3.4: Aging and the Body
It is important to remember that aging is a normal process and is not a disease or a sentence that a person will end up with a disability. As Home Health Aides/Personal Care Aides will likely work with many elderly patients, it is important for them to have a general understanding of the physical and mental changes that occur during the aging process.
Immune System
The immune system becomes weaker as we age, which increases our risk for infection. This also means that it takes older people a longer time to recover from an infection. There are two parts to our immune system: the innate immune system and the adaptive immune system. As we age, changes occur in both systems. The innate immune system consists of barriers that protect us from infection, such as our skin, mucous membranes, and stomach acid (U.S. Department of Health and Human Services, National Institutes of Health, National Institute on Aging (2011). The cough reflex and the ability to develop a fever are also part of the innate system. During the aging process, our skin becomes drier, thinner, and more fragile. More fragile skin may lead to skin tears and openings which allow bacteria to enter and cause infection. Drier skin also leads to an increased risk of cracks and openings from itching, which can allow bacteria to enter.
The adaptive immune system is more complex, and includes the spleen, thymus, tonsils, bone marrow (which makes white blood cells , which are needed to fight infection), circulatory and lymphatic systems (U.S. Department of Health and Human Services, National Institutes of Health, National Institute on Aging (2011). T cells are a type of white blood cell that helps our bodies fight infection. As we age, our body produces fewer T cells (U.S. Department of Health and Human Services, National Institutes of Health, National Institute on Aging). This leads to a diminished ability to fight off bacteria and viruses. Lymph nodes reduce in size and number which makes it harder for the body to develop a fever. A fever is one way our body fights infection. An older adult may not necessarily have a fever, which is the typical sign of infection. Home Health Aides/Personal Care Aides must be aware of even slight changes in temperature as this could indicate that there is an infection (Leahy, Fuzy & Grafe, 2013).
Changes in the respiratory system also lead to an increased risk of respiratory infections. As we age, our lungs have less alveoli which are needed for the exchange of oxygen and carbon dioxide. This leads to less oxygen in the blood, which means breathing may be compromised. If an older person is not able to breathe as well as they did when they were younger, they will be more at risk to contract a respiratory infection. The cough reflex may also be diminished and an older person may have a harder time coughing up mucus, which means it stays in the lungs, leading to more bacteria (Leahy, Fuzy & Grafe, 2013).
Home Health Aides/Personal Care Aides must always remember to practice good hand hygiene. It is the best way to prevent the spread of bacteria and viruses. They should assist their patient with practicing good hand and personal hygiene, and encourage and provide proper nutrition and help to keep their patient hydrated. They should encourage their patient to receive vaccinations such as a yearly influenza vaccination, and encourage them to talk to their nurse or doctor about the vaccinations they could receive to protect themselves from infection.
True or False?
1. Elderly people are more at risk to contract an infection. True or False. _________
2. Elderly people always have a fever when they have an infection. True or False. ________
3. The skin is part of our innate immune system and protects the body from bacteria entering. True or False. _________
4. Hand hygiene is an important way to prevent the spread of bacteria and viruses. True or False. _________
- Answer
-
1. True
2. False
3. True
4. True
Feedback :
1. Due to changes in the immune system (fewer lymph nodes and T cells, fewer alveoli, and changes in skin make elderly people more at risk to contract an infection.
2. An older adult may not necessarily have a fever, which is the typical sign of infection. Even slight changes in temperature should be documented and reported.
3. The innate system consists of our skin, mucous membranes, stomach acid, fever, and inflammation.
4. Hand hygiene is the best way to prevent the spread of any infection. HHA/PCAs should always practice proper hand hygiene.
Respiratory System
As the body ages, there are less alveoli present in the lungs. Alveoli are small sacs at the bottom of the lungs where oxygenation takes place. The lungs take in air which contains oxygen. In the alveoli, oxygen enters the blood to oxygenate the rest of the body. Carbon dioxide, which is a waste, leaves the alveoli. Since there are less alveoli the older person has a diminished ability to remove carbon dioxide from their lungs.
