CHANGES in the OLDER PERSON and their IMPLICATION to CARE

PHYSIOLOGIC CHANGES
I. VISION (Age-related changes in the eye)

1. thinning of the skin surrounding the eye

2. decrease in musculature in the eyelids


o ectropion – bottom lid sags outward
o entropion – the lid turns inward

3. arcus senilis (corneal calcium deposits)

4. smaller pupil size

Changes in vision among older persons are preceded by the following :


o
 Decreasing sensitivity to light
 Increased sensitivity to glare
 Altered color vision

Presbyopia – a universal age-related change in the lens of the eye involving loss of
accommodation.
- objects held closer than 1-2 feet become difficult to see.

5. decreased reading & color discrimination ability

6. atrophy of lacrimal glands – results in dry eyes
7. increased intraocular pressure

Nursing Implications:

1. Urge older adults to schedule routine eye examinations

2. Assess older client’s ability to perform ADL
3. Consider safety measures like:


o adequate lighting
o nonskid surfaces on stairs
o use of stair rails
o toxic substances & medicines with labels that are readable
II. HEARING (Age-related changes in the ear)

1. auricle tends to wrinkle & sag

2. drier and harder cerumen that accumulates in the ear canal & impacted cerumen
3. dry ear canal & pruritus
4. atrophy of the inner ear structures & hearing loss (presbycusis)
o Approximately 30% to 50% of people older than 65 have significant hearing loss
o Hearing loss increases with age and is greater in men.

Nursing Implications:

1. Assess client’s ability to communicate

2. Check if the client is able to hear alarms and doorbells
3. Emphasize safe driving & taking public transportation
4. Encourage the client to engage in leisure & recreational activities

III. TASTE, SMELL & TOUCH

1. decrease in taste buds ( gradual)

o taste deficits result to weight loss, malnutrition, impaired immunity
2. atrophy of olfactory bulbs
o diminished sense of smell (hyposmia)
3. slower conduction of nerve impulses & diminished function of the peripheral nerve
o decreased sensitivity to pain, temperature extremes, and vibration

Nursing Implications:

 Taste

1.
1. Appetite enhancement strategies
2. Check dentures for fit & cleanliness
3. Inspect mouth for ulcers or gingivitis
4. Identify possible offenders known to affect taste (ex. medications)
5. Encourage fluid intake

 Smell

1.
1. implement safety precautions
 placing natural gas detectors
 placing smoke detectors
 date and label food containers
2. house cleaning & personal hygiene
3. encourage daily waste disposal to prevent garbage smell
 Touch

Focus assessment on:


o the impaired sense of touch
o the intactness of the skin
o safety risks

IV. INTEGUMENTARY SYSTEM

1. thinning of the 3 layers of the skin.

2. loss of subcutaneous fat
o visible veins
o wrinkled, dry & sagging skin
o skin prone to damage
3. loss of skin turgor
4. nails grow more slowly, brittle, dull, yellow, or gray color
5. loss of eyelid elasticity
6. epidermal mitosis slows by 30% & skin heals more slowly
7. decrease melanocytes – hair appears gray or white, scalp, pubic & axillary hair
declines due to the decline in the hormones
8. less efficient manufacturing of Vit. D from sunlight
9. photoaging - changes in pigmentation with an accumulation of discoloration due to
chronic exposure to UVA and UVB

Common Skin Problems

1.
o skin cancer
o pressure ulcers
o cellulitis

Nursing Implications: (to older adults at risk for skin problems)

1. Instruct client to avoid excessive use of soap, hot water & brisk rubbing when
bathing. Pat skin dry instead of briskly rubbing.

10. Lubricate the skin with a moisturizer multiple times a day - dry skin causes itchiness
11. Avoid prolonged pressure on bony prominences.
12. Protect skin from temperature extremes.
13. Soak nails before trimming.
14. Dress appropriately for weather and climate.
15. Protect skin from sun exposure & risk of photodamage
16. Evaluate and manage incontinence.
o If soiling occurs, the skin should be cleansed per routine.
o Plastic-lined bed pads should not contact the person’s skin.
17. Monitor nutrition.
o Provide Vitamin C & Zinc to promote skin healing.
18. Adequate fluid intake

V. RESPIRATORY SYSTEM (Changes that occur with aging)

1. lungs appear larger due to loss of elasticity (stiffening of elastin & the collagen
connective tissue) & lungs become more rigid.
2. weaker respiratory muscles
3. increased chest wall stiffness
4. decreased ciliary action
5. decreased number of alveoli
6. decreased respiration due to chest wall & thoracic spine deformities.
7. Slower amount of oxygen carried by the blood

1.
o slower & less efficient gas exchange
o tendency to trap air(not able to exhale fully)
o maximum breathing reduced.

