Geriatric Patient

Geriatric Patient

General Guidelines

■ Be mindful that the elderly may be hard of hearing, but never assume that being elderly automatically makes it hard to hear. ■ Approach and speak to elderly Pts as you would any other adult Pt. It is insulting to speak to the elderly like a child. Speaking slowly is sometimes necessary but does not indicate decreased intelligence. ■ Eye contact helps instill confidence and, in the presence of impaired hearing, will help the Pt to understand you better. ■ Be aware that decreased tactile sensation and ROM are both normal changes with aging. Care should be taken to avoid unnecessary discomfort or even injury during assessment. ■ Be aware of generational differences, especially gender differences (e.g., modesty for women, independence for men). ■ Assess for altered mental states. Use your ′′3-D vision.′′ ■ Dementia: Cognitive deficits. ■ Delirium: Confusion/excitement marked by disorientation to time and place, usually accompanied by delusions and/or hallucinations. ■ Depression: Diminished interest or pleasure in most or all activities.

Age-related Changes and Implications

Decreased Skin Thickness ■ Elderly Pts are more prone to skin breakdown and should be assessed more frequently for pressure ulcers. Decreased Skin Vascularity ■ Altered thermoregulation response can put elderly at risk for heat stroke. Loss of Subcutaneous Tissue ■ Decreased insulation can put elderly at risk for hypothermia. Decreased Aortic Elasticity ■ Increased diastolic blood pressure. Calcification of Thoracic Wall ■ Obscured heart and lung sounds and displacement of apical pulse. Loss of Nerve Fibers/Neurons ■ Allow for extra time to comprehend, to learn, and to perform certain tasks. Decreased Nerve Conduction ■ Response to pain is altered. Reduced Tactile Sensation ■ Puts Pt at risk for injury to self.