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PSW: Final Exam Questions with Detailed Verified Answers A+ Score 2025-2026, Exams of Nursing

PSW: Final Exam Questions with Detailed Verified Answers A+ Score 2025-2026 Holistic Care - ANS-Considering the whole person. Considering their physical, social, emotional, cognitive and spiritual dimensions. Professionalism - ANS-an approach to work that demonstrates respect for others, commitment, competence, and appropriate behaviours. Professional Boundaries - ANS-Appropriate limitations on behaviour, meant to protect the vulnerable client from the caregiver who has access to private knowledge about him or her. Regulation of a PSW - ANS-The PSW is an unregulated profession. For an unregulated care provider there are clearly identified services we provide under the supervision of the client, family member, regulated health care provider or employer. There is no legislation to regulate PSW's or an organization of professional college that governs the role. There is no official code of ethics but they must adhere to the codes of behaviour from their employer. ...

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2024/2025

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Holistic Care - ANS-Considering the whole person. Considering their physical, social, emotional, cognitive and spiritual dimensions. Professionalism - ANS-an approach to work that demonstrates respect for others, commitment, competence, and appropriate behaviours. Professional Boundaries - ANS-Appropriate limitations on behaviour, meant to protect the vulnerable client from the caregiver who has access to private knowledge about him or her. Regulation of a PSW - ANS-The PSW is an unregulated profession. For an unregulated care provider there are clearly identified services we provide under the supervision of the client, family member, regulated health care provider or employer. There is no legislation to regulate PSW's or an organization of professional college that governs the role. There is no official code of ethics but they must adhere to the codes of behaviour from their employer. Regulated Health Professions Act - ANS-Regulated Health Professions. In Ontario, regulated health professions are governed under the Regulated Health Professions Act, 1991 (RHPA) and health profession Acts (i.e., Medicine Act, 1991). This legislative framework establishes health regulatory colleges, which regulate the professions in the public interest. i.e. the college of nurses. Role of the occupational therapist - ANS-Focuses on rehabilitation; teaches clients skills needed to perform ADLs; designs adaptive equipment for ADLs Role of the physical therapist - ANS-Focuses on rehabilitation; assist clients with musculo-skeletal impairments; focuses on restoring function and preventing disability from illness or injury Role of Registered Nurse (RN) - ANS-assesses, makes nursing diagnoses, plans, implements, and evaluates nursing care. Tends to clients with unstable health conditions; provides direct client care, administers medications, supervises support workers, Role of RPN Licensed practical nurse (LPN) - ANS-a health care provider licensed and regulated by the province or territory to carry out nursing techniques and provide client care. Known as a registered practical nurse (RPN) in Ontario. ALL RULES REGARDING DELEGATION - ANS-Only regulated health care providers like nurses have the authority (legal right) to perform certain tasks because they have the knowledge, skill and training to perform them. They are called controlled acts and are considered harmful if they are performed by unqualified people. In some circumstances some acts will be delegated to you. In order to do this, specific conditions called "exceptions" must be met for delegation to be permitted. The nurse must feel confident the support worker understands what the responsibilities are when performing the task, knowns when and who to ask for assistance, and knowns when, how and whom to report the outcome of the task. Tasks that may be delegated to support workers must be routine ones with predictable outcomes that require little supervision and can only be delegated for stable clients. Delegation tasks may include: suctioning a permanent tracheotomy in and out catheterization; administering glucometers, dressings, tube feedings and medication. Only some nursing tasks can be delegated. Your employer's policies and guidelines, your job description and provincial or territorial legislation determine what tasks can be delegated to you. Sometimes these rules vary between community and LTC. In Ontario an RN, RPN and LPN can delegate. A delegated task is not transferrable to another client. Just because you did it for one person, does not mean you are able to perform the SAME task on another client without training. Before delegating tasks, the nurse must know the following: - ANS-* What tasks your province or territory allows support workers