Slide 1: Physical Activity Guidelines for Older Adults
- At least 150 min/week of moderate-intensity activity or 75 min/week of vigorous activity.
- Spread activity throughout the week.
- For greater benefits: 300 min moderate or 150 min vigorous per week.
- Include balance, strength, and aerobic components.
- Perform muscle-strengthening activities 2+ days/week.
- Be as active as possible within one’s abilities.
Slide Notes:
Regular physical activity helps older adults improve heart, muscle, bone, and overall function while reducing disease and depression risk. When possible, they should combine aerobic, balance, and strength exercises. Activities can include walking, dancing, or even household chores. If health limits participation, any amount of activity is beneficial.
Slide 2: Environmental Assessment
- Identify home hazards: poor lighting, loose rugs, cords, low toilets, etc.
- Assess neighborhood safety and transportation access.
- Ensure proximity to essentials: food, pharmacies, banks, healthcare.
- Home visits help reveal unseen issues (nutrition, isolation, hazards).
- Interventions may include home health, transportation, or shopping services.
Slide Notes:
Environmental safety is key to independence. Assess both the home and community environments for risks and accessibility. Simple modifications like adding grab bars or improving lighting can prevent injuries. Home visits allow a clearer understanding of living conditions and help tailor interventions.
Slide 3: Falls in Older Adults
- 1 in 4 older adults falls yearly; 20% cause serious injury.
- Common causes: gait/balance issues, vision loss, medication effects, dementia.
- Fear of falling may reduce activity, worsening health.
- Most falls have multiple contributing factors.
- Evaluate and correct risk factors promptly.
Slide Notes:
Falls are one of the leading causes of injury in older adults. Risk factors often overlap—like vision problems and medication effects. Assessment should address both physical and environmental contributors. Encouraging safe movement and balance exercises reduces fear and fall recurrence.
Slide 4: Older Adult Drivers
- Over 45 million drivers are aged 65+.
- Driving supports independence and social connection.
- Safe driving needs good cognition, vision, flexibility, and reflexes.
- Encourage routine vision/hearing checks and physical exercise.
- Plan gradual driving cessation and alternative transportation options.
- Use warning signs checklist to guide safety decisions.
Slide Notes:
Driving symbolizes freedom, but aging can affect safety. Discuss driving early and openly with older adults. Encourage health maintenance to preserve ability, and plan alternatives before driving cessation becomes necessary. Healthcare providers and families play key roles in these discussions.
Slide 5: Sleep in Older Adults
- Older adults need 7–8 hours of sleep nightly.
- <5 or >9 hours linked to poorer cognition and health.
- Causes of poor sleep: illness, depression, medication side effects.
- Avoid sedatives; focus on nonpharmacologic strategies:
- Relaxing music, sunlight exposure, bedtime routines.
- Limit food/drinks late, reduce light/noise.
Slide Notes:
Sleep changes with age, but chronic insomnia isn’t normal. Evaluate for underlying causes before using medications. Encourage healthy sleep habits like a consistent routine, daylight exposure, and relaxation techniques to improve rest and reduce side effects from sleep medications.
Slide 6: Spiritual & Special Considerations
- Spirituality helps older adults find meaning and cope with illness.
- Assess with open-ended questions (e.g., “Do you consider yourself spiritual?”).
- Involve chaplains/clergy as appropriate.
- For all care:
- Assess function during normal activities.
- Provide written instructions and allow rest breaks.
- Use assistive devices (glasses, hearing aids).
- Speak clearly, face the person, slow your pace if needed.
Slide Notes:
Spiritual care is essential for holistic health and coping. Each person’s beliefs should be respected. When assessing older adults, adapt communication and environment to their needs. Small adjustments—like written instructions or assistive devices—improve safety and understanding.
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TABLE 32.1
Physical Activity Guidelines
To improve cardiorespiratory function, muscular fitness, bone, and functional health and to reduce the risk of noncommunicable diseases, depression, and cognitive decline: • Older adults should do at least 150 minutes of moderate-intensity aerobic physical activity throughout the week (e.g., housework, dancing, brisk walking), or 75 minutes each week of vigorous aerobic activity. • Ideally, activity should be spread throughout the week. • For additional health benefits, older adults should increase their moderate-intensity aerobic physical activity to 300 minutes per week or engage in 150 minutes of vigorous-intensity aerobic physical activity per week or an equivalent combination of moderate- and vigorous-intensity activity. • Multicomponent physical activity that includes balance training, strength training, and aerobic activity is recommended. • Muscle-strengthening activities involving major muscle groups should be done on 2 or more days a week. • When older adults cannot do the recommended amounts of physical activity because of health conditions, they should be as physically active as their abilities and conditions allow.5
TABLE 32.2
Warning Signs for When to Stop Driving
- Almost crashing, with frequent close calls
- Finding dents and scrapes on the car, fence, mailbox, etc.
- Getting lost easily; having issues with memory
- Having trouble seeing or following traffic signals, road signs, and pavement markings
- Responding more slowly to unexpected situations; having trouble moving the foot from the gas to the brake pedal; confusing the two pedals
- Misjudging gaps in traffic at intersections and on highway entrance and exit ramps
- Driving too slow or too fast for conditions
- Easily becoming distracted or having difficulty concentrating while driving
- Physical limitations such as having a hard time turning around while backing up or changing lanes
- Having trouble maintaining the correct lane or switching lanes while driving