NCM 114 – Care for Older Adults 4.

atrophy of the inner ear structures & hearing loss

MODULE 2 (presbycusis)
Changes In Older Person & The Nursing Process in  Approximately 30% to 50% of people older
the Care of Older Adults than 65 have significant hearing loss
 Hearing loss increases with age and is
greater in men.
TOPICS :
 Changes in the older adults and its implications Nursing Implications:
to care. 1. Assess client’s ability to communicate
 Comprehensive Geriatric Assessment. 2. Check if the client is able to hear alarms and
 Nursing Diagnoses related to wellness. doorbells
3. Emphasize safe driving & taking public
CHANGES in the OLDER PERSON and their transportation
IMPLICATION to CARE 4. Encourage the client to engage in leisure &
recreational activities
PHYSIOLOGIC CHANGES
III. TASTE, SMELL & TOUCH
I. VISION (Age-related changes in the eye) 1. decrease in taste buds ( gradual)
1. thinning of the skin surrounding the eye  taste deficits result to weight loss,
2. decrease in musculature in the eyelids malnutrition, impaired immunity
 ectropion – bottom lid sags outward 2. atrophy of olfactory bulbs
 entropion – the lid turns inward  diminished sense of smell (hyposmia)
3. arcus senilis (corneal calcium deposits) 3. slower conduction of nerve impulses &
4. smaller pupil size diminished function of the peripheral nerve
 Changes in vision among older persons  decreased sensitivity to pain, temperature
are preceded by the following : extremes, and vibration
 Decreasing sensitivity to light
 Increased sensitivity to glare Nursing Implications:
 Altered color vision  Taste
 Presbyopia 1. Appetite enhancement strategies
 a universal age-related change in the 2. Check dentures for fit & cleanliness
lens of the eye involving loss of 3. Inspect mouth for ulcers or gingivitis
accommodation. 4. Identify possible offenders known to affect
 objects held closer than 1-2 feet become taste (ex. medications)
difficult to see. 5. Encourage fluid intake
5. decreased reading & color discrimination ability  Smell
6. atrophy of lacrimal glands – results in dry eyes 1. implement safety precautions
7. increased intraocular pressure o placing natural gas detectors
o placing smoke detectors
Nursing Implications: o date and label food containers
1. Urge older adults to schedule routine eye 2. house cleaning & personal hygiene
examinations 3. encourage daily waste disposal to prevent
2. Assess older client’s ability to perform ADL garbage smell
3. Consider safety measures like:  Touch
 adequate lighting o Focus assessment on:
 nonskid surfaces on stairs 1. the impaired sense of touch
 use of stair rails 2. the intactness of the skin
 toxic substances & medicines with labels 3. safety risks
that are readable
V. INTEGUMENTARY SYSTEM
II. HEARING (Age-related changes in the ear) 1. thinning of the 3 layers of the skin.
1. auricle tends to wrinkle & sag 2. loss of subcutaneous fat
2. drier and harder cerumen that accumulates in the  visible veins
ear canal & impacted cerumen  wrinkled, dry & sagging skin
3. dry ear canal & pruritus  skin prone to damage
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 3. loss of skin turgor 7. Slower amount of oxygen carried by the blood
4. nails grow more slowly, brittle, dull, yellow, or  slower & less efficient gas exchange
gray color  tendency to trap air(not able to exhale fully)
5. loss of eyelid elasticity  maximum breathing reduced.
6. epidermal mitosis slows by 30% & skin heals
more slowly Common Illnesses:
7. decrease melanocytes – hair appears gray or  Pneumonia
white, scalp, pubic & axillary hair declines due  Asthma
to the decline in the hormones  COPD
8. less efficient manufacturing of Vit. D from  Tuberculosis
sunlight
 Lung Cancer
9. photoaging - changes in pigmentation with an
accumulation of discoloration due to chronic
Nursing Implications:
exposure to UVA and UVB
1. Clean nostrils to ensure a patent airway.
2. Allow rest periods throughout the day.
Common Skin Problems
3. Avoid exposing the elderly to cold & flu germs.
 skin cancer
4. Encourage plenty of fluid intakes
 pressure ulcers 5. Proper nutrition
 cellulitis 6. Avoid smoking/ exposure to smoke
Nursing Implications: (to older adults at risk for skin VI. CARDIOVASCULAR SYSTEM (Changes that
problems) occur with aging)
1. Instruct client to avoid excessive use of soap, hot 1. More prominent arteries in the head, neck, and
water & brisk rubbing when bathing. Pat skin extremities.
dry instead of briskly rubbing. 2. Stiffening of the heart valves.
