3.5: Aging and the Mind

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Erin O'Hara-Leslie, Amdra C. Wade, Kimberly B. McLain, SUNY Broome

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As we age 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. Older adults may show signs of forgetfulness, which can be normal. However, when there seem to be many memory problems and forgetfulness seems to increase, this may be a sign of a more significant problem.

There may be temporary changes in mental function that come about suddenly. Sudden changes in mental functioning and personality can be indicative of a disease process. Changes in mental function that may appear suddenly and which may be temporary can be the result of dehydration, a urinary tract infection, fever, brain infection such as meningitis, a head injury, stroke, low blood sugar levels, alcohol or substance use, and interactions or side effects from medications. If their patient has any sudden changes in their mental function, mood, or behavior, Home Health Aides/Personal Care Aides should immediately report these to their supervisor.

Working with Patients who have Suffered from a Stroke

Other mental function changes that are more permanent may occur in some elderly people. A stroke, or a cerebrovascular accident can occur when there is a blockage in a cerebral artery in the brain, or if a blood vessel in the brain ruptures. Signs and symptoms of a stroke include numbness or weakness in the face or in the arms or legs, especially on one side of the body, difficulty speaking, using inappropriate words such as the wrong words for objects, and blurred vision. It may be helpful to remember the acronym FAST (Facial drooping, Arm weakness, Speech difficulties, and Time). If Home Health Aides/Personal Care Aides notice any of these signs, they should call for emergency help and inform their supervisor immediately. Time is of the essence. Their patient may need to receive immediate medical attention.

Sometimes, the effects of a stroke are temporary and the person may regain normal functioning. In other cases, there may be permanent changes within the brain and body. Careful attention must be paid while caring for a patient after a stroke. If their patient has lost the ability to use one side of the body, they should encourage use of the stronger side by placing eating and writing utensils on the strongest side. If their patient has developed speech or swallowing problems, a Speech Therapist may become involved in the patient’s care. They will evaluate the patient’s ability to speak and to swallow. Home Health Aides/Personal Care Aides should be patient while communicating. If their patient has swallowing problems, a special diet will need to be followed and liquids may need to be thickened to prevent choking. A patient who has suffered a stroke may also have vision problems. They may only be able to see half of what is in their field of vision. Approach the patient from their stronger side, place items they need on the side they can see from, and ensure they always know what is in front of them, especially when walking.

Working with Patients with Alzheimer’s Disease

Alzheimer‘s disease is a disease affecting the brain which causes permanent and progressive (continuing to get worse) changes in the brain. It is the most common cause of dementia (the loss of the ability to think, remember, reason, and plan tasks) in the elderly.

Symptoms of Alzheimer’s start out typically with memory loss. As it progresses, the person becomes very confused and may forget their family, who they are, and become unable to care for themselves. They may lose the ability to communicate and may have personality changes such as aggression and withdrawal. A person with Alzheimer’s needs special care.

It is important for Home Health Aides/Personal Care Aides to provide a safe environment. They may wander and end up in an unknown place with no memory of who they are, how they got to where they are, or how to go back home. It is also important to try to prevent things such as fires as a person with Alzheimer’s may begin to cook and forget they have food on the stove. Writing lists and labeling objects throughout the house may also be helpful to remind a patient with Alzheimer’s disease what the objects are. It may even be helpful to place a note on the mirror with the patient’s name or a label such as “Myself” if they are at the point where they no longer remember who they themselves are. Home Health Aides/Personal Care Aides should remember to be patient and encouraging, and find the things that seem to bring the most comfort and do these things with their patient. Many patients with Alzheimer’s enjoy music and Home Health Aides/Personal Care Aides can try playing some to help their patient relax and find enjoyment.

Working with Patients with Parkinson’s Disease

Parkinson‘s disease is also a progressive and incurable disease of the mind with permanent changes. People with Parkinson’s have difficulty initiating movement, such as walking and have tremors which make it difficult to perform daily tasks such as feeding and dressing themselves. Muscles will become stiff and the person may have a shuffling gait or eventually not be able to walk at all. Dementia may occur with Parkinson’s as it progresses. When caring for a patient with Parkinson’s, Home Health Aides/Personal Care Aides should remember to be patient and encouraging. It is frustrating for them to be unable to care for themselves. Encourage them to do as much as possible, and assist them with ADL’s as needed. When preparing food, keep in mind to prepare food that is easier for the patient to handle. Using adaptive eating utensils, plates, and cups can help make the eating experience more pleasurable and successful for the patient.

Self Check Activity \(\PageIndex{1}\)

1. Which of the following are signs of a stroke?

a). Drooping on one side of the face

b). Trouble speaking

c). Numbness or inability to use a leg or arm

2. People who have Alzheimer’s Disease need to be carefully monitored for safety as they may forget tasks they are doing or wander.True or False. _______

Answer

1. ALL ARE CORRECT

2. True

Feedback:

1. Remember the acronym FAST to help quickly identify a stroke and obtain help for the patient. This includes: facial drooping, arm weakness, speech difficulties, and time.

2. Patients with Alzheimer’s have memory loss and may quickly forget where they are or what they are doing. It is important for the HHA/PCA to carefully monitor any patients with dementia.

Self-Check Activity M3-19

1. Which of the following are signs of a stroke?

a). Drooping on one side of the face

b). Trouble speaking

c). Numbness or inability to use a leg or arm

2. People who have Alzheimer’s Disease need to be carefully monitored for safety as they may forget tasks they are doing or wander.True or False. _______

Check your answers!