to perform. * The tasks included in your job description. + What you were taught in your training program. + What skills you have learned and how they were evaluated. + Your work experiences. A nurse who delegates a task is required to: - ANS-* Have the knowledge, skill, and judgement to perform the task competently. + Have the additional knowledge, skill and judgement to teach the task to others. The delegating nurse is responsible for providing all necessary teaching, but not everyone is able to teach others how to perform something. Good communication skills and patience required. + Accept responsibility for teaching the task to the support worker. The nurse must first determine the risks and benefits of teaching the task and be able to confidently predict its outcome. + Assess your performance. The nurse must determine if you're able to perform the task correctly. * Determine if the task that is taught can be performed for more than one client. Each client is unique. + Monitor you over time to ensure you remain able to perform the task correctly and safely. In the community the nurse may provide you with written instructions, predicted outcome and what to record. You can refuse a task to be delegated to you if: - ANS-* you have concerns about your ability to do the task Some people have chosen to assimilate their styles of dress, eating habits, or other behaviours when with people from another culture. A person's culture can change over time as the person leaves one group and joins another or encounters new life experiences. Culture and Religion - ANS-In most cultures, religion is very important. Religion relates to spiritual beliefs, needs, and practices and ay promote beliefs and practices related to daily living habits, behaviours relationships with others, diet, healing, days of worship, birth and birth control, medicine and death. Many people rely on religion for comfort during illness. They may want to pray, observe certain practices and may want a visit from a spiritual leader/advisor. Promptly report this request to your supervisor. Never try to convert a client and treat all religious items with respect - do not touch unless. permitted. Maslow's Hierarchy of Needs - ANS-A need is something that is necessary or desirable for maintaining life and psychosocial well-being. According to Maslow, certain basic needs must be met for a person to survive and function. These needs are arranged ina hierarchy, or order or importance. Lower-level needs must be met before higher-level needs. The basic needs from the lowest-level to the highest-level as follows: + Physical needs (must be met first): oxygen, food, water, elimination, rest and shelter. + Need for safety: protection from harm, danger, fear and pain. + Need for love and belonging: Romantic and physical love. The need for a rightful place in society, in a peer group and in family + Need for self-esteem: thinking well of oneself and being well thought of by others. When self-esteem is fulfilled, a person feels confident, adequate and useful. + Need for self-actualization, or the fulfillment of one's potential (last need to be met) Learning, understanding, and creating one's best life. Charter or Rights and Freedoms: federal legislation that applies to all Canadians regardless of where they live. It includes the following: - ANS-* freedom of conscience and religion + freedom of thought, belief, opinion, and expression + freedom of peaceful assembly and association (usually associated with the right to form a union and strike) + the right to vote + the right to enter, stay in, or leave Canada + the right to life, liberty and security + the right to equality before and under the law, without discrimination based on race, ethnic origin, colour, religion, gender, age, or mental or physical disability. Assault - ANS-identified in identified in Canada's Criminal Code and can be defined as intentionally attempting or threatening to touch a client's body without the client's consent, causing the client to fear bodily harm. Canada's Criminal Code and can be defined as intentionally attempting or threatening to touch a client's body without the client's consent, causing the client to fear bodily harm. Battery - ANS-(part of tort law) is the actual intentional touching of a client's body without the client's consent. Slander - ANS-making harmful false statements orally. negligence - ANS-when a person fails to act in a careful or competent manner and thereby harms the client or damages property. It is an unintentional wrong, but the person failed to do what a reasonable or careful person would have done or not done. false imprisonment - ANS-the unlawful restraint or restrictions on a person's freedom of movement. (Preventing someone from leaving a facility or the unnecessary use of restraints.) harassment - ANS-troubling, tormenting, offending, or worrying a person through one's behaviour or comments. autonomy - ANS-have the freedom and choice to make decisions that affect one's life. Also known as self-determination. dependence - ANS-The state of relying on others for support; being unable to manage without help. interdependence - ANS-the state of relying on one another independence - ANS-the state of not relying on others for control or authority CLIENTS RIGHTS - ANS-* The right to be treated with dignity and respect + the right to privacy and confidentiality + the right to give or withhold informed consent + the right to autonomy RIGHTS OF LONG-TERM CARE CLIENT - ANS-Residents' Bill of Rights Every licensee of along-term care home shall ensure that the following rights of residents are fully respected and promoted. 