Lung tissue also becomes less elastic as a person ages. This means that the lungs will not expand during breathing as well as they did when the patient was younger. The rib cage may also not expand as well as it did when the person was younger because the bones become thinner and change shape with age. The diaphragm, which is a muscle below the lungs and supports breathing also becomes weaker, so the elderly person may have a more difficult time taking deep breaths. The cough reflex may be diminished and an older person may have a harder time coughing up mucus, which means it stays in the lungs, leading to more bacteria.
When working with an older adult, Home Health Aides/Personal Care Aides should allow them to take frequent rest periods as they may become easily fatigued or short of breath. If ordered in the Care Plan, they should encourage and assist with performing deep breathing exercises. A patient may also be working with a Respiratory Therapist who will assist them with practicing deep breathing and using tools such as an incentive spirometer . An incentive spirometer is used by having the patient breathe in deeply into a small machine. This helps to keep the alveoli in the lungs open. If the alveoli are open, there will be better oxygenation of the body, and unwanted carbon dioxide can leave the body. It is also a great way to help prevent pneumonia in elderly and bedridden patients.
Some patients may benefit from staying in a higher sitting position, known as Fowler’s Position . This helps people to breathe better than if they were lying down. Home Health Aides/Personal Care Aides can adjust the patient’s bed if it is adjustable to help keep them sitting in a high position. Pillows may also be used propped behind the patient’s back to help keep them upright. They must remember to practice proper hand washing at all times.
If Home Health Aides/Personal Care Aides are sick, they should talk to their supervisor about whether they should go to work or if a mask should be worn while working with patients. If they need to cough, cough away from others into the crook of the arm. Don’t cough into the hands without washing them afterward. It is important to keep the patient away from cigarette smoke and polluted air. During cold weather, ensure the patient is warmly dressed and has a scarf to cover their nose and mouth. This helps to prevent cold air from entering the lungs.
True or False?
1. One way to help an older patient breathe better is to keep them in a sitting position or propped up with pillows. True or False _______
2. Oxygen enters the body and carbon dioxide leaves the body in the alveoli. True or False _______
3. Lungs become stronger as people age. True or False _______
Check your answers!
- Answer
-
1. True
2. True
3. False
Feedback :
1. A high sitting position is known as Fowler’s position and can aide a person who has difficulty breathing to breathe more comfortably. The use of pillows propped behind the back will also aide with breathing.
2. The alveoli are small sacs at the base of the lungs where oxygen and carbon dioxide are exchanged. Oxygen enters and carbon dioxide exit.
3. The lungs become less elastic, making breathing more difficult as we age.
Cardiovascular System
The cardiovascular system consists of the heart and all the blood vessels of the body. As we age, fatty deposits or plaque deposit in our blood vessels. These fatty deposits cause the blood vessels to become stiff and blood does not flow through them as well. If there is a large amount of plaque build-up, the flow of blood can become blocked. Coronary artery disease (narrowing of the arteries that supply blood to the heart) or heart attacks can occur due to blocked blood flow. Some people take medication to lower cholesterol levels and to prevent chest pain. Home Health Aides/Personal Care Aides should report statements of chest pain, shortness of breath, or a feeling of tightness in the chest to their supervisor immediately. The largest artery of the heart, the aorta also becomes thicker and stiffer with age (Aging changes in the heart and blood vessels, 2012). This results in many elderly people having a higher blood pressure. Monitor the patient’s blood pressure as directed in the Care Plan and report changes.
As we age, the normal rhythm of our heart also changes. Heart rate tends to decrease as we age. It is not uncommon for an elderly person to develop an arrhythmia , or an abnormal heart rhythm. In many cases this can be controlled by medications. Some patients may develop heart failure , which means the heart can no longer pump blood through the body as effectively as it used to. Patients may become short of breath, even when walking short distances or develop edema , which is a swelling of a body part, often the legs due to a build-up of water.
