ENSURING QUALITY CARE
NORMAL AGING IMPLICATIONS FOR CARE September 2019 Safety, Oversight and Quality Unit 17
PURPOSE AND KEY TERMS • Long-Term memory The purpose of this section is to help the learner understand the • Memory loss physical changes that occur during • Hearing loss the aging process. This section will • Visual acuity inform the AFH provider how to accommodate those changes • Bladder capacity when providing care for the • Incontinence resident. September 2019 Safety, Oversight and Quality Unit 18
OBJECTIVES The learner will be able to: Identify 11 physical functions that change during the aging process Define the changes of the physical functions and how that affects the resident Describe how changes in physical function will affect how the AFH provider will support the residents; changing physical needs September 2019 Safety, Oversight and Quality Unit 19
BRAIN, INTELLIGENCE, LEARNING AND MEMORY September 2019 Safety, Oversight and Quality Unit 20
CHANGES The aging brain takes longer to search for and retrieve information. Intellectual capacity, judgement, comprehension, accuracy, retention of well-learned material does not usually change with age. Creativity and the ability to solve problems increases with age. September 2019 Safety, Oversight and Quality Unit 21
CONSEQUENCES Learning is more difficult • Under stress • If the task is complex; or • Requires a quick response Memory • Long –term memory usually remains intact • Recently learned material is harder to recall September 2019 Safety, Oversight and Quality Unit 22
CONSEQUENCES CONTINUED Older persons • May take longer to make decisions or respond to questions • May avoid risk or mistakes by relying on past solutions; and • Learn something new, they perform as accurately as younger persons September 2019 Safety, Oversight and Quality Unit 23
IMPORTANT NOTE Forgetfulness is not the same as memory loss. The rate of forgetfulness is about the same among younger as older people: • Forgetfulness is a temporary problem in remembering a persons name - a phone number, keys or glasses, and other recently learned information; these items are usually remembered later and the person is aware of what is forgotten • Most people learn to cope with forgetfulness and use “tricks” such as a note pad to help them remember September 2019 Safety, Oversight and Quality Unit 24
IMPORTANT NOTE CONTINUED Memory loss is the inability to recall events such as a family wedding, recognize familiar people and places. Memory loss is not a normal part of aging. It is most often associated with diseases such as Alzheimer’s disease or other types of dementia. It can also be caused by other illnesses, reactions to medications, untreated infections, allergies, depression or extreme stress. September 2019 Safety, Oversight and Quality Unit 25
IMPLICATIONS FOR CARE Reduce stress of learning situations (e.g., adjusting to new routine, filling out forms): • Keep the atmosphere calm and the pace relaxed • Present information both verbally and visually to reinforce the message Provide opportunities to use their minds, learning interesting things and feel useful • Memory improves with practice Notify physician of any sudden changes in memory September 2019 Safety, Oversight and Quality Unit 26
TASTE AND SMELL September 2019 Safety, Oversight and Quality Unit 27
CHANGES Decline in sense of taste. Fewer taste buds on tongue; sensation of bitter and sour remain intact. Decline in sense of smell. September 2019 Safety, Oversight and Quality Unit 28
CONSEQUENCES Food may taste “funny” or not taste “right”: • May stop eating because food has no flavor • Many use excess sugar, salt or other seasons on food in an attempt to get flavor More vulnerable to malnutrition. May not smell smoke, bathroom or body odors. September 2019 Safety, Oversight and Quality Unit 29
IMPLICATIONS FOR CARE Consider adding herbs, spices and salt substitutes to enhance food flavor. Offer foods the resident enjoys. Offer a variety of different foods. September 2019 Safety, Oversight and Quality Unit 30
MOUTH, TEETH AND DIGESTION September 2019 Safety, Oversight and Quality Unit 31
CHANGES Decrease in production of saliva, enzymes and acids Stomach digests food more slowly Intestines move stool more slowly Tissues of the mouth are dryer Gums shrink September 2019 Safety, Oversight and Quality Unit 32
