Vicki Gillmore, Nursing Home Administrator, Elizabethtown, PA
"The value of this training and its implementation for those at the end of life, in pain or with dementia has been incredible."
Age-Related Changes and Conditions, Part 1
Vol. 08, Issue 06
Older adults make up a growing clientele for massage therapists. According to the 2006 AMTA consumer survey, the use of massage among older adults has tripled in the past 10 years. Serving clients who are over age 65 requires that you have a basic understanding of age-related changes and the conditions many older adults are living with.While no two older adults are exactly alike, there are more or less typical changes that occur in physical and mental condition and function as we age.1,2
Vision: Changes in eyesight often are one of the first noticeable signs of aging. The eye lens stiffens, making focusing on close objects harder and seeing in dim light more difficult. The eyes produce less fluid, making the eyes feel dry. Depth perception can be impaired as the number of nerve cells decrease.
Hearing: Many people experience a decreased ability to hear high-pitched sounds, including consonants, making it difficult to understand words or certain tones in music.
Taste: The sense of taste is duller because the taste buds decrease in number and are less sensitive.
The skin tends to become thinner as the fat layer under the skin thins. The body produces less collagen and elastin (the fibrous tissue that makes skin strong and flexible) resulting in skin that tears more easily. Circulation in the deeper layers of the skin decreases, making the skin slower to heal when injured. There are fewer nerve endings in the skin, leading to diminished sensitivity to pain, temperature and pressure. Blood vessels become more fragile and the skin is more easily bruised. The skin also might be more vulnerable to chemical irritation.
Changes Affecting Physical Activity
Bones and Joints: Bone density tends to decrease somewhat in both men and women; however bone loss increases in some women after menopause due to lower estrogen levels. Less synovial fluid in the joint capsule is produced, leading to stiffness and decreased joint mobility, especially in weight-bearing joints such as the hips, knees and spine. The tendons and ligaments around the joints become weaker and stiff. The joint cartilage might erode.
Muscles: Muscle mass and strength decrease due in part to changes in hormones that regulate muscle development. The degree and impact of muscle loss is affected by the activity level of the individual. Those who do some form of weight-bearing exercise lose less muscle mass.
Balance: Unsteadiness might be a problem when structures in the inner ear that help regulate balance deteriorate. Some people experience dizziness upon standing because the heart pumps less blood to the head, and blood pressure is less able to respond to a change in position.
Changes in Mental Function
The number of brain nerve cells tends to decrease; however, the brain can compensate for this loss by establishing new pathways and connections. Levels of neurotransmitters change and blood flow to the brain decreases. There might be mild decline in some mental abilities such as short-term memory, recalling words, the ability to learn new material or performance under pressure. However, these normal changes do not greatly impact the person's daily functioning.
The motility of bowel contents slows, increasing the risk of constipation. Liver cells tend to decrease in number, decreasing blood flow through the liver, and liver enzymes work less efficiently. The liver then might eliminate toxins less effectively.
The kidneys become smaller and they remove wastes from the blood less efficiently. The bladder holds less urine, causing the need for more frequent urination. For some, this might interrupt restful sleep. The urinary sphincter may be weaker and less able to prevent urine leakage.
Immune System Changes
Immune cells tend to function more slowly, contributing to greater susceptibility to infectious disease such as pneumonia or influenza.
Massage therapists have much to offer older adults living with these changes. Aging, like massage, is a holistic event, not just a physical one. Physical changes are accompanied by psychological, social and spiritual alterations and adjustments as the gradual process of aging unfolds over time. For the older adult receiving massage, the benefits include decreased physical discomfort, greater ease of movement, an improved immune system, emotional support, spiritual acknowledgement and the empowerment of self care.
In Part 2 of this article, common conditions and disease in older adults will be explored, along with considerations for assessing the needs of older clients.
- Merck Manual Online Medical Library. "The Aging Body: Changes in the Body."
- Johnson and Johnson Health Management, Inc., 1990 booklet: Live for Life: What Is Normal Aging?
- Statistics from Trends in Health and Aging, U.S. Dept. of Health & Human Services, Centers for Disease Control and Prevention. www.cdc.gov/nchs/agingact.htm.
- Fallcreek S, Mettler M. A Healthy Old Age. Hawthorne Press, 1984, p. 289.