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  1. 1. Geriatric Care JAMES VALLEY VOCATIONAL TECHNICAL CENTER Brought to you by
  2. 2. MYTHS • Elderly people are incompetent and incapable of making decisions or handling their own affairs. • Most elderly live in nursing homes • All elderly people live in poverty Brought to you by
  3. 3. • Older people are lonely and unhappy • Elderly do not want to work • “Old Age” begins a 65 • Retirement ends your active life Brought to you by
  4. 4. Physical Changes of Aging • Most physical changes that occur with aging are gradual and take place over a long period of time. In addition, the rate and degree of change varies among individuals. Brought to you by
  5. 5. • Factors such as disease can increase the speed and degree of the changes. Lifestyle, nutrition, economic status, and social environment can also have effects. • If an individual can recognize the changes as a/an normal part of aging, the individual can usually learn to adapt to & cope with change Brought to you by
  6. 6. Integumentary System Changes• Production of new skin cells decreases • Oil and Sweat glands become less active • Circulation decreases Brought to you by
  7. 7. • Hair losses color, and hair loss occurs • Skin becomes less elastic & dry • Itching is common • Dark yellow or brown colored spots appear –Senile lentigines (liver spots) Brought to you by
  8. 8. • Fatty tissue layer of skin diminishes • Lines and wrinkles appear • Nails become thick, tough, and brittle • Increased sensitivity to temperature Brought to you by
  9. 9. Care of Skin • Use mild soap • Bath oils or lanolin lotion • Bath or Shower once or twice a week • Brush Hair daily Brought to you by
  10. 10. • Shampoo as often as needed for cleanliness and comfort • Care for sore or injuries immediately • Socks, sweaters, lap blankets, and layers of clothing will help alleviate the feeling of coldness Brought to you by
  11. 11. • Because of the need for oxygen and nutrients the elderly may experience: –Weakness –Dizziness –Numbness in hands & feet –Rapid heart beat Brought to you by
  12. 12. Circulatory System Care • With circulatory changes: –Avoid strenuous exercise or over exertion –Periods of rest –Moderate exercise, according to individual’s tolerance Brought to you by
  13. 13. • Prevent the formation of a blood clot (thrombus) –Support stockings, anti- embolism hose –DO NOT wear garters or tight bands around legs –If confined to bed •ROM Brought to you by
  14. 14. • High Blood Pressure = –Diet low in salt –Decrease fat intake –Exercise as recommended by physician Brought to you by
  15. 15. Respiratory Changes • Respiratory muscles become weaker • Rib cage more rigid • Alveoli thinner & less elastic which decreases exchange of gases - emphysema Brought to you by
  16. 16. • Bronchioles lose elasticity • Changes in larynx lead to higher pitched & weaker voice • Chronic diseases may decrease the efficiency of the respiratory system even more severely Brought to you by
  17. 17. • Changes may cause the elderly to experience: –Dyspnea •Breathing increases in rate •Difficulty coughing up secretions •Increases susceptibility to infections such as a cold or pneumonia Brought to you by
  18. 18. Respiratory Care • Alternate activity with periods of rest • Proper body alignment & positioning • Sleep in semi-fowlers position –Use 2 or 3 pillowsBrought to you by
  19. 19. • Avoid polluted air • Breath deeply & cough frequently • May need continuous oxygen therapy Brought to you by
  20. 20. Nervous System Changes • Blood flow to brain decreases & there is a progressive loss of brain cells - - Interferes with –Thinking - Reacting –Interpreting - Remembering Brought to you by
  21. 21. • Senses of taste, smell, vision, & hearing are diminished • Nerve endings less sensitive –Decreased ability to respond to pain and other stimuli • Decrease in taste& smell frequently affects appetite Brought to you by
  22. 22. • Changes in vision –Problems reading small print –Seeing objects at a distance –Decrease in peripheral vision –Decrease in night vision –Increased sensitivity to glare –Cataracts –Glaucoma Brought to you by
  23. 23. • Changes in hearing –Hearing loss usually gradual –Person may speak louder than usual –Ask for words to be repeated –Not hear high frequency sounds –May not hear well in crowded places Brought to you by
  24. 24. • Decreased sensation to pain & other stimuli = more susceptible –Burns –Frostbite –Cuts –Fractures –Muscle strain and other injuries Brought to you by
  25. 25. Digestive Changes • Fewer digestive juices and enzymes produced • Muscle action becomes slower & peristalsis decreases • Teeth are lost • Liver function decreases Brought to you by
  26. 26. • Dysphagia is frequent complaint –Less saliva –Slower gag reflex –Loss of teeth –Poor fitting dentures • Slower digestion of food –indigestion Brought to you by
  27. 27. • Decrease peristalsis –Increase flatulence (gas) –Constipation • Decrease sensation of taste –Poor appetite –Poor diet Brought to you by
  28. 28. Digestive Care • Good oral hygiene • Repair or replace damaged teeth • Relaxed eating atmosphere • High-fiber high-protein foods with different tastes and textures • Seasoning to improve taste • Increased fluid intake Brought to you by
  29. 29. Urinary Changes • Kidneys decrease in size & become less efficient • Bladder becomes less efficient –May not hold as much –May not empty completely –incontinence Brought to you by
  30. 30. Urinary Care • Increase fluid intake –Decrease before bedtime • Regular trips to bathroom • Easy to remove clothing • Absorbent pads Brought to you by
  31. 31. Endocrine Changes • Increased production of some hormones and decreased of others • Immune system less effective • BMR decreases • Intolerance to glucose Brought to you by
  32. 32. Endocrine Care • Proper exercise • Adequate rest • Medical care for illness • Balanced diet • Healthy lifestyle Brought to you by
