Understanding Aging: Health in the Elderly
Understanding the Aging Process
The aging process, even in healthy elderly individuals, involves functional and morphological alterations. These changes exist on a spectrum between normal and pathological, with an unstable balance of work and functional adaptation to their real capabilities (Pietro de Nicola).
Characteristics of the Elderly
The elderly present with the following:
- Some diseases are specific to their age.
- Diseases that typically occur at an earlier age manifest differently, with a higher incidence.
- The same disease presents with different diagnostic and therapeutic characteristics compared to other age groups.
- Compromise of other organs and systems is more frequent, leading to the concurrence of multiple morbid processes.
- Social and psychological problems significantly influence these processes.
- Defense mechanisms are limited, making them more susceptible to diseases even with weaker stimuli.
Frail Elderly
Frail elderly refers to individuals in a fragile state characterized by a reduced ability to withstand minimal internal or external changes (Woodhouse). This fragility increases the risk of acute illness, dependency, institutionalization, and death. Physical, social, and environmental factors contribute to frailty.
Geriatric Patients
A geriatric patient is typically over 65 and suffers from one or more diseases that tend towards incapacity or disability. These conditions are often influenced by psychological and/or social factors. The management and evolution of the disease are conditioned by the environment.
Characteristics of Geriatric Diseases
Causes
- Prolonged exposure to risks over time.
- Lifestyle habits contribute to the development of severe chronic processes in old age.
Health Alterations in the Elderly
Alterations in the health of the elderly are characterized by:
- The terrain on which they settle: Morphological alterations.
- The time in which change occurs: Functional alterations (yield, tolerance).
- Endogenous and exogenous factors that lower defenses.
Pluripathology
Causes of pluripathology:
- Altered ability to maintain a constant internal environment despite external changes.
- Impaired functional capacities of organs and systems.
- Interaction between systems.
- Long periods of disease evolution.
- Immune disorders.
- Immobility.
- Iatrogeny.
Polypharmacy
Due to multiple disorders, it is common for the elderly to take more than one medication (polypharmacy).
Peculiar Latent Symptomatology
Besides the difficulty in taking a medical history, diagnosis is complicated by the atypical, incomplete, silent, or seemingly unimportant presentation of symptoms in old age.
Tendency Towards Chronicity and Disability
The prognosis is generally less favorable than in younger individuals, with a higher tendency towards chronicity and disability.
Socio-Familial Impact
The presence or absence of family support significantly impacts the elderly. Hospitalized elderly individuals with limited family support often experience longer hospital stays, more frequent readmissions, and greater use of pharmacological substances.
Important Considerations
- Respiratory Complications
- Diagnostic Confusion
- Elimination Issues
- High Risk of Infection
Nursing Records
A comprehensive nursing record is essential for continuity of care, facilitating coordination between different healthcare centers as the elderly patient’s health status and living situation may change.