Transcript Aging & Changes in Touch - School of Nursing

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Aging & Sensory Function
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Vision
Hearing
Balance
Touch
Taste, smell
Content for this module provided by The John A. Hartford
Foundation, Institute for Geriatric Nursing, Online
Gerontological Nursing Certification Review Course
http://www.nyu.edu/education/nursing/hartford.institute/course/
Support for this project provided to School of Nursing, University of Washington by the John A.
Hartford Foundation, Geriatric Nursing Education Grant and
Nursing School Geriatric Investment Program Grant.
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Aging & Changes to the Eyes
Anatomical changes
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 eyelid elasticity
(ectropian, entropian)
Conjunctiva become
thinner & yellow with increased risk of infection
Pingueculae (fat pads under conjunctiva) may develop
Lacrimal gland & ducts loose fatty tissue & quantity of
tears decreases
Photo provided by the Administration on Aging at
http://www.aoa.gov/press/multimed/photos/2002/01_Jan/images_aging/photo_images_aging.asp
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Aging & Changes to the Eyes
Anatomical changes (continued)
• Eyeballs sit deeper
in sockets
• Cornea flattens and iris fades
•  connective tissue may cause
sclerosis of sphincter muscles
• Pupils become smaller, sclera
becomes thick, rigid
Photo provided by the Administration on Aging at
http://www.aoa.gov/press/multimed/photos/2002/01_Jan/images_aging/photo_images_aging.asp
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Aging & Changes to the Eyes
Anatomical changes (continued)
• Vitreous humor can degenerate & also detach
from retina
• Cones in retina deteriorate
• Lenses thicken & lose transparency, decreasing
passage of light to retina
• 1 in 3 persons experiences cataracts
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Aging & Changes to the Eyes
Physiological changes
• Presbyopia ( ability to adjust near/far vision)
•  visual acuity (especially near vision) & narrowing of
visual field
• Difficulty gazing upward & maintaining
convergence, adapting to lighting changes
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Aging & Changes to the Eyes
Physiological changes (continued)
• Impairment of color discrimination
• Dullness, dryness of eyes
• Dry, irritated cornea r/t  tear secretion
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Aging & Changes to the Ears
Anatomical changes
• Gradual buildup & hardening
of cerumen in ear canal
• Possible atrophy of the organ
of Corti & the auditory nerve
• Thickening of tympanic
membrane (ear drum)
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Aging & Changes to the Ears
Physiological changes
•  tone discrimination
• Presbycusis: difficulty hearing high frequency
sounds ( hearing acuity)
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 ability to discern consonants
•  equilibrium due to vestibular changes
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Aging & Changes to the Ears
Hearing loss is NOT a
normal part of aging process
• Hearing loss requires further evaluation for
proper treatment
• conductive loss
• sensory loss
• mixed
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Aging & Changes to the Ears
Signs & symptoms of hearing loss
•  volume on television or radio
• Tilting head toward person speaking
• Cupping hand around one ear
• Watching speaker’s lips
• Speaking loudly
• Not responding when spoken to
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Aging & Changes in Balance
 balance - caused by a combination of factors
•  sensory input
• Slowing of motor responses
• Musculoskeletal limitations
• Increased postural sway
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Aging & Changes in Balance
Functional changes
• May not present in healthy older adults
• Deprivation in more than one system is likely to
lower balance threshold (i.e., vision &
proprioception input)
• Challenging conditions lower balance threshold
• climbing up & down steps, curbs
• getting in & out of bathtub
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Aging & Changes in Taste, Smell
• Alterations in oral mucosa & tongue, & pathologic
state of nasal cavity
•  # of cells, damage to cells,  neurotransmitters
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Aging & Changes in Taste, Smell
• Olfactory losses in healthy adults
• normal aging process
• medications
• viral infections, long-term exposure to toxic fumes
• head trauma
• Taste losses
• disease states of nervous & endocrine systems
• nutritional & upper respiratory conditions
• viral infections
• medications
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Aging & Changes in Taste, Smell
Functional changes
•  in sensitivity to
airborne chemical
stimuli
•  in recognition of
odors
• Many foods taste bitter
or lack taste - potential
 in food intake
 risk for noxious
chemicals &
poisonings (e.g., may
fail to detect odor of
smoke or leaking gas)
 risk for impaired
nutritional & immune
status
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Aging & Changes in Touch
•  sensitivity to light touch
•  spacial acuity thresholds
•  two-point discrimination
•  tactile vibratory thresholds
•  warm-cold difference thresholds
 risk for injury, especially in affected limbs
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Aging & Changes in Touch
Common disorders affecting tactile information
• Cerebrovascular accident (CVA)
• Peripheral vascular disease (PVD)
• Diabetic neuropathy
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Aging & Sensory Changes
Nursing considerations
• Proper screening & intervention are critical:
• assess impact on ADLs & IADLs
• ensure appropriate provision & usage of
assistive devices
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Aging & Sensory Changes
Nursing considerations
•  sight & hearing can lead to:
•  communication
• depression
• social isolation
• loss of self-esteem
• loss of independence (i.e., can’t drive)
• safety concerns