Common Illnesses:

o Pneumonia
o Asthma
o COPD
o Tuberculosis
o Lung Cancer

Nursing Implications:

1. Clean nostrils to ensure a patent airway.

2. Allow rest periods throughout the day.
3. Avoid exposing the elderly to cold & flu germs.
4. Encourage plenty of fluid intakes
5. Proper nutrition
6. Avoid smoking/ exposure to smoke

VI. CARDIOVASCULAR SYSTEM (Changes that occur with aging)

1. More prominent arteries in the head, neck, and extremities.

2. Stiffening of the heart valves.
3. Slight increase in the size of the heart, especially the left ventricle.
o The aorta becomes elongated and dilated.
8. Increase peripheral resistance and decrease cardiac output & BP increases to
compensate.
9. Natural pacemaker (the SA node) loses some of its cells & may result in a slightly
slower heart rate.
10. Less efficient oxygen utilization.
11. Less elasticity of vessels.
o arterial stiffening – due to lipid deposits & calcification
o veins thicken
12. Altered electrical activity of the heart – abnormal heart rhythms
13. Decreased cardiac output – produces renin & increases BP & retains sodium
14. Deposits of the "aging pigment," lipofuscin

Common Illnesses:

 Hypertension/ hypotension
 Hyperlipidemia
 Metabolic syndrome – a condition characterized by elevated waist circumference,
BP, fasting serum triglycerides & serum glucose
 MI
 Angina
 Varicosities due to valvular reflux
 Postural or orthostatic hypotension

Nursing Interventions:

1. Advise elderly to avoid/stop smoking

2. Encourage daily exercises
3. Promote healthy diet – low salt, low cholesterol calcium-rich foods
4. Encourage the client to control his weight
5. Schedule regular check-ups
6. Advise to stay mentally active
7. Socialize with others

VII. NEUROLOGIC SYSTEM

1. Brain decreases in size (approximately 7%)

2. Loss of neurons in the brain (up to 20% ).
3. Decrease in cerebral blood flow.
4. Breakdown of nerves & reduction or loss of reflexes or sensation
5. Slowing of coordinated movements.
6. Deterioration of balance mechanisms.
7. The brain and spinal cord lose nerve cells and weight ( atrophy) & nerve cells may
begin to pass messages more slowly.
8. Decline in ability to concentrate more than one task at a time.
9. Decreased reaction time in processing information.
10. “tip of the tongue” phenomenon
11. Diminished deep sleep.
12. Decrease in reflexes.

Common Illnesses:

 Dementia
o Alzheimer’s Disease
o Vascular dementia

 Parkinson’s Disease
 Stroke / Transient Ischemic Attack (TIA)
 Multiple Sclerosis

Nursing Implications:

1. Clients must remain active & engaged in life.

2. The elderly must develop hobbies and interests.
3. Eat a well-balanced diet.
4. Avoid stress & anxiety – enjoy life.
5. Physical exercise to remain or become fit.
6. Stay connected with at least one person on a daily basis.
7. Encourage a consistent bedtime routine.

VIII. URINARY SYSTEM (Normal renal changes of aging)

4. Kidneys shrink & become less efficient.

5. Decreased ability to concentrate urine & risk for dehydration.
6. Bladder capacity declines.
o increased frequency in urination especially during the night
7. More than 50% of the nephrons are lost before age 80.
8. Blood urea nitrogen (BUN) may increase without serious symptoms.
9. Less contractile detrusor muscle & inability to empty the bladder completely.
10. Increased renal threshold for glucose
11. Impaired thirst perception – due to fluid & electrolyte balance.

Nursing Implications:

1. Monitor intake and output.

2. Unless a patient is on fluid restrictions, he should be offered fluids frequently.
o Fluid intake should be no less than 2500 cc every day.
o Reduce salt intake in the diet.

