5.

Elderly
Joshepin Carmino is a 66-year-old woman who lives alone in a small urban apartment.
She lives on a fixed income from her decreased husbands Social Security. She has come
to the clinic for her routine check up. During the initial interview, you notice that she does
not always answer your question appropriately and she talks very softly when she offers
information spontaneously. When you check her hearing with the whisper test, she asks
you to repeat several times, and finally tells you, with annoyance in her voice, that you
just have to speak up if you expect people to hear you! when you do the Rinne test, the
result show BC > AC. When questioning her about problems, she denies having any
hearing loss. She says she has never had audiometry and she cant afford it now. She also
tells you that she doesnt talk to friends on the telephone anymore, because they dont talk
loud enough.
KEYWORD

Woman a 66-year-old
Rinne test the result show BC > AC.

PROBLEM
Josep Carmino elderly have the disease because of the results shows the results
of BC>AC,

and he did

conversation many times.

not hear what

we're

talking by

asking us

to repeat our

Disease That Often Affects the Ederly are As Follows

1) Less moving: physical impairment, mental, and environmental factors can cause the
less mobile elderly. The most common cause is a disorder of the bones, joints and
muscles, nerve disorders, and diseases of the heart and blood vessels.
2) Instability: causes of falls in the elderly can be either intrinsic factors (things related
to the state of the patient's body), either because of the aging process, disease or
extrinsic factors (things that come from outside the body) such as certain medications
and environmental factors.
3) Depression: change in social status, increased disease and reduced social
independence as well as changes due to aging process to be one trigger depression in
the elderly.However, once symptoms of depression often accompanies patients with
diseases of physical disorders, which can not be known or thought of, because the
symptoms of depression that appears often considered as a part of the normal aging
process or are not typical.
4) Impaired sensory perception, communication, healing, and skin: aging due to all the
senses prosesd reduced function, as well as disorders of the brain, nerves and muscles
used for speaking could menyebabkn disruption of communications, while the skin
becomes

more

dry,

brittle

and

easily

damaged

by

trauma the

minima

Intellectual impairment: a collection of clinical symptoms that include impaired

intellectual function and memory are severe enough to cause the disruption of
activities of daily livingThis incidence increases rapidly from age 60 to 85 years or
more, which is less than 5% of older adults aged 60-74 years had dementia (severe
dementia), while at the age of 85 years after these events increased nearly 50%. One
of the things that can cause depression so it needs interlektual is distinguished from
other intellectual impairment.

Communicating with persons with Alzheimers Disease or related

disorders

1. Always approach the person from the front, or within his/her line of vision no
surprise appearances;

2. Speak in a normal tone of voice and greet the person as you would anyone else;
3. Face the person as you talk to him/her;
4. Minimize hand movements that approach the other person;
5. Avoid a setting with a lot of sensory stimulation, like a big room where many people
may be sitting or talking, a high-traffic area or a very noisy place;
6. Maintain eye contact and smile. A frown will convey negative feeling s to a person;
7. Be respectful of the persons personal space and observant of his/her reaction as you
move closer. Maintain a distance of one to one and a half feet initially;
8. If a person is a pacer, walk with him/her, in step with him/her while you talk;
9. Use distraction if a situation looks like it may get out of hand. A couple of examples
are: if the person is about to hit someone of if he/she is trying to leave the
home/facility.
10. Use a low-pitched, slow speaking voice which older adults hear best;
11. Ask only one question at a time. More than one question will increase confusion;
12. Repeat key words if the person does not understand the first time around;

13. Nod and smile only if what the person said is understood.