Health concerns of women in late adulthood 09012918
1. HEALTH CONCERNS OF
WOMEN IN LATE
ADULTHOOD
Dr. Rosaline Rachel. Ph.D (N)
Principal
MMM College Of Nursing
MMM COLLEGE OF NURSING
2. MMM COLLEGE OF NURSING
Family Is not about blood.
It is about who is willing to hold your hand
when you when you need it most
3. Begin at about age 65
It is the final stage of physical change
The skin continues to lose elasticity
Result is deeper lines and wrinkles
Eyesight deteriorates
Low reflex.
Progressive state beginning from conception and
ending with death. Associated with it are certain
physical, social and psychological changes.
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4. It is a progressive and generalized
impairment of body functions resulting in,
loss of adaptive responses to stress and
increasing the risk of age-related diseases
It is inevitable biological phenomenon
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5. 60 crores of people in the world aged 65
years and over
It is expected to double by 2025 and to
reach 200 crores by 2050.
India is home to 1.04 crores elderly people
(aged 65 years and above), 53 lakhs
women and 51 lakhs men
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6. 55% OF WOMEN ABOVE 60 years are
widows
Joint family structure is changing to small
nuclear families
Without safe , secured dignified position within
the family elderly women find their position
vulnerable
Welfare of elderly women is low priority in recent
days
Over 73 % of elderly women are illiterate
Enhanced life expectancy add fire to their woe.
8. Health Concerns
Indian perspective
India has the lowest ranks for health expenditure per capita
People over the age 65 make up about 12% of the population,
occupy 25% of the hospital beds
The literacy rates among elderly females (28%) is less than
half of the literacy rate among elderly males (59%).
More than 2 of 3 adults age 65 and older live in their own
homes
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9. Genetic theories-
Somatic mutation of genes.
Genetically determined life span.
Cross linkage/loss of important cellular
components and DNA.
Random damage theories-
Accumulation of toxic metabolites and
free oxygen radicals.
Reduced physiological capacity and
wear-n-tear of cells of vital organs.
Non-enzymatic glycosylation of
proteins.MMM COLLEGE OF NURSING
11. Psychological changes
Biophysical changes and challenges
Senescence and health issues
Pharmaceutical interventions
Closer monitoring of health and wellness
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12. Erikson: Integrity vs. Despair
Attitude
Communication
Self concept
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13. Internal changes in
Heart
Bones Muscles and Joints
Digestive System
Kidneys and Urinary Tract
Brain and Nervous system
Eyes
Ears
Hair ,Skin, Nails, weight
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15. Taste Touch
Smell
Ability to taste four basic flavors
does not seem to decline with age
Sense of smell deteriorates with
age
Skin of elderly adults less
responsive to heat and cold
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16. Presbyopia (farsightedness) increases
“Blind spot” and reduction of vision field
Night vision
Cataracts
Glaucoma
Macular degeneration
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17. SLEEPING
• Shifts in sleep patterns
•Wake more frequently at
night
• Show decreases in REM
sleep
EATING
• Loss of feelings of satiety,
thus overeat
• May become rigid in meal
times and food selection to
compensate
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18. Common health issues
Heart Disease
Cancer (ovarian, uterine, and cervical cancer).
Diabetes
Dementia
Alzheimer's disease
Parkinson's disease
Arthritis
Falls
Genito-urinary complaints
Hearing loss
Dizziness
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19. Friends and activities
Environmental changes
Role changes
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20. Retirement
Grandparenthood
Friendship and social net work
Involvement with community activities
Transition from provider of care to
recipient of care
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21.
Successful aging theory :
(According to Polmore)1995,
Survival ( longevity )
Health (Lack of disability )
Life satisfaction (happiness
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Disengagement theory
Cumming & Henry 1961
Physical withdrawal
Less physical energy, slower pace
Psychological withdrawal
Diminished interest in the world
Social withdrawal
Fewer social interactions
22. Social problems
Abuse
Dependency
Insecurity
Rehabilitation
Prevention and management of elder
abuse
Assessment of physical and
mental capacity of the elderly.
Assessment of general quality
of care
Assessment of relation with
the abuser
Assessment of abusers for
their problems
Counseling the abusers
Institutionalization in old age
homes
The old-age dependency ratio climbed
from 10.9% in 1961 to 14.2% in 2011 for
India as a whole.