IX. GASTROINTESTINAL SYSTEM (Normal age-related changes in the older adult)

1. Wearing off or erosion of tooth surfaces – due to frequent intake of acidic foods,
tooth-to-tooth contact
2. Vertical hairline cracks – due to shrinkage of dentine with loss of support for the
enamel
3. Oral mucosa becomes thin, smooth, dry, and inelastic
4. Decreased salivary production – results to dry mouth
5. Decreased blood supply to intestines & digestive disorders/malabsorption syndrome
6. Decreased liver size & function - decreased metabolism, decreased drug
detoxification
7. Delayed gastric motility & emptying & diarrhea, or constipation, fecal incontinence

Common Illnesses:

 Esophageal disorders
 Dysphagia
 Gastroesophageal Reflux Disease
 Gastritis
 Peptic and Duodenal Ulcer
 Crohn’s Disease

Nursing Implications:
Advise client to:

1. Eat a balanced diet that is high in fiber & low in fat & processed carbohydrates
2. Maintain a normal weight.
3. Decrease the size of portions at mealtime
4. Avoid lying down for 2 – 3 hours after eating
5. Stop smoking or using tobacco products.
6. Limit the use of nonsteroidal anti-inflammatory agents
7. Encourage to carry out daily oral self-examinations

X. ENDOCRINE SYSTEM (Normal changes in aging)

1. Decrease in cell mass and weight of pituitary gland – due to atrophy, fibrosis &
decreased vascularity
2. Decline in the secretion of growth hormone - decreased bone density, decreased
lean body mass & increased fat mass.
3. Increase in serum concentration of Parathyroid hormone by about
30% - osteoporosis
4. Lower calcium absorption in women – due to decrease in active calcium transport or
diffusion
5. Dilated pancreatic duct
6. Slow flow rate of pancreatic enzymes and bicarbonate
7. Insulin resistance may accompany age-related glucose intolerance
8. Decrease in estrogen levels à changes in the reproductive organs

Common Illnesses:

 Diabetes Mellitus
 Thyroid disorders
o Hyperthyroidism
o Hypothyroidism

Nursing Implications:
1. Weight management
2. Encourage avoidance or reduction of alcohol intake
3. Advise regular exercise
4. Refer to a dietician for basic food & meal plan guides

XI. IMMUNE SYSTEM (Normal changes of aging)

1. Decreased number of B cells in the circulation - tissues slower to repair / more

vulnerable to diseases
2. Production of IgE decline - decrease in allergic reaction
3. Decline in its ability to detect and correct cell defects & results in an increase in the
risk of cancer

Common Illnesses:

1. Hypersensitivity
2. Primary Immunodeficiency disorders
o HIV/ AIDS
3. Susceptibility to Infections
o pneumonia
o UTI
o Skin infections

Nursing Implications:

1. Get plenty of exercise & helps boost the immune system.

2. Eat healthy foods - good nutrition keeps the immune system strong
3. Do not smoke - weakens the immune system
4. Limit intake of alcohol
5. Look into safety measures to prevent falls and injuries - a weak immune system can
slow healing from falls and injuries
6. Emphasize the importance of obtaining yearly influenza immunization.
XII. MUSCULOSKELETAL (Normal changes of aging)

1. Decrease in height is common (range of 2 to 4 inches from spinal column) them

thinner & flatter
2. Decreases in lean body mass - muscle atrophy especially with a disease
3. Bones become brittle/ may break easily - due to diminishing bone density &
calcium loss
4. Joint degeneration with arthritic changes.
5. Increase postural sway & difficulty maintaining balance.
6. Slower & shorter gait
7. Foot problems like bunions, corns, calluses, can contribute to gait problems and
falls.
8. Deterioration of joint capsule & decrease in ROM movements

Common Illnesses:

 Osteoporosis
 Osteomalacia
 Osteoarthritis
 Kyphosis “ hunchback “

Nursing Implications:

1. Promote diet adequate in calcium & Vit D

2. Reduce or eliminate smoking/ alcohol intake
3. Encourage daily exercises
o stretching 10 mins per day
o active ROM
o weight-bearing exercises
4. Monitor safety measures

HEALTH PROMOTION in OLDER ADULTS

Facts about health & wellness promotion for older adults

 Fitness is not a fad, but a goal to pursue by older adults.

 Chronic illness can be prevented and slowed by well-crafted physical and mental
fitness regimes.
 Health promotion can be achieved through patient education and counseling.
 Keeping physically fit improves emotional health.
 Positive attitudes about lifestyle changes can vastly improve the older adult’s quality
of life.