1. EVERY RESIDENT HAS THE RIGHT to be treated with courtesy and respect and in a way that fully recognizes the resident's individuality and respects the resident's dignity. 2. EVERY RESIDENT HAS THE RIGHT to be protected from abuse. 3. EVERY RESIDENT HAS THE RIGHT not to be neglected by the licensee or staff. 4. EVERY RESIDENT HAS THE RIGHT to be properly sheltered, fed, clothed, groomed and cared for ina manner consistent with his or her needs. 5. EVERY RESIDENT HAS THE RIGHT to live in a safe and clean environment. 6. EVERY RESIDENT HAS THE RIGHT to exercise the rights of a citizen. judging. Empathy can reduce feelings of loneliness and sadness and can create trust between the support worker and clients they support. Avoid quick, thoughtless responses like "| know how you feel," "| feel sorry for you," "I wouldn't want to be in your shoes." Asking Closed Questions - ANS-Focuses on specific information, so you use them when you need to learn something precise. Some closed responses require a yes or no answer, others require a brief response. Asking Open-Ended Questions - ANS-These types of questions invite a person to share thoughts, feelings, or idea. Answers must be more than a yes or a no. The person being questioned chooses and controls what is talked about and the information given. It shows that you are interested in hearing about their life. Use both open and closed ended questions help find out about a client's needs and preferences and to find out if a client is satisfied with your care. Clarifying - ANS-Ensures that you understand a person's message. You can ask the client to repeat the message, say you don't understand or restate the message as a question: + could you say that again? «I'm sorry Mr. Smith. | don't understand what you mean? « Are you saying that you want to go home? Focusing - ANS-Limits the conversation to a certain topic. It's useful when a client rambles or wanders in thought. Give the client 2 choices. "Let's talk about ..." Objective Data (signs): - ANS-The data you gather while using your senses. Subjective Data (symptoms): - ANS-information reported by a client but not directly observed by the support worker. When reporting subjective data, do not interpret the client's words, quote the client directly. Always be alert to changes in the client's condition or behaviour. REVIEW USE OF RESTRAINTS - ANS-A restraint is any device, garment, barrier, furniture, or medication that limits or restricts freedom of movement or access to one's own body. Every effort is to be made to protect the clients without resorting to the use of restraints. Restraints can cause emotional harm and serious physical injury. Restraints require a physician's order, after consultation with the client's family. Support workers never decide if restraints are to be used. Guidelines Regarding the Use of Restraints: - ANS-» Unnecessary restraint is false imprisonment. There must be written consent in the client's chart for using restraints. + Restraints are never used to discipline a client. + Restraints are never used for staff convenience and only in the way the physician ordered. + Always try and determine the reason for the client's agitation or behaviour. Knowing and addressing the reason for this usually prevents the need for use of restraints. Ask yourself: - Is the client injured or in pain? - Is the client afraid? - Is the client seeing, hearing or feeling things that are not there? - Is the client confused or disoriented? - Are medications causing the behaviours? (New meds can affect the client in this way and should be reported immediately to the supervisor.) - Has the client not taken their medication? - Does the client need to urinate or defecate? - Is the client's position comfortable? - Is the client too hot or cold? Are they hungry or thirsty? - Restraint use should always be avoided. Restraint alternatives should always be part of the care plan. + Informed consent is required. The client must understand the reason for the restraint. How the restraint will help and what the risks of the restraint are. (Only nurses and doctors can get informed consent.) + Restraints are used only in extreme cases and when necessary to prevent harm. + Restraints require a physician's order + The least restrictive method is used. + The manufacturer's