  33. 33. Reproductive System Changes • Decrease of estrogen / progesterone in female –Thinning of vaginal wall –Decrease vaginal secretions –Inflammation of vagina common Brought to you by
  34. 34. –Weakness in supporting tissue: •Uterus sags downward (Uterine prolapse) –Breasts sag when fat redistributed • Decrease in Testosterone –Slow production of sperm –Response to sexual stimuli slower –Testes smaller less firm Brought to you by
  35. 35. • Male and Female –Sexual desire may or may not decrease • Advantages of sex in elderly –Improves muscle tone & circulation –Pain from arthritis seems to decrease Brought to you by
  36. 36. Reproductive Care • Understand physical and psychological sexual needs of the elderly –Allow married couples to be in the same room –Give privacy to consenting elderly Brought to you by
  37. 37. Psychocosocial Changes • Some individual cope with psychosocial changes, and others experience extreme frustration and mental distress Brought to you by
  38. 38. • Fears of a sick person: –Death –Chronic illness –Loss of function –Pain Brought to you by
  39. 39. • Dealing with fears created by an illness: –Listening –Patience –Understanding –Provide support Brought to you by
  40. 40. Confusion and Disorientation • Six signs: –Talking incoherently –Not knowing their name –Not recognizing others –Wandering aimlessly –Lacking awareness of time or place Brought to you by
  41. 41. –Displaying hostile and combative behavior –Hallucinating –Regressing in behavior –Paying less attention to personal hygiene –Inability to respond to simple commands or instructions Brought to you by
  42. 42. • Causes of temporary confusion / disorientation –Stress and/or depression –Use of alcohol or chemicals –Kidney disease –Respiratory disease –Liver disease –Medication Brought to you by
  43. 43. • Diseases: –CVA –Arteriosclerosis –Atherosclerosis •Cause TIA’s ministrokes which result in temporary periods of diminished blood flow to the brain. Brought to you by
  44. 44. • Dementia –Loss of mental ability characterized by a decrease in intellectual ability, loss of memory, impaired judgment, personality change, and disorientation Brought to you by
  45. 45. • Acute dementia –When the symptoms are caused by temporary reason: •High fever, dehydration, hypoxia • Chronic dementia –When symptoms are caused by permanent, irreversible damage to brain cells Brought to you by
  46. 46. Alzheimer’s Disease • Form of dementia that causes progressive changes in brain cells Brought to you by
  47. 47. Early Stages: • Memory loss • Mood & personality changes • Depression • Poor judgment • Confusion regarding time & place • Inability to plan and follow through with ADLs Brought to you by
  48. 48. Middle Stages: • Nigh time restlessness • Mood swings increase • Personal hygiene ignored • Weight fluctuates • Paranoia & hallucinations • Full time supervision needed Brought to you by
  49. 49. Late Stages: • Total disorientation • Incoherent • Unable to communicate with words • Loses control of bladder & bowel functions Brought to you by
  50. 50. • Develops seizures • Loses weight despite eating a balanced diet • Becomes totally dependent • Lapses into a coma • Dies Brought to you by
  51. 51. • Certain aspects of care should be followed with any confused or disorientated individual. Provide a/an safe and secure environment, follow the same routine, keep activities simple and last for short periods of time. Brought to you by
  52. 52. Avoid loud noises, crowded rooms, and excessive commotion. Promote awareness of person, time, and place by providing reality orientation (RO) Brought to you by
  53. 53. Reality Orientation: • Address person by name preferred • Avoid: sweetie, baby, honey • State your name, correct elderly if calls you by the wrong name • Make reference to day, time, place • Use clocks, calendars, bulletin bd. Brought to you by
  54. 54. • Keep individual oriented to day night cycles: –Regular clothes during the day –Open curtains during the day] –Close curtains at night –Pajamas at night Brought to you by
  55. 55. • Speak slowly, clearly / ask clear & simple questions • Never rush or hurry the individual • Repeat instructions patiently, allow time for ind. to reaspond • Encourage conversations about familiar things or current events Brought to you by
  56. 56. • Encourage use of TV, radio without over stimulating them • Be sure ind. uses sensory aids • Keep familiar objects in view Avoid moving furniture & belongings • Do not agree with incorrect statements Brought to you by
  57. 57. • Do not hesitate to touch communicate with person • Avoid arguments • Encourage independence and self help whenever possible Brought to you by
  58. 58. Meeting the Elderly Needs • Culture: the values, beliefs, ideas, customs, and characteristics that are passed from one generation to the next. Brought to you by
  59. 59. • Areas affected by an individual’s culture: –Language –Food habits –Dress –Work –Leisure activities –Health care Brought to you by
  60. 60. • The spiritual beliefs and practices of an individual is called their religion. It is important to accept an individual’s belief without bias, and that health care workers not force their own religious beliefs on the ind. being cared for. Brought to you by
  61. 61. • Respect and Consideration of a persons religious beliefs –Proper treatment of religious articles –Allow person to practice religion –Honor request for special food –Provide privacy during clergy visits Brought to you by
  62. 62. • Abuse –Physical –Verbal –Psychological –Sexual Brought to you by
  63. 63. • Report any abuse observed to proper agency • Reasons elderly do not report abuse –Feel they deserve the abuse –Want to protect abuser Brought to you by
  64. 64. • Ombudsman is a specially trained individual who works with the elderly and their families, health care providers, and other concerned individual. To improve quality of care and quality of life. Brought to you by