Medications and diet changes are used to try to control the symptoms of heart failure. Home Health Aides/Personal Care Aides should report any statements made by their patient of chest pain or shortness of breath or if they notice an increase in swelling or a sudden weight gain to their supervisor immediately. These are signs that heart failure is worsening. Patients with heart failure may be told to avoid lifting heavy objects, not to engage in strenuous exercise, and to take more rest breaks while doing physical activity. Help the patient maintain as healthy a lifestyle as possible by monitoring their diet and assisting with exercise as directed in the Care Plan. Home Health Aides/Personal Care Aides should monitor for any physical changes that occur and report them to their supervisor.
True or False?
1. Sudden weight gain, shortness of breath or edema in the legs is a sign that heart failure is worsening.True or False _______
2. Blockages in arteries can lead to a heart attack.True or False _______
- Answer
-
1. True
2. True
Feedback :
1. Sudden weight gain, shortness of breath that increases and edema are signs that heart failure is worsening.
2. Blockages in arteries, which prevent blood flow can lead to a heart attack.
Integumentary System (Skin)
Changes in the integumentary (or skin) system may be the most visible changes of aging (Aging changes in skin, 2012). Hair becomes grey and thins, and skin becomes wrinkled. Nails become harder and more brittle. The skin is the largest organ of our body. Skin serves to protect us from bacteria entering into our bodies, helps regulate our body temperature, helps us to regulate our fluid balance, and allows us to feel sensations such as heat or touch due to the nerve receptors within the skin. As we age, our skin becomes thinner, drier, and more fragile. Changes in the blood vessels within our skin also lead to the skin becoming more easily bruised and to bleeding.
As we age, sebaceous glands , which produce oil, become less active (Aging changes in skin, 2012), so skin is drier, less moist, may be itchy, and is more likely to break, leading to possible infections. To protect the skin, moisture must be added, such as in the form of body lotions. It is also important to encourage older people to stay hydrated by drinking plenty of fluids. Sweat glands also become less active, so older people perspire less. They may not need a complete bath as often, but should receive a sponge bath at least daily with a complete bath about twice per week (Leahy, Fuzy, Grafe, 2013). When we sweat, it is the body’s way to keep cool. Since older people will sweat less, they are more at risk for overheating or getting heat stroke.
The subcutaneous or fat layer of the skin also thins. This leads to more difficulty with temperature regulation. Older people may become cold faster and are more at risk for developing hypothermia (Aging changes in skin, 2012). Care should be taken to ensure they are properly clothed and kept warm. Thinning of the fatty layer of the skin also means that older people have less padding to protect them from injury (Aging changes in skin, 2012). They may have bony areas that are at higher risk for developing pressure sores (Aging changes in skin, 2012). Care should be taken to turn and position bedridden patients every two hours and to protect bony areas with pillows. In addition, it takes about 4 times longer for aging skin to heal than younger skin (Aging changes in skin, 2012). In addition to the changes that occur from aging in the skin, an older patient may also have diseases and disorders such as diabetes that also prolong (lengthen) the period of time it takes for their skin and wounds to heal (Aging changes in skin, 2012).
True or False?
1. You can wait about 4 hours to turn and position a bedridden patient. True or False. ______
2. Lotion helps to protect the skin from breaks, openings, and tears, which can lead to infection. True or False. ______
3. Older people don’t have to worry about their fluid intake.True or False. ______
- Answer
-
1. False
2. True
3. False
Feedback :
1. Patients who are bedridden should be turned at least once every two hours to prevent pressure ulcer development.
2. Lotion helps to protect the skin, which is part of the innate system, and which protects us from infection. Lotion helps to keep the skin supple and moist.
