Developmental Changes in the Older Adult Slides PDF

Developmental Changes in the Older Adult Life Span vs. Life Expectancy Life Span Life Expectancy  Maximum number of  Number of years at birth years a member of a an average person is species can live expected to live  Un...

Developmental Changes in the Older Adult Life Span vs. Life Expectancy Life Span Life Expectancy  Maximum number of  Number of years at birth years a member of a an average person is species can live expected to live  Unchanged in the last  Increased in the last 2000 2000 years years  Humans = 110 – 125 years  Now = approximately 85 years 1. Theories on physical/biological aging 2. Common systemic changes 3. Changes in the brain 4. Sensory changes 5. Effects of physical changes Intrinsic aging Includes changes such as a decrease in lung capacity, hardening of the arteries and arthritis Extrinsic aging Includes the effects on the body of smoking, sunlight and noise Theories on Physical/Biological Aging… 1. Hayflick limit-the # of cell divisions a cell can undergo before the cell dies 2. Telomere shortening When cells divide some of the telomere gets removed so the cell loses the protective effect Aging and Health – Factors Influencing Aging 1. Genetics 5. Medical Care 2. Lifestyle 1. Medical check-ups 1. Sleep 2. Flu shots 2. Substance use 3. Pneumonia vaccine 3. Stress 4. Mammograms 3. Nutrition 5. PAP smears 1. Eating habits 6. Prostate checks 2. Hydration 7. Checking for blood in 3. Weight control the stool or colonoscopy 8. Taking prescribed medications 4. Mental Health 2. Common Systemic Changes  Integumentary system  Respiratory system  Cardiovascular system  Gastrointestinal system  Genitourinary system  Musculoskeletal system-muscle and bone content decrease with age  Nervous system  Motor Function The Brain Somatosensory Function Speech/Language Function Vision Executive Function Balance & Coordination Breathing www.aitinstitute.org 9 3. Normal Physical Changes in the Brain…  When do the changes occur?  throughout life  with age  The nervous system adapts and changes.  Neuroplasticity  the ability of the brain to reorganize itself by forming new neural connections 10 Axons, Dendrites, and Synapses… 11 The Brain: Normal Physical Changes with Ageing  Decreased density of dendrites Results in a loss of synaptic plasticity  Slower synaptic transmission speed Results in increased reaction time 12 The Brain: Normal Physical Changes with Ageing  Loss of grey matter  With more education, less atrophy  With less sleep, more atrophy BRAIN ATROPHY  Decreased brain weight SHRINKAGE 13 4. Normal Sensory Changes…  Vision  Hearing  Taste  Smell  Touch 4. Normal Sensory Changes…  Vision  Diminished visual acuity and adaptability  Atherosclerosis of blood vessels  Causes decreased blood flow to the eyes  Causes enlarged blind spot on the retina  Results in reduced field of vision  Vision problems  Presbyopia  Cataracts (20%)  Glaucoma (6%)  Macular degeneration (20%) 4. Normal Sensory Changes…  Hearing  Degeneration of pathways to the brain  Middle ear becomes more calcified and less elastic  Less responsive cochlear membranes of the inner ear  More ear wax produced  Presbycusis  Difficulty with word discrimination  Decreased ability to hear high-frequency sounds  Tinnitus 4. Normal Sensory Changes…  Taste  Seems to be the least to decline over the years  Flavours seem blander  “Woolly mouth” because less saliva is secreted  Smell  Loss of sensitivity to odours; more in men  Touch  Less responsiveness to cold and heat  Distal loss > proximal loss 5. Effects of Physical Changes…  General slowing down  Impaired motor function  Modified sleeping and eating patterns  Diminished sexual activity 5. Effects of Physical Changes…  General slowing down  Dendritic loss  Decreased speed of nerve impulses  Decreased knowledge retrieval  Decreased muscle elasticity 5. Effects of Physical Changes…  Impaired motor function  Decreased stamina  Decreased fine motor skills  Decreased dexterity  Decreased balance  Decreased postural control  Arthritis 5. Effects of Physical Changes… Modified Sleeping Patterns Modified Eating Patterns  Frequent waking up at night  