Chapter 12

Health Care of the Older Adult

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Number of Persons Age 65+
1900-2030

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Specialized Needs of the Elderly

• Aging is not synonymous with disease.

• The effects of aging are a primary contributor to
disability.
• Functional assessment framework for assessing the
elderly
• Nursing interventions focus upon facilitating the highest
quality of life.
• Need to compensate for/recognize age-related changes
• Early interventions prevent complications and maximize
life quality.
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Age-Related Changes
Table 12-2
• Cardiovascular system
• Respiratory system
• Integument system
• Reproductive system
• Musculoskeletal system
• GU system
• GI system
• Nervous system and cognition
• Sleep
• Senses
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Pharmacologic Aspects

• Older persons use more medications than any other

group.
• Increased risk for adverse drug reactions and
polypharmacy

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Altered Pharmokinetics

• Aging changes alter drug:

– Absorption
– Metabolism
– Distribution
– Excretion
• See Table 12-3

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Nursing Implications

• Need adjustment of dosage due to age; “start low and go

slow”
• Assess medication knowledge and use.
• Need for medication review and coordination of
prescribers
• Problem of noncompliance:
– Factors that affect compliance
– Keep medication regimen as simple as possible.
– Strategies to improve compliance
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Specific Health Issues for Elderly Persons
and Their Families

• Depression
• Alcohol and drug abuse
• Delirium
• Dementia
– Alzheimer's disease
– Vascular dementia

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Common Health Issues

• Impaired mobility
• Dizziness
• Falls
• Urinary incontinence
• Increased susceptibility to infection

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Home Care Services

• Home health care

• Hospice

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Health Care Costs

• Elders, who represent 13% of the population, consume

more than 33% of health costs.
• Health care costs and the elderly population are
increasing.
• Payment sources:
– Medicare
– Medicaid

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Ethical and Legal Issues

• Elder abuse and neglect

• Advance directives
– Living will
– Durable power of attorney

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