1. Physical health
 1.a). Exercise, including aerobic, strength training & flexibility components.
Mobility fosters independence & freedom
Exercise programs should be prescribed by the physician
> type of exercises should consider person’s lifestyle, cardiac status, energy,
endurance level, & mobility limitations
> most acceptable form of exercise is walking
1.b) Good nutrition including adequate calcium & Vit.D intake. Affects the overall well
being & health
Nutritional Screening Initiative (NSI) – determines risks for nutritional deficiencies:
Diseases:
Eating poorly
Tooth loss or mouth pain
Economic hardship
Reduced social contact & interaction
Multiple medications
Involuntary weight loss or gain
Need for assistance with self-care
Elder at an advanced age
1. c) Health maintenance visits
Older adults must be examined at least once a year.
More frequent when health problem exist.
Must include immunizations.

1. d) Adequate rest & sleep

 Sleep serves to rest body organs, conserve energy, preserve biorhythms & restore
mental & neurologic efficiency
 as people age, sleep patterns change
 some have difficulty sleeping; others have shorter sleeping time

1. e) Avoidance of tobacco and alcohol

- Counseling about substance abuse as safety measure can be preventive

or
 Interventional
. Dental examinations – done on a regular basis (at least once a year)
- good oral hygiene periodic assessment of denture fit & functionality of false
dentures

2. Social / Emotional health

- maintain a positive outlook on life

- keep in touch with family & friends
- establish new relationships by joining church or community social groups

3. Mental health

- a loss of control over one’s life & circumstances can impair mental health.
- Elderly must maintain independence / self-esteem/ self-respect
> Facilitate self-care through provision of adaptive & assistive equipment
> Encourage decision-making through building in the perception of control
> Set attainable short- and long-term goals with rewards
> Evaluate progress toward goal achievement.
Stress management
> When an event has a likelihood of producing stress, it is best to avoid that event
> use relaxation techniques
Psychotherapy Commonly Used Among Older Adults
a. One-on-One Therapy
> Provides a non-threatening & therapeutic environment.
> Clients can express themselves to a nurse (anxiety relieving part)
b. Psychodrama - is a form of human development which explores, through dramatic
action, the problems, issues, concerns, dreams, & highest aspirations of
people, groups, systems, & organizations
c. Occupational therapy
> promotes health by enabling people to perform meaningful & purposeful
occupations.
 > includes (but are not limited to) work, leisure, self care, domestic &
community activities
.d. Music therapy
> An interpersonal process that can promote creativity, awareness, expression
and communication
> Beneficial to the elderly patients
For stress, it can dispel anxiety, tension and fear.
For depression, it can alleviate a sense of loneliness and isolation,
especially in group
Sing-alongs or musical participation activities
e. Art therapy
Offers healing by providing social connection, the experience of control and
the opportunity to both express and manage emotions
Offers hope by facilitating nonverbal communication
Providing opportunity to create meaning through life review
f. Animal-assisted therapy
> is a type of therapy that involves an animal with specific characteristics
becoming a fundamental part of a person’s treatment.
> It is designed to improve the physical, social, emotional, & or cognitive
functioning of the client,
as well as provide educational & motivational effectiveness of the
participants.
g. Recreational activities
- a treatment service designed to remediate a elderly person’s level of
functioning and independence in life activities, to promote health and
wellness.
Gardening – involves cognitive benefits of enhanced mood, reduced
arousal & improved concentration.
h. Play therapy
> is generally employed & provides a way to express the older person’s
experiences & feelings through a natural, self-guided, self-healing
process.
Barriers to Health Promotion

1. Socioeconomic factors
2. Beliefs & attitudes of both patients & providers
3. Specific motivation based on efficacy of beliefs
4. Access to resources
5. Financial limitations
6. Lack of transportation

Roles of the Gerontological Nurse:

1. Healer
2. Caregiver
3. Educator
4. Advocate
5. Innovator

FUNCTIONS of the Gerontological Nurse

G – guide persons of all ages toward a healthy aging process
E – eliminate ageism
R – respect the rights of older adults and ensure others to do the same
O – oversee & promote the quality of service delivery
N – notice & reduce risks to health & well-being
T – teach & support caregivers
O – open channels for continued growth
L – listen & support
O – offer optimism, encouragement & hope
G – generate, support, use & participate in research
I – implement restorative & rehabilitative measures
C – coordinate & manage care
A – assess, plan, implement, & evaluate care in an individualized, holistic manner
L – link services with needs

GERIATRIC ASSESSMENT
: Assessment of the health status of older persons.
Purposes:

1. To provide a baseline data to gauge changes in condition & health status.

2. To validate the health history & investigate current complaints.
3. To prevent recurrent & debilitating problems.
4. To support the plan of care.