Impaired satiety  Decreased REM sleep  Rigid eating habits  Waking up early in the  Decreased food intake morning  Malnutrition  Napping in the daytime 5. Effects of Physical Changes…  Diminished sexual activity  Decreased testosterone levels in men  Impotence  Chronic pain affects sexual activity  Women - ??? Hearing Loss  Can lead to withdrawal from social contact  May lead to social isolation and depression  May start to mistrust those who do not speak up Aging and Health – Physical Changes 1. Neurological/Sensory Changes 3. Organ Changes 1. ↓Hearing 1. Slower heart 2. ↓Vision 2. Less elastic lungs 3. Kidney/Liver issues 3. ↓Taste and smell 4. Sexual organs 4. ↓Touch 5. Skin changes 5. ↓Reflexes 4 Bone and Muscle Changes 2. Circulation 1. Weaker bones 1. ↓Energy and stamina 2. Weaker muscles 2. HTN 3. Stiff joints 3. Cold sensitivity ↓ROM/Flexibility 4. Forgetfulness/poor cognition ↓Strength 5. Edema ↓Balance 6. Susceptibility to TIAs ↓Coordination 7. Pressure ulcers Incontinence 8. Orthostatic hypotension Falls Basics of Good Memory You need a good memory to learn!  Cognition = the mental action or process of acquiring knowledge or understanding through thought, the senses, and experience  Memory = recall of info after learning has occurred  Attention is the foundation to memory 25 Basics of Good Memory You need good memory to learn!  Types of memory  Sensory memory  Short-term memory / Working memory  Long-term memory 26 Learning & Memory - www.thebrain.mgcill.ca  Learning & Memory  Information-processing model on how learning happens: 1. Sensory input / Stimulus 2. Respond and transfer to STM 3. Transfer into LTM (usually with effort) 28 Learning, Memory, and Ageing…  Sensory changes – negative effect  Especially visual and auditory changes  Latency =  Increases with age  Increased time/effort for processing required  Application, storage to LTM, and retrieval take more time  Effect on older adults on information retrieval  Free recall - decreased  Recognition - older adults are better at this 29 1. Functional neurological disorders 2. Organic brain disorders (Dementia) Functional Neurological Disorders  Disruption in normal life  Anxiety, depression, emotional upset  Appear as a physical problem  Incidence rises in later life  Other contributors:  Medication misuse  Alcohol consumption  Malnutrition Functional disorders are treatable 31 The 7 A’s of Dementia  Anosognosia-impaired ability to perceive his/her illness inability to realize anything is wrong  Amnesia-partial or total loss of memory  Agnosia-inability to interpret sensations  Aphasia-loss of ability to understand or express speech  Apraxia-inability to perform purposeful actions  Apathy-indifference –lack of interest in the environment  Altered Perception-misinterpretation of sensory perception 32 Communicating with a Person with Dementia  Remove distractions  Make eye contact  Use a relaxed tone and body language  Listen – to words and body language  Allow more time to process  Show and talk  Encourage humour  Account for vision and hearing 33  MMSE* vs. MoCA* *Mini Mental Status Exam *Montreal Cognitive Assessment 1. Difference 2. Relevance to OT and PT Competence  A person with cognitive impairment may lose the ability to understand his or her situation and to make decisions. Competence =  “The ability to understand information relevant to the decision to be made  weigh the pros and cons in terms of his/her goals and values and  to be capable of communicating decisions.” 36 Competence  Decided through an assessment by a professional  Legal rights to make a decision determined  Example – LTC application 37 Legal Capacity  the right of citizens to take part in the legal process and to have civil rights  Civil right to question decisions  Right may be lost, i.e., coming into protective care  Exercised by the: Significant/Substitute Decision Maker (SDM) Power of Attorney (POA) Public Guardian and Trustee (PGT) – for personal care or for finances or both  Legal right to speak on behalf of the client  Health  Property (Finances) 38 Relevance to Therapy  Consent to treatment  Decision-making  Need for supervision – discharge destination  Education 39