Unit 9 Geriatric Care
9:1 Myths on Aging
 Aging begins 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
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Myths
 Most elderly individuals are cared for in
institutions or long-term care facilities
 Anyone over a certain set age (such as
65) is old
 Elderly people are incompetent and not
capable of making decisions or handling
their own affairs
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Myths
(continued)
 All elderly people live in poverty
 Older people are unhappy and lonely
 Elderly individuals do not want to work,
their goal is to retire, and prior to
retirement, they lose interest in work
 Retired people are bored and have
nothing to do with their lives
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Summary
 There are many myths about aging
 Health care workers must recognize
problems that do exist
 Needs of elderly individuals vary
 Even though only 5% of the elderly live
in long-term care facilities, this still means
2 million people will be in these facilities
by 2008
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9:2 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
 Recognizing normal changes allows the
individual to adapt and cope
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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
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Musculoskeletal System
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Muscles lose tone, volume, and strength
Osteoporosis
Arthritis
Methods to adapt and cope with changes
Measures to slow or decrease changes
Providing a safe environment
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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 to adapt and cope with changes
 Measures to slow or decrease changes
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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 adapt and cope with changes
Measures to slow or decrease changes
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Nervous System
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Progressive loss of brain cells
Senses diminish
Nerve endings are less sensitive
Methods to adapt and cope with changes
Measures to slow or decrease changes
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Digestive System
 Fewer digestive juices and enzymes
are produced
 Muscle action becomes slower;
peristalsis decreases
 Teeth are lost
 Liver function is reduced
 Methods to adapt and cope with changes
 Measures to slow or decrease changes
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Urinary System
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Kidneys decrease in size; are less efficient
Decreased circulation to kidneys
Decreased number of nephrons
Bladder function weakens
Methods to adapt and cope with changes
Measures to slow or decrease changes
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Endocrine System
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Increased production of some hormones
Decreased production of some hormones
Methods to adapt and cope with changes
Measures to slow or decrease changes
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Reproductive System
 Female: vaginal walls thin and secretions
decrease; decreased support of uterus;
breasts sag when fat is redistributed
 Male: production of sperm decreases;
response to sexual stimuli is slower;
ejaculation takes longer; testes become
smaller and less firm; seminal fluid
becomes thinner and less is produced
 Methods to adapt and cope with changes
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Summary
 Aging causes many physical changes in
all body systems; rate and degree vary
 All experience some degree of change
 Adapting and coping means fuller
enjoyment of life within physical limitations
 Health care workers need to assess
individuals’ needs and assist with coping
 Tolerance, patience, and empathy
are essential
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9:3 Psychosocial Changes
of Aging
 Elderly individuals also experience
psychological and social changes
 Some cope and others experience
extreme frustration and mental distress
 Health care workers must be aware of this
and assess changes and stresses
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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
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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 with
changes
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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
 Some are forced to move from their home
 Moving to a long-term care facility often
creates stress
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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
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Independence (continued)
 Individuals may need assistance, but
allow maximum independence and
personal choice
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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,
chronic illness, loss of function, and pain
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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, health care workers can assist
individuals as they learn to adapt
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9:4 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 can
result in chronic confusion or disorientation
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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
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Alzheimer’s Disease
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One form of dementia
Causes progressive changes in brain cells
Lack of neurotransmitter
Frequently occurs in 60s, but can occur as
young as 40 years of age
 Cause is unknown
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Alzheimer’s Disease
(continued)
 Terminal incurable brain disease; usually
lasting 3-10 years
 Early stage
 Middle stage
 Terminal stage
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Caring for the Confused or
Disoriented Patient
 Provide safe and secure environment
 Follow the same routine
 Follow “reality orientation” guidelines
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Summary
 Caring for a confused or disoriented
individual can be frustrating and even
frightening
 Perform continual assessments
 Design program to maximize function
 Practice patience, consistency, and
sincere caring
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9:5 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
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Summary
 Needs of the elderly do not vary that much
from needs of others
 Must respect cultural and
religious differences
 Must respect and follow patient’s rights
 Must ensure that the patient is free
from abuse
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