CONSEQUENCES Some foods are harder to digest. Stomach discomfort and gas after eating may be more common. Medications are absorbed more slowly. Dental or denture problems make eating more difficult. September 2019 Safety, Oversight and Quality Unit 33
IMPLICATIONS FOR CARE Avoid serving foods that are difficult to digest or chew. To prevent constipation, offer a well-balanced diet, with plenty of fresh vegetables and fruit. Include whole grain cereals and breads. Encourage fluid intake and exercise. Encourage daily brushing and flossing, rinsing mouth and regular visits to the dentist. September 2019 Safety, Oversight and Quality Unit 34
HEARING September 2019 Safety, Oversight and Quality Unit 35
CHANGES Speech may be distorted • High-pitched consonants such as S, Z, T, F and G are difficult to understand Sounds may be muffled • Due to wax build-up • Other obstruction that keeps sound waves from reaching the inner ear September 2019 Safety, Oversight and Quality Unit 36
CONSEQUENCES Difficulty understanding speech. Difficulty hearing if speaker cannot be seen or with background noise. Difficulty communicating with others, especially in group situations. Hearing loss can lead to isolation, anxiety, depression and suspicion of others • May seem confused, embarrassed, nervous or frustrated. September 2019 Safety, Oversight and Quality Unit 37
IMPLICATIONS FOR CARE Speak clearly and distinctly in the person’s good ear • Speak in a low tone of voice • Do not shout Face the person • Do not exaggerate lip movements - be sure he or she can see your lips • Remove food, gum, etc. from your mouth September 2019 Safety, Oversight and Quality Unit 38
IMPLICATIONS FOR CARE CONTINUED Do not place your hand in front of your mouth. If possible place yourself at same height. Use facial expressions, gestures, touch and objects to help clarify what you are saying. Encourage use of hearing aids. Reduce background noise. Turn off TV and radios. September 2019 Safety, Oversight and Quality Unit 39
IMPLICATIONS FOR CARE CONTINUED Write and speak important things. For the resident to better enjoy music, increase the bass tones . Stand so the light shines above or toward you rather than behind you. Be sure the resident understands what you say: • If they don’t understand, choose different words to say the same thing. Allow plenty of time for the resident to respond. September 2019 Safety, Oversight and Quality Unit 40
IMPORTANT NOTE People need sensory stimulation to stay healthy. Hearing loss can be the most serious of the sensory impairments: • Approximately 30-50 percent of all older people suffer a significant loss that effects their communication and relationship with others. September 2019 Safety, Oversight and Quality Unit 41
VISION September 2019 Safety, Oversight and Quality Unit 42
CHANGES Decreased visual acuity – Ability to see clearly . Changes in color perception. Corneal lens may become cloudy. Increased sensitivity to glare; decreased adaptability to light. Visual field becomes smaller. Eye problems such as cataracts, glaucoma and macular degeneration are common. September 2019 Safety, Oversight and Quality Unit 43
CONSEQUENCES Increased difficulty with reading, watching TV, or doing handwork or hobbies. It is more difficult to judge distance. Shiny objects such as eyeglasses or clear drinking glassed may be more difficult to see, especially against polished furniture or near a lamp or window. September 2019 Safety, Oversight and Quality Unit 44
CONSEQUENCES Less able to distinguish one color from another. May be more difficult to choose the right color of clothing to wear together. Less able to adjust to changes in light. Need three times the light of a younger person. May need to turn head to see to the side. Mobility, orientation and safety may be negatively affected due to vision loss. September 2019 Safety, Oversight and Quality Unit 45
IMPLICATIONS FOR CARE Modify lighting to promote safety and comfort for example, night lights. Tell residents before you move furniture. Avoid clutter. Reduce glare caused by the sun, lighting and reflective light from mirrors and highly polished floors. Make large print/talking books available. September 2019 Safety, Oversight and Quality Unit 46
IMPLICATIONS FOR CARE CONTINUED Use large print written material. Increase light for reading and doing handwork. Use contrasting colors between: • Doorways and walls • Dishes and tablecloths • The risers and the flat surface of steps September 2019 Safety, Oversight and Quality Unit 47
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