3. Older adults have to have adequate fluid intake just as a younger person does. HHA/PCAs should encourage fluid intake and offer fluid to bedridden patients every two hours when turning and positioning
Musculoskeletal System
The skeleton is made up of the bones within the body. It provides support for muscles, protection for organs, and helps people to move. Muscles provide strength for the body to move. Joints are spaces in between bones, which are cushioned by cartilage and what is called synovial fluid . As people age, bones lose mass and calcium. Bones may become thinner and more likely to break. The spinal column may become curved, resulting in some elderly people having a stooped or bent over appearance. The spine is made up of vertebral disks which have fluid in between each disk. As we age, the fluid between these disks become thinner, and some people may actually lose height as this fluid thins and the vertebrae move closer together.
As people age, their muscles also weaken and lose tone. Elderly people may not have the same strength or range of motion or ROM (ability to move joints in different directions) as before and may have more difficulty with movement.Joints may become stiff, and the fluid between joints decreases, resulting in cartilage between the bones rubbing together. This makes it harder for a person to move which can be very painful.
Some people have arthritis , which is painful inflammation in the joints. If safe and directed in the Care Plan, Home Health Aides/Personal Care Aides should encourage patients to perform range of motion exercises and walk as much as possible. This helps to strengthen bones and muscles, which also helps to prevent osteoporosis (Leahy, Fuzy, Grafe, 2013). Osteoporosis results in thin and brittle bones, which increases a person’s risk of fractures. Home Health Aides/Personal Care Aides can assist with range of motion (ROM) exercises as directed in the Care Plan, and can encourage patients to complete as many activities as possible to keep their muscles and bones active.
Home Health Aides/Personal Care Aides may assist with performing range of motion exercises only as directed in the Care Plan (Leahy, Fuzy, Grafe, 2013). They should never perform these types of activities without proper training and direction from their supervisor, as it could result in injury to the patient. Patient’s joints should always be supported during these types of activities. Joints can be supported by holding above and below the joint. For example, when performing exercises involving the knee, the HHA/PCA can hold the area below and above the knee joint during the activity. Patients should never be forced to do exercises that hurt. Joints should be moved slowly and gently during these exercises. Any pain should be reported to the supervisor. Remember, you must NOT perform these exercises unless you have been properly trained and directed to do so.
Range of Motion Movements:
- Abduction : moving a body part away from the midline of the body. For example, abducting the leg involves moving the entire leg away from the middle of the body.
- Adduction : moving a body part towards the midline of the body. For example, adducting a leg means the entire leg is moved towards the middle of the body.
- Flexion : bending a body part. For example, flexing a bicep involves bending it as if to make a muscle.
- Extension : straightening a body part. For example, extending a bicep involves straightening the arm.
- Pronation : turning downward. For example, the forearm and hand are turned so the palm of the hand faces downward.
- Supination : turning upward. For example, the forearm and hand are turned so the palm of the hand faces upward.
- Dorsiflexion : bending backward. For example, the toes are gently pushed towards the body to stretch the foot.
- Plantar flexion : pressing downward. For example, the toes are gently pressed down toward the sole of the foot.
- Opposition : touching the thumb to each finger. In opposition, each finger of the hand is gently moved toward the thumb to provide a gentle stretch of the hand and finger joints.
- Circumduction : making a circle with the joint. For example, circumduction of the shoulder involves the entire arm and shoulder moving in a large circle to gently exercise the joint and improve a person’s ability to move their arm and shoulder.
Many patients may be on supplements such as calcium and vitamin D, which help to support healthy muscles and bones. Be aware of fall risks by keeping items out of the patient’s path of walking, using assistive devices such as canes and walkers correctly, ensuring the patient has on non-skid shoes, and is wearing glasses and hearing aids so the person can see and hear what is going on around them.
True or False?
