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Sensory Loss in Older Adults: Vision; Behavioral Approaches for Caregivers感官损失老年人:展望;行为方式的照顾


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Author: Joseph Casciani 作者:约瑟夫Casciani

As we age, our sensory systems gradually lose their sharpness.正如我们的年龄,我们的感觉系统逐渐失去其锐利。 Because our brain requires a minimal amount of input to remain alert and functioning, sensory loss for older adults puts them at risk for sensory deprivation.由于我们的大脑需要有最低数量的投入,保持警觉和运作,感觉损失老年人使他们处于危险之中的感觉剥夺。 Severe sensory impairments, such as in vision or hearing, may result in behavior similar to dementia and psychosis, such as increased disorientation and confusion.重度感觉障碍,如视力或听力,可能会导致行为类似老年痴呆症和精神病,如增加迷惑和混乱。 Added restrictions, such as confinement to bed or a Geri-chair, increases this risk.新增的限制,如限制睡觉或杰瑞哈主持,增加这一风险。 With nothing to show the passage of time, or changes in the environment, the sensory deprived person may resort to repetitive problem behaviors (calling out, chanting, rhythmic pounding/rocking) as an attempt to reduce the sense of deprivation and to create internal stimulation/sensations. This article is the first in a series of three articles that discuss the prominent sensory changes that accompany aging, and considers the necessary behavioral adjustments or accommodations that should be made by professional, paraprofessional, and family caregivers who interact with older adults.由于没有显示时间的推移,或改变环境,剥夺人的感觉可能诉诸重复的问题行为(喊,唱,节奏的冲击/摇椅)作为一项试图减少意识的匮乏,并建立内部激励/感觉。本文是首次在一系列三篇文章的讨论突出的感觉变化,伴随老龄化,并认为必要的行为调整或住宿,应当作出的专业,准,以及家庭照顾者的互动与谁老年人。 Though the medical conditions are not reviewed in depth, the purpose of this article is to introduce many of the behavioral health insights, principles, and approaches that should influence our caregiving roles.虽然医疗条件不深入审查,本条的目的是为了引入的许多行为健康的见解,原则和方法,应该影响我们的照顾角色。 This article addresses age-related visual changes. CHANGES IN VISION THAT ACCOMPANY AGING A.本文地址与年龄有关的视觉变化。视野中的变化伴随老化字母a. The changes in vision that accompany aging include: 1.的变化,远见,伴随老龄化包括: 1 。 A loss of elasticity of the lens; this means the person is no longer able to focus or accommodate to changes in lighting conditions.失去弹性的镜头;这意味着人已不再能够集中精力或适应变化的照明条件。 (Starting in our 40's, glasses are needed to see fine print). (从我们的40年代,眼镜需要看到罚款打印) 。 It also means the older person cannot adjust to sudden changes in lighting, resulting in an uneasiness when leaving a bright room to enter a dark hallway, or finding seats in the dark in recreation rooms, or theater.这也意味着老年人无法适应突然改变的照明,产生不安时,留下一个光明的房间进入了一个黑暗的走廊,或寻找座位在黑暗中的娱乐室,或剧场。 Going in the reverse direction can be equally difficult: from a dark room to a bright area. 2.走出去的相反方向可同样困难:从黑屋子里一个光明的领域。 2 。 Decreased pupil size; the light reaching the retina is reduced, requiring more light to see.减少瞳孔大小的光到达视网膜减少,需要更多的光线看到的。 This results in the need for lighting 3x to 4x what younger people need to see clearly 3.这样的结果是需要照明3倍到4倍是年轻人必须清楚地看到3 。 A loss of transparency; with age, there is a yellowing of the lens in the eyes, making color discrimination more difficult, especially blue and green.亏损的透明度;与年龄,有一个泛黄的镜头的眼睛,使色彩更加困难的歧视,尤其是蓝色和绿色。 Warmer colors, such as reds and yellows are perceived best, explaining why bright colors are preferred. 4.温暖的颜色,如红色和黄色被视为最好的解释了为什么亮丽的颜色是首选。 4 。 More susceptibility to glare, and longer time is needed to recover from the effects of glare; 5.更多易感性的眩光,并不再需要时间来恢复的影响眩光; 5 。 Eye diseases and disorders, such as cataracts causing a clouding of the lens; glaucoma, resulting from increased pressure of fluids in the eye, damaging the optic nerve and impairing vision.眼科疾病和疾病,如白内障造成混浊的晶状体;青光眼,造成更大的压力流体的眼睛,破坏视神经损害和视野。 Glaucoma, the number one cause of blindness in US, in advanced stages results in yellow halos around images.青光眼,头号致盲原因,在美国,在高级阶段的结果黄色晕周围的图像。 Macular degeneration may occur, where vision is distorted, and images appear different sizes or different shapes, and are missing a central element.黄斑变性可能发生,而愿景是扭曲的,和图像显示不同大小或不同的形状,而且失踪的一个核心要素。 Visual disorders may be secondary to stroke, in which the eye can see the image but the brain cannot interpret the images.视觉障碍可能是二次中风,其中的眼睛可以看到的形象,但大脑不能解释的图像。 Diabetes may result in disrupted blood flow to the retina, causing diabetic retinopathy and a loss of vision, and blindness, in extreme cases. B.糖尿病可能会导致血流中断的视网膜,造成糖尿病性视网膜病变和视力丧失,并失明,在极端的情况下。湾 What are the effects of visual loss on the older adult? 1.什么是视觉效果的损失老年人? 1 。 An increased dependency on others; 2.越来越依赖于他人; 2 。 