instructions must be used. You are never to use non restraint items (like bedsheets) to restrain a client. + Restraints are only to be applied by trained and knowledgeable staff. + The client's basic needs are met. + More than one staff member may be needed in order to apply a restraint correctly and safely. * The client's quality of life is protected. + The client is observed at least every REVIEW FIRE SAFETY - ANS-lIt's essential to have working fire detectors on ever floor of the home and ideally outside of the sleeping area. Identify where the smoke detectors are and notify your supervisor if they are not working. THINK ABOUT SAFETY: + smoke only in designated areas. Do not smoke in the clients' home. + Supervise clients who smoke. This is especially important if the client is confused, disoriented or sedated. + Provide ashtrays for clients who are allowed to smoke. + check smoking areas for dropped cigarettes / ashes (especially furniture) ¢ Be sure all cigars and cigarettes are put out before emptying ashtrays. « Empty ashtrays into metal containers with sand or water, not into plastic or paper lined wastebaskets. + Do not allow clients to smoke in bed or while lying down. * Do not ignite lighters or matches near flammable liquids or materials Masks and Eye Protection - ANS-* Wear during procedures and tasks that are likely to cause splashes of blood, body fluids, secretions or excretions to protect your eyes and mouth from contact with sprays or splashes Gowns - ANS-* Wear during procedures and tasks that are likely to cause splashes of blood, body fluids, secretions or excretions to protect your eyes and mouth from contact with sprays or splashes « Protects contamination of clothing + Aclean nonsterile gown is adequate + Remove gown as soon as possible + Practice hand hygiene after removing gown to prevent spread of microbes Care of Equipment - ANS-* Handle equipment carefully. Do not let it touch your skin, mucous membranes or clothing + Do not use reusable items for another client. The item MUST be disinfected or sterilized first + Discard disposable (single use) items properly Environmental Control - ANS-* Follow your employer guidelines for regular disinfection of surfaces Linen - ANS-* Follow employer policy for dealing with soiled linens + Do not touch soiled linen with your skin, mucous membranes, or clothing + Do not shake linens as to prevent the spread of microbes Occupational Health and Blood-Borne Pathogens - ANS-* Use extreme care when handling sharps (anything that can pierce the skin) + Use extreme care when handling, cleaning or disposing of sharp instruments + Never recap used needles, do not handle with both hands. Do not hold it with the sharp pointing towards the body + Do not bend or break needles, do not remove the needle from a disposable syringe or needle. + Place used sharps in the proper disposable containers + Use barrier devices for rescue breathing in emergencies Client Placement - ANS-* A private room is used if the client contaminates the area, do not or cannot assist in maintaining hygiene or environmental control + Follow your supervisors’ instructions if a private room is not available. Signs and Symptoms of Infection - ANS-* fever and chills + increased pulse and respiratory rates * aches, pain, or tenderness + fatigue and loss of energy + loss of appetite * nausea * vomiting + diarrhea *rash * sores on mucous membranes + redness and swelling of a body part + discharge or drainage from the infected area that may have a foul odour * new or increased cough, sore throat or runny or stuffy nose * burning pain when urinating or the need to urinate more often or with increased urgency + behavioural changes in older adults FALL PREVENTION - ANS-Falls are the most common cause of all accidental injuries in all settings and children and older adults are at greatest risk. While you should always supervise your clients, pay special attention to children, clients in wheelchairs, clients with a history of injuries, sedated clients, older clients and those cognitively impaired as they are at greatest risk. The risk for falls increases with age and illness. Falls may result in death, serious injury or changes to the older person's quality of life. Clients in long term care are at greater risk for a call than those clients who live at home. these clients tend to be older, use more medication and require more assistance. Some have other impairments which increase their risk for a fall. Some strategies to prevent falls are: - ANS-* the client will be assessed to determine their falls risk. Those at high risk are provided extra supervision and assistance. + Staff is kept up to stay with education on how to safely move a client and the equipment used to avoid getting injured themselves. + Methods to identify the falls risk are can be colour coded bracelets, posted above the client's bed, and is done in a way that is respectful and protects the client's privacy. + Most falls