1. The risk for osteoporosis can be decreased by exercise such as walking.True or False. ______
2. Removing fall risks and teaching patients to use assistive devices correctly are the best ways to prevent a fall from happening.True or False. ______
- Answer
-
1. True
2. True
Feedback :
1. Walking and light exercises help to strengthen muscles, joints, and bones. This can help decrease the risk for osteoporosis.
2. Fall prevention is the best treatment for falls. HHA/PCAs should always be alert to fall risks and take measures to ensure their patient safety.
Sensory System
The sensory system consists of our sense of vision (eyes), hearing (ears), smelling (nose), taste (tongue), and touch . Changes in vision can result in an increased risk of falls. Home Health Aides/Personal Care Aides must be aware of fall hazards. They should ensure their patient wears eyeglasses and keep rooms well lit. This will also help their patient to enjoy activities in which vision is important, such as reading. There are visual aids available that can enhance a patient’s reading experience such as books on tape, reading materials with large print, and magnifying glasses. They can also read to their patient if they would like.
For patients who have trouble hearing, they should speak in a low pitched voice without shouting, and ensure that they are directly in front of them when speaking. If they wear hearing aids, ensure they are in good working order with working batteries and that the patient uses them correctly. Remember, not every older patient will have vision or hearing problems.
Our sense of smell also diminishes as we age. This puts elderly people at a risk for not smelling fumes such as gas or in the case of fire, smoke. Home Health Aides/Personal Care Aides should ensure smoke detectors and carbon monoxide detectors are in good working order. As we age, we also lose taste buds. Combined with a decreased sense of smell, this can result in a poor appetite and weight loss. Provide food choices that are appealing to the patient and find out what their preferences are about favorite foods.
The sense of touch also diminishes as we age. It is important to be cautious about extreme temperatures as an elderly patient may not be able to tell if something is too hot or too cold. Home Health Aides/Personal Care Aides should always use ice packs and heating pads as directed by the Care Plan. Never leave them on for long periods of time as it could result in frostbite or burns. They must watch the temperature of foods and drinks they serve their patient and ensure they are not too hot which could result in burns and scalds. Some older people and those with special conditions such as diabetes may also have poor circulation. This can result in lack of feeling in their feet. Inspect the patient’s feet on a regular basis and ensure they wear proper footwear to protect them from injury.
True or False?
1. Heating pads and ice packs can be left on for long periods of time because they will help decrease pain.True or False. _______
2. All elderly people have vision and hearing problems.True or False. _______
3. Smoke detectors should be checked on a regular basis.True or False. _______
- Answer
-
1. False
2. False
3. True
Feedback :
1. The health care worker should take caution to only leave heating pads and ice packs on for the prescribed length of time as older adults have a diminished sense of touch and may not be aware that their skin is burning or freezing.
2. Not all elderly people have vision or hearing problems.
3. Smoke detectors should be checked on a regular basis as they can help alert a patient to the presence of fire, even if they do not see, hear, or smell it.
Digestive System
The digestive system starts with the mouth where we take in food and begin the process of digestion by chewing. Food moves down the esophagus into the stomach , then into the small intestine , then into the large intestine , and finally, it is eliminated through the anus through peristalsis .
Some elderly people may have a problem with chewing or swallowing food. This could result in a safety risk if the patient chokes. If Home Health Aides/Personal Care Aides notice their patient has any difficulties with chewing or swallowing, they should report these to their supervisor. Some patients may need to be on soft or pureed diets. If a patient wears dentures, ensure they are in place prior to meals. This will help them with chewing and properly digesting their food.
The movement of food through the digestive tract may also be slowed in some older adults. This could result in constipation.
1. True
2. True
Feedback :
1. People with diabetes have high glucose levels and may not produce enough insulin to allow the body to effectively use it for energy. They often have to monitor their blood glucose levels and sugar intake.
2. Due to aldosterone release decreasing, older adults may have a drop in blood pressure when getting up from a lying or sitting position. To provide for safety, patients should be allowed to dangle their legs at the edge of the bed before standing up.
means a lack of bowel movements, or a decrease in the number of bowel movements that are normal for that particular person. It may not be uncommon for some elderly people to only have a bowel movement every couple of days.
