In the realm of healthcare, understanding the intricate and evolving needs of our aging population is a

fundamental aspect of providing holistic and effective care. As we embark on this journey to explore the
physiological changes that occur in older clients, we find ourselves navigating the remarkable terrain of
the human nervous system.

The nervous system, with its intricate web of communication, plays a pivotal role in orchestrating our
every thought, sensation, and movement. Comprising of the brain, spinal cord, and nerve cells- this
dynamic system is a marvel of nature.

Join us as we embark on this exploration of physiological changes in older clients and the profound
impact these changes have on their overall well-being. Together, we will uncover the complexities of
aging, the resilience of the human body, and the role of healthcare professionals in optimizing the health
and quality of life for our older clientele.

Brain Shrinkage:
As we age, it is normal for the brain to undergo some degree of shrinkage, a phenomenon known as
brain atrophy. This shrinkage is particularly noticeable in regions of the brain associated with memory
and learning, such as the hippocampus and the frontal cortex. The reasons behind this shrinkage include
a reduction in the number of neurons (brain cells) and a decrease in the density of synaptic connections
between these neurons.
What is the impact of atrophy on Cognitive Function?
The shrinkage in these memory and learning-related brain regions can have a direct impact on
cognitive function. It may result in difficulties with memory consolidation, information retrieval, and the
ability to learn new information efficiently. As a result, older adults may experience challenges in tasks
that require working memory, attention, and problem-solving skills.
Reduced Blood Flow:
Another common age-related change in the nervous system is a decrease in blood flow to the
brain. This can occur due to the natural stiffening and narrowing of blood vessels over time. Reduced
blood flow means that the brain may receive less of the essential nutrients, including glucose and oxygen,
that it requires to function optimally.
What is the impact of reduced blood flow on Brain Function?
The brain relies on a constant and adequate supply of nutrients and oxygen to support its
functions. When blood flow is compromised, brain cells may not receive enough energy, leading to
reduced cognitive performance. Individuals may experience difficulties in focusing, processing
information, and maintaining mental clarity.
Neuron Changes:
Neurons are the fundamental building blocks of the nervous system, responsible for transmitting
electrical signals throughout the brain and body. With age, neurons may undergo various changes:

 Decreased Efficiency: Neurons may become less efficient in transmitting signals. This reduced
efficiency can lead to slower response times in processing information and executing tasks.
 Structural Changes: Neurons may also show structural changes, such as the accumulation of
cellular debris, which can interfere with their normal function.
 Synaptic Changes: The connections between neurons, known as synapses, may undergo
alterations. These changes can affect the strength of signals between neurons, potentially leading
to memory decline and slower thought processes.
With older patients having these kinds of cognitive changes as nurses, how do we communicate with
them?
1. Speak Clearly and Slowly:
 a. Enunciate your words clearly and speak at a moderate pace. Avoid using medical jargon
or complex language.
b. Allow the client time to process and respond to what you've said, as they may need more
time to formulate their thoughts.

