Understanding Changes in Older Adults Flashcards
With old age, there will be an increase in
heart size.
CHANGES IN CARDIOVASCULAR SYSTEM IN OLDER ADULTS INCLUDE
Increase heart size (hypertrophy)
Heart valves and walls- thickens, stiffer
Decreased cardiac output, slower HR/PR, high BP
Artery-loss elasticity (hypertension)
Veins tortuous
Reports easy fatigability, activity intolerance, palpitations
Varicose veins are common in
older adults
HEALTH - PROMOTION ACTIVITIES CARDIOVASCULAR SYSTEM
● There should be a balance with rest and activities. Encourage
patient the importance of regular exercise 3-5 times a week
○ Avoid sedentary lifestyle
● Encourage patient to do heart-promoting activities (alcohol intake
and smoking cessation)
● Decrease:
○ Regular exercise, Pace Activities, Low- salt diet, Low-fat diet,
Regular BP monitoring, Weight Control, Medication Compliance,
Stress Reduction
CHANGES IN GASTROINTESTINAL SYSTEM
Decreased pancreatic enzyme leads to diabetes (decreased insulin production)
GI motility decreases leading to constipation and peristaltic tone
Difficulty swallowing food
Tooth decay
Loss of teeth, Malabsorption, Delayed Gastric emptying, Dry
mouth, Fullness, Heartburn, Indigestion, Flatulence,
Incontinence
______foods are easier to swallow
Soft
Tooth decay is due to
decreased calcium
HEALTH - PROMOTION ACTIVITIES GASTROINTESTINAL SYSTEM
● Impaired nutrition
○ Balanced meal with appropriate percentages (big bulk of protein
and vegetables)
○ Provide them Vitamin A to Zinc
● Impaired oral mucous membrane
○ Dental problems (dental check up is important and proper care,
regular tooth brushing and flossing)
○ Dry mouth= ice chips
● Impaired elimination
○ High fiber diet- urge the patient to eat high fiber foods
○ Bowel training (setting defecation time)
○ Increase OFI
○ Avoid Laxatives
CHANGES IN RESPIRATORY SYSTEM
Decrease:
○ Lung Capacity, Loss of elastic recoil, Gas exchange, Coughing
efficiency
○ Respiratory Infections
collapse of the lungs is called
Atelectasis
is the inflammation and infection of the lungs due to consolidation of fluid and liquid substances
Pneumonia
Common Problems in respiratory system
Difficulty Breathing, SOB, Coughing, Sputum
HEALTH - PROMOTION ACTIVITIES RESPIRATORY SYSTEM
● Avoid Smoking, Handwashing, Deep breathing exercises
● Annual Influenza and Pneumococcal vaccine
● Avoid exposure to people with respiratory infections / susceptible
infections.
○ It is important to avoid exposure to crowded places, large gathering, individuals with respiratory infections, and person with susceptible infection
○ Older people have decreased immune system making them
prone to respiratory infections
● Regular Exercises, Increase OFI
CHANGES IN NERVOUS SYSTEM
Decrease: Brain size, weight, volume
Insomnia
Slow Reaction Time
Loss short term memory, nerve cells, cognition, confusion
Reduced cerebral flow
HEALTH - PROMOTION ACTIVITIES IN NERVOUS SYSTEM
● Assess cognitive and mental functioning
○ Assess vital signs and level of consciousness
● Mental exercises, sensory stimulation
○ Sudoku, crossword puzzles in newspapers
○ It is good for older adults to read at least 30 minutes a day to
promote brain functioning and mental stimulation
● Sleep, rest, adequate diet
● Social stimulation, visitors, socialization
○ Interaction with other people helps
● Slow pace/ short teaching, mnemonics, sensory cues
○ Make sure when giving health teaching to the patient, be slow
and understandable while talking considering their level, short
and concise health teaching
● Give adequate time to respond to stimulus
CHANGES IN SENSORY SYSTEM
● Sensory changes: loss, deprivation
● Decreased hearing, hearing loss/ deficit (inappropriate
response, repeat instructions, strain forward to hear)
○ Needs hearing aids
● Poor eyesight, poor night vision, blindness
