September 15, 2011

Physical Aspects of Aging -- Part 4 of 4

CoupleTeeth and Mouth

Older adults are more likely to lose teeth to gum disease than to problems with the teeth themselves. However, with proper personal care, regular checkups, and improved dentistry methods, older people are more able to retain their natural teeth throughout their lives. Older people who do lose their teeth may now expect and demand comfortable, well-fitting, and durable dentures.

Digestion

The digestive system is very sensitive to emotions. An older person may experience an upset stomach or lack of appetite when lonely, depressed, or worried. Regular contact with friends and relatives, through visits and telephone calls, can help prevent these problems.
It is fairly common for older people to have less frequent bowel movements and to suffer from constipation. This is due to changes in tissue and muscles and reduced thirst. Regular exercise, such as a daily walk, can prevent constipation. A well-balanced diet that includes adequate fiber and fluid intake also encourages normal bowel function and minimizes the need for laxatives. In contrast, self-prescribed laxatives are an expensive substitute for foods that naturally keep the gastrointestinal system running smoothly, such as bran cereals, fruits, and vegetables. Overuse of laxatives can interfere with the availability of nutrients for healthy body functioning.

Adequate fluid intake is essential for maintaining proper body temperature and functioning of the digestive system. However, some older people make the mistake of limiting their fluid intake in order to avoid frequent urination. Dehydration is a serious problem for the elderly. This is due to their decreased sense of thirst and reduced capacity to conserve water. In addition, laxative abuse, diuretic therapies, infections, immobility, or excessive use of alcohol or caffeine tend to promote dehydration.

Caregivers and older adults should follow the guidelines below to assure proper gastrointestinal functioning.
  • Get some form of regular exercise that is appropriate to the level of physical ability.
  • Maintain a well-balanced diet that includes natural sources of fiber such as whole grains, fruits, and vegetables.
  • On a daily basis, drink eight cups of water and other fluids.
  • Watch for signs of dehydration, such as mental confusion, decreased urine output, constipation, nausea, lack of appetite, dryness of lips, and elevated body temperature.
  • Pay special attention to fluid intake during hot weather.
  • Monitor the fluid balance in older people with special medical problems, such as congestive heart failure or kidney disease. Discuss the appropriate methods to monitor fluid intake and output with your doctor.

Circulation

The older heart slows down and is less able to pump blood through the body than the younger heart. This results in older people having less energy and stamina for physical work. Decreased circulation also contributes to cold sensitivity, particularly in the hands and feet. Because oxygen necessary for proper physical and cognitive functioning is carried through the blood, the elder with poor circulation may experience forgetfulness and other symptoms of poor cognition.

Blood vessels, which play an important role in the circulation of blood throughout the body, lose elasticity as we age. This causes blood to tend to "pool" in the feet and legs. This means that swelling (edema) may occur in the extremities. Consequently, the heart, which undergoes muscle changes as we age, must pump harder in order to carry the blood to all parts of the body.

Changes in circulation make the older person more susceptible to the development of "little strokes" (TIAs) than when younger. Symptoms of such episodes include headache, vision disturbances, loss of balance, confusion, and dizziness when standing quickly from a sitting or reclining position. Because "little strokes" can be harbingers of a larger stroke, consult with the older person's primary health care provider, should these occur.

Many older people are on medications that impact circulation. Be familiar with these medications, and their side effects. This may prevent complications, which may arise from their use.

Pressure ulcers, a skin problem found in people with limited mobility, are due to impaired circulation. When an older person is unable to move about, tissue may die due to lack of an adequate blood supply to the skin. Areas particularly susceptible to these ulcers are those over bony prominences such as hips, shoulders, elbows, knees, ankles, and the heels of the feet.

To facilitate proper circulation and its effects:
  • Prop the feet on a footstool or other appropriate stable object when sitting.
  • Change the person's position at least every two hours to prevent pressure ulcers of the skin.
  • Develop an activity routine which conserves energy and yet includes opportunities for movement.
  • When the elder is sitting, rotate her or his feet at the ankles frequently to promote circulation.
  • When the elder is rising from a reclining position, help her or him sit on the edge of the bed for a few moments before standing.
  • Be familiar with the older person's medications and their side effects to prevent falls and other complications.
  • Be alert to sensitivity to cold in the older person. Make certain there are sweaters, blankets, and other warm materials available.
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