For females and males, the value of the
ratio was 14.9% and 13.6% in 2011.
In the age-group of 60-64 years, 76%
persons were married while 22% were
widowed. Remaining 2% were either
never married or divorced.
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23. Psychiatric complaints
8.5% of the old age complaints
Alzheimer’s disease
Depression
Anxiety
Delirium
Schizophrenia
Personality disorder
Suicide and deliberate self harm
Schizophrenia
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24. Psychological Symptoms
Sleep
Physical discomfort feeling
Interest
Guilt (as if a burden to others)
Energy
Concentration
Appetite
Psychomotor changes
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25. Changes in Women
Many of the physical changes in women is the estrogen production. The
vaginal walls lose their elasticity and grow paler and thinner which cause sex
to become painful.
The vagina also shrinks and when women go through menopause they produce
less vaginal lubrication.
Women also have fewer orgasms as they get older and they become less
powerful
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26. Ovarian, uterine, and cervical cancer
The rate of death for women over
the age of 65 from cervical cancer
is higher than that of women
below the age
Approximately 7.6 per 1,00,000
of elder women die from cervical
cancer, as compared to only
2.1for younger women.
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27. Heart Disease and Strokes
Cancer is the leading cause of death in women
ages 40 and 79
The risk of most cancers rises as we age
because our immune system becomes less able
to fight off cancerous cells.
A study has found that women older than 65
diagnosed with early-stage, hormone-receptor-
positive breast cancer had worse outcomes than
younger women with similar diagnoses
The risk of recurrence also was greater for the
older women. Compared to women younger
than 65, recurrence was:
7% more likely among women age 65 to 74
29% more likely among women 75 or older
. Feb. 15, 2012 issue of the Journal of the American Medical Association.
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28. Heart Disease
CAD is the leading cause of death
and disability in women after
menopause. In fact, a 50-year-old
woman faces a 46% risk of
developing CAD and a 31% risk
of dying from coronary artery
disease. In contrast, her
probability of contracting and
dying from breast cancer is 10%
and 3%, respectively.
Heart disease risk
factors for women
Diabetes. Women with
diabetes are at greater risk of
heart disease than are men
with diabetes.
Mental stress and
depression
Inactivity. A lack of physical
activity -research has found
women to be more inactive
than men.
Menopause. Low levels of
estrogen after menopause
pose a significant risk factor
for developing cardiovascular
disease
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29. Sleep
Sleep apnea- is temporary
suspension of breathing while
asleep it is most common in late
adulthood.
Sleep medications are the most
common treatment for sleep
apnea. Alternatives include
regular sleep schedule, relaxation
techniques, and exercise.
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30. Sexuality
People do not loose their
sexuality as they age
But when get older sexual
daydreaming, sex drive, and
sexual activity decreases
Most older people report that they
like having sex
People with partners usually
remain sexually active.
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31. Vision and hearing loss
Approximately one person in three
has some form of vision-reducing
eye disease by the age of 65..
According to the 2012
Regular screening examinations are
recommended for elderly patients
The most common causes of vision
loss among the elderly are age-related
macular degeneration, glaucoma,
cataract and diabetic retinopathy
Age-related macular degeneration is
characterized by the loss of central
vision
Primary open-angle glaucoma results
in optic nerve damage and visual field
loss
Eating foods with high antioxidant content may be helpful in
reducing vision lossdueto macular degeneration.
And taking vitamin supplementsfor eyehealth may help.
32. Causes of age-related
hearing loss
Changes in the structures of the inner ear
:changes in blood flow to the ear
Impairment in the nerves responsible for
hearing
Changes in the way that the brain processes
speech and sound
Damage to the tiny hairs in the ear that are
responsible for transmitting sound to the
brain
Age-related hearing loss can also be caused
by other issues, including:
Diabetes
Exposure to loud noises
Use of certain medications
Family history of hearing loss
Hearing loss takes a toll on
the quality of life and can
lead to depression and
withdrawal from social
activities
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33. Arthritis
common forms of arthritis
Osteoarthritis- is a painful,
degenerative disease
characterized by wear and tear on
joints.
