Description
Book SynopsisThe Physiological Effects of Ageing is a comprehensive resource for all nurses working with older people, enabling them to apply their knowledge of the ageing process to their practice, and, in doing so, enhance care delivery. This book emphasizes the normal ageing changes before considering possible effects of ageing on body systems, using as its framework Roper, Logan and Tierney's activities of living. Although problems associated with ageing are identified, nursing assessment and interventions are considered which can help reduce the impact these changes have on a person's functional ability.
Special Features:
- Explores current theories of ageing
- Makes use of reflective points and points of practice
- Looks at key topics of maintaining a safe environment and communication
- Discusses error theory, free radical theory and the immune theory
- Ahighly accessible text which encourages holistic patient-centred care
Trade Review"In order to provide quality and effective care, it is important that we are knowledgeable about the needs of this group and this book provides a good grounding in this area." (International Journal of Orthopaedic and Trauma Nursing, 1 November 2011)
"The value of this book lies in the skilful way in which the authors have meshed normal and disordered physiology of ageing with Roper's models of living and nursing." (Nursing Older People, 1 May 2011)
Table of ContentsAuthor profi les xiii
Preface xv
1 Growing Older 1
Introduction 1
Drivers in the care of older adults 2
Activities of living 3
Overall aims 4
References 5
2 Theories of Ageing 7
Aims 7
Learning Outcomes 7
Introduction 7
Ageing theories 7
Error theory 8
Free radical theory 8
Immune theory 9
Programmed theory of ageing: changes in cell replication 10
Neuroendocrine theory 11
Effects of ageing on homeostasis and body function 11
Summary 12
References and further reading 13
3 Maintaining a Safe Environment 14
Aims 14
Learning Outcomes 14
Introduction 14
Immune system 15
Physical/mechanical and chemical barriers 15
Phagocytosis 15
Acute infl ammatory response 16
Typical immune response to the presence of pathogenic microorganisms 17
Relationship between innate (non-specifi c) and acquired (specifi c) immunity 17
Wound healing 18
Ageing changes in the immune system 19
Changes in the thymus 20
T cell function 20
B cell function 20
Natural killer cells 21
Infl ammatory process 21
Nutrition 22
Changes to the skin and mucous membranes 23
HIV/AIDS 24
Assessment of the immune system 24
HIV/AIDS 26
Stages of HIV infection 26
Modes of transmission related to older adults 26
Issues relating to older people and HIV/AIDS 27
Summary 29
References and further reading 30
Useful websites 31
4 Communicating 32
Aims 32
Learning Outcomes 32
Introduction 32
Normal structure and function 33
The nervous system 33
Ageing changes in the nervous system 39
Brain 39
Neuronal loss 39
Neuronal networks 40
Neurotransmitters 40
Lipofuscin and neurofi brillary tangles 41
Movement 41
Changes in the spinal cord 41
The eye 42
Structures of the eye 42
Aqueous humour and vitreous humour 43
Accessory structures 43
Physiology of vision 43
Refraction 44
Accommodation 44
Constriction 44
Convergence 44
Retina and the conversion of light to an electrical signal 44
Ageing changes in the eye 45
The ear 46
Normal structure and function 46
Physiology of sound 48
Ageing changes in hearing and vestibular function 49
Conditions associated with communication diffi culty in older adults 49
Delirium 49
Assessment for delirium 51
Management 52
Pain in older people 53
Epidemiology of pain for older people 53
Criteria for choosing a pain assessment tool 54
Other factors 58
Management of pain for older people 59
Parkinson's disease 59
Pathophysiology 60
Diagnosis 62
Medical management 62
Nursing management 63
Summary 64
References and further reading 64
Useful websites 66
5 Breathing 67
Aims 67
Learning Outcomes 67
Introduction 67
Normal structure and function 68
Upper respiratory tract 68
Lower respiratory tract 69
Mechanics of respiration 71
The mechanics of breathing 71
Inspiration 71
Expiration 72
Gas exchange 73
Oxygen and carbon dioxide transport 73
Control of breathing 73
Nervous system control 73
Chemical control 74
Ageing changes in the respiratory system 75
Changes in the structure of the respiratory tract 75
The thoracic cage and muscular function 76
Alveoli 76
