1. Chapter 10
Geriatric Care
© 2009 Delmar, Cengage Learning

2. 10:1 Myths on Aging
• Aging for everyone begins at at birth and
ends at death
• Gerontology: scientific study of aging and
the problems of the old
• Geriatric care: care of the elderly
• Health care worker must distinguish fact
from myth
© 2009 Delmar, Cengage Learning

3. Myths and Facts
• Myth: most elderly individuals are cared
for in institutions (nursing homes), or
long-term care facilities
• Fact: most older people are living at
home, with family, or in retirement
communities or facilities
(continues)
© 2009 Delmar, Cengage Learning

4. Myths and Facts
(continued)
• Myth: all elderly people live in poverty
• Fact: less than 10 percent of people over
65 are living at poverty level
• Myth: the older generation are unhappy
and lonely
• Fact: many elderly individuals socialize
by being involved in charity or volunteer
work
(continues)
© 2009 Delmar, Cengage Learning

5. Myths and Facts
(continued)
• Myth: anyone over 65 is old
• Fact: many elderly are active and
productive into their 80s and beyond
• Myth: elderly people are not able to
manage their finances
• Fact: older people have lots of
experience and knowledge
(continues)
© 2009 Delmar, Cengage Learning

6. Myths and Facts
(continued)
• Myth: elderly individuals do not want to
work; their goal is to retire
• Fact: there are many elderly who prefer
to work into their 70s and 80s
• Myth: retired people are bored and have
nothing to do with their lives
• Fact: retirees are busy with hobbies,
church, family, and community
© 2009 Delmar, Cengage Learning

7. Summary
• There are many myths about aging
• Needs of elderly individuals vary
• Even though only 5% of the elderly live in
long-term care facilities, this still means
that 3 million people will be in these
facilities by the year 2020
• Recognizing normal changes allows the
individual to adapt and cope
© 2009 Delmar, Cengage Learning

8. 10:2 Physical Changes of Aging
• Physical changes are a normal part of
the aging process
• Rate and degree of change varies
• Usually related to a decreased function
of body systems
© 2009 Delmar, Cengage Learning

9. Integumentary System
• Production of new skin cells decreases
• Sebaceous (oil) and sudoriferous (sweat)
glands become less active
• Circulation to skin decreases
• Hair loses color; hair loss may occur
• Methods to adapt and cope with changes
• Measures to slow or decrease changes
© 2009 Delmar, Cengage Learning

10. Musculoskeletal System
• Muscles lose their tone, volume, strength
• Osteoporosis
• Arthritis
• Coping with changes
• Measures to slow or decrease changes
• Providing a safe environment
© 2009 Delmar, Cengage Learning

11. Circulatory System
• Heart muscle becomes less efficient at
pushing blood into the arteries
• Blood vessels narrow and become less
elastic
• Blood flow may decrease to brain and
other vital organs
• Methods used to adapt and cope with
changes
© 2009 Delmar, Cengage Learning

12. Respiratory System
• Respiratory muscles become weaker
• Rib cage becomes more rigid
• Bronchioles lose elasticity
• Changes in larynx affect voice
• Methods to cope with changes
• Measures to slow or decrease changes
© 2009 Delmar, Cengage Learning

13. Nervous System
• Progressive loss of brain cells
• Senses diminish
• Nerve endings are less sensitive
• Methods to adapt and cope
• Measures to slow or decrease changes
© 2009 Delmar, Cengage Learning

14. Digestive System
• Fewer digestive juices and enzymes are
produced
• Muscle action becomes slower;
peristalsis decreases
• Teeth are lost
• Liver function is reduced
• Methods that are used to adapt and cope
with changes
© 2009 Delmar, Cengage Learning

15. Urinary System
• Kidneys decrease in size; not as efficient
at producing urine
• Decreased circulation to kidneys
• Bladder function weakens
• Methods to adapt and cope with
ongoing changes
• Measures to slow or decrease changes
© 2009 Delmar, Cengage Learning

16. Endocrine System
• Increased production of hormones
• Decreased production of hormones
• Measures to slow or decrease changes
© 2009 Delmar, Cengage Learning

17. Reproductive System
• Female: vaginal walls thin and secretions
decrease; uterus can drop; breasts sag
• Male: sperm decreases; sexual stimuli is
slower; ejaculation takes longer; testes
become smaller; seminal fluid becomes
thinner and less is produced
• Measures to cope with changes
© 2009 Delmar, Cengage Learning