2. Lubricate the skin with a moisturizer multiple 3. Slight increase in the size of the heart, especially
times a day - dry skin causes itchiness the left ventricle.
3. Avoid prolonged pressure on bony prominences.  The aorta becomes elongated and dilated.
4. Protect skin from temperature extremes. 4. Increase peripheral resistance and decrease
5. Soak nails before trimming. cardiac output & BP increases to compensate.
6. Dress appropriately for weather and climate. 5. Natural pacemaker (the SA node) loses some of
7. Protect skin from sun exposure & risk of its cells & may result in a slightly slower heart
photodamage rate.
8. Evaluate and manage incontinence. 6. Less efficient oxygen utilization.
 If soiling occurs, the skin should be cleansed 7. Less elasticity of vessels.
per routine.  arterial stiffening – due to lipid deposits &
 Plastic-lined bed pads should not contact the calcification
person’s skin.  veins thicken
9. Monitor nutrition. 8. Altered electrical activity of the heart –
 Provide Vitamin C & Zinc to promote skin abnormal heart rhythms
healing. 9. Decreased cardiac output – produces renin &
10. Adequate fluid intake increases BP & retains sodium
10. Deposits of the "aging pigment," lipofuscin
V. RESPIRATORY SYSTEM (Changes that occur
with aging) Common Illnesses:
1. lungs appear larger due to loss of elasticity  Hypertension/ hypotension
(stiffening of elastin & the collagen connective  Hyperlipidemia
tissue) & lungs become more rigid.
 Metabolic syndrome – a condition characterized
2. weaker respiratory muscles
by elevated waist circumference, BP, fasting
3. increased chest wall stiffness
serum triglycerides & serum glucose
4. decreased ciliary action
5. decreased number of alveoli  MI
6. decreased respiration due to chest wall &  Angina
thoracic spine deformities.  Varicosities due to valvular reflux
 Postural or orthostatic hypotension

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Nursing Interventions: 4. More than 50% of the nephrons are lost before
1. Advise elderly to avoid/stop smoking age 80.
2. Encourage daily exercises 5. Blood urea nitrogen (BUN) may increase
3. Promote healthy diet – low salt, low cholesterol without serious symptoms.
calcium-rich foods 6. Less contractile detrusor muscle & inability to
4. Encourage the client to control his weight empty the bladder completely.
5. Schedule regular check-ups 7. Increased renal threshold for glucose
6. Advise to stay mentally active 8. Impaired thirst perception – due to fluid &
7. Socialize with others electrolyte balance.

VII. NEUROLOGIC SYSTEM Nursing Implications:

1. Brain decreases in size (approximately 7%) 1. Monitor intake and output.
2. Loss of neurons in the brain (up to 20% ). 2. Unless a patient is on fluid restrictions, he
3. Decrease in cerebral blood flow. should be offered fluids frequently.
4. Breakdown of nerves & reduction or loss of  Fluid intake should be no less than 2500 cc
reflexes or sensation every day.
5. Slowing of coordinated movements.  Reduce salt intake in the diet.
6. Deterioration of balance mechanisms.
7. The brain and spinal cord lose nerve cells and IX. GASTROINTESTINAL SYSTEM (Normal age-
weight ( atrophy) & nerve cells may begin to related changes in the older adult)
pass messages more slowly. 1. Wearing off or erosion of tooth surfaces – due to
8. Decline in ability to concentrate more than one frequent intake of acidic foods, tooth-to-tooth
task at a time. contact
9. Decreased reaction time in processing 2. Vertical hairline cracks – due to shrinkage of
information. dentine with loss of support for the enamel
10. “tip of the tongue” phenomenon 3. Oral mucosa becomes thin, smooth, dry, and
11. Diminished deep sleep. inelastic
12. Decrease in reflexes. 4. Decreased salivary production – results to dry
mouth
Common Illnesses: 5. Decreased blood supply to intestines & digestive
disorders/malabsorption syndrome
 Dementia
6. Decreased liver size & function - decreased
o Alzheimer’s Disease
metabolism, decreased drug detoxification
o Vascular dementia 7. Delayed gastric motility & emptying & diarrhea,
 Parkinson’s Disease or constipation, fecal incontinence
 Stroke / Transient Ischemic Attack (TIA)
 Multiple Sclerosis Common Illnesses:
 Esophageal disorders
Nursing Implications:  Dysphagia
1. Clients must remain active & engaged in life.  Gastroesophageal Reflux Disease
2. The elderly must develop hobbies and interests.  Gastritis
3. Eat a well-balanced diet.  Peptic and Duodenal Ulcer
4. Avoid stress & anxiety – enjoy life.  Crohn’s Disease
5. Physical exercise to remain or become fit.
6. Stay connected with at least one person on a Nursing Implications:
daily basis. Advise client to:
7. Encourage a consistent bedtime routine. 1. Eat a balanced diet that is high in fiber & low in
fat & processed carbohydrates
VIII. URINARY SYSTEM (Normal renal changes of 2. Maintain a normal weight.
aging) 3. Decrease the size of portions at mealtime
1. Kidneys shrink & become less efficient. 4. Avoid lying down for 2 – 3 hours after eating
2. Decreased ability to concentrate urine & risk for 5. Stop smoking or using tobacco products.
dehydration. 6. Limit the use of nonsteroidal anti-inflammatory
 Bladder capacity declines. agents
3. increased frequency in urination especially 7. Encourage to carry out daily oral self-
during the night examinations
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X. ENDOCRINE SYSTEM (Normal changes in Nursing Implications:
aging) 1. Get plenty of exercise & helps boost the immune
1. Decrease in cell mass and weight of pituitary system.
gland – due to atrophy, fibrosis & decreased 2. Eat healthy foods - good nutrition keeps the
vascularity immune system strong
2. Decline in the secretion of growth hormone - 3. Do not smoke - weakens the immune system
decreased bone density, decreased lean body 4. Limit intake of alcohol
mass & increased fat mass. 5. Look into safety measures to prevent falls and
3. Increase in serum concentration of Parathyroid injuries - a weak immune system can slow
hormone by about 30% - osteoporosis healing from falls and injuries
4. Lower calcium absorption in women – due to 6. Emphasize the importance of obtaining yearly
decrease in active calcium transport or diffusion influenza immunization.
5. Dilated pancreatic duct
6. Slow flow rate of pancreatic enzymes and XII. MUSCULOSKELETAL (Normal changes of
bicarbonate aging)
7. Insulin resistance may accompany age-related 1. Decrease in height is common (range of 2 to 4
glucose intolerance inches from spinal column) them thinner &
8. Decrease in estrogen levels à changes in the flatter
reproductive organs 2. Decreases in lean body mass - muscle atrophy
especially with a disease
Common Illnesses: 3. Bones become brittle/ may break easily - due to
 Diabetes Mellitus diminishing bone density & calcium loss
 Thyroid disorders 4. Joint degeneration with arthritic changes.
o Hyperthyroidism 5. Increase postural sway & difficulty maintaining
o Hypothyroidism balance.
6. Slower & shorter gait
Nursing Implications: 7. Foot problems like bunions, corns, calluses, can
1. Weight management contribute to gait problems and falls.
2. Encourage avoidance or reduction of alcohol 8. Deterioration of joint capsule & decrease in
intake ROM movements
3. Advise regular exercise
4. Refer to a dietician for basic food & meal plan Common Illnesses:
guides  Osteoporosis
 Osteomalacia
XI. IMMUNE SYSTEM (Normal changes of aging)  Osteoarthritis
1. Decreased number of B cells in the circulation  Kyphosis “ hunchback “
- tissues slower to repair / more vulnerable to
diseases Nursing Implications:
2. Production of IgE decline - decrease in allergic 1. Promote diet adequate in calcium & Vit D
reaction 2. Reduce or eliminate smoking/ alcohol intake
3. Decline in its ability to detect and correct cell 3. Encourage daily exercises
defects & results in an increase in the risk of  stretching 10 mins per day
cancer  active ROM
 weight-bearing exercises
Common Illnesses: 4. Monitor safety measures
1. Hypersensitivity
2. Primary Immunodeficiency disorders HEALTH PROMOTION in OLDER ADULTS
 HIV/ AIDS Facts about health & wellness promotion for older
3. Susceptibility to Infections adults
 pneumonia  Fitness is not a fad, but a goal to pursue by older
 UTI adults.
 Skin infections  Chronic illness can be prevented and slowed by
well-crafted physical and mental fitness regimes.
 Health promotion can be achieved through
patient education and counseling.
