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CH 6- Age Related Changes

Chapter 6 discusses age-related health changes and common issues in geriatrics, including cardiovascular, respiratory, neurological, renal, gastrointestinal, musculoskeletal, immunological, and sensory systems. It highlights safety goals, risks of falls, medication management, and psychosocial concerns such as depression and ageism. The chapter emphasizes the importance of recognizing and addressing these challenges to improve the quality of life for elderly patients.

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Kandice Tan
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1 views4 pages

CH 6- Age Related Changes

Chapter 6 discusses age-related health changes and common issues in geriatrics, including cardiovascular, respiratory, neurological, renal, gastrointestinal, musculoskeletal, immunological, and sensory systems. It highlights safety goals, risks of falls, medication management, and psychosocial concerns such as depression and ageism. The chapter emphasizes the importance of recognizing and addressing these challenges to improve the quality of life for elderly patients.

Uploaded by

Kandice Tan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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CH 6: Geriatrics

Age related changes and common health issues


Heart and Vascular
CHF  most often caused by MI or HTN
CAD
MI
A.Fib
Stroke
Venous thrombosis
Thromboembolism

Goals for Safety by J.CO:


Correctly ID pt
Using medications safely
Preventing infection
Preventing falls
ID safety risks
Respiratory
Pneumonia  viral, bacterial, aspiration  weakened cough reflex and diaphragm strength allow secretions to pool in lungs
Swallowing risk  use thickening agents to decrease risk of aspiration (makes liquid thicker)
COPD  emphysema and chronic bronchitis  SMOKING IS PRIMARY FACTOR

Neurological
Dementia  cognitive decline affecting social and occupational functioning
Most common is Alzheimer’s dementia
*DELIRIUM is SHORT TERM, ACUTE LOSS of SOME COGNITIVE Abilities

Depression  hard to dx b/c of symptoms similar to aging and chronic disease (fatigue, impaired concentration and memory,
insomnia)
Parkinson’s  movement (tremor, rigidity and gait disturbance, may affect speech
CVA  stroke (paralysis, weakness, speech and vision impairments)

Renal

Common health issues:


*Increased risk of dehydration
*Decreased excretion of drugs and toxins w/associated increase in side effects and morbidity
*HYPO and HYPERnatremia r/t impaired renal diluting capacity and concentrating ability
*HYPO and HYPERkalemia  occur from GI losses and diuretic uses (HYPER is more common in elderly)
GU/Reproductive

*general decline
*stress incontinence is more common in women
*male  characterized by hesitancy and weak urinary stream, BPH
GI
*Delay emptying, delayed transport through colon, increase acid secretion and decrease size of liver and pancreas
Health issues:
*Increased risk of gastric and duodenal ulcers and atrophic gastritis
*GERD
*Vit B12 deficiency and resultant anemia
*Increased feeling of fullness, possible nutrient deficiency
-Cachexia: loss of weight and muscle mass, can’t be reversed nutritionally
*Bone loss
*Constipation and fecal impaction
*Increased risk of adverse reaction and toxicity from medications (result of liver changes)
*DM 2
Musculoskeletal
Decrease in muscle mass, stiffening of tendons and ligaments, decreased bone density and increased bone loss
Common health issues:
*Arthritis w/chronic joint and skeletal pain
*Osteoporosis w/ risk of fx caused by trm and spontaneous fx
*Limitations of movements and ability to perform tasks  increasing dependence on others for assistance
*Sarcopenia  loss of muscle mass and increase in body fat  to prevent: increase protein intake and resistance
training  enhance protein synthesis and improve body composition by increasing lean mass in relation to fat mass
*Increased risk for falls
Deconditioning; a rapid loss of strength, occur when pt is hospitalized or bed bound
*Factors associated w/increased falls
Confusion/Disorientation
Symptomatic depression
Altered elimination
Male gender
Dizziness/Vertigo
Medications (benzo and antiepileptics)
Appropriate score on get up and go test (Stay close to pt)
Ask pt to raise, walk forward to specific spot, turn and return to chair and sit back down
Look for shuffling gait, lack of arm swing unequal shoulder or hip height, ability to turn
without support and ability to stand and sit in controlled fashion

Immunological and Skin


*Blunted response to infection (making dx more difficult)  LESS likely to have fever or elevated WBC or obvious s/s
UTI  delirium (sudden mood shift, memory loss, inattention, confusion or lethargy)
*Increased risk for skin breakdown
*Shingles  postherpetic neuralgia (chronic pain after lesions healed)  vaccine >60y/o
*Increased change of xeroderma (dry, rough skin) and associated itching
*Intrinsic factors: cellular progress (genetis)
~Extrinsic  external factors (environment, smoking, UV light, medication, chronic illness)
**BOTH factors affect wound healing**
Sensory
*SAFETY CONCERNS for elderly’s ability to navigate environment
VISION and HEARING impairment
*Hearing loss

Safety and Psychosocial Issues


-Safety: physical, medical and protection from abuse
Physical: accidents and falls
Medication: compliance and drug/drug interactions monitoring, polypharmacy
BEERS CRITERIA: risks > benefits to adults >65 y/o
Abuse: be aware, financial, physical and emotional
-Psychosocial: transition into elder adult, social isolation, housing and financial issues, plan of care/advance directive
Ageism: treated with less respect and consideration b/c of advanced age

Major depressive episode:


Depressed mood most of the day nearly every day
Markedly diminished interest or pleasure in all or most activities
Significant, unintentional weight loss, or decreased appetite nearly every day
Insomnia or hypersomnia (sleeping too much)
Psychomotor agitation or retardation (slowness or speed of movement)
Fatigue or loss of energy
Feelings of worthlessness or excessive guilt feelings
Diminished ability to think or concentrate
Recurrent thoughts of death, recurrent suicidal ideation

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