COMMON AGING CHANGES

Physical Changes of Aging

System Special Senses Sight Physical Change Diminished visual acuity Reduction in visual fields Reduced accommodation to light changes Decreased ability to distinguish colors Major eye problems:presbyobia(difficulty seeing clearly at close range), cataracts, glaucoma, retinal detachment, senile macular degeneration Decreased hearing acuity Presbycusis: hearing impairment especially in higher frequencies Decrease in sense of smell and number of taste buds Nursing Interventions Provide increased illumination without glare Provide safe environment by orienting client to surroundings and removing potential hazards. Use sunglasses outdoors. Use large print books Avoid night driving Use contrasting colors for color coding Look directly at person when speaking and speak clearly and slowly; low-pitched voice heard best. Decrease background noise Provide attractive meals in comfortable social setting. Vary taste, textures, and colors of food. Be alert for difficulty chewing and swallowing when selecting foods Promote independence in daily activities. Allow ample time for completion of task Use sleeping medications with caution. Provide adequate warmth.
Maintain social functioning by providing recreational and diversional activities

Hearing

Taste/Smell

Nervous

Progressive loss of number of neurons in brain and spinal cord Loss of total bulk of brain substance Slowed speed of nerve impulse and conduction; slowed reaction time Decreased blood flow to brain Change in sleep patterns Impaired thermoregulation Behavioral changes:diminished emotional responses; lessened adaptability:decreased short-term memory; narrowed interest;confusion/disorientation

Prevent translocation shock, minimizing frequency of transfers. Orient to reality to prevent and treat confusion/disorientation.

Integumentary Skin: Thinning, wrinkling, loss of elasticity, dryness Decreased perspiration Increased sensitivity to cold Hair: loss of pigment (graying), thinning Increased vascular fragility(senile purpura) Subcutaneous drugs absorbed more slowly

Observe and assess the skin frequently. Protect the skin from trauma. Avoid overexposure to sun. Maintain adequate hydration Keep skin clean, dry, lubricated, and pressure free. Provide adequate humidity and heat in environment. Lower bath water temperature to 100-105 degrees F Decrease frequency of complete baths Encourage exercise program to help minimize age related changes. Promote optimum physical activity within level of ability. Maintain optimum nutrition ,especially intake of protein, calcium and vitamins Encourage use of appropriate adaptive or assistive devices to enhance mobility. Assess symptoms and make appropriate modifications in care Minimize edema and fatigue with rest periods and elevation of legs Encourage exercises tolerated. Teach energy conservation methods in daily activities Teach person to change position slowly to avoid falls. Manipulate environment to enhance ventilation. Position to promote optimum ventilation. Maintain tone and efficiency of respiratory muscles by encouraging exercises and prescribed pulmonary exercises. Encourage person to get influenza vaccines Assess condition of teeth and mouth, fit and comfort of dentures, and ability to chew. Encourage fluids and foods high bulk and fiber.

Musculoskeletal

Atrophy of muscles with decreased strength, endurance, and agility Bones more porous and lighter through calcium loss; Falls are dangerous Enlarged, stiff joints Stooped posture Decreased cardiac output Decreased endurance Arteriosclerosis,edema Increased sytolic blood pressure Orthostatic hypotension Impaired ventilation and diffusion Reduced vital capacity Reduced cough Diminished lung capacity Increased risk of pneumonia

Cardiovascular

Respiratory

Gastrointestinal

Reduced gastric motility and impaired absorption Diminished food appeal Reduced peristalsis and decreased excretory efficiency

Decreased gastric acid Decreased liver size Decreased saliva Loss of teeth common Constipation common problem Urinary Decreased kidney function Common problems:frequency, dysuria, incontinence Enlargement of prostate in males

Encourage optimal activity Promote independence and privacy in use of bathroom. Keep stool record and observe for constipation.

Assess voiding problem Provide adeqaute fluids Encouarge independencein use bathroom. Establish voiding schedule or bladder program as needed to control incontinence(assist to bathroom or offer bedpan every 2-3 hours). Avoid catherization unless no other alternative Promote good perineal care, treat with prescribed creams Use vaginal lubricant as needed. Provide encouragement and discuss modification in sexual expression as necssary;rest before and after sexual activity Assess for endocrine deficiency conditions such as DM and hypothyroidism

Reproductive Decreased production of estrogen/progesterone Female Atrophy and drying of vaginal canal Male Impaired ability to achieve full penile erection; reduced frequency of ejaculation Sexual responses slower and less intense Endocrine Decreased function of pituitary gland, thyroid, adrenal cortex, pancreas, parathyroid, and gonads

Biological / Physiological Changes

CHRONOLOGICAL AGE DOES NOT CORRELATE WITH BIOLOGICAL AGE. While most of us recognize advanced age in people when we see it, appearances alone do not determine how old we really are. Something more is needed. Two biological phenomena appear related to the aging process:

1. Accumulation of waste products in the cells = AS CHRONOLOGICAL AGE INCREASES, cells function less efficiently = Most frequently, this is an accumulation of lipofuscin, an insoluable fatty substance which, when it exists in large quantities, is known to affect cellular functioning.

2. Loss of elasticity of the connective body tissue = THE CULPRIT IS COLLAGEN, a substance which constitutes more than one-fourth of the body's protein. As age increases, the connective tissue becomes less elastic. = The most obvious evidence of changes in collagen is wrinkles. However, since collagen fibers also surround the cells and blood vessels of the body, stiffening of these fibers could also affect the efficient functioning of many body systems.

Social Factors
SOCIETY IS CREATED FROM A CONSENSUS OF INDIVIDUALS. These individuals, in turn, are influenced by the society in which they live. Thus, both Individuals and groups define and re-define our sense of self as we develop and as society changes. And society's view of "growing old" or being "old" is no exception to this process. 1. Ageism = AGEISM REFERS TO DISCRIMINATION BASED ON AGE. = This attitude arises because of age-related changes in appearance, in beliefs, and in other behaviorsthose characteristics which supposedly make older persons "different." 2. Gerontophobia GERONTOPHOBIA IS THE FEAR OF OLD AGE, especially of growing old. This fear is a by-product of the high value contemporary society places on youth and productivity. It touches all facets of life, from physical appearance to the fear of death. In his book, Age Wave, Ken Dychtwald identifies seven markers that can induce our phobia:

If If If If If If If

young is good, then old is bad the young have it all, the old are losing it the young are creative, the old are dull the young are beautiful, then the old are unattractive the young are stimulating, then the old are boring the young are full of passion, then the old are beyond caring the children are tomorrow, the old represent yesterday

3. Retirement

RETIREMENT IS AN AMBIVALENT CONCEPT. It represents a reward for participation in the labor force. It also represents a mechanism to ensure turnover of the labor force, with younger workers moving into slots vacated by retirees. On the other nand, retirement results in decreased income. It also leaves an older person with what some gerontologists describe as a "roleless role"i.e., no alternative to the role, status, and significance of "employee" has yet evolved.

Emotional needs

needs someone to talk to (plan time to visit; allow visits with a clergyman) comforted by touch (conveys feelings of concern, interest and acceptance) mainly family contact Provide diversional activities(books/magazines with large prints, radio, TV) allow to verbalize feelings on death (do not avoid the topic)