Key Takeaways
- Normal aging involves gradual physiological changes that affect all body systems
- Sensory changes (vision, hearing) affect safety and communication with older adults
- Polypharmacy is common in older adults and increases the risk of drug interactions and adverse effects
- Fall prevention is critical as falls are a leading cause of injury in older adults
- The LPN/LVN promotes independence while ensuring safety for aging patients
Last updated: January 2026
The Aging Process and Self-Care
As the population ages, LPN/LVNs increasingly care for older adults. Understanding normal aging changes helps distinguish expected changes from pathology and guides appropriate interventions.
Normal Physiological Changes of Aging
Cardiovascular System:
- Decreased cardiac output
- Stiffening of blood vessels
- Increased blood pressure
- Slower heart rate response
Respiratory System:
- Decreased lung elasticity
- Reduced vital capacity
- Weaker cough reflex
- Increased risk of respiratory infections
Musculoskeletal System:
- Loss of muscle mass and strength
- Decreased bone density
- Joint stiffness
- Reduced flexibility
Nervous System:
- Slower reflexes
- Decreased balance
- Sleep pattern changes
- Memory changes (mild forgetfulness is normal)
Integumentary System:
- Thinner, drier skin
- Decreased subcutaneous fat
- Slower wound healing
- Increased bruising
Sensory Changes
| Sense | Changes | Nursing Implications |
|---|---|---|
| Vision | Presbyopia, decreased night vision, glare sensitivity | Adequate lighting, large print, reduce glare |
| Hearing | Presbycusis (high-frequency loss) | Face patient, speak clearly, reduce background noise |
| Taste | Decreased taste buds | Season food appropriately, check nutritional intake |
| Smell | Decreased olfactory sensation | Check smoke detectors, watch for gas leaks |
| Touch | Decreased sensitivity | Check water temperature, inspect skin carefully |
Medication Considerations in Older Adults
Pharmacokinetic Changes:
| Process | Change | Effect |
|---|---|---|
| Absorption | Decreased GI motility | Slower, but usually complete |
| Distribution | Increased fat, decreased water | Fat-soluble drugs last longer |
| Metabolism | Decreased liver function | Slower drug breakdown |
| Excretion | Decreased kidney function | Drugs stay in system longer |
Polypharmacy Concerns:
- Multiple medications increase interaction risk
- Side effects may be mistaken for disease symptoms
- Confusion about medication schedules
- Cost and adherence challenges
High-Risk Medications in Older Adults (Beers Criteria):
- Benzodiazepines
- Anticholinergics
- NSAIDs (chronic use)
- Certain antihistamines
- Some muscle relaxants
Fall Prevention in Older Adults
Risk Factors:
- History of falls
- Muscle weakness
- Gait and balance problems
- Use of assistive devices
- Medications (sedatives, antihypertensives)
- Visual impairment
- Environmental hazards
Prevention Strategies:
| Setting | Interventions |
|---|---|
| Home | Remove throw rugs, improve lighting, install grab bars, secure cords |
| Healthcare | Bed in low position, call light within reach, non-skid footwear, frequent toileting |
| Exercise | Strength training, balance exercises, tai chi |
Nutrition in Older Adults
Nutritional Concerns:
- Decreased appetite
- Difficulty chewing/swallowing
- Financial limitations
- Social isolation affecting meals
- Chronic disease dietary restrictions
Nursing Interventions:
- Assess nutritional status regularly
- Encourage small, frequent meals
- Provide nutrient-dense foods
- Address dental issues
- Consider Meals on Wheels or congregate meals
Hydration
Risk Factors for Dehydration:
- Decreased thirst sensation
- Medication effects (diuretics)
- Fear of incontinence
- Difficulty accessing fluids
- Cognitive impairment
Signs of Dehydration:
- Dry mucous membranes
- Concentrated urine
- Confusion
- Tachycardia
- Orthostatic hypotension
- Poor skin turgor (check on forehead or sternum)
Promoting Independence
| Need | Promoting Independence |
|---|---|
| Mobility | Assistive devices, exercise, environmental modifications |
| Self-care | Adaptive equipment, allow extra time, encourage participation |
| Cognition | Calendars, reminder systems, structured routines |
| Social | Community programs, transportation, technology for connection |
Cognitive Changes
Normal Aging vs. Dementia:
| Normal Aging | Dementia |
|---|---|
| Occasional forgetfulness | Frequent memory loss affecting daily life |
| Slower processing speed | Difficulty with familiar tasks |
| May forget names temporarily | Confusion about time or place |
| Knows they forgot something | Doesn't recognize a problem |
| Functions independently | Needs assistance with daily activities |
Supporting Self-Care
Strategies:
- Simplify medication regimens
- Use pill organizers and alarms
- Provide written instructions in large print
- Involve family in care planning
- Connect with community resources
- Address sensory deficits
- Allow adequate time for tasks
Safety Considerations
| Hazard | Prevention |
|---|---|
| Driving | Assess vision, cognition, reaction time; discuss alternatives |
| Medication errors | Use pill organizers, simplify regimens |
| Financial exploitation | Educate about scams, involve trusted family |
| Burns/scalds | Check water heater settings, use caution with hot items |
| Fire | Check smoke detectors, no smoking in bed |
On the NCLEX-PN
Expect questions about:
- Normal vs. abnormal aging changes
- Fall prevention strategies
- Medication safety in older adults
- Promoting independence while ensuring safety
Test Your Knowledge
An older adult patient has difficulty hearing the LPN's instructions. Which communication technique is most appropriate?
A
B
C
D
Test Your Knowledge
An older adult patient is taking 12 different medications. What concern should the LPN prioritize?
A
B
C
D
Test Your Knowledge
When assessing skin turgor in an older adult, which site provides the most accurate assessment?
A
B
C
D