Hello, welcome to our geriatric nursing series.
Now in this part of our series, we're going to
talk about the age-related changes in health,
specifically in the cardiovascular system.
So let's go back to our friends.
Picture being a summer Sunday, and our friend Ricardo
here decides he's going to visit his granddad Jose.
Now, Jose lives close by,
but it's really hot outside
and as Ricardo is walking to his granddad's house,
he started to think this wasn't exactly a good idea.
It's like 90 degrees outside and Ricardo
can definitely feel it in his skin.
After a while, he's just wanting to get
there and get into the air conditioning.
Ricardo finally gets air he knocks on
the door and he walks into the house.
He says hi to his granddad then realizes,
"Oh, my Lanta, it is even hotter inside here.
This is ridiculous."
So he looks at the thermostat, and look at that.
How can my granddad feel
comfortable in this? Ricardo thinks.
Now, we're going to break that down, but
if you have an elderly person in your life,
my mom and dad kept the house
so warm, and I live in Oklahoma
so I can really relate to what Ricardo was saying.
So let's look at why in the world an
elderly person in the heat of summer
would have the thermostat that hot in their home.
Because the answer to this question
is really kind of interesting.
Now, here's Jose, remember, he's our example
of someone who has aged successfully
so the changes in his body are simply
due to aging, not due to chronic illness.
So look at his skin.
Now this is when he was like 30 years old.
Look at the bottom, you see that layer of fat
tissue and then the other layers of his skin.
Now this is Jose as he's aged.
Whoa, that's a bit of a drastic difference.
Before we go on, I want you to pause
the video and see if you can list
all the changes between young Jose's layer
of skin, and aged Jose's layer of skin.
Okay, welcome back.
What we just had you do is called prediction.
Now, when you're studying and you're
preparing, if you want to get the most
out of the time you're investing in studying,
I want you to keep using that skill.
Prediction is, even before you have
the answer or all of the information,
I want you to try to guess and make a logical guess.
Research shows us that if you'll do
that, when you do know the answer,
and you have more of the information, it
will stay in your brain much more effectively
and you'll be able to recall it
when you need it, like on an exam
or when you're caring for an elderly patient.
So let's walk through the specific differences.
First of all, older Jose has a thinner
layer of fat underneath his skin.
So look at those two pictures,
and kind of lay that in your mind
let's see how the fat layer is
thinner than when he was younger.
Next, sadly, your metabolism slows down as you
age, it's something I'm dealing with myself.
So as your metabolism slows down, your
ability to respond to cold environments
might not be quick enough or appropriate.
So that makes sense why he would be keeping
the temperature of the home so high.
So first reason was, thinner layer of fat, right?
The second factor is, as everyone
ages, their metabolism slows down.
So that's why Jose is keeping
that place so hot as he ages,
because he likely has a slower response to cold
environments so it might not be quick enough
or appropriate enough to help him stay warm, which
is why he keeps that thermostat cranked way up.
Okay, so let's pause and review.
What are the first two factors we've talked about?
Right, thinner layer of fat now and
the second one is a slower metabolism.
Now what we just did there together is a great
way for you to reinforce information in your mind.
So don't ever hesitate as you're
going through our videos to pause
and ask yourself a question
about the content you just heard.
See, as you're going along, if you check for
your own comprehension, that's beautiful.
That's going to help you encode
that information in your brain
in a way that it's going to stick
with you and help make more sense.
Now we're going on to the third.
The third factor is, the blood
vessels lose their elasticity.
Now look at our graphic on the screen there.
You'll see how the younger Jose, his blood vessels
are showing you how they can shrink and enlarge.
So when we talk about elasticity, that's the blood
vessel's ability to constrict, right and to dilate.
Now as we age even with normal aging without
disease process, those vessels become stiffer.
They lose elasticity.
That means you're going to
have less effective blood flow,
and less blood flow means it's
harder for the person to retain heat.
So that's the third reason that Jose
likely has that thermostat cranked up.
So the next time you walk into
an elderly person's place,
see if you can remember the three reasons why they
likely have that thermostat cranked all the way up.
Now, as you can see, our bodies
keep changing as we grow old,
and these are the kinds of changes we're
going to discuss in this series of lectures.
So here we have Jose and Enrique.
Remember, these two guys are best friends.
So think of them as starting
kind of at the same place.
We're going to show you how Jose aged
successfully and without chronic disease,
and how Enrique aged challenged
by some disease and events.
So here they are in their 80s, Jose and Enrique.
Let's take a look at Jose first
because understanding what is normal
is the best way to recognize
what is slightly abnormal.
So Jose, look at him there,
he was always very active.
He's a runner, he made sure
that he got regular exercise
and that's one of the most important
reasons why he experienced normal aging.
So since we're talking about the cardiovascular
system, this is what Jose's looked like:
He had normal cardiac function at rest,
he had a normal resting heart rate,
and he had a normal cardiac
output and ejection fraction.
So that means his heart was pumping
efficiently for a man of his age.
Now, this is a very different story.
Enrique on the other hand, if you just looked
at him, he looks overall more tired than Jose.
He had a heart attack at age 52, which is
why we've labeled this, 'very eventful aging'
because he had a cardiac event
at a relatively early age.
Now after his heart attack, his hearts
ability to pump efficiently was decreased
so his heart didn't pump the same
after the initial heart attack.
He's also developed congestive heart failure, so
he becomes pretty short of breath with exercise.
So let's compare Enrique to Jose.
Now he has abnormal cardiac function at
rest, he has an abnormal resting heart rate,
and he has an abnormal cardiac
output and ejection fraction.
So pause for just a minute,
look away from your notes,
and see if you can remember the three
cardiac factors that we've talked about
comparing Enrique to Jose