Maggie Kuhn
American activist known for founding the Gray Panthers movement after her retirement. She dedicated her life to fighting for human rights, social and economic justice, and global peace.
The Gray Panthers
Advocacy group known for advocating nursing home reform and fighting ageism
“Sickness care”
What did Maggie Kuhn coin health care?
Aging
The process of change in properties of a material occurring over a period. Gradual deterioration of physiological function.
The older adult
There is more variability between individuals at what stage of life than any other?
An explanation of observations
What do theories offer?
To predict future events and situations
Theories serve to what?
A language and a framework by which we, as nurses, can understand situations and identify proper action
What do theories provide?
Theory
An explanation that makes sense of a phenomenon. A supposition, or a system of ideas intended to explain something
Error theories
Predetermined/programmed aging theories
Two main groups of biological aging theories. Both agree that at the end the cells in the body become disorganized, are unable to replicate and cell death occurs.
Change due to genetic/environmental factors (sun, pollution, cigarette smoking)
Thinning of the epidermis
Lightening of the skin= decreased UV filtration
Longer wound healing
Dermis thins
Collagen decreases
Hypodermis atrophy
Decreased sebum secretion
Physical changes of the skin with age: [8]
Blood vessels and bruises are much more visible.
Results of thinned epidermis in older adults
Dermal blood vessels are reduced resulting in skin pallor and cooler temperature
Results of thin dermis
Skin tears more easily (problematic when accompanied by slow wound healing)
Results of decreased collagen
Older person may be more sensitive to cold. Increased chance of hyperthermia because of inability to produce sweat.
Results of atrophied hypodermis
Sebum contains precursor of vitamin D and when skin is exposed to sunlight vitamin D is produced. Lack of vitamin D effects calcium absorbtion and effects prevention of osteoporosis.
Results of sebum secretion decrease
Avoid excessive exposure to UV light
Apply moisterizer after bathing
Use sunscreens, paying attention to face, ears, neck, and hands
Wear a hat in sunshine
Keep well hydrated
Use humidifier in winter to prevent dry skin
How, as a nurse, can we promote/encourage healthy skin in adults? [6]
Muscolo-skeletal system
system important for movement and posture. Consists of bones, joints, tendons, ligaments, and muscles
they ecome dry, hardened, rigid, and less flexible
Effect of aging on ligaments, tendons, and joints
Arthritis
A condition when joint space is reduced
Bone mass decreases with age, becoming increasingly brittle.
Effect of aging on bones
Genetics
Decreased hormone levels
decreased bone formation
vit d-magnesium-calcium deficiencies
smoking
alcohol use
physical inactivity
Age-related bone loss is related to what factors? [7]
Sarcopenia
Age related changes to muscles
30-40%
How much of muscle mass of a thirty year old is lost by the time they reach their 90s?
Vertebral disks become thin
What causes shortening of the trunk in older adults?
Kyphosis
Stooped appearance because of curvature of the cervical vertebrae that results from reduced bone mineral density (BMD)
Osteoporosis
What is diagnosed when bone mineral density (BMD) is too low?
They increase the risk for dehydration in older adults
Why can changes in water distribution have significant implications?
Heart muscles and blood vessels stiffen, and these changes are progressive
What happens to heart muscles and blood vessels with age?
These changes only become significant when there are environmental, physical, or psychological stresses. A sudden increase in oxygen demands may mean that the heart ma not respond adequately. There is a delay in increase in heart rate, may also not respond adequately to infection, anemia, pneumonia, surgery, low blood sugar, dehydration, etc.
When does ventricle wall stiffening become significant?
Cardiac output and blood flow are decreased.
What happens when left ventricle wall thickens and left atrium increases in size?
Heart disease
What is the number one cause of non-accidental death?
Don’t smoke
Keep cholesterol, BP, BS levels normal
Daily exercise/physical activity
Healthy weight
eat more vegetables and fruits, less fat and red meat
Cope with stress in a healthy way
Avoid trans fats and saturated fats
limit sodium intake
What are some heart-healthy aging lifestyle choices that nurses can promote? [8]
Processed, fast food
In what foods are saturated and trans fats found?
Milk, butter, etc. as long as it isn’t processed
In what foods are healthy (in moderation) trans fats found?
Loss of elastic recoil
stiffening of the chest wall
insufficient gas exchange
Age-related changes in lungs/respiratory system [3]
Environmental toxins: pollution, cigarette smoking, etc.
What is often the cause of respiratory problem (not the aging process?)
These increase the risk for aspiration, and lung infections become a problem
Why is a decreased ability to cough and and less effective respiratory cilia dangerous for the older adults?
