{"id":29,"date":"2017-09-13T19:32:30","date_gmt":"2017-09-13T19:32:30","guid":{"rendered":"https:\/\/courses.lumenlearning.com\/suny-home-health-aide\/chapter\/working-with-the-elderly\/"},"modified":"2017-10-02T18:54:22","modified_gmt":"2017-10-02T18:54:22","slug":"working-with-the-elderly","status":"publish","type":"chapter","link":"https:\/\/courses.lumenlearning.com\/suny-home-health-aide\/chapter\/working-with-the-elderly\/","title":{"raw":"Working with the Elderly","rendered":"Working with the Elderly"},"content":{"raw":"
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Introduction<\/h1>\r\nThis module is devoted to learning about the special needs facing elderly patients. We will begin by looking at social factors that change as people age and societal attitudes about the aging process. We will then explore all the different body systems and look at how the body and mind changes as a person ages throughout the lifespan. Finally, we will look at special diseases such as cerebrovascular accident<\/a>s (stroke<\/a>), Alzheimer\u2019s<\/a> and Parkinson\u2019s Diseases and then discuss how to work with people who suffer from these disorders.\r\n

What is Aging?<\/h1>\r\n

Aging and the Individual<\/h2>\r\nAging<\/b> is a normal<\/u> <\/b>physical and psychological process that all humans go through as they move throughout the lifespan<\/a>. It includes all the changes which occur over the course of a person\u2019s life (U.S. Department of Health and Human Services, National Institutes of Health, National Institute, 2011). Lifespan<\/a><\/b> means the length of time that a person or living thing can be expected to live (Oregon Department of Human Services, 2012). As people age, or get older, there are many changes that occur within their bodies (physical<\/b> <\/b>changes<\/b>) and within their minds and behavior (psychological<\/b> <\/b>changes<\/b>). These changes are known as human growth and development<\/a> (Leahy, Fuzy & Grafe, 2013).\r\n\r\nWhile all humans go through the same<\/i> <\/i>stages<\/i> of development as they age, no<\/i> <\/i>two<\/i> <\/i>humans<\/i> <\/i>will<\/i> <\/i>have<\/i> <\/i>the<\/i> <\/i>same<\/i> <\/i>exact<\/i> <\/i>experience<\/i> of development. People vary greatly in the rate and extent which their body ages (Mauk, 2008). Everyone has different experiences as they move throughout the lifespan<\/a>. Psychological, environmental and social factors such as stress and financial situations impact the pattern of people's development. Biology or genetics<\/a><\/b> (a person\u2019s genes) also has a strong influence on how people develop and the physical changes that will occur. Diseases such as heart disease, infections, strokes<\/a>, and the use of substances such as alcohol and drugs all affect physical changes that occur in the human body.\r\n\r\nEach person will have different experiences of development throughout their lifespan, which result in development being a unique<\/i> and highly individualized<\/i> process for each person. It is important to understand the general physical and psychological changes and stages of development that humans go through. And, it is even more important to understand that no two people will go through these stages in exactly the same way. Keep in mind that each person is a unique individual.\r\n
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Self-Check Activity M3-1<\/h3>\r\nTrue<\/b> <\/b>or<\/b> <\/b>False<\/b>?<\/b>\r\n\r\n1. \u00a0All people have the same experience of development as they age. True<\/b> <\/b>or<\/b> <\/b>False<\/b>. _________<\/b>\r\n\r\n2. Physical changes are those that occur within the body. True<\/b> <\/b>or<\/b> <\/b>False<\/b>. _________<\/b>\r\n\r\n3. Psychological changes are those that occur within the mind and can include behavioral changes. True<\/b> <\/b>or<\/b> <\/b>False<\/b>. _________<\/b>\r\n[reveal-answer q=\"910511\"]Show Answer[\/reveal-answer]\r\n[hidden-answer a=\"910511\"]1. False 2. True 3. True\r\n\r\nFeedback: 1. While all humans go through the same stages of development as they age, no two humans will have the same exact experience of development. Genetics, the environment, and diseases all influence a person\u2019s experience of development. 2. Physical changes are those which occur within the body, such as changes to skin, digestion, and bones. 3. Psychological changes are those which occur within the mind, such as changes to memory, concentration, and behaviors.[\/hidden-answer]\r\n\r\n<\/div>\r\n

