Elder Learning

Question 1

Types of sensory loss experienced by older adults?

Answer 1

changes in vision, hearing, vestibular

Question 2

Visual acuity

Answer 2

using a Snellen eye chart

Question 3

Visual field

Answer 3

determines the extent and distribution of sensitivity to light

Question 4

Contrast sensitivity

Answer 4

how large an object must be seen (step or a difference in depth)

Question 5

Glare sensitivity

Answer 5

recovery after exposure to a glare (oncoming headlight)

Question 6

Color perception

Answer 6

related to macular region (densely packed with cones) may affect ability to see traffic light colors and matching clothing

Question 7

Dark adaptation

Answer 7

difficulty adjusting to changes in light, may result in increased falls

Question 8

4 most common sight threatening conditions in older adults:

Answer 8

1. cataracts
2. age related maculopathy (ARM)
3. glaucoma
4. diabetic retinopathy

Question 9

Cataracts

Answer 9

a clouding or change in clarity of the crystalline lens of the eye, typically bilateral
- may lead to problems with visual acuity, contrast sensitivity, glare, blurred vision, or difficulties seeing a printed page
- highly treatable with surgical removal and insertion of an intraocular lens

*** the most common cause of visual loss after the age of 55

Question 10

Age related maculopathy (ARM)

Answer 10

the macula is the area of the retina containing the most acute vision
- atrophic = dry
- exudative = wet
- symptoms include reduced acuity, contrast sensitivity, scotomas, or image distortion and sometimes visual hallucinations
- risk factors include genetics, cataracts, smoking, hypertension, sun exposure, farsightedness, light skin or eye color, and a diet low in vitamins

*** the leading cause of irreversible vision impairment in older adults

Question 11

Glaucoma

Answer 11

increased intraocular pressure within the eye
- chronic and progressive optic neuropathy with changes in structure of the optic disk and thinning of the retinal nerve fiber layer
- major symptom is impairment of peripheral visual field but may also affect color vision, flicker sensitivity, motion, contrast and acuity
- treatment can only reduce the rate of progression by reducing production of aqueous humor and relieving IOP

Question 12

Diabetic Retinopathy

Answer 12

secondary to type I or II diabetes with alterations in the small blood vessels of the retina
- common symptoms are changes in refraction, varying focus, blurred or hazy vision, sensitivity to glare, faulty color vision and blindness
- necessitates comanagement by a team of specialists including diabetic specialist, ophthalmologist, physical therapist, and low vision optometrist

Question 13

Impact of visual loss on ADLs and emotional status

Answer 13

• severe impacts seen in relation to ADLs such as driving a car, reading, crossing the street, seeing traffic signs, reading temp on oven, using the stove
• clinical depression may result from such losses

Question 14

Presbycusis

Answer 14

old hearing (hearing loss associated with old aging)
- affects cochlea of both ears
- sound is distorted from inner ear damage, causing problems in clarity and understanding
- especially with F, G, S, Z, T, SH, CH
- difficulty screening out other noises
- slowed auditory processing
- can be from metabolic , vascular, renal diseases, inflammations and infections, medications, head trauma, nutritional deficiencies, genetics, degenerative changes in the inner ear

Question 15

Effects of hearing loss

Answer 15

• hearing loss can make is hard to follow conversations
• can withdraw from others and feel socially isolated
• can lead to depression and decrease in quality of life
• may not respond to questions if unsure of what they heard
• can be judged as senile since they appear inattentive and withdrawn
• can be a safety hazard if unaware of surroundings
• con be frustrating for those trying to communicate to hearing impair elders may avoid conversion with them and keep communication brief

Question 16

Hearing aids

Answer 16

NOT A CURE but makes improvements
- stigma with needing a hearing aid
- problems with amplifying all noises, can be distracting
- technology using computer chips is making hearing aids smaller and more discriminating against background noise
- cochlear implants can be placed for those with severe deficits

*** hearing aids are $$$$$$ and medicare doesn’t cover them

Question 17

Communicating with the hearing impaired:

Answer 17

• get close enough to the person
• get the person’s attention before you speak
• speak clearly and slowly, don’t shout or exaggerate
• look at the person in the eyes
• giver visual cues like hand movements and facial expressions
• if asked to repeat, use different words to say same thing
• avoid noisy areas
• be patient and don’t look irritated
• learn to read the person’s face to make sure your words were understood
• don’t chew gum, eat, or smoke while talking
• masks or you may consider a face shield or make with a clear cutout