Obtain pneumonia immunization
Obtain annual influenza immuniztion
Obtain COVID vaccinations
Avoid exposure to pollutants indoor spaces (control dust, clean and maintain appliances and surfaces, ventilate)
Avoid smoking and secondhand smoke
Avoid persons with respiratory illnesses
Seek prompt treatment of respiratory infections and problems
wash hands freqently
regular oral hygiene
How can nurses promote healthy aging of the lungs?
Bacteria can accumulate in the mouth. That can easily go through the trachea and into the lungs. Potential pneumonia
Why is it important to maintain good oral hygiene with the older adult, in regards to the respiratory system?
Risk to fluid and electrolyte imbalance
Why are age related changes in the kidneys significant?
Disease, surgery or fever
What are some reasons kidney function may deteriorate?
Glands atrophy and decrease their rate of secretion
How do endocrine glands change with age?
Decrease in estrogen
What causes menopause?
Decrease in insulin and glucagon sensitivity in older persons, combined with obesity, can cause type II diabetes
How can the older adult develop type II diabetes?
Monitoring of thyroxine levels
Regular blood test that tests for hypothyroidism (what is monitored?)
Slowed basal metabolic rate
thinning hair
dry skin
What are some characteristics of hypothyroidism that are also normal parts of aging? (hypothyroidism can be harder to diagnose) [3]
Menopause (end of reproductive phase)
Vaginal epithelium changes
pH rises significantly (painful intercourse and higher susceptibility to infection)
Age-related changes to female reproductive system: [3]
Fertility decreases due to sperm motility and structural abnormalities
erectile changes
Prostatic hypertrophy
Age-related changes to male reproductive system: [2]
When enlargement causes compression to the urethra, that can cause retention, urinary tract infections and incontinence
When is prostatic hypertrophy considered problematic?
Teeth eventually become more vulnerable to decay
roots may break more easily
gums more susceptible to disease
Age-related teeth changes: [3]
Taste buds decline in number, reducing sense of taste
Age-related changes to taste buds
Reduced sense of taste can lead to decreased appetite, malnutrition, and weight loss. This is why old people like sweets (because they can taste it better), but it is counterproductive to eat unhealthy foods
Risk of low taste buds in older adults:
Xerostomia
Condition in which decreased salivary secretion causes very dry mouth
GERD (Gastroesophageal reflex disease)
Sluggish emptying of the esophagus creates stress and digestive discomfort
More susceptible to peptic ulcers because the protective alkaline viscous mucus is lose because of an increase in stomach pH. Exacerbates when NSAIDS are taken.
Age-related changesto the stomach:
Aspirin, ibuprofen
Common examples of NSAIDS [2]
nutrition absorption is affected
Peristalsis is slowed
Age-related intestine changes [2]
Side effect of medications
habits
immobility
inadequate fluid intake
Constipation is NOT a normal part of aging, and is problematic
Constipation in the older adult is usually a sign of what? (and NOT a sign of what?) [4]
Liver function slows and medication doses must be adjusted accordingly
Age-related liver changes
Gallbladder changes might occur, may result in increases in serum cholesterol levels
Older adults have a high incidence of gallbladder stones
Age-related gallbladder changes [2]
Practice good oral hygiene
wear properly fitting dentures
seek treatment of dental caries and gum disease
eat meals in a relaxed atmosphere
maintain adequate intake of fluids
eat a balanced diet
Avoid prolonged immobility
avoid tobacco products
How can patient promote healthy digestion? [8]
The brain is very resilient to aging, and changes in cognitive function are NOT a normal part of aging
Are cognitive changes a normal part of aging?
Less deep sleep
More time spent in light sleep (stages 1 and 2)
Reason why older people tend to spend more time in bed
Describe changes in the sleep pattern of the older adult:
pressure injuries
skin breakdown
Can be prevented by using a soft or gel mattress, and continually assessing the integrity of the skin
Risks of increased time in bed, and how they can be prevented [2]
Subtle changes in thinking and movement\
Mild memory impairments
difficulty with balance
performance of tasks takes longer (same intellectual ability)
sensitivity to touch and vibration decreases
proprioception is altered
Sensory changes (vision, ocular)
What are some normal neurological age-related changes? [7]
Delayed reactions to hot surfaces, increases risk for burns
What is the risk of lowered sensitivity to touch?
Presbyopia
Age-related decrease in vision. Includes glaucoma, cataracts, and macular degeneration
Ptosis
Age-related extraocular change, eyelids lose elasticity resulting in drooping
Have eyes examined regularly
Use bright lighting
see professional for vision changes
don’t smoke
reduce glare
Wear sunglasses (UV protection)
Protect eyes from accidents and injury (safety glasses
How to promote healthy eyes: [7]
Reduced immunity at the cellular level (increased risk for infection)
Experience of infections in the absence of characteristic symptoms (such as fever)
Age-related changes to immunity