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Notes

Physical Changes	Implication
Decreased Skin Thickness	Elderly Pts are more prone to skin breakdown. Assess more frequently for pressure injuries.
Decreased Skin Vascularity	Thermoregulation is altered. Increased risk for heat stroke.
Loss of Subcutaneous Tissue	Insulation is decreased. Risk for hypothermia is increased.
Decreased Aortic Elasticity	Diastolic BP is increased.
Possible Decreased Auditory Ability	Do not assume it, but allow for it as a possibility. If Pt is hard of hearing: Approach Pt from front and make eye contact to build confidence. Speak slowly. Do not speak to Pt as if he or she were a child.
Calcification of Thoracic Wall	Heart and lung sounds are obscured. Apical pulse is displaced.
Loss of Nerve Fibers/Neurons	Extra time is needed to comprehend and learn and to perform certain tasks.
Decreased Nerve Conduction	Response to pain is altered.
Reduced Tactile Sensation and Range of Motion	Risk for injury to self is increased. Use extra care with exams to avoid discomfort and injury.
Social Changes	Implication
Marital or Companion Status	Pts living alone are less likely to access health care and are more likely to suffer from heath problems, social isolation, and/or depression.
Generational Differences	Women: Be careful to maintain modesty when giving care. Men: Be careful to maintain independence when giving care.
Living Arrangements	Living situation affects Pt's ease of access to shopping and services and influences available support from family and friends.
Financial Status	Income level influences Pt's ability to access health care, especially prescription drugs.
Education	Education level influences Pt's ability to understand and carry out instructions.
Caregiver Responsibilities	Pts with caregiving roles may be reluctant to report their own symptoms.
Caregiver Availability	Availability (or unavailability) of caregivers influences Pt's access to health care.
ADLs	Pts of advanced age have more difficult time completing common ADLs.
Hobbies and Interests	Lack of hobbies or interests may lead to social isolation and depression.