○ Loss of vision and peripheral vision, with cataract (cannot read
anymore)
○ Some patients are “doble vista” where they have both near and
farsightedness
● Farsightedness (hyperopia)- unable to focus on near objects
● Loss, dull sense of smell and taste (food is tasteless, blunt)
○ Anosmia - lack of taste
● Skin dry, loss skin elasticity, reduced fats, collagens, hair loss
(balding) in men
○ Prone to skin breakdown and pressure ulcers
○ Sagging - reduced subcutaneous fat
○ Hair loss - common in men and prone to balding (reduce
chemicals in the hair)
HEALTH - PROMOTION ACTIVITIES SENSORY SYSTEM
● Main: sensory stimulation
● Provide prescribed/ well-fitted hearing aid
● Hearing exams, aids, low background noise, face patient
○ Should be done every year
○ Consult doctors (ENT) if need prescription for hearing aid
○ Reduce background noise to half
○ Talk to the patient face to face
● Speak with low pitch voice, nonverbal cues
○ Calm tone
○ Check if the patient is suffering based on nonverbal cues
(guarding behavior)
○ Offer physical presence and therapeutic touch, tissue
● Give substitutes (herb, onion, garlic, lemon spices)
● Encourage social interaction, simple conversation, and speak
clearly
○ Older adults love interaction and simple conversations
○ Easy to trust and mistrust
○ Establish rapport
○ Maintain effective therapeutic communication
● Wear reading glass, magnifier, annual eye checkup, adequate
lighting, night light, large- print books, with pictures, large texts
○ Annual eye check up is a must
○ Prints should be large (Font size 14) with pictures for them to
easily understand
○ Wear prescription glasses appropriate to the patient’s vision
CHANGES IN MUSCULOSKELETAL SYSTEM
● Loss of bone mass, mineral density (osteoporosis, fall, fracture)
○ It’s very important to maintain bone mass
○ Common in older adults na nawawala na yung bone mineral
(loss of bone density and mass)
● Loss of height (kyphosis), back pain, joint pain
○ Prone to fractures and falls (may lead to rib fracture, head
trauma, intracerebral bleeding and hemorrhage and GI bleeding)
○ Osteoporosis is common in old adults (kyphosis = decrease in
height)
● Sacropenia (decrease muscle mass, mobility)
● Loss of muscle strength, endurance, and flexibility
○ Decreased muscle tone, mass and mobility = loss of muscle
strength, endurance and flexibility and the like
○ Older adults cannot do exercise
WHAT BONE DISEASE IS common in old adults
Osteoporosis
decrease in
height IS AKA
kyphosis
decreased muscle mass, mobility is called
Sacropenia
HEALTH - PROMOTION ACTIVITIES IN MUSCULOSKELETAL SYSTEM
Calcium-rich foods, calcium supplements, Vitamin D, dairy products,
smoking/ alcohol cessation, bone density test, weight- bearing
exercises, aerobic exercise, swimming, brisk walking, increase in
physical activity
WHERE CAN WE USUALLY GET CALCIUM
Calcium rich foods include milk and dairy products (egg, cheese,
yogurt)
Vitamin D exposure (sunlight) every morning between ______
7-9 am
this test is to detect Osteopenia (precursor to Osteoporosis)
Bone density test
Weight- bearing exercises include
swimming and walking
CHANGES in REPRODUCTIVE SYSTEM
● Delayed libido/ sexual orgasm
○ Very common among older adults
○ This is the reason why they prefer companionship over sex
● Decreased vaginal secretions (dyspeareunia), elasticity
○ It’s hard and painful for older women to have sex because of
decreased vaginal secretions (dyspeareunia)
○ Hence, they have difficulty during sexual intercourse
● Prostate gland enlarge (Benign Prostatic Hyperplasia or BPH)
○ Older men are prone to enlargement of prostate gland (benign
prostatic hyperplasia)
■ Precursor to prostate cancer
○ By the age of 40, older men should undergo digital rectal exam
(DRE) to check for enlargement of prostate
