Transcript Do you feel what I feel? Understanding Sensory Changes in the

Do you feel what I feel?
Understanding Sensory Changes in the Aging
Population
Presenters
Sue Brooks MSN, RN, AOCNS®
Clinical Nurse Specialist – ACE Unit and Patient
Education
Amanda Himes MSN, RN, BC
Clinical Nurse Manager- ACE Unit
Acute Care of the Elderly




Spectrum Health Blodgett Hospital
21 Bed Inpatient Medical-Surgical Unit
Goal: Maintain the functional status of the older
adult during acute hospitalization by focusing on
their unique needs
Interdisciplinary Team Approach: Nurse Manager,
Clinical Nurse Specialist, Educator, Pharmacist,
Dietician, Physicians, Physical/Occupational therapy,
Pastoral care, Nursing and Nursing Support
Sensory Changes





Vision
Hearing
Touch
Smell
Taste
Effects of age related sensory changes
•
Barriers during communication and care
–
–
–
Reduced independence
•
–
•
Misinformation
Confusion
Wrong assumptions
Reduced ability to provide self care
Isolation
Vision









Thicker lens
Loss of elasticity in the lens of the eye
Pupil takes longer to dilate and contract
Reduced pupil size
Visual field becomes smaller
Eyelids start to lag
Decreased upward gaze
Problems with glare
Decrease in color vision
Vision - impact


Inability to adjust to glare and change in lighting
conditions
Decrease in eyes ability to change the shape of the
lens to focus on near objects
 Medication


labels
Safety risk for driving and maneuvering in the
environment
Increased safety risk in changing environmental light
Hearing







Loss of sensory hair cells and nerve cells
Decreased movement of the bones in ears
Increased dryness of ear wax
Increase in number of coarse hair in the ears
Eardrum thickens
Loss of high frequency hearing
Decreased ability to process sounds after age 50
Hearing - impact




Decreases in sound moving across the ear canal
Decreased ability to hear sounds such as p,w,f,sh
and women’s and children’s voices
More time needed to process and respond to
sounds
Decreased hearing
Hearing - impact



Decreased quality of communication
Social isolation
Low self-esteem
Hearing - impact


“I went to a table to join four friends. When one of
them asked me a question which I could not understand,
the other repeated it for me. However, I was still unable
to lip read it. They paused while one of them wrote it
down. I was aware that the easy going conversation
they had been enjoying before my arrival now ended.
Within a few minutes two of them left and after a brief
pause the others explained they had pressing
engagements. I sat alone.”
Patient Cycle of Hearing Loss
Responds inappropriately
Is labeled confused
Caregiver avoids
Becomes frustrated
Becomes angry
Is labeled
uncooperative
Taste

Most changes in taste are due to:
 Condition
of the mouth
 Medications
 Decreased number of taste buds
 Dry mouth
 Decreased sense of smell
 Disease
 Use of tobacco
Taste - Impact





Decreased sensitivity to flavors
Swallowing ability
Difficulty with cooking
Decreased appetite
Eating spoiled food
Smell

Decrease in nerve fibers associated with smell
 Decreased
ability to identify odors
Smell - Impact





Impacts ability to taste
Inability to identify spoiled food
Inability to identify smoke or gas leaks
Limits enjoyment in eating
Limits pleasures of everyday life
 Smell
of spring rain, Christmas tree, flowers, coffee
brewing
Touch/sensation

Decreased sensitivity to:
 Temperature
 Pressure
 Touch



Decreased balance
Decreased sense of position of legs
Change in pain sensation
Touch/sensation - Impact

Increased risk for:
 Falls
 Burns
 Lacerations
 Calluses
 Pressure
ulcers
Do you feel what I feel?
Hands on interactive experience
Vision

What are you experiencing?

Glaucoma

How would this impact your day to day life?
Vision

What are you experiencing?

Macular Degeneration

How would this impact your day to day life?
Vision

What are you experiencing?

Hemianopsia

How would this impact your day to day life?
Vision

What are you experiencing?

Cataracts

How would this impact your day to day life?
Vision

What are you experiencing?

Yellowing of the lens
Medication Experience
References

Capezuti, E., Zwicker, D., Mezey, M., & Fulmer, T.
(Ed’s.). (2008). Evidence-based geriatric nursing
protocols for best practice (3rd ed.). New York, NY:
Springer Publishing Company, LLC.