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Gerontology
CCC Gerontology Unit I
57
Nursing
Not Applicable
09/12/2011

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Cards

Term
What are the A. Psycho-social aspects of aging?
Definition
“Aging, the normal process of time related change, begins with birth and continues throughout life.”
Term
When does old age start?
Definition
*65 years old: every older adult is unique and special
Term
What is a centenarian?
Definition
Someone age 100 or greater
Term
What are causes for decline in aging peoples health?
Definition
Reduced ability to respond to stress,
The toll that repeated losses takes, and
Physical changes that are a normal part of aging.
Term
In elderly people, what are the 5 most common chronic conditions?
Definition
Hypertension
Diagnosed arthritis
Heart disease, all types
Any cancer
Diabetes
Term
What is ageism?
Definition
“emotional prejudice or discrimination against people because of increasing age”
Term
How can ageism effect elderly adults?
Definition
Ruining self-confidence
Limiting access to care
Causing caregivers to not appreciate the uniqueness of each older person
Term
A total person consists of ___________.
Definition
Physical
Mental
Spiritual
Emotional
Social
Environmental
Term
What makes a complete person?
Definition
Culture
Faith beliefs
Upbringing as a child
Medical history
Term
How are threats to health viewed by the aging population?
Definition
With Fear!
Term
What some health fears that aging adults have?
Definition
Losing their faculties (ability to have a clear mind, incontinence)
Being forced into a facility
Lost independence
Loss of respect from others, being devalued
Being alone
Term
What stage of Erikson's developmental tasks are elderly adults in?
Definition
Integrity vs. despair
Term
What are the Tasks vs. Conflicts in Integrity vs. Despair?
Definition
Reflecting back on life and either accepting their lifestyle or feeling dissatisfied and disappointed with their life
Term
What are positive behaviors of aging adults?
Definition
Using past experiences to guide others
Accepting new ideas and limitations
Maintain productivity in some area
Exploring philosophy of living and dying
Enjoying some aspect of things as they are
Actively participating in own care as much as able
Term
What are positive and negative outcomes of Integrity vs. Despair?
Definition
Positive outcomes
Wisdom
Understanding
Acceptance
Negative outcomes
Doubt
Fear
Gloom
Term
Identify several crises that may have been experienced by the older adult
Definition
Retirement
Death of friends/loved ones
Financial uncertainty
Health concerns
No family near to help care for them
Term
Describe some of the feelings experienced by, and needs of, patients’ families when they place a relative in a long-term care facility.
Definition
Guilt
Relief
Inadequacy
Scared about finances
Term
Describe several ways that nurses can assist the older adult in meeting his/her spiritual needs.
Definition
Assess spiritual needs, wants, and desires
Encourage prayer group participation/church activities/worship services
Encourage individual prayer: offer to pray with them if you are comfortable
Encourage local clergy to visit, if elder cannot attend church
Term
Identify sources of significant others for elderly people without close family relationships.
Definition
Community resources (local church)
Neighborhood, close neighbors
Senior center
Term
What biological changes affect aging?
Definition
History of chronic illness: diab, copd, cardiac conditions
Acceleration of aging
Exacerbation with illness does not return to previous state of health
Term
What are psychological changes affect aging?
Definition
Being sick can cause these problems internally
Threats to developmental task - integrity vs. despair: Illness is a threat
Potential threat of cognitive problems, such as dementia, depression, etc.
Worry about forgetfulness
Biological changes or effects, such as anoxia and sensory changes, may accelerate: Anoxia: not having enough O2 in the blood stream
Drug interactions and pharmaceutical effects. Can cause memory problems
Term
Social Changes affect aging?
Definition
May experience isolation (if they live in the country, but now can’t get to town)
Stresses related to retirement (no $$, what will I do, more time with spouse?)
Term
What cognitive impairment changes affect aging?
Definition
Worry about forgetting or being treated differently
Possible relocation
Loss of spouse/family/friends
Their own death
Term
What cultural changes affect of aging?
Definition
May either embrace or avoid aging
Family support is affected by culture
If the elderly are respected, growing old could be wonderful
Term
What economical changes affect aging?
Definition
Fixed income
Social security
Together, these limit budget and ability to acquire needed items, such as meds, food, health care, etc.
Term
How is the cardiovascular system affected by aging?
Definition
Decrease cardiac output, diminished ability to respond to stress, heart rate and stroke volume do not increase with maximum demand, slower heart recovery rate, blood pressure tends to be higher
This is why elderly people complain of fatigue with increased activity, it takes them longer to recover from activity or stress, and normal BP is >¬ 140/90
Promote regular exercise, paced activities, and avoidance of smoking, consuming a low-fat, low-salt diet, participation in stress-reduction activities, weight control, and medication compliance.
Monitor blood pressure regularly.
Term
How is the endocrine system affected by aging?
Definition
Decreased muscle mass, due to a decrease in growth hormone from the pituitary gland
Decreases metabolic rate, due to a decrease in thyroid-stimulating hormone in some older adults, which causes more sensibility to cooler temperatures.
