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National Association for Home Care

The Process of Normal Aging

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  • Aging begins the moment we are born. Aging is NOT a disease, although we do develop more aches and pains and undergo many changes as we grow older. Therefore, it is important to understand the aging process in order that it not be confused with a disease.

    After about age 25 we tend to lose height as the disks in the vertebrae in the spine begin to shrink, causing the bones to move closer together. The back begins to bend forward after about 40. From age 20 to age 70 a woman may shrink about two inches, while a man about one inch. Some women lose as much as one-third of their skeletal structure by the time they reach 75, twice the rate of men.

    Weight also changes with age. It is likely to go up until middle age, perhaps to age 50, and then start decreasing. The rate at which the resting body converts food into energy slows down about 3% every decade after age 20. When combined with a sedentary lifestyle and an undiminished appetite, middle age spread can result. At the same time, we lose muscle tissue at the rate of about one-half of one percent per year. In the years between 20 and 70, a quarter of the original muscle mass can disappear, replaced by fat. In some people the loss of muscle tissue is balanced by the gain of fat. In the elderly, however, the loss of muscle tissue is more conspicuous. Because muscle tissue weighs more than fat, overall weight usually declines.

    Don't be discouraged by the list of changes that accompany aging. They occur gradually, not instantly the day we turn 65!

    Here's a list of specific changes that occur as we age, with tips on how to manage them successfully:

    APPETITE:
    Decreases occur in our sense of smell and taste. This can lead to a decrease in appetite and a loss of interest in eating. TIP: Add more seasonings to foods, eat meals with friends, prepare favorite meals, eat small but more frequent meals.

    BLADDER:
    The size of the bladder decreases, by or more, leading to increased frequency of urination. The brain's inability to control the bladder's muscles can result in incontinence. The structure of a female's urethra changes and may lead to an increased incidence of urinary tract infections. The prostate enlarges in men often leading to difficulty with urination. TIP: Avoid drinking fluids before bedtime.

    COMMUNICATION:
    Comprehension (understanding) of conversations remains good unless hearing is impaired. Some decrease in vocal volume may be noted as well as in vocal quality, producing roughness or hoarseness. An individual may demonstrate increased difficulty with remembering names, dates and the like. TIP: It can help to think through the alphabet to recall a name, or to relax when trying to come up with a name or fact. To help a person with a hearing loss, remember to speak up.

    TEETH:
    Atrophy (shrinking) of gums and bone tissue can occur. This can lead to loss of teeth and/or dentures which may, in turn, cause difficulty in chewing solid food. TIP: Visit the dentist twice a year. If without natural teeth, see dentist yearly to check for any gum lesions, etc. Have dentures realigned every five years or more often if a decrease in weight has occurred.

    GASTROINTESTINAL:
    General slowing of function of the intestines, stomach, liver, etc., may lead to decreased metabolism and clearance of medications. Delays in transit time in the colon due to this slowing may lead to constipation, hemorrhoids, and dehydration. TIP: Have adequate fluid intake (6-8 glasses of water daily) and good fiber intake (fresh vegetables, whole grain breads, cereals, etc.)

    HEARING:
    May experience high frequency hearing loss due to decreased movement of the bones and muscles of the ear. May have difficulty hearing women's voices, or hearing in a noisy environment. A high frequency loss may affect the ability to hear certain speech sounds such as s,z,f,v, and th. TIP: Have your hearing checked and, if warranted, consider a hearing aid.

    HEART:
    As the heart ages, it may become enlarged and function less efficiently. If the elasticity in the blood vessels decreases you may see an increase in blood pressure. Lightheadedness may occur if one changes position too quickly as the circulatory system is unable to adapt quickly. The heart may be unable to meet the demands of the activity. TIP: When using heart medication, be sure to follow physicians' recommendations, including exercise.

    IMMUNE SYSTEM:
    Decreased ability of the immune system to repair damage from disease or to resist disease may cause increased susceptibility to pneumonia or viruses such as the flu. TIP: Maintain a good diet, get adequate rest, manage stress, ask the doctor about taking vitamin supplements and exercise regularly.

    KIDNEY:
    Decreased circulation to the kidneys results in shrinkage in size. Function becomes less efficient but is generally adequate under normal conditions. However, certain medications that filter through the kidneys may remain longer in the system. TIP: Have adequate fluid intake, review all medications with your doctor periodically.

    MUSCLES:
    Decline in the number and size of the muscle cells leads to decreased strength. This may get worse with inactivity and can improve with increased activity. TIP: Keep active, exercise daily.

    LUNGS: Decreased elasticity of the lungs and chest wall and decreased strength in respiratory muscles often leads to decreased oxygen delivery. TIP: Have a regular exercise routine, avoid smoking and second hand smoke. If experiencing shortness of breath see your physician.

    MEMORY:
    Minimal changes in memory. One of the greatest fears people have about growing old is senility. Senility is not a normal part of the aging process. People don't lose their power to think and to reason without a physical cause. TIP: Use lists, a day book, calendars, etc. to help remember appointments, important information, birthdays, etc.

    REPRODUCTION:
    Men - Enlargement of the prostate, shrinkage of the testes, ejaculation is slower and volume decreases. Women - After menopause, decreased hormone levels can lead to dryness of the vagina. These changes can make intercourse uncomfortable. TIP: Sexuality can still be an enjoyable part of life. Check with the doctor about hormone medications, use of lubricating gel, etc.

    SKIN:
    Thinning of the outer layer and loss of circulation increases the chances of wounds from minor traumas (tear in skin from bumping against an object), or areas of pressure (bed sores). These changes make the skin less effective in retaining body heat. TIP: Practice good skin hygiene including use of moisturizing lotions; drink 6-8 glasses of water a day. May require extra layer of clothing or extra blankets on the bed.

    SLEEP:
    Sleep patterns become altered: periods of deep sleep become shortened and may result in more frequent awakenings. Signs of inadequate sleep include anxiety, fatigue, and irritability. TIP: May need to include more time for naps during the day. Keep the drapes open during the day to provide plenty of daylight. Some form of exercise during the day may improve sleep patterns. Maintain a regular routine (always go to bed about the same time). If you can't sleep, it is better to get up for awhile than to lay there and toss and turn.

    VISION:
    More light is needed to see because the eyes adapt to changes in light more slowly. Eye lens gradually clouds causing vision to become less clear. Problems with depth perception may require bifocals to see things both near and far. Decreased tear production may lead to dryness, itching, and burning. TIP: Increase the lighting in the home, especially in the work and reading areas. Use a hand-held magnifying glass. Large print books and magazines may be available at your local library. Ask the doctor about artificial tears.

    Excerpted from The Caregiver's Guide, A Hands-on Book, 3rd Edition by The Continuum, 1997

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