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  Keeping physically fit improves emotional 2. SOCIAL / EMOTIONAL HEALTH
health.  maintain a positive outlook on life
 Positive attitudes about lifestyle changes can  keep in touch with family & friends
vastly improve the older adult’s quality of life.  establish new relationships by joining church or
community social groups
1. PHYSICAL HEALTH
a) Exercise, including aerobic, strength training & 3. MENTAL HEALTH
flexibility components.  a loss of control over one’s life & circumstances
 Mobility fosters independence & freedom can impair mental health.
 Exercise programs should be prescribed by o Elderly must maintain independence / self-
the physician esteem/ self-respect
o type of exercises should consider  Facilitate self-care through provision of
person’s lifestyle, cardiac status, adaptive & assistive equipment
energy, endurance level, & mobility o Encourage decision-making through
limitations building in the perception of control
o most acceptable form of exercise is o Set attainable short- and long-term goals
walking with rewards
b) Good nutrition including adequate calcium &  Evaluate progress toward goal
Vit.D intake. Affects the overall well being & achievement.
health  Stress management
 Nutritional Screening Initiative (NSI) – o When an event has a likelihood of producing
determines risks for nutritional deficiencies: stress, it is best to avoid that event
o Diseases o use relaxation techniques
o Eating poorly
PSYCHOTHERAPY COMMONLY USED AMONG
o Tooth loss or mouth pain OLDER ADULTS
o Economic hardship a. One-on-One Therapy
o Reduced social contact & interaction  Provides a non-threatening & therapeutic
environment.
o Multiple medications
 Clients can express themselves to a nurse
o Involuntary weight loss or gain (anxiety relieving part)
o Need for assistance with self-care b. Psychodrama - is a form of human
o Elder at an advanced age development which explores, through dramatic
c) Health maintenance visits action, the problems, issues, concerns, dreams,
 Older adults must be examined at least once & highest aspirations of people, groups,
a year. systems, & organizations
o More frequent when health problem c. Occupational therapy
exist.  promotes health by enabling people to
o Must include immunizations. perform meaningful & purposeful
d) Adequate rest & sleep occupations.
 Sleep serves to rest body organs, conserve  includes (but are not limited to) work,
energy, preserve biorhythms & restore leisure, self care, domestic & community
mental & neurologic efficiency activities
 as people age, sleep patterns change d. Music therapy
 some have difficulty sleeping; others have  An interpersonal process that can promote
shorter sleeping time creativity, awareness, expression and
e) Avoidance of tobacco and alcohol communication
 Counseling about substance abuse as safety  Beneficial to the elderly patients
measure can be preventive or o For stress, it can dispel anxiety, tension
and fear.
 Interventional
o For depression, it can alleviate a sense
 Dental examinations – done on a regular
of loneliness and isolation, especially in
basis (at least once a year)
group
 good oral hygiene periodic assessment of o Sing-alongs or musical participation
denture fit & functionality of false dentures activities
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 e. Art therapy
 Offers healing by providing social R – respect the rights of older adults and ensure others
connection, the experience of control and to do the same
the opportunity to both express
and manage emotions
O – oversee & promote the quality of service delivery
 Offers hope by facilitating nonverbal
communication
 Providing opportunity to create meaning N – notice & reduce risks to health & well-being
through life review
f. Animal-assisted therapy T – teach & support caregivers
 is a type of therapy that involves an animal
with specific characteristics becoming a O – open channels for continued growth
fundamental part of a person’s treatment.
 It is designed to improve the physical, L – listen & support
social, emotional, & or cognitive
functioning of the client, as well as provide
educational & motivational effectiveness of
O – offer optimism, encouragement & hope
the participants.
g. Recreational activities G – generate, support, use & participate in research
 a treatment service designed to remediate a
elderly person’s level of functioning and I – implement restorative & rehabilitative measures
independence in life
activities, to promote health and wellness. C – coordinate & manage care
 Gardening – involves cognitive benefits of
enhanced mood, reduced arousal &
improved concentration.
A – assess, plan, implement, & evaluate care in an
individualized, holistic manner
h. Play therapy
 is generally employed & provides a way to
express the older person’s experiences & L – link services with needs
feelings through a natural, self-guided, self-
healing process.
GERIATRIC ASSESSMENT
BARRIERS TO HEALTH PROMOTION Assessment of the health status of older persons.
1. Socioeconomic factors
2. Beliefs & attitudes of both patients & providers Purposes:
3. Specific motivation based on efficacy of beliefs 1. To provide a baseline data to gauge changes in
4. Access to resources condition & health status.
5. Financial limitations 2. To validate the health history & investigate
6. Lack of transportation current complaints.
3. To prevent recurrent & debilitating problems.
ROLES OF THE GERONTOLOGICAL NURSE: 4. To support the plan of care.
