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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
(continues)
© 2009 Delmar, Cengage Learning
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)
© 2009 Delmar, Cengage Learning
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)
© 2009 Delmar, Cengage Learning
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
© 2009 Delmar, Cengage Learning
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
© 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
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Muscles lose their tone, volume, strength
Osteoporosis
Arthritis
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
changes
© 2009 Delmar, Cengage Learning
Respiratory System
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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
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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
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
© 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
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)
© 2009 Delmar, Cengage Learning
Independence
(continued)
• 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
disabilities
• 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
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
© 2009 Delmar, Cengage Learning
11:4 Confusion and Disorientation
in the Elderly
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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
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
© 2009 Delmar, Cengage Learning
Alzheimer’s Disease
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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)
© 2009 Delmar, Cengage Learning
Alzheimer’s Disease
(continued)
• 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
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
© 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
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
© 2009 Delmar, Cengage Learning