Summary of Geriatric Development

The saying "Age is just a number" is true in some respects. The pace of change and how much occurs in the body depends on how well one takes care of himself in earlier years. Nevertheless, it is inevitable. By the time a person reaches 65 years of age, system functions have declined, bringing on new health challenges. Brain size decreases overall and it becomes more difficult to retain new information. The neuronal conduction rate also begins to slow down, resulting in slower movements and reaction times. This, combined with decreased proprioceptors in the somatosensory system and vision loss, leads to an increased fall risk in this population. Hearing loss is also common. Other changes include decreased strength and flexibility as muscle and bone mass decline rapidly. Besides normal, age-related changes, geriatric patients often face comorbidities such as arthritis, diabetes, and cardiovascular disease.

With the physical changes that occur, some adults may become depressed, knowing that they can't do the things they were once able. It can be especially depressing for those faced with the decision to move out of their homes. In addition, close family and friends may no longer be living, leading to social isolation. Patients may have trouble accepting their own fate as they contemplate their life choices, reflected in Erickson's stage of Integrity vs. Despair and the 5 Stages of Grief. 

In the clinic, having these patients wear gait belts and giving physical assistance as needed are ways to reduce fall risks. PTAs should take hearing and vision loss into consideration during treatment, giving simple verbal and visual cues to minimize confusion. In addition, home exercise and education handouts are excellent tools, especially for those who have poor memory. Finally, it is important to remember that mental health is more important than ever before. Encouraging the patient to find activities he/she enjoys doing with other people and providing resources are some ways PTAs can help. However, simply being understanding and empathetic can make a huge difference.