Increase blood calcium levels in some, due to an apparent increase of parathyroid hormone, such as in osteoporosis, confusion, and kidney stones, all of which afflict mainly older women
Decrease pancreatic function in some, which causes Type II diabetes.
Monitor lab values, especially minerals such as calcium and sodium, and also blood glucose; educate elderly regarding dietary needs and self-testing of blood glucose.
Decreased gonad tropic hormones, causing:
For men: lower sperm counts, smaller testes, erections that are less firm and slower to develop, delayed orgasm
For women: lower estrogen production; development of facial hair; degeneration of ovaries; atrophy of vagina, uterus, and breast; painful intercourse with delayed orgasm.
Term
How is the GI system affected by aging?
Definition
Decreased salivation; difficulty swallowing food; delayed esophageal and gastric emptying; reduced gastrointestinal motility
These problems cause people to experience: dry mouth; fullness, heartburn and indigestion; constipation, flatulence, and abdominal discomfort
Encourage:
Use of ice chips/hard candy and mouthwash
brush, floss, and massage gums daily helps keep teeth strong, decrease in dry mouth
Get regular dental care
Eat small, frequent meals, and sit up and avoid heavy activity after eating
Limit use of antacids and laxatives: encourage high fiber diet and exercise frequently to decrease need for laxatives
Eat a low-fat, high-fiber diet and drink adequate fluids
Toilet regularly
Term
How is the immune system affected by aging?
Definition
Decrease ability to respond to invading organisms makes older people more susceptible to infections and diseases. Both production and function of T- and B- lymphocytes may be impaired. (Fights infection and disease) Declining function of organ systems also impair immunity.
- Urge older people to get immunized yearly against influenza and every five years against pneumonia. The following are all common infections for the elderly: flu, pneumonia, urinary tract infections, tuberculosis, GI infections, and skin infections. Anyone working with the elderly should also be immunized.
Term
How is the integumentary system affected by aging?
Definition
Skin appears thin and wrinkled, tends to be dry: easily prone to tearing, bruising, and sunburn; less tolerant of heat and cold; bony structures beneath skin are prominent.
Lubricate skin; avoid sun exposure; dress appropriately for the temperature; maintain a safe indoor temperature; shower preferable to tub bath
Term
How is the musculoskeletal system affected by aging?
Definition
Height loss; prone to fractures; kyphosis (slouched over back); back pain; loss of strength, flexibility, and endurance; joint pain
Exercise regularly; eat a high-calcium diet; limit phosphorus intake; take calcium and vitamin D supplements as prescribed
Term
How is the neurological system affected by aging?
Definition
Slower to respond and react, due to slower nerve conduction; learning takes longer; increased confusion with illness and loss of environmental cues; reduced cerebral circulation, which causes faintness and loss of balance, making older people more prone to falls
Enhance sensory stimulation; pace teaching; with hospitalization, encourage visitors; with sudden confusion, look for cause; encourage slow rising from a resting position
Term
How is vision affected by aging?
Definition
Holds objects far away from face; complains of glare; poor night vision; confuses colors
Wear eyeglasses; use sunglasses outside; avoid abrupt changes from dark to light; use adequate indoor lighting; use large-print books and magnifiers as needed for reading; avoid night driving; use contrasting colors for color-coding. Blue et green are two colors that are hard to distinguish.
Age related macular degeneration is the leading cause for loss of night visions
Term
How is hearing affected by aging?
Definition
Gives inappropriate responses; asks people to repeat words; strains forward to hear.
Recommend hearing exam; reduce background noise; face person; enunciate clearly; speak with a low-pitches voice; use nonverbal cues
Term
How is taste and smell affected by aging?
Definition
Uses excessive sugar and salt
Encourage use of lemon, spices, and herbs
If taste is diminished then so are the # of taste buds on the tongue
Smell is diminished because of decrease in olfactory bulb
Term
How is the urinary system affected by aging?
Definition
Men: urinary retention; irrigative voiding symptoms including frequency, feeling of incomplete bladder emptying, multiple nighttime voiding. These are symptoms of BPH (benign prostatic hypertrophy or hyperplasia)
Get referral to urologist for urology workup; have ready access to toilet; wear easily manipulated clothing; drink adequate fluids, avoiding bladder irritants, such as caffeine, alcohol, and artificial sweeteners; pelvic floor muscle exercises, preferably learned via biofeedback. Biofeedback taught by physical therapy. Biofeedback: a stimulator used to help with feeling for where you know where to tighten.
Women: Urgency/frequency syndrome, decreased “warning time,” bathroom mapping. These are due to relaxed perinea muscles and detrusor instability which cause urge incontinence. Stress incontinence is due to urethral dysfunction, where drops of urine are lost with cough, laugh, sneeze, or position change.
Wear easily manipulated clothing; drink adequate fluids, avoiding bladder irritants, as above; pelvic floor muscle exercises, preferably utilizing biofeedback; consider urologic work-up.
These signs can be caused by UTI.
Term
How is the reproductive/sexuality system affected by aging?
