Hi, welcome to our series
on Geriatric Nursing
where we're looking at
age-related changes in health.
Now in this particular part,
we're going to talk about gastrointestinal
tract changes or the GI tract.
Here's our friends,
José and Enrique.
This is when they were young.
José has experienced normal aging.
Enrique has had a bit of a rough go because
he's had several major health events.
Now these guys hook
up, they get together,
they decide, you know,
let's go back to that restaurant.
we used to go in the good old days,
we would have those
cheeseburgers and french fries,
maybe drink a beer with that,
maybe some bacon on the side of that,
you know what I'm talking about, okay.
So they go back to their favorite
restaurant from when they were young,
and they decide to
have lunch together.
And the food was as good
as they remembered it.
So after they had great conversation,
they caught back up with each other
in their lives and their
grandkids and all that's going on,
they both part their ways
and go back to their homes.
Now, here's where they have
a very different experience.
Look at Enrique
saying, "Oh, why?!".
He just feels miserable.
And he felt like his
chest was on fire.
And he just kept burping
and burping and burping.
I mean, this is not a
So he wondered what's
going on with José?
Look at José,
he's feeling perfectly fine.
It's chill, kick back,
doing some reading.
So I hope you're starting to ask
yourself, why is that?
Well, I'm going to show you.
Stay with me and we'll talk
about age-related changes
that you experience in the
GI tract with normal aging.
Remember with José
as our example.
And then what happens
And we'll use poor, Enrique.
So we're showing you here,
the oropharyngeal area
and how it connects down
to the bottom of the GI
So we've got all these
different structures here.
What I'd love for you to do
is try to pause the video
and try and label all those
things that we have there.
So try and recall what are each
one of these anatomical features.
And remember, it is to this side,
so you want to see what you can label.
Okay, I hope you did that,
because that will really help
you cement that in your memory.
But we have the top
the nasal cavity,
then the white area
is their teeth.
And that pinkish
area is his tongue.
Underneath his tongue,
you get the one sublingual gland
and you've got the
Now on the other side,
you've got the parotid gland,
the pharynx and the esophagus,
which is the tube down to the stomach.
Now we're gonna slide
on down to the stomach
and look where you have there,
you see the esophagus at the very top,
Food is going to move through the
stomach to the small intestine.
It's going to pick up things from
the liver and the pancreas, right?
It's got bile and it's got enzymes
that will help break up that food.
It's going to travel through the
duodenum and the small intestine
to the large intestine,
and then out of the body.
So this is another great
example for you to get a visual
on how this part of the
GI tract is all connected.
It's a minimum expectation
that each nurse understands
the path that food will
take from the mouth
all the way through to the exit from
their body as stool or fecal matter.
So as you age,
you see young José, old José,
know that the most important thing
is that gastric motility slows down.
Okay, so your stomach moves in
all different kinds of areas
that kind of help you
start to digest that food,
but it's just not
going to be as strong.
It's going to be a little slower
than when he was a young man,
that's an age specific
That something that you would
expect in normal healthy aging.
Now because that gastric
motility is slowed down,
the stomach is going
to empty slower
so foods going to be in
there a little bit longer,
have an increased risk of GERD that
is gastroesophageal reflux disease.
So you want to
keep this in mind.
This is a part of normal aging.
Here's one of our
We know that asking yourself questions or
even someone in your study group questions.
This is the best way
to retain information.
So we've given you one here,
let's see if you can answer it.
What common GI disease to geriatric
clients have an increased risk of
due to their decreased gastric
motility and delayed MTA?
Okay, that is a full on question
like you could see on an exam.
So make sure you
break that down.
Put it into your own words.
And even if you don't
know the answer,
just the effort of trying makes your
studying that much more effective.
So we're breaking this down,
we're looking for a common GI
disease in geriatric clients
that have an increased
risk of getting
because of their decreased
They're delayed emptying.
So what's your answer?
If you said (GERD) Gastroesophageal
Reflux Disease, you're right.
Okay, so we have the stomach there,
we say it's a normal healthy stomach.
It's follow that gastric acid,
and it's that lower esophageal sphincter
that helps keep that gastric
acid in your stomach.
Because your stomach
can handle it.
it's got that mucus and bicarbonate
that can protect
that fragile lining.
And that lower esophageal sphincter is
meant to keep that gastric acid in there
because it is what I say, right?
Acid, anywhere that bubbles
up into the esophagus,
you're going to have
a burning sensation.
What did Enrique complain of after he
had that cheeseburger and french fries?
He felt like his
chest was on fire.
This is why.
His esophagus isn't as good at keeping
all that gastric acid in the stomach.
And so it's bubbling up into the esophagus,
and it burns because it's acidic.
So let's compare the eating behaviors
of young Enrique to old Enrique.
But before we go there,
can you look at the expression on his face?
It looks like such a little
curmudgeon in this picture.
But we do that just because
we want to emphasize
that he's not feeling
comfortable about things.
And these are the things that are
challenging for geriatric clients.
So young Enrique, look at there,
he could take back a whole pizza.
Reminds me of college days, when you watch
Friends, take down a whole pie, right?
They could do that
without any problems.
But as we age, things change.
We already talked about your
motility, your stomach changing,
we've talked about GERD.
But there's some other changes.
They're going to be less hungry,
so they don't have the same
appetite that they used to had.
And that's pretty common.
I know when I eat with my mom and we
give her just a moderate sized portion,
she will usually cut that in half
and make two meals out of it.
She just doesn't have the same
appetite that she used to have.
Now also, when it comes to seasonings,
their taste buds are different.
So if my mom is salting something for
us, it's going to be, "Whoa".
It could be super salty because
those flavors don't register
as easily as they did
when they were younger.
So between young
Enrique and old Enrique,
you're going to see a
change in their appetite.
You're also going to see a
change in their taste buds.
And now they can taste salty and
sweet will be dampened or lessened.
But there's a real risk for
malnutrition in the elderly.
There's lots of psychosocial factors,
maybe their partner is no longer with them.
I know, my mom's a widow.
And it's just really not that
exciting for her to eat a meal.
She's used to eating with someone
who were married for 65 years.
When her husband passed away,
when my dad passed away,
she now eats all her
meals by herself.
So she just doesn't feel
like cooking things.
So we work really
hard to make sure
that she has prepared meals
in an appropriate size,
ready to go so all she has
to do is just heat them up.
So keep that in mind,
especially when you're nursing with clients
look for malnutrition.
Weight is not always the best
indicator of how nourished they are,
or how good and healthy the
food is that they're eating.
So be careful to be alert,
to watch for the signs
and to ask specific questions to help
identify some of these challenges.