[GERON] Common Aging Changes

Reduction in intracellular fluid

Prevent dehydration by ensuring fluid intake of at least 1,500 mL daily

Decrease in subcutaneous fat content, decline in natural insulation

Ensure adequate clothing is worn to maintain body warmth; maintain room temperatures between 70"F (21"C) and 75"F (24"C)

Lower oral temperatures

Use thermometers that register low temperatures; assess baseline norm for body temperature when patient is well to be able to identify unique manifestations of fever

Decreased cardiac output and stroke volume; increased peripheral resistance

Allow rest between activities, and procedures; recognize the longer time period required for heart rate to return to normal following a stress on the heart, and evaluate presence of tachycardia accordingly; ensure blood the pressure level is adequate to meet circulatory demands by assessing physical and mental function at various blood-pressure levels

Decreased lung expansion, activity, and recoil; lack of basilar inflation; increased rigidity of lungs and thoracic cage; less effective gas exchange and cough response

Encourage respiratory activity; recognize that atypical symptoms and signs can accompany respiratory infection; monitor oxygen administration closely, keep oxygen infusion rate under 4 mL, unless otherwise prescribed

Brittleness of teeth; retraction of gingiva

Encourage daily flossing and brushing; ensure patient visits dentist annually; inspect oral cavity for periodontal disease, jagged-edged teeth, other pathologies

Reduced acuity of taste sensations

Observe for overconsumption of sweets and salt; be sure foods are served attractively; season food healthfully

Drier oral cavity

Offer fluids during meals; have patient drink before swallowing tablets and capsules, and examine oral cavity after administration to ensure drugs have been swallowed

Decreased esophageal and gastric motility; decreased gastric acid

Assess for indigestion; encourage 5–6 small meals rather than 3 large ones; advise the patient not to lie down for at least 1 hour following meals

Decreased colonic peristalsis; duller neural impulses to lower bowel

Encourage toileting schedule to provide adequate time for bowel elimination; monitor frequency, consistency, and amount of bowel movements

Decreased size of renal mass, number of nephrons, renal blood flow, glomerular filtration rate, tubular function

Ensure age-adjusted drug dosages are prescribed; observe for adverse responses to drugs; recognize that urine testing for glucose can be unreliable, urinary creatinine excretion and creatinine clearance are decreased, and blood urea nitrogen level is higher

Decreased bladder capacity

Assist patient with need for frequent toileting; ensure safety for visits to bathroom during the night

Weaker bladder muscles

Observe for signs of urinary tract infection; assist patient to void in upright position

Enlargement of prostate gland

Ensure patient has prostate examined annually

Drier, more fragile vagina

Advise patient in safe use of lubricants for comfort during intercourse

Increased alkalinity of vaginal canal

Observe for signs of vaginitis

Atrophy of muscle; reduction in muscle strength and mass

Encourage regular exercise; advise patient to avoid straining or overusing muscles

Decreased bone mass and mineral content

Instruct patient in safety measures to prevent falls and fractures; encourage good calcium intake and exercise

Less prominent stages III and IV of sleep

Avoid interruptions at night; assess the quantity and quality of sleep

Decreased visual accommodation; reduced peripheral vision; less effective vision in dark and dimly lit areas

Ensure patient has ophthalmologic exam annually; use night lights; avoid drastic changes in level of lighting; ensure objects used by patient are within visual field

Yellowing of lens

Avoid using shades of greens, blues, and violets together

Decreased corneal sensitivity

Advise patient to protect eyes

Presbycusis

Ensure patient has audiometric exam if problem exists; speak to patient in loud, low-pitched voice

Reduced capacity to sense pain and pressure

Ensure patient changes positions before tissue reddens; inspect body for problems that patient may not sense; recognize unique responses to pain

Slower metabolic rate

Advise patient to avoid excess calorie consumption

Reduced immunity

Prevent persons who have infectious diseases from infection early; recommend pneumococcal, tetanus, and annual influenza vaccinations; promote good nutritional status to improve host defenses

Altered secretion of insulin and metabolism of glucose

Advise patient to avoid high carbohydrate intake; observe for unique manifestations of hyper- or hypoglycemia

Flattening of dermal–epidermal junction; reduced thickness and vascularity of dermis; degeneration of elastin fibers

Use principles of pressure ulcer prevention

Skin drier

Recognize need for less frequent bathing; avoid use of harsh soaps; use skin softeners

Slower response and reaction time

Allow adequate time for patient to respond, process information, perform tasks