happen in bedrooms, bathrooms and on the stairs - make sure these areas are as safe as possible. + Falls can happen when the client feels rushed, provide adequate time, reminders to ask for help if they need it. + Most falls happen between 1800-2100 hours when the hallways may be darker. Keep hallways well-lit and free of clutter. + Falls are also most likely during shift changes as the 2 shifts are giving/receiving reports. To mitigate this risk, overlap shifts. THINK ABOUT SAFETY (falls) - ANS-* Report unsecured small rugs or mats. Use carpet tape or a non-skid pad. Small rugs should not be used in high traffic areas. + Report any damaged flooring, lumpy carpet + Keep cords off the floor. (Tape them to the wall) + Keep hallways and stairs clutter free and well lit. * use only non-glare and nonsilip floor wax * Keep a clear path from the bedroom to the bathroom + Do not rearrange the client's furniture. + Make sure clothing and shoes fit well. *« Remember that clients have the right to live at risk of injuring themselves. TRANSFERRING A CLIENT FROM THE BED TO A CHAIR OR WHEELCHAIR - ANS- It's important to ensure safety, prevent falls and protect your back from injury. Always hold the client securely and ensure the client is wearing non-skid footwear to prevent sliding or slipping. The chair or wheelchair must be able to support the client's weight. Some agencies use transfer boards to assist with sliding from the bed to a chair or wheelchair. Transfer boards are used when the client can assist with the transfer. Make sure there is adequate padding on the buttons and the staff must ensure shearing does not happen. Most chairs have vinyl seats and backs, because vinyl holds in body heat and can stick to the client, you should cover the back and seat of the chair with a folded blanket. Place a small pillow or cushion behind the client if instructed to do so. A support workers responsibility is to promote comfort, prevent pressure ulcers and maintain proper posture in the client. Bones that weight bear are called - ANS-long bones Turning the immobile patient - frequency: - ANS-at least every 2 hours, or as directed by the care plan Friction - ANS-the resistance the skin encounters when it rubs against another surface, such as clothing, bedding or another fold of skin. Shearing - ANS-the tearing of skin tissues caused when the skin sticks to a surface (usually the bed or chair) and deeper tissues move downward, exerting pressure on the skin. Shearing can happen when a client slides down in bed, or is moved in bed. Shearing can be very painful and can lead to serious skin and health problems. Body alignment - ANS-the way in which body parts (head, trunk, arms and legs) are positioned in relation to one another, whether lying, sitting, or standing. Also known as posture. muscular atrophy - ANS-the decrease in size or wasting away of muscles. It's a complication from lack of exercise and must be prevented. Contracture - ANS-the lack of joint mobility caused by abnormal shortening of a muscle Flexion - ANS-Bending a body part Abduction - ANS-Movement away from the midline of the body Adduction - ANS-Movement toward the midline of the body abuse - ANS-physical or mental harm caused by someone in a position of trust. Types of Abuse: - ANS-Physical abuse, sexual abuse, psychological (emotional) abuse, financial abuse, and neglect. physical abuse - ANS-force or violence that causes pain, injury and sometimes death. Examples: pinching, hairpulling, kicking, choking, burning poisoning, throwing things. sexual abuse - ANS-unwanted sexual activity such as rape and attempted rape. Unwanted touching, fondling, kissing and exposure are also considered sexual abuse. Sexual Harassment - another form of sexual abuse, it's any conduct, comment, gesture, threat or suggestion that is sexual in nature emotional (psychological) abuse - ANS-words or action that cause mental harm. It usually involves an attack on a person's self-esteem, insulting, humiliating or rejecting a person. These cause harm to a person's self-worth and self-confidence. Emotional abuse can happen to infants, children, teens, adults and older adults. The client may not be allowed to do their preferred activities, or visit with friends and family. Threatening to harm someone or something the victim loves. financial abuse - ANS-the misuse of a person's money or property, usually for the abuser's financial gain. It includes stealing, forging signatures, selling property or possessions without permission, and persuading or tricking victims to change their wills or give up control of their finances. neglect - ANS-the failure to meet basic needs of a dependent person. Victims of neglect are usually children, people with disabilities, and frail older adults. Neglect occurs when a clean, comfortable and safe environment is not provided. Neglect can be intentional or unintentional. the cycle of abuse - ANS-1. The tension-building phase. every day events and comments irritate the abuser. The abuser becomes more aggressive and the victim may try to calm soothe and please the abuser or try and stay out of the abuser's way. 2. The abusive phase. Tension explodes into an abusive event. It may involve neglect or physical, sexual, emotional or financial abuse. Often the abuse is triggered by an even unrelated to the victim's behaviour. 