NCM 114

Care of the
Older Adult
Lesson Module 3: Unit 1: Lesson 3: The Aging Body;
Expected Changes in Growth and Development
 1.Assess the signs and symptoms
of aging associated for each body
Learning system.
Objectives
 Lesson 1. Expected Changes in Growth and
Content Development with Aging
 Physiologic changes affects a person’s biological, psychological,
social, and environmental status. Numerous physiological changes
occur in all body systems during the natural aging process. There is
Introduction strong evidence that inactivity is the most important contributor to
declining physical mobility and function. The degree in rate at which
changes occur vary among individuals, systems, and organs, as thus
a person’s ability to compensate.
 Expected Changes in
Growth & Development
Physical Changes

Physical changes related to older adults:

• A decrease in skin turgor, subcutaneous fat, and tissue (dermis), which leads to
wrinkles and dry, transparent skin. connective

• A loss of subcutaneous fat, which makes it more difficult for older adults to adjust
to cold temperature.

• Thinning and graying of the hair, as well as a more sparse distribution.

• Thickening of the fingernails and toenails.

• A decrease in chest wall movement, vital capacity, and cilia, which increases the
risk for respiratory infections.

• A slower reaction time.

• A decrease in touch, smell, and taste sensations.

Leonardo DiCaprio
Ben Affleck
Tom Cruise
Robert Downey Jr.
Kris Aquino
Ian Veneracion
Thinning and Graying of Hair
Thickening of Nails
 Expected Changes in
Growth & Development
Physical Changes

Physical changes related to older adults:

• A decrease in the production of saliva.

• A decline in visual acuity.

• A decrease in the ability for the eyes to adjust from light to dark leading to
night blindness, which is especially dangerous when driving.

• An inability to hear high-pitched sounds (presbycusis).

• A decrease in height due to intervertebral disk changes.

• A decrease in muscle strength and tone.

• A decrease in digestive enzymes.

 Expected Changes in
Growth & Development
Physical Changes

Physical changes related to older adults:

• A decrease in intestinal motility, which can lead to an increase in the

risk of constipation.

• An increase in dental problems.

• Decalcification of bones.

• Degeneration of joints.

• A decrease in bladder capacity.

• Prostate hypertrophy in men.

• A decline in estrogen or testosterone production.

 Expected Changes in
Growth & Development
Physical Changes
Physical changes related to older adults:
• A decline in triiodothyronine (T3) production, yet overall function remains
effective.
• Decrease in sensitivity of tissue cells to insulin.
• Atrophy of breast tissue in women.

Cognitive Changes
• Piaget – formal operations.
• Many older adults maintain their cognitive function. There is some decline in
speed of the cognitive function versus cognitive ability.
Expected Changes in Growth &
Development
Cognitive Changes
• A number of factors influence older adults’ abilities to function, such as
overall health, the number of stressors, and lifelong mental well-being.
Slowed neurotransmission, vascular circulation impairment, disease states,
poor nutrition, and structural brain changes can result in the following
cognitive disorders:
• Delirium – Acute, temporary, and usually relates to other physiologic
problems. Delirium is often the first symptom of infection (urinary tract
infection) to older adults.
• Dementia – Chronic, progressive, and possibly with an unknown cause
(Alzheimer’s disease, vascular dementia).
• Depression – Chronic, acute, or gradual onset (present for at least 6
weeks).
 Expected Changes in
Growth & Development
Psychosocial Changes

• Older adults’ stage of psychosocial development, according to

Erikson, is integrity vs despair.

Older adults need to:

• Adjust to lifestyle changes related to retirement (decrease in

income, living situation, loss of work role).

• Adapt to changes in family structure (may be role reversal in

later years).

• Deal with multiple losses (death of a spouse, friend, siblings).

• Face death.
 Expected Changes in
Growth & Development
Psychosocial Changes

Self-Concept Changes

Older adults face difficulties in the area of self-concept, which include:

• Seeing oneself as an aging person.

• Finding ways to maintain a good quality of life.

• Becoming more dependent on others for activities of daily living.

