Some physiological changes include: Perfusion (cardiac output is decreased by 40%, vessel elasticity, periheral vascular resistance, elevated BP...)  Oxygenation (lungs larger more ridgid) Nutrition (peristalsis, gag reflex digestive enzymes...) Elimination (nephrons lost, renal flow, filtration rate, urge/sphincter control) Mobility (loss of height, joint changes, cartilage degerneration, loss of muscle mass)  Neural regulation (slowing of thinking, reacting, slower relfexes, slow response to heat and cold)  Sensory perception (sight, tear production, focusing, adjustment to light and dark, hearing, touch, taste, smell) Skin Changes (mositure loss, thinning of epithelial and subcut fat layers, hair changes) Congnition ( memory slowing, reduced attention span) Psychosocial Integrity (personality not really changed, basic intelligence maintained) lecture power points

Systems which are affected by normal aging include: Integumentary, Respiratory, Cardiovascular, Gastrointestinal, Musculoskeletal, Neurological, Sensory: (eyes, ears, taste, smell, touch, proprioception) Genitourinary, Repreoductive, Endocrine (General, thyroid, thymus, cortisol, glucocorticoids, pancreas)  Potter Perry pg. 198

 #8  What are physiological and psychological changes associated with normal aging?

Some psychological changes associated with normal aging are:slower thinking, slower reactinon time, memory slows and attention span decreases.

delirium, demential and depression are considered common, but they're not necissarily normal parts of aging.

When doing an assessment, nursing assessments take into account 5 key points to ensure age specific approach: 1) interrelation between physical and psychological aspects of aging, 2) effects of disease and disability on functional status, 3) decreased efficiency of homeostatic mechanisms, 5) altered presentation and response to different disease. (pg 196 Potter & Perry)

Know what is a normal finding for the older adult vs. the younger adult.

Nurses try to approach situations of elder abuse by not being judgemental and look at the situation as a two person problem. The abuser needs help and the abused need help.  Abuse can come in various forms: verbal, physical, psychological, material, financial and neglect. 

Sometime the caregiver is a family member and not trianed in care giving and has to deal with a great deal of responsibility and stress.  Sometimes the caregiver is an elderly senior who is simply doing the best he/she can with his/her own strngth and resources.

Often times the absued elder is dependent on caregiver/abuser.  If a nurse has even the slightest notion or suspicion that there may be some elder abuse and neglect, he/she MUST report it to the authorites (or supervior) immediately.  The nurse is ethically bound and duty bound to repot any incling of elder absue.  If you not sure or ask yourself "what if I'm worng?" then ask yourself "What if I'm right?"

Among older adults, complications form falls are the leading cause of death. The risk factors for falls are a combination of health related issues and environmental hazards.

Some safety considerations to prevent falls in the home

 which have to do with

1) Health Related Issues include: impaired vision conditions affecting mobility (arthritis, muscle weakness...)  Alterations in bladder function (frequency to incontinence) Cognitive impairment, Adverse medication reactions, Conditions affecting balance. 

2) Enviornmental hazzards include: Poor lighting, Slippery or wet floors, Stairs or sidewalks in ill repair, Shoes in poor repair with slippery soles, many stairs which must be navigated by unsteady elder, household items easy to trip over like throw rugs, stools, extension cords....