1. Healer
2. Caregiver Principles of Comprehensive Geriatric Assessment:
3. Educator 1. Physical, psychological & socioeconomic
4. Advocate factors interact in complex ways to influence the
5. Innovator health & functional status of the older person.
2. Comprehensive evaluation of an older person’s
FUNCTIONS OF THE GERONTOLOGICAL health status requires an assessment in each of
NURSE these domains.
3. Functional abilities should be a central focus of
the comprehensive evaluation.
G – guide persons of all ages toward a healthy aging
process

E – eliminate ageism
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COMPONENTS OF COMPREHENSIVE  Common medical conditions to watch out
GERIATRIC ASSESSMENT for in older persons are HPN, Arthritis,
1. History taking Heart disease, DM & Cancer
a. types of history taking a. types of history 2. Functional Status
taking  it is central to assessment of older persons
 episodic and makes it different from assessment of
 complete younger persons.
b. accuracy of the history taking  measures the older person’s ability to
2. Health assessment perform self-care activities (ADL) & assume
A. History taking social roles in order to determine the
 entails an interview with the older status of health & well being of the older
person on certain aspects of health . person.
 requires a balance between encouraging  Barthel Index of ADL – assesses ability for
the person to share concerns and self-care
focusing the data gathering on  Katz Index of ADL – describes person’s
particularly important factors functional level at a specific point in time
i. Episodic health history  Lawton Scale – used to assess more
 nurse focuses questions & examination complex activities
on the chief complaints  PULSES profile – assessment of progress
ii. Complete health history made in rehab as well as to help identify the
 a comprehensive compilation of data severity of disability
from a variety of sources in order to  Basic ADLs (BADLs) consist of self-care
provide an in-depth profile on which to tasks, including
plan care.  Dressing/ Bathing
Accuracy of history taking  Eating/ feeding (chewing/ swallowing)
 Potential difficulties in obtaining a health  Ambulating (walking/ mobility)
history from older persons:  Toileting (complete act of urinating &
1. Communication difficulties defecating)
2. Underreporting of symptoms  Hygiene/ grooming ( brushing,
 fear of being labeled as a complainer combing, styling hair)
 fear of institutionalization  Instrumental activities of daily living
 fear of serious illness (IADLs) are not necessary for fundamental
3. vague or non-specific complaints functioning, but they let an individual live
 may be associated with cognitive independently in a community:
impairment, drug or alcohol use, atypical  Shopping for groceries or clothing
presentation of disease  Housekeeping
4. multiple complaints  Accounting/ Managing money
5. lack of time  Food preparation/taking medications as
prescribed
HEALTH ASSESSMENT  Telephone or other form of
1. Physical health communication usage
 Checks for the presence of illness or disease  Using technology (as applicable)
 Follows the same principles as health  Transportation within the community
assessment in general  Advanced ADL – assessment of activities
 Nurse should carefully note the chief that demand high cognitive functioning and
complaints in the patient’s own words à elderly is more responsive to subtle changes
minimizes the chance of misinterpretations - include such high-level functions as:
 Common handicaps/disabilities that must  Being gainfully employed
be reported during physical assessment
 Hobbies
1. Hearing impairment
 Socializing and involvement in activities
2. Vision impairment
3. Limited ROM in the community
4. Speech difficulty
5. Memory loss
6. Acute confusion
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 3. Psychological function  caring enough to want to help to make
 involves assessment of cognitive and the situation better
affective status.  doing something which is not the usual -
 adequate mental & affective functioning is -- It’s not just “doing your job”
required in health history taking & problem 2. PROCESS - delivering quality care which
identification. promotes dignity by nurturing and supporting
 2 most common Psychological Impairment the older person’s self-respect and self-worth
1. Dementia through:
2. Depression  Communicating with older people by not
 Examples of psychological tests used for only talking with them, but listening to what
the elderly: they say.