Principles of Comprehensive Geriatric Assessment :

1. Physical, psychological & socioeconomic factors interact in complex ways to

influence the health & functional status of the older person.
2. Comprehensive evaluation of an older person’s health status requires an
assessment in each of these domains.
3. Functional abilities should be a central focus of the comprehensive
evaluation.

Components of Comprehensive Geriatric Assessment

1. History taking a.types of history taking a. types of history taking

- episodic
- complete
b. accuracy of the history taking
2. Health assessment
2. a) History taking
- entails an interview with the older person on certain aspects of health .
- requires a balance between encouraging the person to share concerns
and focusing the data gathering on particularly important factors

1. Episodic health history

- nurse focuses questions & examination on the chief complaints

2. Complete health history

- a comprehensive compilation of data from a variety of sources in order

to provide an in-depth profile on which to plan care.
Accuracy of history taking
Potential difficulties in obtaining a health history from older persons:
1. Communication difficulties
2. Underreporting of symptoms

- fear of being labeled as a complainer

- fear of institutionalization
- fear of serious illness
3. . vague or non-specific complaints
- may be associated with cognitive impairment, drug or alcohol use,
atypical presentation of disease

4. multiple complaints
5. lack of time

Health Assessment

1. Physical health

- Checks for the presence of illness or disease

- Follows the same principles as health assessment in general
- Nurse should carefully note the chief complaints in the patient’s own words à
minimizes the chance of misinterpretations
Common handicaps/disabilities that must be reported during physical
assessment

1. Hearing impairment
2. Vision impairment
3. Limited ROM
4. Speech difficulty
5. Memory loss
6. Acute confusion

Common medical conditions to watch out for in older persons are HPN,
Arthritis, Heart disease, DM & Cancer
2. Functional Status
- it is central to assessment of older persons and makes it different from assessment
of younger persons.
- measures the older person’s ability to perform self-care activities (ADL) & assume
social roles in order to determine the status of health & well being of the
older person.
 - Barthel Index of ADL – assesses ability for self-care
- Katz Index of ADL – describes person’s functional level at a specific point
in time
- Lawton Scale – used to assess more complex activities
- PULSES profile – assessment of progress made in rehab as well as to help
identify the severity of disability

Basic ADLs (BADLs) consist of self-care tasks, including

 Dressing/ Bathing
 Eating/ feeding (chewing/ swallowing)
 Ambulating (walking/ mobility)
 Toileting (complete act of urinating & defecating)
 Hygiene/ grooming ( brushing, combing, styling hair)

Instrumental activities of daily living (IADLs) are not necessary for fundamental
functioning, but they let an individual live independently in a community:

 Shopping for groceries or clothing

 Housekeeping
 Accounting/ Managing money
 Food preparation/taking medications as prescribed
 Telephone or other form of communication usage

- Using technology (as applicable)

Transportation within the community

Advanced ADL – assessment of activities that demand high cognitive functioning and
elderly is more responsive to subtle changes - include such high-level functions as:

 Being gainfully employed

 Hobbies

Socializing and involvement in activities in the community C. Psychological function

- involves assessment of cognitive and affective status.
- adequate mental & affective functioning is required in health history taking &
problem identification.

2 most common Psychological Impairment

 1. Dementia
2. Depression
Examples of psychological tests used for the elderly:
MMSE ( Mini Mental State Examination)
Cornell Scale for Depression in Dementia
Mini-Cog
3. Social function
- measured by the social network & social support of the older adult.
Social network – refers to the web of relationships that the person has around
him/her, including family, relatives, & friends who give support in various
moments

Wellness Diagnoses for the Older Adults{

Health perception- Health Management Pattern
Readiness for enhanced immunization status
Nutritional-Metabolic Pattern
Readiness for enhanced nutrition
Elimination Pattern
Readiness for enhanced for urinary elimination
Cognitive-Perceptual Pattern
Readiness for enhanced decision making3
Main Elements In Providing Care to Older Persons:

1. PEOPLE – these are nurses who are efficient and able to deliver safe, effective,
quality care by being:

 competent - having the right KSA to care for older people

- Nurse must recognize & work within the limits of his competence
Assertive- challenging poor practice, including attitude & behavior and safeguarding
older people
Reliable & dependable
 Present a professional image which demonstrates that the nurse is well-
Organized and manages time well

 Empathetic, compassionate and kind

- putting yourself in the person’s place

- caring enough to want to help to make the situation better
- doing something which is not the usual ---
It’s not just “doing your job”

2. PROCESS - delivering quality care which promotes dignity by nurturing and

supporting the

older person’s self-respect and self-worth through:

 Communicating with older people by not only talking with them, but listening to what
they say.