3. The honeymoon phase. The abuser feels ashamed or sorry. He apologizes and never to do it again. perhaps offering presents or be very loving. At this stage, the abuser and the victim may believe the abuser can change. Role of the PSW and Abuse: - ANS-You should be prepared for the possibility of a client or child telling you about being abused. It's important you know how to offer immediate help. Follow your employer's guidelines and policies. Here are some general guidelines: + Listen attentively. Let your clients tell you what happened in your own words. + Reassure the client that you believe what they have said. Stay calm, do not show anger or disgust. Do not ignore the problem. + Assure your clients that you will do whatever you can do to help. Notify your supervisor at once. Follow your employer's policies. Helpful resources include the police, women's shelters, counselling services, telephone helplines and legal clinics. Starches: found in bread, pasta, rice and potatoes Fibre: found in bran, nuts, seeds, and raw fruits with skin. Fibre cannot be digested and is passed through the intestines undigested. During digestion, most carbohydrates (except fibre) are broken down into sugars, which are then absorbed into the bloodstream. FATS: - ANS-Provide energy, help the body to use certain vitamins, and add flavour to food. Some fat is needed, but fat that is not needed will be stored as body fat. There are 3 types of fat: Saturated fat: found in animal and dairy products (meat, butter, cheese) Trans fat: (margarine, cookies, pies etc.) Created when liquid oil is chemically alerted to form a more solid substance. It is used to increase flavour and shelf life. Unsaturated fat: (fish and vegetable oils) Healthier than saturated fat or trans-fat. VITAMINS: - ANS-Needed daily for normal function and growth, but they do not provide calories. Each Vitamin is needed for specific body functions. Excess doses of fat- soluble vitamins (A, D, E and K) can cause complications. Vitamins C and B in excess amounts are excreted through your urine. (These are known as water soluble vitamins). Older adults are at risk of developing deficiencies because of issues with aging and absorption. MINERALS: - ANS-Chemical substances found in both plant and animal foods. Each Mineral is needed for specific body functions. For example, calcium and phosphorus are used to form strong bones and teeth. WATER: - ANS-The most important nutrient necessary for life. The body needs water for maintaining cell function, regulating body temperature, delivering nutrients, removing waste and performing other bodily processes. Water enters through food and fluids and is excreted through urine, feces, perspiration and respiration (expiration of the lungs). The amount of fluid taken and lost must be in a balance. Death can result from inadequate water intake or from excessive fluid loss. Fluid requirements: - ANS-1500 ml / day for survival 2000-2500 ml / day for normal fluid balance. Guidelines for Feeding Clients: - ANS-+ to ensure safety, check care plans to be aware of any food or liquid allergies or intolerances your client may have + if shopping for a client, review and check expiry dates + do not substitute ingredients when cooking without your client's permission. + Follow the care plan when feeding a client + Use spoons not forks. + sit facing the client so you can see signs of choking, swallowing difficulty * offer fluids during the meal as they help with chewing and swallowing * some clients may fall asleep while eating, gently stroke their cheek to rouse them. The number of older adults is increasing as people - ANS-are living longer. Older people have knowledge, wisdom and experience that we can all benefit from. Baby boomers (people born during post WWII) from, 1946 - the mid 1960's age, Canada is increasing it's efforts to better understand the implications of the aging population - ANS-on health and long-term care needs and costs. "Active Aging" is becoming the norm, meaning that older adults are increasingly contributing to society through pain and unpaid activities. Gerontology - ANS-study of the aging process geriatrics - ANS-is the branch of medicine that provides care for older adults. Aging and growing older is - ANS-normal process during which the body experiences changes in body structure and function, increasing the risk for illness, injury, persistent illness and disability. These changes are usually gradual. Emotional and social changes also occur. The developmental tasks of late adulthood are as follows: - ANS-+ adjusting to decreased physical strength and loss