GERONTOLOGY & HOME NURSING

LESSON 3

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COMPILED BY ; COURSE TEAM
 CHANGES ASSOCIATED WITH
AGEING

INTRODUCTION
A lot of changes occur as one grows from infancy to old age.
The changes observed are classified into
Physical,
Emotional and
Social changes.
 Physical and Physiological Changes

 Changes in the skin/ Integumentary system:

Changes of the skin, hair and nails are common manifestation of ageing
process. Decrease elasticity and dryness are responsible for wrinkled
skin.
SKIN; The wrinkling of the epidermis makes the skin to be easily
injured and healing is reduced due to the decreased blood supply to the
dermis.
The toe and finger nails of the elderly become thick and split open easily.
Teaching proper nails care is important to avoid nail injury to the fingers
and toes
 Cont.
 Musculoskeletal System: The joint, muscles and bones begin to
change as they grow old. In the elderly, changed joints, diminished
bones and muscles increases which lead to incidents of shorten
structures, stooped posture and loss of muscle power, misshaping of
joints, pains, stiffness and limited mobility.
 Cont.
 Eye, Ear, Nose and Teeth ( EENT) : Visual accommodation is altered in
adult around the age of 30yrs and progress throughout all of old age. This
visual change is due to inability of the lens of the eye to adopt to near vision.
By the age 40yrs, most people need corrective lenses for near visions.
EYE ;The capillary sphincters caused the pupils size to decrease, hence need
bright light becomes necessary for reading. This decreased in sight expose the
aged to accidents when moving in less bright areas. The lacrimal glands of
older folks produce fewer tears, leading to dry corneas and irritating eyes due
to tears.
 Cont.
EAR ; As one grows old, the hearing mechanism and balance becomes
altered to be appreciated, the situation becomes worst when a pathological
state emerge.
 NOSE ;Similar changes occur to the nose to a level that anosmia, i.e. loss
of sense of smell may results. In the elderly, the throat develops increasing
level of hoariness and frequent clearing of the throat, may result in sore
throat leading to heart diseases.
TEETH; regular care of the teeth is very important. It falls off in old age
due to weak roots. They should avoid cracking of bones and other hard
foods that may cause gum bleeding.
 Cont.
Neurological Systems; Neurological changes in the elderly may be
due to physiological and psychological causes.
In the very aged people, there a decrease in size and weight of the
brain with some decrease in number of functioning neurons.
However, there is no evidence to support brain size with
neurological functioning.
 Cont.
 Endocrine System: Oestrogen and Testosterone is the hormone that
generally decrease with age. Growth hormones continue to be
secreted in the elderly. Some hormones continue to be secreted in the
elderly than the young ones.
Decrease of oestrogen causes a lot of physiological changes in females.
Change in the breast tissue results in less glandular tissues, reduced
elasticity and more connective tissue and fat.
 Cont.
 Urinary System: During the ageing process the urethra and the
bladder turns to loose muscle tone. The bladder may lose enough
muscle tone to result in complete emptying with the increasing the
risk of urine retention and cystitis.
The kidneys concentrate urine inadequately causing frequent
urination and nocturia, because of the relaxation of the pelvic
muscles. Multiparous elderly woman frequently experience urine
incontinence. Prostate hypertrophy in old men and decrease
capacity of bladder urinate more frequently. These conditions
mostly affect the lifestyle of the elderly.
 Cont.
 Gastrointestinal System: Even though the mortality rate due to GIT problems is low in
the aged, cases of indigestion, bulging diarrhoea, constipation, nausea, vomiting,
flatulent are worrying them. The bony structure of the mouth shrinks at this age, there is
also loss of teeth which are replaced by dentures. This may pose difficulty in chewing
food properly and nutritional food such as meat, fish, fruits and vegetable.
Decrease peristalsis of the GIT causes a feeling of fullness and this cause the individual
to inject less food. A light decrease in the amount of pancreatic enzymes in the aged
further diminishes the individual food digestion and adsorption of food nutrients.
Most elderly people have daily bowel movement despite reduced peristalsis muscular
movement. Characteristically, there is decreased dentin production, there is retraction of
gingivae, atrophy of taste bud, and stomach discomfort as food remains in the stomach
for longer time. Atherosclerosis occurs in the vessels especially in the arteries.
 Cont.
 Cardiovascular System: There is decrease of the elasticity of blood vessels.
The heart muscle, stroke volume and electrical activity of the heart is also
reduced. This leads to an increase in Blood Pressure.
There is also a decrease in oxygen carrying capacity of the blood cells and
maximum heart rate. The critical events are that;
 The production of growth factor gradually declines
 More ageing substances are produced
 Gross sizes and cells that have been destroyed are not replaced
 Cell malfunctions
 Harmful substances are gradually accumulated in the cells.
 Cont.
THE HEART: It turns to maintain its size in age and rarely becomes smaller in
individuals with some special illness. There is frequent reduction in the cardiac
muscle strength and output unless coronary arterial disease (CAD) occurs.
 Automatic and physiological changes that take place in the aged heart does not
allow it to function adequately because of the metabolic needs of the age body.
The heart and blood vessels becomes stiffer in the elderly. THUS the heart can
not speed up and pump blood in older adults compared to younger individuals.
The thickening of the valves especially the mitral valves and the aortic valves
makes it rigid and fibrosis. Therefore the stiffer arteries are less able to expand
when more blood is pumped through them. Blood pressure tend toincrease.
 Cont.
The effects of the above causes;
a). Weak contractions
b). Systolic pressure increases to compensate the non-elastic and
increase in peripheral resistance of blood vessels.
c). Cardiac reverse is reduced
d). Low capacity of cardiac activity
e). Vasomotor tone is decrease and vagus/vagal tone increase.
 Possible CVS Disease in elderly are;

 CCF-Congestive Cardiac Failure

 Pulmonary Heart Disease, e.g. pulmonary embolism
 Coronary heart diseases, e.g. Angina pectoris
 Myocardial infarction
 Hypertension
 Arrhythmias, e.g. tachycardia, premature contraction, block heart
 Bacterial endocarditis, acute and sub-acute
 Rheumatic heart disease
 Congenital heart diseases

 Cont.
 RESPIRATORY SYSTEM:
There is generally decreased reserve capacity of the respiratory system such
as:
 The decrease lungs elasticity and changes in the thoracic bone affects the
ventilation of the lungs. Unless illness occur, elderly people adopt to this
changes without difficulties.
Pneumonia and other respiratory illness increase in frequency in the elderly
due to inability of the lungs to handle proper ventilation. The reserve
capacity of the lungs is increased if the person continues to exercise
regularly.
 EMOTIONAL CHANGES IN THE ELDERLY

The elderly change emotionally by acting less emotional when

confronting issues of life whether negative or positive. They
approach issues with more of their thinking caps on than with
emotions.
This may be due to much experience they have gotten from life.
Scientist found that older adults have less connectivity between the
an area of the brain that generates emotions but stronger
connection to the frontal cortex, the higher thinking and reasoning
area of the brain.
SOCIAL CHANGES IN THE ELDERLY

The old folk changes to become more isolated and lonely in life.
They feel less useful in life and actively involved in the daily of life.
This makes them prone to depression and suicide.
THANK YOU