Home Health Aides/Personal Care Aides should report the frequency of bowel movements to their supervisor. Some older people may need to be on a bowel regimen to help them have regular bowel movements. This may mean they need increased fiber, which is found in foods such as fruits, vegetables and whole grains, or even medications such as stool softeners. Fluid intake and exercise are also important to maintain good bowel health.
True or False?
1. Dentures help people to chew their food which makes digestion easier.True or False. ________
2. If a patient has trouble swallowing, you don’t need to tell anyone. Just cut their food smaller. True or False. ________
3. Taking in more fruits, vegetables, and water can help prevent constipation.True or False. ________
- Answer
-
1. True
2. False
3. True
Feedback :
1. Dentures are prosthetic teeth that aid in chewing and digestion of food. HHA/PCAs should ensure patients who wear dentures have them placed prior to eating.
2. Difficulty swallowing can result in a choking risk. Always document any chewing or swallowing difficulties and inform your supervisor.
3. Increasing fluid intake, exercise, and eating foods high in fiber can help prevent constipation.
Urinary System
The urinary system consists of the kidneys (which make urine by filtering blood), ureters (which are tubes that carry urine from the kidneys to the bladder), the bladder (which stores urine), and the urethra (where urine passes through to the outside of the body). As we age, our kidney’s ability to filter blood decreases. Nephrons are the filtering units of the kidney. They filter waste material and make urine. The number of nephrons decreases with age. This means the ability to filter waste products decreases. Some older people may have problems with their kidneys and have to have their kidney function monitored.
The muscle tone of the bladder becomes weaker and some elderly people may have difficulty holding the same amount of urine as they did when they were younger. They may need to urinate more frequently and wake during the night to do so (Leahy, Fuzy & Grafe, 2013). Since the bladder is weaker, it may also not empty completely. This leads to urine remaining stagnant in the bladder, which makes the person more at risk for a urinary tract infection. Home Health Aides/Personal Care Aides should report any changes in urination, such as in frequency, incontinence, inability to start the flow of urine, and reports of pain or burning while urinating to their supervisor.
Encourage patients to drink plenty of fluids. Some elderly people hesitate to drink enough water because they fear they will have “an accident” or become incontinent. Home Health Aides/Personal Care Aides should encourage them to not do this as it will only lead to dehydration and a higher chance of getting a urinary tract infection. Remember, incontinence is not a normal part of aging. They should report incidences of incontinence to their supervisor.
True or False?
1. Incontinence is a normal part of the aging process. True or False. _______
2. As we age our kidneys are not able to filter blood and get rid of waste as well.True or False. _______
3. A weak bladder and not drinking enough fluid can result in a urinary tract infection. True or False. _______
- Answer
-
1. False
2. True
3. True
Feedback :
1. Incontinence is not a normal part of the aging process. It can indicate an illness, infection, or problem with medication. Incontinence should be documented and reported to a supervisor.
2. The kidneys lose nephrons, which are the functional unit of the kidney, as we age. This means we are less able to filter blood and remove wastes from the body.
3. If the bladder is weak and unable to empty well, it will cause urine to remain in the bladder stagnant. Not drinking enough fluids will result in wastes not being efficiently removed from the body. This will increase the risk of urinary tract infections.
Endocrine System
The endocrine system consists of hormones and organs such as the thyroid, parathyroid glands pancreas, and reproductive organs (Aging changes in hormone production, 2012). The thyroid is important for metabolism. Metabolism begins to slow as we age, beginning around the age of 20 (Aging changes in hormone production, 2012). Some older people may develop nodules on their thyroid gland and have to take medications for a thyroid gland that is overactive or underactive. The parathyroid glands , which are located near the thyroid are important to help with calcium balance. As people age, parathyroid hormone release increases (Aging changes in hormone production, 2012). This results in too much calcium in the bloodstream and not enough calcium in the bones. This can result in weaker and more brittle bones such as that found in osteoporosis.
