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Online Companion:
Fundamentals of Nursing Standards and Practice 2E
Frequently
Asked Questions
Many older people can't remember to take their medicine as prescribed
but not all of them have Alzheimer's Disease. What's the difference in these
memory problems?
Age-related memory loss begins in human beings around 40-50 years of age and
continues into later years. This is due to changes in the brain associated with
normal aging. It is a gradual process and most individuals build compensatory
mechanisms to assist them to remember, such as writing down information and
keeping keys in the same place at home etc. When a new medication is ordered,
it may take a few days for the older adult to establish a routine or method
for taking the drug as prescribed. Most older people adapt to memory loss and
maintain the ability to function well at work and at home. They pay their bills
on time, keep clinic appointments, drive around and get home safely. When the
older person has difficulty with daily functioning because of memory loss, such
as forgetting to eat meals, further assessment is indicated. When an older person
shows changes in behavior or unsafe behavior, assessment factors can be summarized
by the "4 D's": Delirium, Dementia, Depression, Drugs. Any recent
change in drug regimen provides a clue to presence of an adverse drug reaction.
Recent abrupt behavior differences are indicative of delirium or acute confusion
in which the underlying cause may be infection or other illness. Dementia is
characterized by gradual and progressive loss of memory and judgment impairments.
At what age should an older person stop driving a car?
Aging brings about changes in the nervous system and reaction time is usually
slowed. Sensory changes include loss of visual acuity and night vision difficulties.
The extent and impact of these changes are widely variable among older people.
Assessment of safety issues is very important when working with older clients.
When family members express concern about the safety of an elder's driving,
the client should be referred for evaluation. In some states, the motor vehicle
registry may request an older driver to complete a road test at the time of
license renewal. The nurse should examine the impact on the older person of
giving up driving. Loss of independence and social isolation are common concerns
of older people. There may not be available public transportation. The nurse
should work closely with an older client and family members to find safe alternatives
when driving a car is a high risk situation.
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