Professional Documents
Culture Documents
Learning Guide - 10
65-74 years
75-84 years
85-100 years
>100 years
Text Book
Kozier & Erbs Fundamentals of Nursing
concepts, process and practice. 8 th
edition.
Chapter 23
Pages: 406 425.
Frail elderly
An individual who has significant
physiological and functional impairment,
whatever the age.
Sensation
Changes in sensory nerve endings
Decreased sense of touch, temperature
and pain.
High risk for burns and injuries.
Skin
Loss of adipose tissue
Hollow or gaunt appearance of face and
hands,
Decreased tolerance to cold.
Muscle atrophy
Double chin, Sagging eye lids, Sagging ear
lobes,
Wrinkling, Sagging breast
Dryness
Itching
Decreased blood flow
Loss of elasticity, Pale appearance.
Hair
Decreased blood flow
Hair loss
Baldness
Decrease in number of pigment
producing cells
Graying (loss of hair color)
Temperature
Decrease in metabolic rate
Body temperature decreases. 35 0C (950F)
is considered as normal body
temperature for the aged clients.
Slow sweating and circulatory mechanisms
Poor heat tolerance.
Ears
Changes in nerve tissue
thickening eardrum
Presbycusis
Chest
Musculo-skeletal changes in chest wall
Reduced chest size
Decreased lung volumes and
capacities
Poor coughing
Reduced ciliary activity
High risk for respiratory infections.
Cardio-vascular
Decreased heart size, cardiac output and
working capacity of heart
Heart rate is slow to respond to stress and
slow to return to normal
Shortness of breath on exertion
Pooling of blood in the systemic veins
Increased arteriosclerosis
Decreased of heart muscle and blood vessels
elasticity
Increased systolic BP and diastolic BP.
Orthostatic hypotension
Urinary
Enlarged prostate gland
Urinary urgency and frequency in men
Weaker muscles supporting bladder and
weak urethral sphincter in females
Urinary urgency and frequency in women
Bladder capacity reduced
Reduced ability to empty
Nocturnal frequency
Retention of residual urine leading to cystitis
Digestion
Decrease in digestive enzymes
Decreased number of absorbing villi in the
intestinal tract
Increase in gastric pH
Low absorption rate
Slow absorption of nutrients and medicines
Indigestion
Loss of muscle tone of intestines
Decreased peristalsis
Indigestion
Constipation.
Extremities
Osteoporosis
Pathologic fractures
Degenerative joint changes
Stiff and restricted movements
Decrease in muscle fibers
Lack of strength
Easy fatigue
Slow pace
Wasted appearance
Sexuality
Male
Decreased testosterone levels
Decreased rate and force of ejaculation
Decreased speed gaining erection
Female
Decreased secretion of ovarian hormones
Shrinking of uterus and ovaries
Atrophy of breasts
Decreased vaginal lubrication
Painful sexual intercourse.
Cognitive changes
Decreased perception. ie. Decreased ability
to interpret the environment. Decreased
intellectual capacity and cognitive ability.
Memory impairment. Difficulty in learning
new facts or skills.
Dementia: A permanent and progressive
organic mental disorder that is
characterized by personality changes,
confusion, disorientation, deterioration of
intellectual functioning, impaired memory,
judgment and impulses. One type of
dementia is alzheimers disease.
Developmental stressors
Memory impairment
Primary memory (short-term memory/working
memory): Not affected much.
Secondary (recent memory): Much affected.
Tertiary memory (long-term memory):
Memories of childhood. Not affected. Elderly
people are much interested in talking about
their past. This is called reminiscing.
To promote the memory of the elderly person
nurses can encourage their clients to write
lists, use diary or calendar.
Encourage use of remainders and alarms.
Spiritual development
(Murray and Zenter, 1993)
Elderly people contemplate new religious
and philosophical views and tries to
understand ideas missed previously or
interpreted differently. They develop a sense
of worth by sharing experiences or views.
In contrast , the elderly person who has not
matured spiritually may feel impoverishment
or despair as the drive for economic and
professional success wanes.
Developmental stressors
Health Promotion
1 Regular health check-up (yearly).
2 Protect from hypothermia
Health Promotion
3
Nutrition
1200 cal/day
8 glasses of water a day
Balanced diet with vit. A, B, C, D and
Calcium and Iron.
Soft cooked, easily chewable food.
Use properly fitting dentures and enhance
oral hygiene.
Health Promotion
4
Elimination
To avoid constipation
Adequate roughage in the diet
Regular exercise
8 glasses of water a day
Nocturnal frequency
Limit fluid intake at night
Avoid natural diuretics-coffee and alcohol
Treat urinary tract infections
Correction of cystocele, rectocele or uterine
prolapse.
Health Promotion
5
Health Promotion
7 Rest and sleep
Requires 6 hours of sleep at night
Limit day time naps
Increase day time activities
8 Independence and self esteem
Encourage activities as much as possible
Health Promotion
9 Prevent elder abuse
Types of abuse
Psychological threatening
Sexual abuse
Nurses when come across with such abuse
situations must report it.