Insulin , which is produced by the pancreas, and important for glucose (sugar) metabolism also decreases. Older patients may need to watch their sugar intake. Some elderly patients may develop diabetes . This means that the body is not producing enough insulin to allow the glucose (sugar) which we get from the food we eat to be used correctly. Some symptoms of diabetes include: excessive thirst, hunger, frequent urination, weight gain, and elevated blood glucose levels. A supervisor and the Care Plan will direct Home Health Aides/Personal Care Aides as to whether their patient should be on a low sugar diet and if they need to monitor their blood glucose prior to meals.
The adrenal glands are located one on top of each kidney. The adrenal glands produce cortisol , which is the stress response hormone, and aldosterone , which is the hormone that regulates our fluid balance in the body. While cortisol level release decreases as we age, the amount of the hormone stays the same in the bloodstream (Aging changes in hormone production, 2012). Elderly people are just as susceptible to stresses as any other person. High levels of stress can result in a weakened immune system and cause other physical problems, such as high blood pressure. Home Health Aides/Personal Care Aides should help their patient to eliminate stresses from their life and provide them with time to talk about what is bothering them.
As we age, aldosterone release decreases. This can result in an elderly patient having a drop in blood pressure and feeling light-headed since the body is not able to regulate its blood pressure as well (Aging changes in hormone production, 2012). Watch for signs of light headedness anytime a patient moves from a lying down to a sitting and then standing position. Allow them a few minutes to sit and dangle their legs before they stand. This will allow their body to adjust to the changes in blood pressure.
True or False?
1. People who have diabetes have to monitor their blood glucose levels and watch their sugar intake.True or False. ________
2. Before getting an older person out of bed, you should let them dangle their feet at the edge of the bed to allow their body to adjust to changes in blood pressure.True or False. ________
- Answer
-
1. True
2. True
Feedback :
1. People with diabetes have high glucose levels and may not produce enough insulin to allow the body to effectively use it for energy. They often have to monitor their blood glucose levels and sugar intake.
2. Due to aldosterone release decreasing, older adults may have a drop in blood pressure when getting up from a lying or sitting position. To provide for safety, patients should be allowed to dangle their legs at the edge of the bed before standing up.
Neurological System
The neurological system or nervous system consists of the brain and spinal cord. Aging can result in memory loss and concentration difficulties. There is generally a slowing of nerve firing, which results in a slowing of processing information or performing tasks. Elderly people may not be able to think or perform tasks as quickly as they could before. Remember, this is not necessarily a part of aging that occurs for everyone, and it varies from person to person. Home Health Aides/Personal Care Aides should encourage their patient to make decisions and choices and to be as independent as possible. Encourage a patient to make lists to help them remember tasks. Home Health Aides/Personal Care Aides should provide plenty of time for their patient to process information and to complete tasks.
While the brain loses some nerve cells, brain connections do continue to develop. Encourage patients to think about good times by asking them about their life stories and to show photographs. Encourage and assist with activities to keep their minds active such as jigsaw puzzles, reading, crosswords, and other activities to stimulate their mental processes.
Some patients who have short–term memory loss or loss of memory about recent events can become agitated and anxious about this. Home Health Aides/Personal Care Aides should provide reassurance to them and report any changes to their supervisor so that the healthcare team is aware. If their patient shows signs of forgetfulness or confusion, they should report these to their supervisor immediately.
True or False?
1. All elderly people become forgetful and have short-term memory loss.True or False. ______
2. Activities such as jigsaw puzzles, crosswords, and reading can help keep the mind active.True or False. ______
- Answer
-
1. False
2. True
Feedback :
1. Forgetfulness and short-term memory loss is not a normal part of aging and not all older adults will exhibit these symptoms.
