What is the general effect of ageing on organ systems?
All organ systems decline in function, reducing the body’s ability to respond to stress (infection, injury, surgery).
What are the main age-related cardiovascular changes and their effects?
↓ elasticity → ↑ blood pressure; ↓ cardiac output → fatigue, dizziness, risk of heart failure.
What are the main respiratory changes with ageing?
↓ lung elasticity and muscle strength → ↓ oxygen exchange, ↑ infection risk.
What musculoskeletal changes occur as people age?
↓ muscle and bone density → falls, fractures, and reduced mobility.
What renal and urinary changes occur with ageing?
↓ kidney function and bladder tone → dehydration, drug toxicity, incontinence.
What are common neurological changes in older adults?
Slower reflexes and mild memory decline → slower reactions and increased delirium risk.
What gastrointestinal changes occur in older adults?
Slower digestion and ↓ liver metabolism → constipation, nutrient absorption issues, and drug metabolism problems.
What sensory changes occur with ageing and what are the effects?
↓ vision, hearing, and taste → safety issues, communication difficulties, and poor appetite.
What happens to the skin with ageing?
Skin becomes thinner and drier → fragile skin, poor healing, and temperature regulation problems.
What changes occur in the immune system with ageing?
↓ immune response → increased infection risk.
What endocrine changes occur with ageing?
↓ hormone regulation and insulin sensitivity → ↑ risk of diabetes and fatigue.
What is the key concept behind age-related physiological decline?
Older adults have less physiological reserve, requiring careful monitoring, lower drug doses, fall prevention, and hydration support.
Why are older adults more vulnerable to hospital complications?
Due to reduced physical reserves, immobility, polypharmacy, delirium risk, poor nutrition/hydration, infection risk, and psychological decline.
What are key nursing focuses to reduce hospital complications in older adults?
Encourage early mobility, nutrition, hydration
Review medications
Provide orientation aids (clocks, photos)
Maintain a calm, person-centred environment
What are the main differences between delirium and dementia?
Onset:
- Delirium – sudden (hours to days)
- Dementia – gradual (months to years)
Course:
- Delirium – fluctuates, often worse at night
- Dementia – steady decline
Cause:
- Delirium – acute illness (e.g. infection, medications, dehydration)
- Dementia – chronic brain disease (e.g. Alzheimer’s)
Attention:
- Delirium – impaired
- Dementia – usually intact until late stages
Consciousness:
- Delirium – altered
- Dementia – usually clear until late stages
Reversible?:
- Delirium – often reversible
- Dementia – irreversible
What is the “DELIRIUM” mnemonic used for identifying causes?
Drugs
Electrolytes
Lack of drugs/pain
Infection
Reduced input (vision/hearing)
Intracranial causes
Urinary/constipation
Myocardial/pulmonary issues
What are key nursing interventions for delirium?
Treat the underlying cause, reorient the patient, ensure hydration, sleep, and mobility, use sensory aids, and involve family.