- be able to interpret body language

- use eye contact
- do not raise your voice
- speak slowly, use simple
language
- use the right language
- listen

 Assessment of need
 Respect for privacy and dignity
 Engaging in partnership working with older people, their families, carers &
colleagues in the profession
 act as advocate to support them in fulfilling their needs respect their decisions as
you work hand in hand with them

3 . PLACE – diverse environments in the community or hospital where care is provided

for older people which is:

 committed to equality and diversity

 appropriate environment
 resourced adequately
 effectively managed
Committed to equality and diversity

 providing care in a non-discriminating, non-judgmental & respectful way

 nurse familiarizes self with the likely characteristics of groups & respond accordingly
 Appropriate environment
 environment conducive to care that meets the needs of older people
 safe, clean, tidy and quiet environment
 one that promotes independence
 Resourced adequately
 Adequate number of nurses, staff and other hospital workers
 Also includes equipment, supplies, medicines, etc
 Effectively managed
 Commitment from management at all levels within an organization
 Effective nurse managers and leaders make explicit the standard of care which they
expect to deliver
 Provide excellence in the care of older people
 Training of staff are identified & provided for.

Living Arrangement of the Elderly

Assessments of living conditions is a special component of assessing the health
of older persons
Factors that may affect living options of the older adult

1. income
2. health status
3. activity level
4. level of independence
5. family or other support systems

Continuum of Living Arrangements for the Elderly

Independent Family provided Assisted Living Home Health

Care Long term care
Living ------> at Home ------> Facilities ------> or Hospice Care --
----> Facilities at home

 Assisted Living Facility (ALF) – consists of private apartments that either

purchased or rented.
 Why ALF?
 lower in cost
 more homelike
 Offer more opportunities for control, independence & privacy.
o – a preferred transition between living independently at home and residing in the
nursing home.

Home Health Care – provides care in the home and eases the burden that family
members may feel.
- it provides skilled nursing care
Hospice care – method of providing palliative and supportive care when the older
adult no longer wants active medical treatment.
Long-term care facilities – best living option when health needs of the elderly
necessitate extensive or full-time supervision. Socorro D. Abejo of the National
Statistics Office…
“Historically, the Filipino elderly have been dependent on their children or co-
resident kin for economic, social and physical support.
However, it has been observed that as long as elderly parents own land or have
means of support, they tend to maintain their own household. This household may
either be nuclear or extended. In either case, they are able to retain their authority
over their adult children.”

 A strong attachment to one’s own home and the desire to maintain one’s
autonomy are the two most compelling reasons for the preference of the
elderly to stay in their own dwellings.
 They eventually live with their children when their health fails and their
children would fulfill their moral obligation to care for and support their frail
parents.
 Domingo et al. (1993) According to Centers for Disease Control

According to the Centers of Disease Control:

Usually when an older person is diagnosed with a chronic condition, there is an
immediate feeling of facing a loss of freedom and autonomy, a sense that his/her
days of living independently at home are numbered.
à the only alternative for some older adults with serious, chronic health
problems is the nursing home.
Fact: Older persons are more vulnerable to the problems of inadequate, unsafe
housing.

 Home safety must be evaluated.

 What to evaluate?

1. Housekeeping 5. Stairways
2. Floor .
3. Bathroom 4.
4. Lighting
5. Stairways
6. Outdoor area
7. Traffic lanes

Suggested products specifically made to help people “age at home”:

 Kitchen implements - devices that make opening jars and bottles, peeling and
cutting vegetables easier

REACHERS – lobster claw –like devices for older adult having arthritis or other muscle
or joinh that makes reaching or bending difficult

 Shower chairs and bath benches and hand-held shower heads for bathing
 Elevated toilet seats
 Automatic lifts for stairwells, beds and chairs

Talking clocks, wristwatches, and calculators for people with

Suggested products specifically made to help people “age at home”:

 Kitchen implements - devices that make opening jars and bottles, peeling and
cutting vegetables easier

REACHERS – lobster claw-like devices for older adult having arthritis or other muscle
or joint that makes reaching or bending difficult.

 Shower chairs and bath benches and hand-held shower heads for bathing
 Elevated toilet seats
 Automatic lifts for stairwells, beds and chairs
 Talking clocks, wristwatches, and calculators for people with poor vision