Sensory Deprivation and Loss

Catherine McClendon, RN MSN

Sensory Deprivation
Definition
Absence of stimuli in environment Inability to interpret existing stimuli

Sensory Deprivation
Leads to:
Boredom Confusion Irritability Disorientation Anxiety

Sensory Deprivation
Prevention
Color Pictures Textures Smells Sounds Interpret environment Change scene often

Cataracts

Clouding of normally clear, transparent lens. Leading cause of blindness in the worldper WHO.

www.sabateseye.com

Cataracts
Causes
Aging Congenital Trauma Long term corticosteroid use Diabetes Radiation Exposure---SUN!

Cataracts
Pathophysiology
No clearly understood Physical changes in suspension of lens Chemical changes in lens protein Occurs bilaterally, but at the same rate

Cataracts

Signs/Symptoms
Decreased visual acuity Glare sensitivity Poor night vision Pupil may appear gray or pearly white

Cataracts

Diagnosis by eye exam.

Snellen visual acuity test Ophthalmoscopy Slit-lamp biomicroscopic exam

Cataracts

Treatment
No non-surgical treatment cures cataracts. Determine extent to which it hinders ADLs. Corrective glasses and magnifying glass

Cataracts

Surgical Treatment
Topical anesthetic Outpatient 95% successful

Cataracts
Types of Surgery
Intracapsular
Remove entire lens Not used much anymore

Extracapsular
98% done this way Remove anterior capsule and lens Leave posterior capsule Place plastic lens

Cataracts

Complications
Corneal damage Glaucoma Hemorrhage IOL malposition Secondary lens develop

Cataracts
Post Operative Care
May read and watch TV NO bending forward at the waist Kneel or squat to pick up objects Sleep with protective shield Sleep on back Wear glasses during day Sunglasses outside

Cataracts
Post Operative Care, cont.
Avoid: rubbing eyes, straining to have BM, soap in eyes, lifting over 15 pounds, driving, coughing, sneezing, vomiting Medications: Steroids, antibiotics, given locally. REPORT: pain, headache, ocular redness, swelling, drainage, discharge, changes in visual acuity (dots or floaters).

Glaucoma
Visual field loss from damage to optic nerve from high intraocular pressure generally. Leading cause of blindness in US. Asymptomatic until extensive and irreversible damage done. www.sabateseye.com

Glaucoma
More prevalent in elder Occurs most often in diabetics, African Americans, those with family history, and those with history of eye trauma or eye surgery.

Glaucoma
Classification
Open Angle Angle Closure Primary Secondary

Glaucoma

Diagnosis
Assess ocular history, medications Ophthalmic exam Tonometry

Glaucoma
Symptoms
Loss of peripheral vision Halo vision Blurred vision Ocular pain with increases in IOP

Glaucoma
Medications
Beta Blockers
Timolol Betagen Betoptic

Cholinergics
Pilocarpine

Glaucoma

Surgery
Iridectomy Trabeculoplasty Done with laser if possible

Glaucoma
Post Operative Care
No straining, lifting, or bending for 1 week No driving for at least 1 week Patch 24 hours a day No water in eye Antibiotic drops Corticosteroid drops

Glaucoma

Patient Education
Strict, lifelong adherence to medications Keep eyes clean No rubbing Non-allergic cosmetics Continuous follow up with physician

Hearing Loss
Consequences
Speech discrimination lost Social isolation Lower performance on mental exams Depression Boredom Safety issues Cant test reality-leads to paranoia

Hearing Loss
Characteristics
Often gradual and difficult to recognize Denial is common Blamed on acoustics or others mumbling

Hearing Loss
Conductive-decreased or absent transmission of sound from external auditory canal to and through the middle ear. Causes
Impacted cerumen Loss of elasticity of tympanic membrane Bone rigidity-otosclerosis

Hearing Loss
Sensorineural-gradual hearing loss in elder. Presbycusis in elder. Damage to the inner ear, auditory nerve, brainstem and/or cortical-auditory pathways. Causes
Noise damage Aging Drug toxicity (ototoxicity)

Hearing Loss
Management
Prevention in the first place! Health problems can go untreated due to hearing loss. Make whatever accommodations are needed Sign language
Think about it: You are elderly and ill. You are in a strange place having strangers do strange things to your body. The room is darkened and they are wearing masks. You cant hear or understand what they are saying. Would you feel comfortable?

Hearing Aids
Body worn Eyeglasses Behind the ear Intra-auricular In the canal Completely in the canal

Hearing Aids
Issues
Cost Dexterity needed Tiresome Adjustment to fit Old types intensify all noise Batteries needed Digital technology

Hearing Aids
Care

Acquisition of hearing aids

Hearing Guide Dogs