I. Physical Changes Related to Difficulty in Bathing and Transferring
Bathing and transferring activities require mobility, energy, and safety precautions. These attributes are necessary in order for the caregiver and the care recipient to perform these tasks safely. Age-related, neuromusculoskeletal and cardiopulmonary changes contribute to the difficulty of performing bathing and transferring activities by older adults.
Neuromusculoskeletal Changes
Aging Related Changes |
Functional consequences |
Decrease in muscle mass |
Decrease in movement, strength and endurance |
Loss of elasticity of ligaments, tendons |
Stiffening and mild flexion of joints, neck and vertebrae resulting in postural changes
Increased postural sway
Decreased flexibility
Narrow-based waddling gait in women, wide-based gait in men
Impaired balance, coordination |
Decrease in bone density |
Osteoporosis. Kyphosis (dowager's hump), Stooped posture. Decrease in height. Falls, hip fractures |
Deterioration of articular cartilage |
Osteoarthritis. Symptoms of pain, stiffness |
Lipofusion accumulation in neurons
Decreased effectiveness of neurotransmitters
Altered motor neuronconduc-tion |
Decrease in the speed of movement and reaction time
Increase in the threshold for vibration sensation and decreased proprioception |
Cardiopulmonary Changes
Aging Related Changes |
Functional Consequences |
Increase in anteroposterior chest diameter, "barrel chest"
Weakening of respiratory muscles |
More energy required for inspiration, expiration
Reduced vital capacity and oxygen available for gas exchange |
Decrease in number of alveoli in lung and thickening
of membranes for gas exchange |
Decrease in PaO2 levels. Shortness of breath. Increase in susceptibility to fatigue |
Decreased cardiac output
Decreased elasticity cardiac valves |
Need to pace activities and conserve energy
Decreased endurance
Blunted cardiovascular response to high stress or high demand situations |
Increased peripheral resistance resulting in
compensatory blood pressure increases |
Dependent edema |
Baroreceptors less sensitive |
Orthostatic hypotension (altered blood pressure regulation with position change |
Integumentary Changes
Aging Related Changes |
Functional Consequences |
Sweat glands diminish in number, size & function |
Inability to regulate heat and maintain body temperature in hot weather extremes |
Thinning of skin and fragility of blood vessels under skin |
Susceptible to skin tears, bruising |
Chart Source: Adapted from Using Technology to Promote Independence for Older Adults-A RERC-Aging Workshop, NIDRR
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