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Do you feel what I feel? Understanding Sensory Changes in the Aging Population Presenters Sue Brooks MSN, RN, AOCNS® Clinical Nurse Specialist – ACE Unit and Patient Education Amanda Himes MSN, RN, BC Clinical Nurse Manager- ACE Unit Acute Care of the Elderly Spectrum Health Blodgett Hospital 21 Bed Inpatient Medical-Surgical Unit Goal: Maintain the functional status of the older adult during acute hospitalization by focusing on their unique needs Interdisciplinary Team Approach: Nurse Manager, Clinical Nurse Specialist, Educator, Pharmacist, Dietician, Physicians, Physical/Occupational therapy, Pastoral care, Nursing and Nursing Support Sensory Changes Vision Hearing Touch Smell Taste Effects of age related sensory changes • Barriers during communication and care – – – Reduced independence • – • Misinformation Confusion Wrong assumptions Reduced ability to provide self care Isolation Vision Thicker lens Loss of elasticity in the lens of the eye Pupil takes longer to dilate and contract Reduced pupil size Visual field becomes smaller Eyelids start to lag Decreased upward gaze Problems with glare Decrease in color vision Vision - impact Inability to adjust to glare and change in lighting conditions Decrease in eyes ability to change the shape of the lens to focus on near objects Medication labels Safety risk for driving and maneuvering in the environment Increased safety risk in changing environmental light Hearing Loss of sensory hair cells and nerve cells Decreased movement of the bones in ears Increased dryness of ear wax Increase in number of coarse hair in the ears Eardrum thickens Loss of high frequency hearing Decreased ability to process sounds after age 50 Hearing - impact Decreases in sound moving across the ear canal Decreased ability to hear sounds such as p,w,f,sh and women’s and children’s voices More time needed to process and respond to sounds Decreased hearing Hearing - impact Decreased quality of communication Social isolation Low self-esteem Hearing - impact “I went to a table to join four friends. When one of them asked me a question which I could not understand, the other repeated it for me. However, I was still unable to lip read it. They paused while one of them wrote it down. I was aware that the easy going conversation they had been enjoying before my arrival now ended. Within a few minutes two of them left and after a brief pause the others explained they had pressing engagements. I sat alone.” Patient Cycle of Hearing Loss Responds inappropriately Is labeled confused Caregiver avoids Becomes frustrated Becomes angry Is labeled uncooperative Taste Most changes in taste are due to: Condition of the mouth Medications Decreased number of taste buds Dry mouth Decreased sense of smell Disease Use of tobacco Taste - Impact Decreased sensitivity to flavors Swallowing ability Difficulty with cooking Decreased appetite Eating spoiled food Smell Decrease in nerve fibers associated with smell Decreased ability to identify odors Smell - Impact Impacts ability to taste Inability to identify spoiled food Inability to identify smoke or gas leaks Limits enjoyment in eating Limits pleasures of everyday life Smell of spring rain, Christmas tree, flowers, coffee brewing Touch/sensation Decreased sensitivity to: Temperature Pressure Touch Decreased balance Decreased sense of position of legs Change in pain sensation Touch/sensation - Impact Increased risk for: Falls Burns Lacerations Calluses Pressure ulcers Do you feel what I feel? Hands on interactive experience Vision What are you experiencing? Glaucoma How would this impact your day to day life? Vision What are you experiencing? Macular Degeneration How would this impact your day to day life? Vision What are you experiencing? Hemianopsia How would this impact your day to day life? Vision What are you experiencing? Cataracts How would this impact your day to day life? Vision What are you experiencing? Yellowing of the lens Medication Experience References Capezuti, E., Zwicker, D., Mezey, M., & Fulmer, T. (Ed’s.). (2008). Evidence-based geriatric nursing protocols for best practice (3rd ed.). New York, NY: Springer Publishing Company, LLC.