○ Do not catheterize patients with BPH and prostate cancer
because it will cause bleeding
● Decrease: estrogen/ progesterone (menopause), uterine size
(atrophy), sexual desire, testosterone, androgen (andropause),
testes size, semen
○ Due to decreased androgen (andropause), older men become
more grumpy
○ Decreased uterine size (older women) leads to problems with
pregnancy (bearing a child)
why should you not catheterize patients with BPH and prostate cancer
it will cause bleeding
Common problems in REPRODUCTIVE SYSTEM
vaginal itch, dryness, bleed, erectile
dysfunction
HEALTH - PROMOTION ACTIVITIES IN REPRODUCTIVE SYSTEM
● Vaginal estrogen replacement, gynecology/ urology follow-up, use a
lubricant with intercourse, Viagra (Sildenafil citrate), penile pumps
■ Common in advanced older women
○ Cervical cancer is usually caused by having multiple partners
○ We do not limit older adults from having sexual intercourse;
instead, we recommend use of lubricant while doing intercourse
■ This is due to decreased secretions, which may cause pain
during intercourse
○ For older adults, advise use of Viagra (sildenafil citrate)
■ Ask matter-of-fact and direct-to-the-point questions
(otherwise, it may cause embarrassment to the patient as this
topic is sensitive):
● “Kamusta ang pagtatalik?”
● “Kamusta ang pagsasama?”
For older men, it’s important to consult ______
urologists
For older women, it’s important to consult to
gynecologists
Why is it important to visit OB-gyne
To check for vaginal cancer, uterine cancer, myomas, cervical
cancer
sildenafil citrate is AKA
Viagra
CHANGES IN IMMUNE SYSTEM
Decline: immune system (prone to infections), antibody
protection
Decreased WBC, differential count (basophil, neutrophil,
eosinophil)
HEALTH - PROMOTION ACTIVITIES IN IMMUNE SYSTEM
● Vaccines, immunization, vitamins, nutritious foods, avoid persons
with susceptible infections/ raw foods/ flu
○ Hence, it’s important to
■ Promote regular vaccines,
■ Vitamin C (to boost immunity) and zinc (to fight infections)
■ Avoid crowded places as they are susceptible to infection
■ Promote adequate rest and nutrition
■ Well-balanced diet
■ Vitamin C-rich food
■ Increase hydration
■ Avoid flu
______ if lead untreated may lead to _______
Flu
Pneumonia
CHANGES IN INTEGUMENTARY SYSTEM
● Skin: sag, wrinkle, dry, thin, easy bruising
● Diminished subcutaneous fats (colds), elasticity, skin natural oils
○ Take note of subcutaneous fats
○ Prone to experience colds (d/t decreased subcutaneous fats &
elasticity & skin natural oil)
● Hair: gray, alopecia
HEALTH - PROMOTION ACTIVITIES INTEGUMENTARY SYSTEM
● Limit sun exposure, sunscreen, skin cream, lotion, shower, daily
personal hygiene, increase oral fluid intake
○ Promote use of lotions (with SPF 40+) to prevent dry skin & moisturize, as well as provide protection from the sun
○ Increase oral fluid intake to help provide skin moisture
CHANGES IN GENITOURINARY SYSTEM
Decrease: kidney size, renal blood flow/ vessels, GFR, bladder
capacity (250 mL only from 600 mL)
○ Decreased renal blood flow leads to oliguria (decreased urine output) which tampers the function of the kidney that may lead to acute renal failure leading to end-stage renal disease
Increase: urinary incontinence, frequency, urgency, retention,
nocturia, prostatic hyperplasia
Increased GFR = prone to
DIALYSIS
Normal GFR:
100-150
Normal Bladder Capacity
600 mL
Normal Bladder Capacity For older adults:
250 mL
physician specialized in the urinary system
Urologist
HEALTH - PROMOTION ACTIVITIES GENITOURINARY SYSTEM
Avoid bladder irritants (caffeine, alcohol, sweet drinks), increase OFI, refer to urologist, accessible toilet, bedside commode, pelvic
muscle exercise
Kegel exercises should be done every how many hours to prevent urinary
incontinence and urgency
two (2)