Social Factors and Aging<\/h2>\r\nAs people develop and change through the lifespan<\/a>, there are many social factors that affect their development. Social factors include family structure and roles within the family, gender roles, and culture<\/a>.\r\n\r\nChanges in family structure and the role that one has in the family occur throughout the lifespan<\/a>. While an elderly person may still be considered to be at the head of the family, their role may have changed now that they are older. For example, an elderly person may now not be able to provide for their family financially and physically. Younger members of the family may take on the role of financial provider or as caretaker. Families must make adjustments to the changes that occur throughout the lifespan<\/a>. These can be emotionally and physically difficult. They can put great strain on members of the family and on the elderly patient.\r\n\r\nThe communication<\/a> skills from Module Two are good tools to help people deal with new emotions. Home Health Aides\/Personal Care Aides must be sensitive to the adjustments their patient's family must make. They must perform their job well and refer any issues that they cannot competent<\/a>ly handle to their supervisor. Also, they should empathize with family members. If a family member comes to them with a problem, listen to their concerns. Sometimes just talking about a problem can make a person feel better about it. Home Health Aides\/Personal Care Aides must be supportive and encouraging. Paraphrasing what the person says and summarizing the feelings they are convey<\/a>ing (what they are trying to express) is most helpful. They should demonstrate empathy<\/a> and positive regard toward their patient and their family members.\r\n\r\nBe aware of cultural values and differences. As discussed in Module Two, members of African American, Asian, Latino, and Middle Eastern cultures<\/a> place a strong emphasis on the role of family and may be very involved with the elderly patient's care. They may prefer to take on caretaking responsibilities at home, rather than place their elderly loved one into a long-term care facility. Gender differences<\/a> also exist within the various cultures<\/a>. Middle Easterners may prefer to have their health care provided by a member of the same gender. As discussed in Module Two, the concept of machismo<\/a> for Latinos means male members of the family feel a certain amount of responsibility to provide for other family members. When a male member of a Latino family becomes ill, it can have a heavy emotional and financial burden on that person and their family. If they were the sole bread winner, there will be a financial strain upon the family. The eldest son or the wife may need to take on employment in order to support the family. This shift in family role can be very unsettling and emotionally taxing for all family members.\r\n\r\nWithin the United States, the head of the household and primary bread winner has traditionally been the male. Even with the shift in gender roles within the United States where most women are now employed and have fulfilling careers, gender stereotypes<\/a> still exist. An elderly male who can no longer provide for his family physically or financially may have a difficult time adjusting to this shift within the family. He may feel his masculinity is being questioned if he now must be cared for by another person, such as a Home Health Aide\/Personal Care Aide. These psychological adjustments are difficult, but with the support and empathy<\/a> of a Home Health Aide\/Personal Care Aide, the patient and family can better make adjustments to developmental changes. Religious beliefs also influence how people practice health care rituals, prepare for death and care for loved ones after death. Refer back to Module Two for a review of various cultural and religious beliefs and how they impact health care a person wishes to receive.\r\n
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Self-Check Activity M3-2<\/h3>\r\nTrue<\/b> <\/b>or<\/b> <\/b>False<\/b>?<\/b>\r\n\r\n1. Cultural beliefs and gender roles can impact how a person handles changes in physical health.\u00a0True<\/b> <\/b>or<\/b> <\/b>False<\/b>. _________<\/b>\r\n\r\n2. Good communication skills, listening, and empathy are ways to help families deal with changes in physical and psychological health.\u00a0True<\/b> <\/b>or<\/b> <\/b>False<\/b>. _________<\/b>\r\n[reveal-answer q=\"813747\"]Show Answer[\/reveal-answer]\r\n[hidden-answer a=\"813747\"]1. True 2. True\r\n\r\nFeedback: 1. Cultural beliefs and gender roles (such as what roles men and women take on) can affect how a person handles physical changes. 2. Using good communication skills is a way HHA\/PCAs can help families adjust to changes which occur in their physical and mental health.[\/hidden-answer]\r\n\r\n<\/div>\r\n

Observing and Reporting Changes<\/h2>\r\nAs Home Health Aides\/Personal Care Aides work with elderly patients, they may come to have first-hand knowledge of the physical and psychological changes that occur during the aging process. They may also come to recognize and be the first to notice signs of a new disorder or disease process that is not related to the aging process, but which can be mistaken for and disregarded as \u201cjust aging.\u201d\r\n\r\nFor example, it is not<\/u> a normal part of aging to have dementia. If a patient suddenly begins to show signs of forgetfulness, difficulty concentrating, or disorientation<\/b><\/a> (an inability to recognize themselves, where they are, what year or season it is or events that are occurring), the HHA\/PCA should immediately report these signs to their supervisor. These signs are not necessarily due to \u201cjust aging\u201d. They could be signs of a stroke<\/a> or dementia related to Alzheimer\u2019s<\/a> or a vascular<\/a> (blood vessel) problem, such as changes in oxygenation within the brain. Confusion and delirium could also be the result of side effects from medications, drug-drug interactions, dehydration, or infection (Mauk, 2008). It is important to remember that aging in and of itself is normal, and not part of a disease (Leahy, Fuzy & Grafe, 2013).\r\n\r\nIt is also not a normal part of aging for older adults to experience incontinence<\/a> (loss of control of bowel or bladder<\/a>). These could be signs ofmedication side effects, urinary tract infections or imbalances of electrolytes<\/b><\/a> <\/b>in the body (Mauk, 2008). It is also not a normal part of aging for adults to fall. Falls can be the result of medication side effects, medication interactions, or a sign of an acute (sudden) illness (Mauk).\r\n\r\nIf Home Health Aides\/Personal Care Aides notice any of the following, especially if they occur suddenly, they should immediately report them to their supervisor:\r\n