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Do you feel what I feel?Understanding Sensory Changes in the Aging
Population
Sue Brooks MSN, RN, AOCNS®Clinical Nurse Specialist – ACE Unit and Patient Education
Amanda Himes MSN, RN, BCClinical Nurse Manager- ACE Unit
Presenters
Acute Care of the Elderly
Spectrum Health Blodgett Hospital 21 Bed Inpatient Medical-Surgical Unit Goal: Maintain the functional status of the
older adult during acute hospitalization by focusing on their unique needs
Interdisciplinary Team Approach: Nurse Manager, Clinical Nurse Specialist, Educator, Pharmacist, Dietician, Physicians, Physical/Occupational therapy, Pastoral care, Nursing and Nursing Support
Sensory Changes
Vision Hearing Touch Smell Taste
Effects of age related sensory changes
• Barriers during communication and care– Misinformation– Confusion– Wrong assumptions
• Reduced independence– Reduced ability to provide self care
• Isolation
Vision
Thicker lens Loss of elasticity in the lens of the eye Pupil takes longer to dilate and contract Reduced pupil size Visual field becomes smaller Eyelids start to lag Decreased upward gaze Problems with glare Decrease in color vision
Vision - impact
Inability to adjust to glare and change in lighting conditions
Decrease in eyes ability to change the shape of the lens to focus on near objects Medication labels
Safety risk for driving and maneuvering in the environment
Increased safety risk in changing environmental light
Hearing
Loss of sensory hair cells and nerve cells Decreased movement of the bones in ears Increased dryness of ear wax Increase in number of coarse hair in the
ears Eardrum thickens Loss of high frequency hearing Decreased ability to process sounds after
age 50
Hearing - impact
Decreases in sound moving across the ear canal
Decreased ability to hear sounds such as p,w,f,sh and women’s and children’s voices
More time needed to process and respond to sounds
Decreased hearing
Hearing - impact
Decreased quality of communication Social isolation Low self-esteem
Hearing - impact “I went to a table to join four friends. When one
of them asked me a question which I could not understand, the other repeated it for me. However, I was still unable to lip read it. They paused while one of them wrote it down. I was aware that the easy going conversation they had been enjoying before my arrival now ended.
Within a few minutes two of them left and after a brief pause the others explained they had pressing engagements. I sat alone.”
Responds inappropriately
Is labeled confused
Becomes frustrated
Is labeled uncooperative
Becomes angry
Caregiver avoids
Patient Cycle of Hearing Loss
Taste
Most changes in taste are due to: Condition of the mouth Medications Decreased number of taste buds Dry mouth Decreased sense of smell Disease Use of tobacco
Taste - Impact
Decreased sensitivity to flavors Swallowing ability Difficulty with cooking Decreased appetite Eating spoiled food
Smell
Decrease in nerve fibers associated with smell Decreased ability to identify odors
Smell - Impact
Impacts ability to taste Inability to identify spoiled food Inability to identify smoke or gas leaks Limits enjoyment in eating Limits pleasures of everyday life
Smell of spring rain, Christmas tree, flowers, coffee brewing
Touch/sensation
Decreased sensitivity to: Temperature Pressure Touch
Decreased balance Decreased sense of position of legs Change in pain sensation
Touch/sensation - Impact
Increased risk for: Falls Burns Lacerations Calluses Pressure ulcers
Hands on interactive experience
Do you feel what I feel?
Vision
What are you experiencing?
Glaucoma
How would this impact your day to day life?
Vision
What are you experiencing?
Macular Degeneration
How would this impact your day to day life?
Vision
What are you experiencing?
Hemianopsia
How would this impact your day to day life?
Vision
What are you experiencing?
Cataracts
How would this impact your day to day life?
Vision
What are you experiencing?
Yellowing of the lens
Medication Experience
References
Capezuti, E., Zwicker, D., Mezey, M., & Fulmer, T. (Ed’s.). (2008). Evidence-based geriatric nursing protocols for best practice (3rd ed.). New York, NY: Springer Publishing Company, LLC.