Читать книгу Helping Relationships With Older Adults - Adelle M. Williams - Страница 36

Gastrointestinal issues can have a negative effect on the psychological well-being of older adults. Problems in this area can also adversely affect the ability of older adults to maintain good nutritional habits, which might lead to malnourishment that can precipitate a host of other problems (e.g., susceptibility to illnesses/diseases, hospitalizations, increased use of medications). Another example is problem with the absorption of calcium required for bone growth and maintenance can be disrupted, which may lead to osteoporosis that may precipitate falls, injuries, and subsequent hospitalizations. Mental health practitioners may serve the role of a coach to encourage older adults to maintain their health, maintain appointments with health providers, and recommended tests and encourage healthy behaviors. They can teach coping strategies for dealing with stress and the consequences associated with any abnormalities within the digestive system. Mental health practitioners must also assist in the coordination of care and provide appropriate referrals. They must also encourage older adults to separate their personal experience of the aging process from the disease or illness that they may be experiencing. Mental health practitioners may also need to address issues of social withdrawal, isolation, fear, and depression. These psychological issues will definitely decrease the overall functioning for older adults. The psychological well-being of older adults can be enhanced by the supportive and trusting relationship with the mental health practitioner.

The gastrointestinal (GI) system is the digestive system of the human body. The major functions of this system are the processing of food and the absorption of nutrients, minerals, vitamins, and water (AAHF, 2015). Aging has relatively little effect on GI functioning because of the large functional reserve capacity of most of the GI tract. The digestive system is made up of the mouth, teeth, tongue, salivary glands, pharynx, esophagus, stomach, pancreas, liver, gall bladder, and both the large and small intestines. Essentially normal digestion and absorption occur in the elderly; however, there are many changes in the digestive system that parallel age-related changes seen in the other systems. Like other systems, the rate of new cell growth declines and tissues become more susceptible to damage (AAHF, 2015).

The elderly face changes to their digestive systems. Though the digestive system suffers little from changes related directly to aging, psychological and social strains threaten the system’s functionality (Whitbourne, 2000). The digestive system is a series of tubes and glands that run all the way from the mouth to the rectum. It is responsible for extracting nutrients from food and then eliminating the remaining waste. Anxiety and stress are key components to problems linked to the digestive system. Stress inhibits saliva and gastric juice secretion, which makes swallowing foods and eliminating waste difficult. Saliva secretion is important for lubricating food, making it easier to move down the esophagus (p. 127).

One change associated with aging and the digestive system is known as presbyesophagus. This particular condition is characterized by a weakening of the esophagus muscles. It reduces food movement down the esophagus and leads to difficulty swallowing. Another challenge for older people is maintaining a healthy appetite. A condition known as anorexia of aging is when older adults fail to eat a sufficient amount to satisfy his or her nutritional needs. This can be made worse by poor teeth and taking multiple prescription medications that reduce appetite. Psychological changes, such as anxiety, also affect this system. Anxiety and stress can lead to a loss of sensory functioning such as taste and smell, further ruining a person’s appetite and causing disturbances to the digestive system (Whitbourne, 2000).

Aging causes a slight decrease in the amount of pancreatic enzymes, which further decreases digestion and the absorption of nutrients. Thus digestion is slowed but remains fairly adequate until an advanced age. Slowed peristalsis (involuntary contraction and relaxation of the muscles of the intestine or another canal), reduced abdominal muscular strength, inadequate exercise, and reduced food and fluid intake are responsible for a high prevalence of constipation. Some older adults may have problems related to relaxation of the anal sphincter because of cold environments or ulcers or hemorrhoids that lead to constipation (Talbot & Hogstel, 2001).

The digestive system remains a cause of concern among older adults. They fear that they may lose control of or not be able to have bowel movements. Constipation is problematic because they cannot eliminate waste, which could build up in the system to toxic levels and has been linked to cancer of the gastrointestinal tract. The loss of control of defecation is often linked to more advanced stages of Alzheimer’s disease, which is becoming an increasing problem for older people (Whitbourne, 2000). Changes in the digestive system of older adults can negatively affect their overall well-being, as does changes in the musculoskeletal system.