In-Home Care for Senior Citizens

Understanding the Aging Process will be very helpful to any health care assistant. As people grow older, their bodies gradually change both physically and mentally. Bones may become more brittle and more easily broken. Due to decreased calcium in the diet and decreased circulation, lack of exercise, or illnesses, a condition called osteoporosis (brittleness of the bones), may occur. Muscular reflexes become slower or absent. Due to lack of exercise, muscles will waste away. The nervous system becomes less effective due to brain damage caused by strokes.

The nervous system as a whole, becomes less efficient and uncoordinated. At times, unrecognized strokes take place, due to inadequate blood supply to the brain, producing episodes of confusion, loss of memory of both recent and past events, and disorientation (the loss of the sense of location, person, and time). Hardening of the blood vessels (arteriosclerosis), closes off the vascular blood supply to component parts of the body, causing gradual changes during the aging process. The degree of the vascular blood supply to the body parts, will determine the level of the aging process that the individual will attain. Also, changes of behavior and personality should be noted. The inability to respond and effectively communicate with others may be seen. It is to be pointed out that "From a medical standpoint, these may be the earliest manifestations of the person reacting to the simple process of aging, and it is important to recognize these symptoms when the person shows episodes of confusion, disorientation, memory loss, behavioral changes, or uses poor judgment. The individual should be referred to his or her physician for evaluation. Treatment at this point may be most effective in interrupting or delaying the progression of the illness before severe damage occurs. Asking the simple question, "What did you eat for breakfast?" or "What day is it?" may give a clue that the person is showing signs of aging. If the person gives an answer unrelated to the question, he or she may be showing signs of loss of memory for recent or past events, or even brain damage".

If the health care assistant notices any changes in the individual’s behavior or personality, that change must be brought to the attention of the physician. The earlier the diagnosis is established, of physical or mental problems, the earlier treatment can be instituted. Therefore, it is important to re-emphasize that any changes noticed with the elderly individual, must be reported to the physician for him to make a diagnosis.

The aging person may become paralyzed in some portions of the body or may have illnesses causing trembling or jerking of the hands and arms. Physical therapy can at times, help to prevent further damage.

Special care of the skin must be given to the elderly person. The skin often becomes dry and thin and can be protected with less frequent bathing and the use of creams and lotions.

Extra care must be given to prevent decubiti, (bedsores). This is especially true with the person who frequently sits or stays in a wheelchair or bed for long periods of time. (See Bedsores, Chapter 29) The elderly person’s sense of smell touch, hearing, sight, and taste, become less acute with age. Hearing aids, false teeth and eyeglasses are frequently helpful.

Infections and other complaints of the respiratory system become more frequent. Well-ventilated rooms and the avoidance of crowds may be helpful. Pneumonia can possibly be prevented by immunization with vaccines. Flu shots are often recommended. Protection from cold and drafts can be obtained by using extra clothing and blankets. This clothing should be comfortable and adequate. Check for the source of the problem.

Many problems with digestion, such as vomiting, belching, constipation, and diarrhea become frequent. In any such cases, the physician must be notified.

Basic needs such as proper diet, shelter, safe environment, rest, sleep, cleanliness, and exercise must all be considered. All complaints of pain should be heeded as they may indicate serious illness. Most older folks do not complain as soon as younger people and these aches and pains may indeed be symptoms or signs of illness. The physician should be called if the symptoms persist.

It is important to understand when the person has hematuria (blood in the urine), that this should be taken seriously and must be immediately reported to the physician. He or she will advise what should be done. Any other symptoms such as painful or frequent urination, should be reported. Do not try to make your own diagnosis as serious mistakes can be made with serious consequences. Leave diagnosis up to the physician.

Any shortness of breath, difficulty in walking, such as pains in the calves of the legs or other body parts, changes in heart rhythm, pains in the chest, arm or neck, cold clammy sweat, should immediately be called to the attention of the physician. Make the person as comfortable as possible and do not administer medication without physician’s direction. If the physician is not available and you as caregiver, believe the person needs emergency care, call for the emergency squad at once. Post emergency squad and doctor’s phone numbers nearby for quick reference.