Definition
Female: Vaginal narrowing and decreased elasticity; decreased vaginal secretions
Painful intercourse; vaginal bleeding following intercourse; vaginal itching and irritation; delayed orgasm
Male and female: Slower sexual response
Male: Decreased size of penis and testes
Delayed erection and achievement of orgasm
Term
Guidance for females:
Libido - does it naturally decrease?
No, but frequency of sexual activity usually declines, and sexual activity may decrease due to: illness, use of certain medications that affect libido, death of one’s sexual partner, or decrease socialization.
Definition
May need a vaginal estrogen replacement; gynecology/urology follow-up; use a lubricant with intercourse
Guidance for males and females: be patient and use sensitivity with each other! Make it a fun activity and don’t get hung up on being too serious!
Questions older adults may have about sexual activity:
Term
Does menopause end a woman’s sex life?
Definition
No, but without the use of lubricants, intercourse may be painful and may cause bleeding, as mucous membranes become dry due to no more estrogen or progesterone from the ovaries.
Term
What can men expect with old age and their sexuality?
Definition
Men may experience changes in erections or longer recovery periods between episodes of sexual activity.
A man’s fertility starts to decline in his 40’s, but continues into their 90’s.
Term
How is the respiratory system affected by aging?
Definition
the one system does not change that much. Elderly are able to adapt easily.
Term
What changes in nutrition is common with the elderly?
Definition
Fewer calories
More nutrient-dense foods
Protein
Fruit
Vegetables
Less fat (no more than 20-25% of calories)
Less sodium
64-80 ounces of water/day
carbs should be 55-60% of daily calories
Potatoes
Whole grains
Brown rice
Fruit
Multivitamin each day
daily calcium 1,200 mg
daily Vitamin D: 10-15 min of sun exposure 4 -5 times a week.
Term
What things hinder elderly from getting proper nutrition?
Definition
Anything that alters the pleasure of eating
Decrease in taste and smell
Poor oral health
Apathy, depression, or loneliness
Immobility
Poverty
Inadequate knowledge of what is healthy and not healthy
Term
Why is exercise important for the elderly?
Definition
Helps keep joints flexible
Maintains muscle mass
Helps control blood glucose levels and weight
Promotes a sense of well-being
Without exercise gradual bone loss and deterioration start before age 40
Degenerative joint disease is seen in all adults older than 70
Weight-bearing joint and back pain is common complaint
Excessive bone loss leads to Osteoporosis which causes Fractures
Term
Why is adequate rest important for elderly adults?
Definition
Elders needs as much sleep as younger people
Sleep disturbances affect more than 50% of adults 65 and older
takes longer to fall asleep
wake up easier and more often
less time in deep sleep
lack of quality sleep at night means more napping needed during the day
incidence of sleep apnea increases with age
Term
What are the proper sleep hygiene?
Definition
Use bed only for sleep and sex
Consistent bedtime routine
Avoid or limit daytime napping
Limit alcohol intake to < 3 drinks/day
Avoid caffeine and nicotine after noon
Term
What are some community services that enhance a healthy geriatric lifestyle?
Definition
Senior centers
Adult day care facilities
Retired and Senior Volunteer Program (RSVP)
Singles dances
Term
What is the active role of the PN in the geriatric setting?
Definition
charge nurse
med nurse
treatment nurse
teams up with/supervises CNA’s to perform pt care
Term
How does Alzheimer's disease effect a client?
Definition
Progressive: increases
Irreversible: can not be reversed
Degenerative: deterioration of tissue
Neurologic: concerned with the structure and function of the nervous system
Disease
Begins insidiously; begins without you being aware of it
Term
Large number of brain cells and tissue undergo ____________?
Definition
Atrophy: wasting away
Beta-amyloid plaques: waxy substance consisting of protein. That deposits in the cells in the brain
Neurofibrillary tangles: little growths or filaments that take over the brain
Term
At what age does Alzheimer's Disease usually effect a client?
Definition
Can occur as early as 40
Uncommon before 65
Prevalence increases dramatically with increasing age; effects 30% of people 85 and older
Most common form of dementia
Definite diagnosis can only be made during an autopsy
Term
What is Arteriosclerosis?
Definition
Most common disease of the arteries
Process in which muscle fibers and the endothelial lining of the walls of small arteries and arterioles thicken
“hardening of the arteries”
Term
What is the difference of Arteriosclerosis et atherosclerosis?
Definition
Atherosclerosis is a form of arteriosclerosis
Term
What is Atherosclerosis?
Definition
Atherosclerosis is a collection of lipids, calcium, blood components,carbohydrates, and fibrous tissue on the intimal layer of the artery. These collections are called atheromas or plaques.
Term
What happens when clogging or clotting off happens in the heart?
Definition
a heart attack happens
Term
What happens when clogging or clotting off happens in the carotid artery?
Definition
brain attack happens, stroke, MI in the brain
Term
What happens when clogging or clotting off happens in the popliteal artery?
Definition
gangrene can result
When the plaque breaks of it is called an embolus
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