Rheumatoid arthritis- A painful
disease characterized by chronic
inflammation of the membranes
that line the joints
Needed: Lifestyle change
better food habits, higher
antioxidant content through green
leafy vegetables, high protein diet
and adequate Vitamin D and
calcium foods
- Leg strengthening exercises
- Cartilage restoring medication
Indian women over the age of 45 are more
prone to arthritis while in the West women
over 60
Arthritis of the hip is common in the West,
whereas in India arthritis of the knee is more
common.
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34. Dementia and
Alzheimer’s Disease
A total of 3.7 million people in India
are suffering from Alzheimer’s
disease,
People over the age of 60 are
becoming victim of Alzheimer’s, with
women constituting 70 per cent
Dementia- a condition characterized
by deterioration of cognitive
functioning.
Causes of dementia are brain
infections such as meningitis, HIV,
infections, strokes, and tumors.
Therapies and pharmacologic
treatments that focus on stopping the
brain cell death
Use of non-pharmacologic behavioral
interventions Participation in
activities, which improve mood
Behavioral interventions (to help with
common changes, such as aggression,
sleep issues and agitation)
Education about the disease
Building a care team for support
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35. Falls
According to the Center for
Disease Control and Prevention,
each year, one in every three
adults age 65 and older falls.
In a Multi-centric Community
Study, evaluating Health
Problems in the Elderly (Year
2013), in India, the incidence of
falls (History of a single fall in
the last 6 months) was found to be
14%
. Fractures among females
(26.4%) were reported more
frequently compared with males
(16%) and fracture was seen more
in urban subjects (29.4%)
compared with rural subjects
(13.4%).
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36. Falls
it is so common
Injury
prevention
Falls should be
prevented by;-
Removal of
obstacles
Keep the floor
dry
Bright lighting
Flat shoes
Railing/holding
bars in bathrooms
Low level
switches
Easy and safe
access to water
and rest rooms
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37. Genito-urinary complaints
These form about 3.5% of the
old age complaints
Rates of infection are high in
postmenopausal women because
of bladder or uterine prolapse
causing incomplete bladder
emptying; loss of estrogen with
attendant changes in vaginal flora
(notably, loss of lactobacilli),
Women are particularly at risk of
developing UTIs because of their
short urethra, and certain behavioral
factors which include delay in
micturition, sexual activity and the use
of diaphragms and spermicides
women most often results from
perineal or periurethral bacteria that
enter the urethra and ascend into the
bladder, or due to mechanical
instrumentation such as
catheterization.
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38. Wisdom
Psychologist Lynn Hasher suggest that distractibility can
enable older adults to take a broader view of various
situations.
They consider not only the present but the past as well as
thecontextsin which theproblemsarise.
Older people approach life’s problems in a way that address
the meaning of life, this may play a significant role as to
why wethink of older peopleaswiser.
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39. Preventive Health Care in older adulthood
The role of prevention in geriatrics is to delay the onset of age-
related decompensatory problems of body functions.
It includes-
Primary prevention.
Secondary prevention.
Tertiary prevention.
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40. Primary Prevention
Health habits-
Inadequate nutrition
Addiction to smoking & alcohol
Lack of exercise
Inadequate sleep
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42. Secondary prevention
SCREENING
Screening helps in early detection of modifiable risk factors and
their adequate management.
Hyper/hypotension, diabetes mellitus
Dental problems
Drug adverse effects
Cancers
Infections
Nutritional deficiency states
Eyes /ears
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43. Tertiary Prevention
It deals with rehabilitation and caregiver support.
Rehabilitation is a problem solving process focused
on the patients functional abilities.
Rehabilitation team includes; a physician, a
physiotherapist, an occupational therapist, a speech
and language therapist, a psychiatrist, a dietitian, a
nurse and a social worker.
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44. Interventions in rehabilitation
Hard interventions-
Drugs.
Physiotherapy.
Occupational therapy.
Aids and adaptation.
Speech and language therapist.
Soft interventions-
Advice.
Education.
Counseling.
Encouragement.
Listening.
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45. Supporting the caregiver
Social attitude
Physicians support
Organization of “day care centers”
Hospitalization in case of chronic illness
Counseling the caregiver
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46. Conclusion
Growing old is mandatory
- Chili Davis.
MMM COLLEGE OF NURSING
Do not regret growing elder , it
is a privilege denied to many
- Chili Davis.