 MMSE ( Mini Mental State  be able to interpret body language
Examination)  use eye contact
 Cornell Scale for Depression in  do not raise your voice
Dementia  speak slowly, use simple
 Mini-Cog  language
4. Social function  use the right language
 measured by the social network & social  listen
support of the older adult.  Assessment of need
 Social network – refers to the web of  Respect for privacy and dignity
relationships that the person has around  Engaging in partnership working with older
him/her, including family, relatives, & people, their families, carers & colleagues in
friends who give support in various the profession
moments  act as advocate to support them in fulfilling
their needs respect their decisions as you
WELLNESS DIAGNOSES FOR THE OLDER work hand in hand with them
ADULTS 3. PLACE – diverse environments in the
 Health perception- Health Management Pattern community or hospital where care is provided
 Readiness for enhanced immunization status for older people which is:
 Nutritional-Metabolic Pattern  committed to equality and diversity
 Readiness for enhanced nutrition  appropriate environment
 Elimination Pattern  resourced adequately
 Readiness for enhanced for urinary  effectively managed
elimination  Committed to equality and diversity
 Cognitive-Perceptual Pattern  providing care in a non-discriminating,
 Readiness for enhanced decision making non-judgmental & respectful way
 nurse familiarizes self with the likely
3 MAIN ELEMENTS IN PROVIDING CARE TO characteristics of groups & respond
OLDER PERSONS: accordingly
1. PEOPLE – these are nurses who are efficient  Appropriate environment
and able to deliver safe, effective, quality care  environment conducive to care that
by being: meets the needs of older people
 Competent - having the right KSA to care  safe, clean, tidy and quiet environment
for older people
 one that promotes independence
 Nurse must recognize & work within the
 Resourced adequately
limits of his competence
 Adequate number of nurses, staff and
 Assertive- challenging poor practice,
other hospital workers
including attitude & behavior and
 Also includes equipment, supplies,
safeguarding older people
medicines, etc
 Reliable & dependable
 Present a professional image which
demonstrates that the nurse is well-
Organized and manages time well
 Empathetic, compassionate and kind
 putting yourself in the person’s place
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  Effectively managed  However, it has been observed that as long as
 Commitment from management at all elderly parents own land or have means of support,
levels within an organization they tend to maintain their own household. This
 Effective nurse managers and leaders household may either be nuclear or extended. In
make explicit the standard of care which either case, they are able to retain their authority
they expect to deliver over their adult children.”
 Provide excellence in the care of older  A strong attachment to one’s own home and
people the desire to maintain one’s autonomy are the
 Training of staff are identified & provided two most compelling reasons for the
for. preference of the elderly to stay in their own
dwellings.
LIVING ARRANGEMENT OF THE ELDERLY  They eventually live with their children when
 Assessments of living conditions is a special their health fails and their children would
component of assessing the health of older fulfill their moral obligation to care for and
persons support their frail parents.
 Factors that may affect living options of the older  Domingo et al. (1993) According to Centers
adult for Disease Control
1. income  According to the Centers of Disease Control:
2. health status  Usually when an older person is diagnosed
3. activity level with a chronic condition, there is an immediate
4. level of independence feeling of facing a loss of freedom and
5. family or other support systems autonomy, a sense that his/her days of living
independently at home are numbered.
CONTINUUM OF LIVING ARRANGEMENTS FOR  à the only alternative for some older adults
THE ELDERLY with serious, chronic health problems is the
 Independent living at home nursing home.
 Family provided at home  Fact: Older persons are more vulnerable to the
 Assisted living facilities problems of inadequate, unsafe housing.
 Home health care or hospice care  Home safety must be evaluated.
 Long term care facilities  What to evaluate?
1. Housekeeping
Assisted Living Facility (ALF) – consists of private 2. Stairways
apartments that either purchased or rented. 3. Floor .
Why ALF? 4. Bathroom
 lower in cost 5. Lighting
 more homelike 6. Stairways
Offer more opportunities for control, independence & 7. Outdoor area
privacy. 8. Traffic lanes
 a preferred transition between living independently
at home and residing in the nursing home. SUGGESTED PRODUCTS SPECIFICALLY MADE
TO HELP PEOPLE “AGE AT HOME”:
Home Health Care  Kitchen implements
 provides care in the home and eases the burden  devices that make opening jars and bottles,
that family members may feel. peeling and cutting vegetables easier
 it provides skilled nursing care  REACHERS – lobster claw –like devices for
Hospice care older adult having arthritis or other muscle
 method of providing palliative and supportive care or joinh that makes reaching or bending
when the older adult no longer wants active difficult
medical treatment.  Shower chairs and bath benches and hand-
Long-term care facilities held shower heads for bathing
 best living option when health needs of the elderly
 Elevated toilet seats
necessitate extensive or full-time supervision.
Socorro D. Abejo of the National Statistics
 Automatic lifts for stairwells, beds and chairs
Office…  Talking clocks, wristwatches, and calculators
 “Historically, the Filipino elderly have been for people with poor vision
dependent on their children or co-resident kin for
economic, social and physical support.