Physiological Changes
perceptionof well-being defines quality of life; understanding perceptions about health status is essential for accurate assessment and development of clinically relevant interventions; older adults engaged in ADLs usually consider themselves healthy; whe
Normal Aging - General Survey
begins during initial nurse-pt encounter and includes a quick but careful head-to-toe scan of older adult that nurse writes in brief description; reveals if eye contact and facial expressions are appropriate to situation and universal aging changes such a
Normal Aging - Integumentary System
skin loses resilience and moisture; epthelial layer things, and elastic collagen fibers shrink and become rigid; wrinkles of face and neck reflect lifelong, repetitive muscle movement, pull of gravity on tissue and diminished elasticity; spots and lesions
Normal Aging - Integumentary System - Bad Skin Items
need to rule out 3 malignancyies related to sun exposure when examining skin lesions: melanoma, basal cell carcinoma, and squamous cell carcinoma
Normal Aging - Head and Neck
facial features may become more pronounced from loss of sub-Q fat and skin elasticity; can appear asymmetrical; comon vocal changes include rise in pitch and loss of power and range; Visual acuity declines with age; Noise i most prevalent risk factor for
Normal Aging - Thorax and Lungs
configuration of thorax sometimes changes due to changes in musculoskeletal system; Respiratory muscle strenght begins to decrese, and anteroposterior of thorax increases; Vertebral changes lead to dorsal kyphosis; calcification of costal cortliage causes
Normal Aging - Heart and Vascular System
decreased contractile strength of myocardim results in decreased caridc output; the decrease is significant when older adult experiences anxiety, excitement, illness or strenuous activity; Systolic and/or diastolic BP are sometimes abnormally high; Perifp
Normal AGing - Breasts
as estrogen preduction diminshed, mild ducts of breasts are replaced by fat, making breast tissue less frim; decreased muscle mass,tone and elasticity result in smaller breasts and sagging; Gynecomastia, enlarged beasts in men, often result of med side ef
Normal Aging - Gastrointestinal System and Abdomen
aging leads to increase in amount of fatty tissue in trunk which results in abdomen size increase; muscle tone and elasticity decrease so becomes more protuberant; gastrointestinal functions change include slowing of peristalisis and alterations in secret
Normal Aging - Reproductive System
changes in structure and function occur in both sexes as result of hormonal alterations; female menopause is related to reduced responsiveness of ovaries to pituitary hormones and resultant decrease in estrogen and progesterone levels; in men there is no
Normal Aging - Urinary System
hypertorphy of prostate gland is frequently seen in older men; hypertrophy enlarges gland and places pressure on neck of bladder so urinary retention, fequency, incontinence and UTI occur; results in difficulty initiating voiding and maintaing urinary str
Normal Aging - Musculoskeletal System
muscle fibers become small; muscle strength diminishes in proportion to declie in muscle mass; beginning in 30s, bone densitiy and bone mass start to decline; Osteoporosis is major public health trheat; postmenopausal women experience greater rate of bone
Normal Aging - Neurological System
decrease in number and size of neurons in nervous system begins in middle of 2nd decade; neurotrasmitters change w/age; all voluntary refelxes are slower, and individuals often have less ablitiy to respond to multiple stimuli; alterations in quality and q
Functional Changes
physical function is a dynamic process it changes as individuals interact w/environ; it is the complex relationship among all areas that influences older adult's functional abilities and overall well-being; fear of becoming dependent is overwhelming for p
FActors that Promote Highest Level of Function
healthy, well balanced diet; paced and appropriate activity; regularly scheduled visits w/health care provider regular particiaption inmeaningful actvities; use of stress management techniques and avoidance of alcohol, tobacco or illicit drugs
What does functional status refer to?
the capacity and safe performance of ADLs and IADLs; this is a sensitive indicator of health or illness; ADLs (bathing, dressing, toileting) and IADLs (ability to write check, shop, prepare meals, make phone calls) are essential to indipendent living; A s
Cognitive Changes
Some structural and physiological changes within brain are associated w/cognitive impairment; Symptoms of cognitive impairement such as disorientation, loss of language skills, loss of ability to calculate, and poor judgemen ARE NOT normal aging changes a
Cognitive Changes - Delirium
acute confusional state, is potentially a reversible cognitive impairment that often has a physiological cause; some are electrolye imbalances, cerebral anoxia, hypoglycemia, med effects, tumors, subdural hematomas, cerebrovascular infection, infarctions,
Cognitive Changes - Dementia
generalized impairment of intellectual functioning that interferes with social and occupational functioning; an umbrella term that includes Alzheimers, Lew body diseas, frontal-temporal dementia and vascular dementia; Cognitive function deterioration lead
Cognitive Changes - Depression
older adults sometimes experience late-life depression but is NOT normal part of aging; depression most common, yet most undetected and untreated; clinical depression is treatable and includes meds, psychotherapy or combination of both
Psychosocial Changes
the changes that occur during aging involve life transitions and loss; the longer people live,the more transitions they must cope with and the more losses they experience; include: retirement and associated financial changes, changes in roles and relation
What to ask about psychosocial changes
during assessment ask how older adult feels about self, self in relation to others and self as one who is aging and what coping methods and skill have been benificial; ask about family, intimate relationships,past and present role changes, finances, housi
Pychosocial Changes - Retirement
many mistakenly associate retirement w/passivity and seclusion; actually is stage in life characterized by transitions and role changes; requires letting go of ertain habits and structure and developing new ones; stress of retirement usually related to ro
Pychosocial Changes - Retirement Satisfaction
factors that influence satisfaction w/life: health status and sufficiant income; positive preretirement expectations also contribute to satisfaction; nurse can help pt and family prepare bydiscussing: relations w/spouse & children, meaningful activities &
Psychosocial Changes - Social Isolation
may pts experience; sometimes a choice (result of desire not to interact w/others), also response to conditions hat inhibit ability or opportunity to interact (ex-lack of access to transportation); some choose isolation but others don't and they become vu
Psychosocial Changes - Sexuality
all older adults, whether healthy or frail, need to express their sexual feelings; sexuality involves love, warmth, sharing, touching, not just intercourse; plays important role in self-esteem; openended questions inviting pt to explain sexual activites o
Psychosocial Changes - Housing and Environment
extend of pts ability to live independently influences housing choices; changes in social roles, family responsibilities, and health status influence living arrangements; ass pts enviro to consider resources that promote independence and functional abilit
Psychosocial Changes - Housing and Environment - Safety Risks
factors leading to injury: water heaters set to hot, enviro barriers such as throw rugs or slippery floor surface that could cause fall; have pet that could cause fall; lighting; The enviro can support or hinder physical & social functioning, enhance or d
Psychosocial Changes - Death
part of life historyis experience of loss thorugh death of relatives and friends; includesloss of older generations of families and sometimes loss of child; death of spouse is loss that affects lives of most older adults; have wide variety of attitudes an
Psychosocial Changes - Death - How to help
knowledge of grieving process, excellent communication skills, understnding of legal issues, familiarity w/community resources, and awareness of own feelings, limitations and strengths as they relate to care of confronting death are critical