Chapter 9 Meeting Safety Needs of Older Adults Copyright © 2012, 2008 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 1

Chapter 9

Meeting Safety Needs of

Older Adults

Copyright © 2012, 2008 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 1

Lesson 9.1


Objectives

Discuss the types and extent of safety problems experienced by the aging population.

Describe internal and external factors that increase safety risks for older adults.

Discuss factors that place older adults at risk for imbalanced thermoregulation.


Internal Risk Factors


Vision and Hearing

Diminished range of peripheral vision and changes in depth perception are common and can interfere with the ability of older adults to judge the distance and height of stairs and curbs or to determine the position and speed of motor vehicles

Decreased auditory acuity reduces an older person’s ability to detect and respond appropriately to warning calls, whistles, or alarms


Senses of Smell and Taste

Decreased sensitivity of these senses increase the risk for accidental food or chemical poisoning in older adults


Cardiovascular, Nervous,and Musculoskeletal Systems

Any cardiovascular condition that results in decreased cardiac output and decreased oxygen supply to the brain can cause older adults to experience vertigo (dizziness) or syncope

Older persons with neurologic disorders such as Parkinson’s disease or stroke experience weakness and alterations in gait and balance that increase risk for falls


Cardiovascular, Nervous,and Musculoskeletal Systems

(cont.) Musculoskeletal conditions such as arthritis

further reduce joint mobility and flexibility, decreasing the ability of the older person to move and respond to hazards and intensifying the likelihood of accidents or injury


Injury Risks for Older Adults

Impaired physical mobility Sensory deficits Lack of knowledge of health practices or

safety precautions Hazardous environment History of accidents or injuries


Medications

Medications often contribute to falls and, because older adults commonly take one or more medications, their risk for untoward effects is increased

Any medication that alters sensation or perception, slows reaction time, or causes orthostatic hypotension is potentially dangerous for older adults


Falls

The most common safety problems in older adults

Many independent elderly are reluctant to report a fall because of the implication that they are frail and dependent

In addition to causing bodily harm, falls take a psychological toll on older adults, causing them to lose confidence and decrease mobility


Falls (cont.)

Older adults living independently in the community often do not recognize hazards in their home environment because they are too accustomed to their surroundings to view them as potential hazards


Reducing the Risk for Falls

Prepare safe surroundings Allow adequate time to complete an activity or

task Wear properly fitting footwear Use assistive devices if needed Ask for help when necessary


Assistive Devices Promote Support and Safety


Audience Response System Question 1

The most common safety problem in older adults is:

A.falls.

B.visual disturbances.

C.hearing impairment.

D.decreased sense of smell.


External Risk Factors


Preventing Injuries in the Home Ensure that all rugs are firmly fixed to the

floor Maintain electric safety Decrease clutter and other hazards Provide adequate lighting Provide grip assistance wherever appropriate Place frequently used items at shoulder

height or lower where they can be reached easily

Take measures to prevent burns


Fire Hazards

Older adults are among the highest risk groups for injury or death caused by fire

Residential fires injure an average of 3000 older adults each year

Most of the injuries are a result of cooking accidents, whereas most of the deaths are smoking-related


Fire Hazards (cont.)

Basic fire safety precautions in the home Make sure smoke detectors are installed Use caution with cigarettes or open flames Make sure that there are no open flames from

things such as cigarettes, matches, or candles if oxygen is in use

Check extension cords for fraying or loose plugs


Fire Hazards (cont.)

Basic fire safety precautions in the home (cont.) Be sure to turn off the stove or oven if you are

leaving the area Never cook while wearing long loose sleeves that

could catch fire Have an escape plan Do not use elevators when there is a fire


Home Security

People, particularly strangers, present a risk to older adults

Older adults are more vulnerable than younger persons to attack and injury from those who prey on weaker or more defenseless people, such as the infirm or older adults


Home Security Guidelines

Think and plan ahead to reduce risks to personal safety

Identify ways an intruder could enter the home Maintain regular contact with friends and family Use the telephone safely Answer the door safely Bank safely Prepare for emergencies


Vehicular Accidents

Probably the most dangerous hazards, because of their size and speed, are motor vehicles

Motor vehicle accidents are more likely to occur with aging, whether the older person is a pedestrian or a driver


Safe Driving Practices for Older Adults

Older adults are often unwilling to stop driving in spite of the serious risks to themselves and others


Thermoregulation The ability to maintain body temperature in a

safe range is controlled by the hypothalamus Internal factors include muscle activity,

peripheral circulation, amount of subcutaneous fat, metabolic rate, amount and type of foods and fluids ingested, medications, and disease processes

External factors include humidity, environmental temperature, air movement, and amount and type of clothing or covering


Audience Response System Question 2

What is the main reason voiced by elderly adults for continuing to drive?

A.Medical appointments

B.Independence

C.Lack of other transportation

D.They see no reason to stop driving


Lesson 9.2


Objectives

Describe those older adults who are most at risk for developing problems related to imbalanced thermoregulation

Identify signs and symptoms of thermoregulatory problems

Discuss interventions that promote safety for older adults


Thermal Hazards for Older Adults

What are some thermal hazards for older adults?


Hypothermia

A core body temperature of 95° F or lower Normal changes that occur with aging affect

the body’s ability to regulate temperature Changes in the skin reduce ability to perceive

dangerously hot or cold environments Decreased muscle tissue, decreased muscle

activity, diminished peripheral circulation, reduced subcutaneous fat, and decreased metabolic rate affect the amount of heat produced and retained by the body


Signs of Hypothermia

Mental confusion Decreased pulse and

respiratory rate Decreased body

temperature Cool/cold skin Pallor or cyanosis Swollen or puffy face


Muscle stiffness Fine tremors Altered coordination Changes in gait and

balance Lethargy, apathy,

irritability, hostility, or aggression

Hyperthermia

A higher than normal body temperature, occurs when the body is unable to get rid of excess heat

Can be caused by excessively high environmental temperatures, an inability to dissipate heat, or increased heat production caused by exercise, infection, or hyperthyroidism


Heat Stroke

A condition in which the body temperature can climb as high as 104° F

A life-threatening emergency A very real concern for active older persons,

particularly those living in hot climates


Nursing Interventions for Risk for Injury

Evaluate the person for the risk for falls Modify the environment to reduce risks


Nursing Interventions for Hypothermia or Hyperthermia

Monitor the environmental temperature, humidity, and air movement

Monitor body temperature at regular intervals Provide clothing and bed covers suitable for

the environment Promote adequate fluid and food intake Monitor activity level in accordance with

environmental temperature


Audience Response SystemQuestion 3

One of the first signs of hypothermia in older adults is:

A.bradycardia.

B.slow respiratory rate.

C.pallor.

D.mental confusion.


Documents

Chapter 9 Meeting Safety Needs of Older Adults Copyright © 2012, 2008 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 1