Learning
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
© 2009 Delmar, Cengage Learning
Alzheimer’s Disease
• Terminal incurable brain disease; usually
lasting 3–10 years
• Early stage
• Middle stage
• Terminal stage
© 2009 Delmar, Cengage Learning
Caring for the Confused or
Disoriented Patient
• Provide safe and secure environment
• Follow the same routine
• Follow “reality orientation” guidelines
© 2009 Delmar, Cengage Learning
• 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
© 2009 Delmar, Cengage Learning
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
© 2009 Delmar, Cengage Learning
• 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
© 2009 Delmar, Cengage Learning