Body Image Changes

• Adjustments to decrease in physical strength and endurance may be difficult, especially

for older adults who are cognitively active and engaged. Many older adults feel
frustrated that their bodies are limiting what they desire to do.
Expected Changes in Growth &
Development
Psychosocial Changes

Social Development

• Find ways to remain socially active and to overcome

isolation.
• Maintain sexual health.
 Health Promotion
Health Risks

Cardiovascular diseases that can affect older adults

• Coronary artery disease

• Hypertension

• Cerebrovascular accident

Factors affecting mobility of older adults:

• Arthritis

• Osteoporosis

• Falls
 Health Promotion
Health Risks

Mental health disorders that can affect older adults

• Dementia

• Suicide

• Depression

Other disorders that can affect older adults

• Diabetes mellitus

• Cancer

• Incontinence
Warning Signs of Suicide
 Health Promotion
Health Risks

Other disorders that can affect older adults

• Abuse and neglect

• Cataracts

• Alcoholism

• Pain
 Health Promotion
Immunizations

• Immunizations against diphtheria, tetanus, pertussis, varicella, seasonal influenza,

herpes, zoster, and pneumococcal infections.

• Immunizations against measles, mumps, rubella, hepatitis A and B, and meningococcal

infections for high-risk individuals.

Heath Screenings

Older adults should follow age-related guidelines for screening.

Other screenings:

• Dual-energy x-ray absorptiometry (DEXA) scanning for osteoporosis.

• Eye examination for glaucoma and other disorders every 2 to 3 years or annually.

• Mental health screening for depression.

 Health Promotion
Nutrition

In addition to gastrointestinal alterations, other factors influence nutrition in older

adults.

• Difficulty getting to and from the supermarket to shop for food

• A low income

• Impaired mobility

• Depression or dementia

• Social isolation (preparing a meal for one person and eating alone)

• Medications that alter taste or appetite

• Prescribed diets that are unappealing

 Nutrition

• Incontinence that may cause the person to limit fluid intake

• Constipation

Metabolic rates and activity decline as individuals age; therefore, total

Health caloric intake should decrease to maintain a healthy weight. With the
reduction of total calorie intake, it becomes even more important that the
calories older adults consume be of good nutritional value.
Promotion Nutritional recommendations for older adults

• Increasing the intake vitamins D, B12, folate, fiber, and calcium

• Increasing fluid intake to minimize the risk of dehydration and prevent

constipation

• Taking a low-dose multivitamin along with mineral supplementation

 Nutrition
Nutritional recommendations for older adults
• Limiting sodium intake
Psychosocial interventions to improve self-
concept and alleviate social isolation for
Health older adults:
Promotion • Therapeutic communication
• Touch
• Reality orientation
• Validation therapy
• Reminiscence therapy
 Health
Promotion
Psychosocial interventions to improve self-concept
and alleviate social isolation for older adults:

• Attending to physical appearance

• Assistive devices (canes, walkers, hearing aids)

Injury Prevention

• Install bath rials, grab bars, and handrails on

stairways

• Remove throw rugs

• Eliminate clutter from walkways and hallways

• Renice extension and phone cords from walkways

and hallways
 Injury Prevention

• Instruct clients about how to properly use ambulation-assistive devices

(walkers, canes)

• Teach clients about safe medication use

Health
• Ensure adequate lighting

• Remind client to wear eyeglasses and hearing aids

Promotion • Avoid drugs, including alcohol; Prevent substance use disorders

• Avoid driving a vehicle during or after drinking alcohol or taking drugs

that impair sensory and motor functions

• Wear a helmet while bike riding, skiing, and other recreational

activities that increase the risk of head injury

• Install smoke and carbon monoxide detectors in the home

 Key Points
 Nutritional problems account for one third to one half of all health problems in older adults.

 Many independently living older adults have nutritional deficiencies.

 Urinary incontinence is not a normal part of aging. Although many believe that it is and do not seek treatment.

 By 90 years of age, nearly everyone has some degree of chronic obstructive pulmonary disease.

 Experts estimate that more than 90% of the population 40 years of age or older are affected by osteoarthritis.

 Repeated infections, slower healing, blurred vision, and weight gain or loss are often the initial signs and symptoms of diabetes mellitus.

 Cognitive decline is not a universal process of aging. Research indicates that most older people retain their intelligence and are capable of
learning throughout their lives.

 Falls are the leading causes of accidental death in individuals older than age 65.

 40% or more of adults use alternative pharmacotherapy.

Learning Activity
Your grandfather/grandmother has come to the clinic for a routine check-up. The policy of the clinic is
to review all medications at every clinic visit. As a granddaughter/grandson, list down all the
medications that your grandparent is taking. Indicate the classification of the drug, indication, possible
side effects, and nursing responsibility of the drugs. What specific health teachings are you going to
give to your grandparent related to his/her medication?

Submission is on or before the next lesson.

Next Lesson: Lesson 3a