A sharply reduced quality of life (changes in activities in daily living and instrumental activities of daily living, reduced connection with outside world); 3.大幅降低生活质量(变化的活动在日常生活和器乐日常生活活动,减少与外部世界) ; 3 。 And, a fearfulness and reduced tendency to venture outside. C.和,一个恐惧和减少风险的倾向之外。角 What are the effects of vision changes on demented elderly? 1.是什么影响视力变化对老年痴呆? 1 。 With the losses in visual acuity, other problems in cognitive functioning are heightened, such as difficulty processing unfamiliar faces and settings; 2.随着损失的视力,其他问题认知功能的提高,如处理不熟悉的困难和面临的设置; 2 。 Because the person with dementia already has difficulty learning new behaviors, he or she is less able to learn new habits to compensate for the visual losses (eg, learning to use visual aids to identify articles of clothing or other possessions; 3. There is likely to be an increased disorientation and confusion, as the search for structure and external cues is strained. PRINCIPLES FOR CAREGIVERS The following principles apply to caregiving approaches with older adults who have diminished sensory function. Increased sensitivity and insight to the needs of these individuals improves their quality of life and improves our effectiveness: 1. Observe the behavior of the person, and look for cues and signs of pain or discomfort; 2. Help the person work through the emotional impact of the sensory changes, allowing expression, acceptance, and support of the grief and sadness accompanying these losses; 3. Do not try to fix the unpleasantness; acceptance and support goes a longer way toward healing than a quick fix or a patronizing attitude; 4. Reduce excess disability by maximizing whatever functioning is still left, such as proper eyeglass prescriptions, or functioning hearing aids; 5. Consider assistive devices (phone amplifiers, large text books, headphones, and the Braille Institute for a variety of useful visual aids). Approaches for impairments in vision: 1. Address the person before you touch him or her, identify yourself, let him or her know when you are leaving, speak normally, and do not shout; 2. Describe his or her surroundings to help orient and familiarize the person to the environment, tell him or her location of belongings, and if things have been moved; 3. Use as much contrast as possible, eg, red objects on white background is better than black on a gray background, or blue on green background, (consider switch plates on walls, toothbrushes, combs); 4. Avoid moving quickly from a bright room to a darkened room, or vv Make sure the visually-impaired person takes the time for the pupils to adapt to the changes in lighting; 5. Introduce yourself every time you come into contact with the person, and explain what you are going to do because there are no visual cues; 6. Help to identify others in their environment with colored clothing, name tags with large print, etc. 7. Clean eyeglasses regularly, provide adequate lighting, and avoid glare; 8. Provide night lights, and arrange furnishings in the environment for safety and ease of mobility. Even with normal aging, functioning of our five senses is not like it was when we were younger adults. This article offers caregivers who work with visually-impaired older adults some insights into the special needs and adjustments that will turn unpleasant, frustrating situations into more caring, helpful, and sensitive interactions. By integrating these behavioral approaches in the delivery of the health care with older adults, we can favorably impact the management of these conditions. Copyright 2008 Concept Healthcare, LLC由于老年痴呆症的人已经很难学习新的行为,他或她是那么能够学习新的习惯,以弥补视觉损失(例如,学习使用直观教具,确定条款的衣物或其他财产; 3 。有可能要增加迷惑和混乱,为寻求结构和外部线索是紧张。原则照顾者以下原则适用于照顾办法,老人谁也感觉功能减弱。提高敏感性和洞察力的需要,这些人改善他们的生活质量和改善我们的效力: 1 。遵守的行为人,并寻找线索和迹象,疼痛或不适; 2 。帮助的人的工作情绪影响的感觉变化,使表达,接受,并支持在悲痛和哀伤伴随这些损失; 3 。不要试图解决不愉快;接受和支持不用更长的道路愈合不是权宜之计或居高临下的态度; 4 。减少过剩的残疾的一切运作最大化仍然是左,如适当的眼镜处方,或运作的助听器; 5 。试想辅助装置(电话放大器,大型文字的书籍,耳机,以及盲文学会了各种有益的直观教具) 。途径损伤视力: 1 。地址的人然后触摸他或她,确定自己,让他或她知道什么时候你将要离开,说话正常,不喊; 2 。描述他或她的周围,以帮助指导和熟悉的人的环境,告诉他或她所在地的财物,如果事情已经移到; 3 。使用了相反的可能,例如,红色的物体在白色背景优于黑色的灰色的背景,或蓝绿色的背景, (考虑板开关在墙上,牙刷,梳子) ; 4 。避免迅速从明亮的房间黑暗的房间,或超强确保视障人需要的时间为学生适应变化的照明; 5 。引进自己每次到接触的人,并解释你要做的,因为没有视觉线索; 6 。有助于查明其他方面的环境,有色服装,名称与大型标签印刷等7 。定期清洁眼镜,提供足够的照明,并避免强光; 8 。提供夜间照明,并安排家具的环境,安全和方便的流动性。即使有正常老化,运作我们的五感是不喜欢这是当我们年轻的成年人。本文提供照顾谁与视障老年人的一些见解的特殊需要和调整,把不愉快的,令人沮丧的情况下更多的关怀,帮助,和敏感的相互作用。通过整合这些行为的办法,提供保健与老年人,我们可以积极影响管理的这些条件。版权所有2008年医疗保健的概念,有限责任公司


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