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Chapter 13
Connecting With Others
Rewards of Social Interaction
• Sharing joys and burdens.
• Deriving feelings of normalcy.
• Validating perceptions.
• Maintaining a link with reality.
Presbycusis
• Definition
– Age-related sensorineural hearing loss.
– May cause speech to be inaudible or distorted.
• Effect on Communication
– May cause problems due to self-consciousness and
difficulty using the telephone.
– Corrective measures for hearing problems should be
explored.
Use of Hearing Aids
• Hearing aids can benefit persons with some hearing
disorders, but they may not solve all hearing problems.
• An audiometric evaluation can determine if the specific
hearing problem can be improved by the use of a hearing
aid.
• A hearing aid should never be purchased without being
specifically prescribed.
Problems Associated with Hearing Aid Use
• Inability to adjust to the presence of the aid.
• Distortion of sound:
– Caused by the amplification of environmental noise
along with speech sounds.
Suggestions for Hearing Aid Use
• Wear the aid for progressively longer periods until
comfort is gained.
• Avoid its use in noisy environments.
• Check the aid regularly to ensure earpiece is not blocked
with cerumen and the battery is working.
Interventions for Patients with Hearing
Deficits (Without Hearing Aids)
• Speak clearly and distinctly, in a low frequency but at an
audible level, while facing the individual.
• Avoid shouting as it raises the high-frequency sounds
that older persons already have difficulty hearing.
• Cup the hands over the less deficient ear and talk
directly into the ear.
• Use gestures and pictures and point to items while
talking about them.
Advocating for Hearing Safety
• Provide health education about the effects of
environmental noise on hearing and general health.
• Take an active role in advocating legislation to control
noise pollution and the enforcement of that legislation.
Measures for Assisting with Visual Deficits
• Schedule a thorough eye examination, including
tonometry, performed by an ophthalmologist.
– Detects vision changes and needs for alterations in
corrective lenses.
– Discovers problems such as cataracts, glaucoma, and
other disease processes.
• Assess the financial ability of the individual to afford an
eye examination and glasses.
Compensating for Visual Limitations
• Face the individual.
• Exaggerate gestures and facial expressions when
speaking.
• Approach the individual from the front.
• Ensure that seating allows for full sight of persons or
objects in the conversation.
• Supply ample lighting using several soft indirect lights.
• Use large-print materials.
Nursing Interventions Promoting Social
Interaction
• Review and readjust the person’s schedule to conserve
energy and maximize opportunities for socialization.
• Plan medication administration to accommodate social
activity.
• Plan fluid intake and bathroom visits prior to activities.
• Promote social activity among the elderly.
• Help persons of all ages see the attributes of the unique
human being housed within the aged body.
Prejudice Toward the Sexuality of Elders
• Respect for the elderly as vital, sexual beings is
minimized by:
– The lack of privacy afforded them.
– The lack of credence given to their sexuality.
– The lack of acceptance, respect, and dignity granted
to their continued sexual expression.
Role of the Nurse in Promoting Sexuality
• The myths, ignorance, and vulgar status previously
associated with sex have been conferred on the sexuality
of the aged.
– Nurses can play a significant role in educating and
counseling about sexuality and the aged.
– Nurses can encourage attitude changes by their own
examples.
Factors Contributing to Lack of Research
on Sex and the Elderly
• The acceptance and expansion of sexology has been
relatively recent.
• Impropriety was formerly associated with open
discussions of sex.
• There is a misconception that the aged are neither
interested in, nor capable of, sex.
• Practitioners lack experience in discussing sex with any
age group.
Sex and the Older Person
• There tends to be a decrease in sexual responsiveness
and a reduction in the frequency of orgasm.
• Older men are slower to erect, mount, and ejaculate.
• Older women may experience dyspareunia (painful
intercourse).
• Many older women gain a new interest in sex.
Factors That May Interfere with Sexual
Expression in Later Life
• The unavailability of a partner
• Ageism
• Changes in body image
• Boredom
• Misconceptions
• Physical conditions/cognitive impairments
• Medications
Misconceptions about Sex in Later Life
• Erections are not possible after prostatectomy.
• Penile penetration can be harmful to a woman after a
hysterectomy.
• Menopause eliminates sexual desire.
• Sex is bad for a heart condition.
• After a hip fracture, intercourse can refracture the bone.
• Sexual ability and interest are lost with age.
Examples of Drugs Affecting Sexual
Functioning
• Anticholinergics
• Phenothiazines
• Benztropine
• Reserpine
• Clonidine
• Sedatives
• Cytoxic agents
• Thiazide diuretics
• Digoxin
• Tranquilizers
• Diphenhydramine
• Trihexyphenidyl
• Guanethidine
• Tricyclic antidepressant
• Haloperidol
Strategies to Facilitate Connections
• Assist patients in evaluating current relationships.
• Guide patients in becoming aware of their behaviors and
responses that impact relationships.
• Teach strategies that promote effective expression of
inner feelings.
• Provide information on sources of social activities.
• Refer patients for hearing and/or vision examinations as
needed.
Strategies to Facilitate Connections
(cont.)
• Respect patients’ interest and efforts to be sexually
active.
• Assist patients in improving sexual function.
• Provide positive feedback for successful connections with
others.
Source
• Eliopoulos, C. (2005). Gerontological Nursing, (6th
ed.). Philadelphia: Lippincott, Williams & Wilkins (ISBN
0-7817-4428-8).