2. Engaging older adults in stimulating activities can help keep their mind active.
Reproductive System
Changes occur in the reproductive system as people age. Changes occur in both the female and male reproductive systems.
Females
In females, a process called menopause occurs. During this time, hormone levels change as ovaries stop making estrogen and progesterone and stop releasing ova (eggs) (Aging changes in the female reproductive system, 2012). Menstruation (otherwise known as a monthly “period”) stops during this time. This typically occurs between the ages of 45-55 (Aging changes in the female reproductive system, 2012). Women can no longer become pregnant. As the hormone levels decrease, the vagina becomes thinner, drier, and less elastic. The labia (the external genital tissue) also becomes thinner, drier, and less elastic (Aging changes in the female reproductive system, 2012). These changes may be painful for some women. If a patient complains of pain in the vaginal area, Home Health Aides/Personal Care Aides should inform their supervisor.
A loss of estrogen also leads to an increased risk of osteoporosis (Aging changes in the female reproductive system, 2012), which is a condition in which bones become more brittle and are more at risk for fractures or breaks. There may also be an increased risk for urinary tract infections due to loss of bladder muscle tone. Loss of muscle tone in the pubic area could potentially lead to prolapsed bladder, vagina, or anus (Aging changes in the female reproductive system, 2012), which is a condition in which these organs drop from their original position to the outside of the body. If Home Health Aides/Personal Care Aides notice this condition, they should inform their supervisor. She will direct them about how best to care for this particular patient.
There may be a diminished sexual drive due to changes in hormones and physical changes within the vagina, but this is not necessarily the case. Many elderly women continue to have sexual desires and engage in sexual activity.
True or False?
1. After menopause, women are at a greater risk for osteoporosis due to a decrease in the hormone estrogen.True or False. _______
2. Menopause is the time when menstruation stops and women can no longer become pregnant.True or False. _______
- Answer
-
1. True
2. True
Feedback :
1. As estrogen decreases, the risk for osteoporosis increases. Estrogen decreases after menopause.
2. Menopause is the cessation of menses (a woman’s period). She is unable to become pregnant after this period as ova (eggs) are no longer released.
Males
In males, testicular tissue decreases with age and there may be a decrease in testosterone , which is the male sex hormone (Aging changes in the male reproductive system, 2012). Testes do continue to produce sperm, but at a slower rate than before. Some men may experience erectile dysfunction, which is an inability for the penis to obtain or maintain an erection (Aging changes in the male reproductive system, 2012).
The prostate gland becomes enlarged. The prostate gland is at the base of the bladder and around the urethra, which carries urine to the outside of the body. As it enlarges, it presses on the urethra. This can result in difficulty during urination. Men may experience dribbling, only urinating small amounts at a time, or difficulty starting or stopping the flow of urine. This is called Benign Prostatic Hypertrophy (BPH), which occurs in about 50% of men (Aging changes in the male reproductive system, 2012). The risk for prostate cancer increases as men age (Aging changes in the male reproductive system, 2012). In some instances, an enlarged prostate may indicate prostate cancer.
It is a good idea for men to be screened for prostate cancer yearly by their health care professional.This is done by what is called a DRE or Digital Rectal Exam , where the physician feels the prostate for bumps with a finger entered into the anus. Men are also screened for prostate cancer by having blood work drawn to measure levels of PSA or prostate specific antigen . Higher levels could indicate that a man has BPH or possibly prostate cancer. Decreases in sex drive may occur in some men, but this is not a definitive part of aging (Aging changes in the male reproductive system, 2012).
True or False?
1. Benign Prostatic Hypertrophy (BPH) is a very common disorder occurring in older men.True or False. ________
2. Males should have their prostate gland checked yearly.True or False. ________
- Answer
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1. True
2. True
Feedback :
1. About 50% of older men have BPH.
2. To detect the risk for prostate cancer, which increases with age, men should have their prostate gland checked by their physician yearly.