health

1. Geriatric Care
JAMES VALLEY VOCATIONAL TECHNICAL CENTER

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

3. • Older people are lonely and
unhappy
• Elderly do not want to work
• “Old Age” begins a 65
• Retirement ends your active life

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.

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

6. Integumentary
System
Changes• Production of new skin cells
decreases
• Oil and Sweat glands
become less active
• Circulation decreases

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)

8. • Fatty tissue layer of skin
diminishes
• Lines and wrinkles appear
• Nails become thick, tough, and
brittle
• Increased sensitivity to
temperature

9. Care of Skin
• Use mild soap
• Bath oils or lanolin lotion
• Bath or Shower once or twice a
week
• Brush Hair daily

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

11. • Because of the need for oxygen
and nutrients the elderly may
experience:
–Weakness
–Dizziness
–Numbness in hands & feet
–Rapid heart beat

12. Circulatory System
Care
• With circulatory changes:
–Avoid strenuous exercise or over
exertion
–Periods of rest
–Moderate exercise, according to
individual’s tolerance

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

14. • High Blood Pressure =
–Diet low in salt
–Decrease fat intake
–Exercise as recommended by
physician

15. Respiratory Changes
• Respiratory muscles become
weaker
• Rib cage more rigid
• Alveoli thinner & less elastic
which decreases exchange of
gases - emphysema

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

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

18. Respiratory Care
• Alternate activity with periods
of rest
• Proper body alignment &
positioning
• Sleep in semi-fowlers position
–Use 2 or 3 pillows

19. • Avoid polluted air
• Breath deeply & cough
frequently
• May need continuous oxygen
therapy

20. Nervous System
Changes
• Blood flow to brain decreases
& there is a progressive loss of
brain cells - - Interferes with
–Thinking - Reacting
–Interpreting - Remembering

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

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

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

24. • Decreased sensation to pain &
other stimuli = more susceptible
–Burns
–Frostbite
–Cuts
–Fractures
–Muscle strain and other injuries

25. Digestive Changes
• Fewer digestive juices and
enzymes produced
• Muscle action becomes slower
& peristalsis decreases
• Teeth are lost
• Liver function decreases

26. • Dysphagia is frequent complaint
–Less saliva
–Slower gag reflex
–Loss of teeth
–Poor fitting dentures
• Slower digestion of food
–indigestion

27. • Decrease peristalsis
–Increase flatulence (gas)
–Constipation
• Decrease sensation of taste
–Poor appetite
–Poor diet

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

29. Urinary Changes
• Kidneys decrease in size &
become less efficient
• Bladder becomes less efficient
–May not hold as much
–May not empty completely
–incontinence

30. Urinary Care
• Increase fluid intake
–Decrease before bedtime
• Regular trips to bathroom
• Easy to remove clothing
• Absorbent pads

31. Endocrine Changes
• Increased production of some
hormones and decreased of
others
• Immune system less effective
• BMR decreases
• Intolerance to glucose

32. Endocrine Care
• Proper exercise
• Adequate rest
• Medical care for illness
• Balanced diet
• Healthy lifestyle

33. Reproductive System
Changes
• Decrease of estrogen /
progesterone in female
–Thinning of vaginal wall
–Decrease vaginal secretions
–Inflammation of vagina common

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

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

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

37. Psychocosocial
Changes
• Some individual cope with
psychosocial changes, and
others experience extreme
frustration and mental distress

38. • Fears of a sick person:
–Death
–Chronic illness
–Loss of function
–Pain

39. • Dealing with fears created by
an illness:
–Listening
–Patience
–Understanding
–Provide support

40. Confusion and
Disorientation
• Six signs:
–Talking incoherently
–Not knowing their name
–Not recognizing others
–Wandering aimlessly
–Lacking awareness of time or place

41. –Displaying hostile and
combative behavior
–Hallucinating
–Regressing in behavior
–Paying less attention to
personal hygiene
–Inability to respond to simple
commands or instructions

42. • Causes of temporary
confusion / disorientation
–Stress and/or depression
–Use of alcohol or chemicals
–Kidney disease
–Respiratory disease
–Liver disease
–Medication

43. • Diseases:
–CVA
–Arteriosclerosis
–Atherosclerosis
•Cause TIA’s ministrokes which
result in temporary periods of
diminished blood flow to the brain.

44. • Dementia
–Loss of mental ability
characterized by a decrease in
intellectual ability, loss of
memory, impaired judgement,
personality change, and
disorientation

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

46. Alzheimer’s Disease
• Form of dementia that causes
progressive changes in brain
cells

47. Early Stages:
• Memory loss
• Mood & personality changes
• Depression
• Poor judgment
• Confusion regarding time & place
• Inability to plan and follow
through with ADLs

48. Middle Stages:
• Nigh time restlessness
• Mood swings increase
• Personal hygiene ignored
• Weight fluctuates
• Paranoia & hallucinations
• Full time supervision needed

49. Late Stages:
• Total disorientation
• Incoherent
• Unable to communicate with
words
• Loses control of bladder &
bowel functions

50. • Develops seizures
• Loses weight despite eating a
balanced diet
• Becomes totally dependent
• Lapses into a coma
• Dies

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.

52. Avoid loud noises, crowded
rooms, and excessive
commotion. Promote
awareness of person, time, and
place by providing reality
orientation (RO)

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.

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

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

56. • Encourage use of tv, radio
without overstimulating them
• Be sure ind. uses sensory aids
• Keep familiar objects in view
Avoid moving furniture &
belongings
• Do not agree with incorrect
statements

57. • Do not hesitate to touch
communicate with person
• Avoid arguments
• Encourage independence and
self help whenever possible

58. Meeting the Elderly
Needs
• Culture: the values, beliefs,
ideas, customs, and
characteristics that are passed
from one generation to the next.

59. • Areas affected by an
individual’s culture:
–Language
–Food habits
–Dress
–Work
–Leisure activities
–Health care

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.

61. • Respect and Consideratin 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

62. • Abuse
–Physical
–Verbal
–Psychological
–Sexual

63. • Report any abuse observed to
proper agency
• Reasons elderly do not report
abuse
–Feel they deserve the abuse
–Want to protect abuser

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.