2. Use Non-Verbal Communication:

a. Pay attention to your body language, facial expressions, and gestures. Ensure your non-
verbal cues convey empathy, patience, and understanding.
b. Use touch appropriately and with sensitivity, taking into account the client's comfort level
and cultural preferences.
3. Listen Actively:
a. Give your full attention to the client during conversations. Minimize distractions and
interruptions.
b. Be patient and avoid interrupting when they are speaking. Allow them to express
themselves fully.
4. Repeat and Confirm:
a. Repetition can be helpful. Summarize key points of the conversation and ask if they
understood or have any questions.
b. Use open-ended questions to encourage them to share their concerns and feelings.
5. Visual Aids and Written Information:
a. Utilize visual aids, written instructions, or diagrams when discussing complex medical
information or procedures.
b. Provide written materials or resources for the client to review at their own pace.
6. Empathize and Validate:
a. Acknowledge their feelings and concerns, even if they seem unrelated to the immediate
medical issue.
b. Use empathetic statements to show understanding and support.
Nerve Degeneration:
Peripheral nerves are responsible for transmitting sensory information from the body to the brain
and for carrying motor signals from the brain to the muscles. With age, these nerves may degenerate or
become less efficient in transmitting signals.
What is the impact of nerve degeneration on Sensory and Motor Function?
Degeneration of peripheral nerves can result in decreased sensitivity to touch, temperature, and
pain. This can make older individuals more susceptible to injuries or accidents because they may not feel
sensations as acutely. Additionally, motor function may be affected, leading to muscle weakness, reduced
coordination, and impaired balance.
What is the most common risk for patients having decreased motor function?
FALLS!
As nurses, how do we manage falls?
Home Assessment
1. Around the House
a. Avoid having mats on the floor or make them securely fastened
b. Check for worn carpets and loose flooring as these can be hazardous
c. Be careful of loose cords hanging on the telephones or other house implements, for the
older person can easily trip these.
d. Keep areas well lit at night: nigh light (Blue or green light bulb)
2. Bedroom
a. Check height of bed
b. Instruct the older person to take time to gain balance when getting io from chair or bed
 c. Instruct the older person to wear shoes or slippers that have slip-resistant tread patterns
and have low heals with a broad surface.
3. Bathroom
a. Check slippery surface on the floor and avoid mats in the bathroom unless firmly fixed
b. Rails may be fitted in the shower or bath to help the older person get in and out or to
steady himself or herself.
c. If getting on and off the toilet is difficult, consider installing handrails and perhaps a
raised toilet seat.
4. Kitchen
a. Put Items for everyday use where they can be reached easily.
b. Try to have power outlets placed where they are easy to reach.
c. Make sure the floor surface is non-slip and always clean up water, food spills, etc.
d. Encourage the older person to ask for help with tasks that might be too risky, such as
transferring heavy pots an pans, pouring boiling water in to a thermos etc.
5. Medication- no diuretics at night!
Thoughts and Feelings:
Older people are more prone to depression for several reasons, many of which are interconnected. It's
important to note that depression is not a normal part of aging, but rather a treatable condition. What are
some key factors that contribute to higher rates of depression in older individuals?
Before we talk about that, let's meet Otto. Insert adlib regarding movie.

 Physical Health Issues: As people age, they are more likely to experience chronic health
conditions, such as heart disease, diabetes, arthritis, and neurological disorders. These health
issues can be painful, debilitating, and reduce overall quality of life, leading to feelings of sadness
and hopelessness that can contribute to depression. Otto has hypertrophic cardiomyopathy, a
condition that affects the heart’s main chamber and makes it difficult for the heart to pump
blood through the body as usual.
 Loss and Grief: Aging often comes with the loss of loved ones, including spouses, friends, and
family members. Coping with the death of a spouse or close friends can be emotionally
devastating and may lead to prolonged grief and depression. Otto’s rude and grumpy behavior is
the man’s coping mechanism for his wife’s death some six months ago.
 Social Isolation: Social isolation and loneliness are common issues among older adults,
especially for those who live alone or have limited mobility. Lack of social interaction and a
support system can lead to feelings of loneliness and depression.
Other reasons:

 Stigma and Generational Beliefs: Older generations may have grown up with stigmatizing
beliefs about mental health, viewing depression as a sign of weakness. This can deter older
individuals from seeking help or talking openly about their feelings.
 Lack of Awareness: Depression in older adults can be underdiagnosed and undertreated
because it may be mistaken for normal aging or other medical conditions. Healthcare providers
and family members may not always recognize the signs of depression in older adults.
 Loss of Independence: As people age, they may experience a loss of independence due to
physical or cognitive limitations. This loss can lead to a sense of helplessness and contribute to
depressive symptoms.
It's crucial to emphasize that depression in older adults is treatable. Early diagnosis and
appropriate treatment, which may include psychotherapy, medication, or a combination of both, can
significantly improve an individual's quality of life and mental well-being. Supportive family members,
caregivers, and healthcare professionals play a vital role in identifying and addressing depression in older
adults. Encouraging open communication and providing access to mental health services are essential
steps in addressing this issue and improving the mental health and overall well-being of older individuals.