18. Summary
• Aging causes physical changes in all
body systems; rate and degree vary
• Adapting and coping means fuller
enjoyment of life
• Health care workers need to assess
individuals’ needs
• Tolerance, patience, and empathy are
essential
© 2009 Delmar, Cengage Learning

19. 10:3 Psychosocial Changes of
Aging
• Elderly individuals also experience
psychological and social changes
• Some cope well, while others experience
extreme frustration and mental distress
• Health care workers must be aware of
this and assess changes and stresses
© 2009 Delmar, Cengage Learning

20. Work and Retirement
• Most adults spend a large portion of their
days working
• Retirement is often viewed as an end to
the working years
• Many enjoy retirement
• Some feel a major sense of loss
© 2009 Delmar, Cengage Learning

21. Social Relationships
• Change occurs throughout life
• In elderly individuals, it may occur
more rapidly
• Some elderly people adjust to changes
• Some elderly people cannot cope
© 2009 Delmar, Cengage Learning

22. Living Environments
• Changes in living environments create
psychosocial changes
• Many elderly people prefer to stay in
their own homes
• Some individuals leave their home by
choice
• Moving to a long-term care facility often
creates stress
© 2009 Delmar, Cengage Learning

23. Independence
• Most individuals want to be independent
and self-sufficient
• Elderly people learn that independence
can be threatened with age
• Factors that can lead to decreased
independence include physical disability,
illness, and decreased mental ability
(continues)
© 2009 Delmar, Cengage Learning

24. Independence
(continued)
• Individuals may need assistance, but the
health care worker needs to allow the
elderly maximum independence and
personal choice
© 2009 Delmar, Cengage Learning

25. Disease and Disability
• Elderly people are more prone to disease
and disability
• Diseases sometimes cause permanent
disabilities
• When functioning is affected,
psychological stress is experienced
• Sick people often have fear of death,
illness, loss of function, and pain
© 2009 Delmar, Cengage Learning

26. Summary
• Psychosocial changes can be a major
source of stress
• As changes occur, individuals must learn
to accommodate the changes and
function in new situations
• With support, understanding, and
patience, workers can assist individuals
as they learn to adapt
© 2009 Delmar, Cengage Learning

27. 10:4 Confusion and Disorientation
in the Elderly
• Most remain mentally alert until death
• Signs of confusion or disorientation
• It is sometimes a temporary condition
• Disease and/or damage to the brain
© 2009 Delmar, Cengage Learning

28. Dementia
• Term used to describe a loss of mental
ability
• Characteristics include decrease in
intellectual ability, loss of memory, and
personality change
• Acute dementia
• Chronic dementia
© 2009 Delmar, Cengage Learning

29. Alzheimer’s Disease
• One form of dementia
• Causes progressive changes in the brain
cells
• Lack of neurotransmitter
• Frequently occurs in 60s, but can occur
as young as 40 years of age
• Cause is unknown
(continues)
© 2009 Delmar, Cengage Learning

30. Alzheimer’s Disease
(continued)
• Terminal incurable brain disease; usually
lasting 3–10 years
• Early stage
• Middle stage
• Terminal stage
© 2009 Delmar, Cengage Learning

31. Caring for the Confused or
Disoriented Patient
• Provide safe and secure environment
• Follow the same routine
• Follow “reality orientation” guidelines
© 2009 Delmar, Cengage Learning

32. Summary
• Caring for a confused or disoriented
individual can be frustrating and even
frightening at times
• Perform continual assessments
• Design program to maximize function
• Practice patience, consistency, and
sincere caring
© 2009 Delmar, Cengage Learning

33. 10:5 Meeting the Needs of the
Elderly
• Geriatric care can be challenging but
rewarding
• Elderly people have the same needs as
others
• Cultural needs
• Religious needs
• Freedom from abuse
• Respect patient’s rights
© 2009 Delmar, Cengage Learning

34. Summary
• Needs of the elderly do not vary that
much from needs of others
• Sensitive to individual cultural and
religious differences
• Important to respect and follow all of the
patient’s rights
• Must ensure that the patient is free from
abuse
© 2009 Delmar, Cengage Learning