Elastic recoil 77
Control of ventilation 77
Assessing respiratory function 78
Common respiratory problems associated with ageing 79
Pneumonia 79
Management of the older adult with pneumonia 80
Infl uenza 82
Cardiovascular system 84
Normal structure and function 84
Blood fl ow 85
Changes in the cardiovascular system of the older adult 86
Heart failure 86
Clinical features 87
Classifi cation of heart failure 87
Outlook 87
Management 87
Summary 88
References and further reading 89
Useful websites 90
6 Eating and Drinking 91
Aims 91
Learning Outcomes 91
Introduction 91
Normal structure and function 92
The mouth 93
The stomach 94
The small intestine 95
Absorption of nutrients in small intestine 96
The large intestine 98
The liver 99
The gall bladder 100
The pancreas 100
Ageing changes in the digestive system 101
Oral hygiene 103
Assessment of oral health 105
Nursing management of oral hygiene 105
Nutritional assessment 106
Common GI problems associated with ageing 110
Under-nutrition in older people 110
Food guide pyramid 111
Constipation 112
Summary 116
References and further reading 117
Useful websites 119
7 Eliminating 120
Aims 120
Learning outcomes 120
Introduction 120
Normal structure and function of the urinary system 121
Blood supply to the kidneys 121
Renin–angiotensin mechanism 124
The bladder 124
The urethra 125
Micturition 125
Ageing changes in the urinary system 125
Glomerular fi ltration rate 126
Creatinine 126
Day/night changes in renal function 126
Hormones 127
Common problems of the urinary system 128
Urinary incontinence 128
Urinary tract infection 130
Assessment of continence 132
The urogenital distress inventory 134
Long form of UDI 134
Short form of UDI 135
Management of urinary incontinence 136
Scheduled voiding 137
Prompted voiding 137
Bladder training 137
Pelvic muscle exercises 137
Intermittent catheterisation 138
Summary 139
References and further reading 139
Useful websites 141
8 Controlling Body Temperature 142
Aims 142
Learning Outcomes 142
Introduction 142
Normal structure and function 142
Structure of the skin 143
Gaining and losing heat 143
The effects of ageing on the ability to maintain body temperature 145
Epidermal changes with ageing 145
Conditions affecting thermoregulation in older adults 148
Hypothermia 148
Prevention of hypothermia 149
Acute management of hypothermia 153
Re-warming techniques 154
Heat stroke 155
Summary 155
References and further reading 156
Useful websites 157
9 Mobilising 158
Aims 158
Learning Outcomes 158
Introduction 158
Normal structure and function 159
The locomotor system 159
Control of skeletal muscles 162
Ageing changes related to mobilising 162
Bones 162
Joints 164
Muscles 164
Age-related health problems 166
Osteoporosis 166
Falls in older people 167
Falls risk assessment 169
Interventions 170
Preventative measures 172
Exercise 173
Summary 174
References and further reading 175
Useful websites 176
10 Expressing Sexuality 177
Aims 177
Learning Outcomes 177
Introduction 177
Male reproductive system 178
Normal structure and function 178
General function 179
Sexual arousal and ejaculation 180
Female reproductive system 181
Ovaries 181
The menstrual cycle 181
Meiosis 181
The fallopian tubes 182
The uterus 182
The vagina 182
The external genitalia 183
Breasts 183
Sexual arousal in females 183
Changes in the reproductive systems associated with ageing 184
Maintaining sexuality 184
The ageing man 184
Testosterone 184
Sperm production 185
Changes in sexual arousal 185
The ageing woman 185
Hormonal changes related to the menopause 185
Effects of the hormonal changes on the female body 186
Sexual arousal in older women 187
Sexuality in older people 187
Factors affecting sexuality in older people 190
Assessment of sexual function 191
Permission giving 191
Limited information stage 192
Specifi c suggestions stage 192
Intensive therapy stage 192
Management of health issues related to sexuality 193
Summary 193
References and further reading 194
11 Sleeping 195
Aims 195
Learning Outcomes 195
Introduction 195
The normal sleep cycle 195
Ageing changes with sleeping associated with the sleep–wake cycle 197
Assessment of sleep 199
Sleep disorders in older adults 200
Apnoea 200
Leg movements during sleep 201
Insomnia 201
REM sleep disorder 202
General interventions 203
Specifi c interventions 205
Summary 205
References and further reading 206
12 Final Thoughts on Ageing 207
Index 209