of health * adjusting to retirement and reduced income * coping with the death of a partner + developing new friends and relationships * preparing for one's own death CARING FOR OLDER CLIENTS: - ANS-Mainstream culture in North America tends to overvalue youth. Treating older people s if they are boring, useless or childlike is ageism. Treating older people disrespectfully threatens their dignity and sends the message they are no longer a useful, productive members of society. To care for older clients effectively, you need to understand the emotional, social and physical changes that occur with aging. Retirement: - ANS-Now a days more people are looking to further their education in retirement. Most enjoy their retirement, but some are not so fortunate. Some are forced to retire because of a persistent illness or disability or poor health. Retirement is often a person's first real experience with aging. Work has social and emotional effects. - ANS-It helps meet the basic needs of love and belonging and self-esteem and brings fulfillment and feeling of usefulness. Some people use the time after retirement to pursue hobbies and goals, however if a person hasn't cultivated any interests outside of work, retirement can be abrupt and upsetting. Always report signs of depression or expressions of sadness after a client has retired. REDUCED INCOME: - ANS-Retirement income is often less than half of a person's full income during her working years. for some CPP may be the only source of income, but + fixation on death or suicidal thoughts * increase in physical complaints, such as arthritis or headaches PHYSICAL CHANGES: - ANS-Certain physical changes are a normal part of aging and occur in everyone, some are due to lifestyle choices. Physical processes slow down, and energy level and body efficiency decline. The rate of the degree of change is different for everyone and is influenced by: diet, general health, exercise, stress, environment, and heredity. Normal aging does not mean a loss of health. Integumentary System - ANS-» skin becomes less elastic « skin loses its strength * brown spots "age spots" or "liver spots" appear on the wrists and hands * nerve endings decrease in number + blood vessels decrease in numbers + fatty tissue layer is lost « skin thins and sags « skin becomes fragile and easily injured + folds, lines, wrinkles appear + secretion from oil and sweat glands decreases « skin becomes dry + skin becomes itchy + sensitivity to extreme hear and to cold environments decreases + sensitivity to pain decreases + nails become thick and tough + hair whitens or greys + hair thins + facial hair appears on some women + hair becomes dry Musculo-Skeletal System - ANS-* muscles atrophy + strength decreases + bones become brittle; can break easily + joints become stiff and painful + height gradually decreases + mobility decreases Nervous System - ANS-* vision and hearing decrease * senses of taste, smell and touch decrease + sensitivity to pain is reduced + blood flow to the brain is reduced + cells shrink * memory becomes shorter (forgetfulness) * ability to respond slows + sleep patterns change + dizziness occurs Circulatory System - ANS-* heart pumps with less force + arteries narrow and are less elastic + less blood flow through narrowed arteries + weakened heart has to work harder to pump blood through narrowed vessels Respiratory System - ANS-* respiratory muscles weaken + lung tissues become less elastic * breaking becomes difficult + strength for coughing decreases Digestive System - ANS-* saliva production decreases * swallowing becomes difficult * appetite decreases + secretion of digestive juices decreases + Digesting fried and fatty foods becomes difficult + ingestion occurs + teeth fall out * peristalsis decreases, causing flatulence and constipation Urinary System - ANS-+ blood supply to kidneys is reduced + kidneys atrophy + kidney function decreases * urine becomes concentrated + Urinary frequency, urgency and incontinence may occur * nighttime urination may occur Female Reproductive System - ANS-* menstruation stops + estrogen production decreases + ovaries and uterus decrease in size * vaginal walls become thinner, drier and less elastic + fat and elastic tissue in external genitalia decrease + breasts become less firm Male Reproductive System - ANS-» testosterone production decreases + force of ejaculation decreases * sperm count is reduced + testes become smaller * prostate gland enlarges + erections develop more slowly THE OLDER ADULT AND SEXUALITY - ANS-love, affection and intimacy are needed throughout life, as sexuality is part of the whole person. These needs do not disappear. Some older people are not able to have sexual intercourse but that does not mean the desire has gone. They can express these needs through hand holding, touching, caressing, and embracing. Members of the health care team must respect their clients’ sexuality and allow and promote ways to meet their sexual needs.