Journal of Gerontological Nursing

Publications 

Sensory Changes in the Elderly

Lois N Knowles, RN, PhD

Abstract

Sensory Changes in the Elderly by Francis B. Coivi ta. Springfield, Illinois, Charles C. Thomas, 1978. 142 pp. $13.00.

This book, directed to "the intelligent lay reader," presents Colvita's inquiry into the question of the unrecognized degree of control people may actually have over the way culture will perceive them after they have lived for a long time. Specifically, he discusses the possibility that an aging person's sight, hearing, smell, taste, touch, and other senses are programmed to fail, asks why sensory changes accompany aging, and asks why withdrawal and lack of involvement are so characteristic of the aged.

The book is based on the premise that knowledge of how the senses function is important not only for understanding the behavior of the elderly, but also is important for understanding all behavior. The author points out that, because behavior is the result of how one perceives the environment and because the senses are one's primary means for perceiving, correct responses to environmental stimuli depend upon correct perceptions.

The volume's organization follows the normal sequence of the anatomy and physiology of the senses, including illustrations, common changes in aging that may affect perception, and suggestions about how to adapt to changes. Suggestions include such simple but important pointers as how to increase the available light by using larger Iightbulbs, and how to wear assistive devices without embarrassment.

For the "educated layman" the book provides a good introduction to age-related changes in the senses, particularly the gustatory and olfactory senses. The attitude chapter contains recipes for healthy living, such as some dos and don'ts about learning to live with changes. Relationships, such as that between the role of nutrition and osteoporosis, are discussed in the chapter on attitudes toward sensory deficiencies, rather than in the chapters that describe the changes.

The author omits consideration of the following five significant matters: (1) he raises but does not answer the question of whether aging is due to a biologic time clock that includes programmed functioning, with organs aging according to a time plan; (2) he does not answer the question of whether others will perceive him as old or whether, on the contrary, he will be seen as old only if he behaves "old"; (3) there is no mention of the disengagement theory of aging nor of the activity theory of aging, to compensate partially for the lack of discussion of other possible reasons for withdrawal that include, but are not limited to, an individual's lifestyle, degree of social participation, and energy level; (4) there is no reference to the fact that although one's attitude may be positive, and one may understand one's sensory changes, still medical science is limited in its ability to correct the changes, as human ability to adapt is limited; (5) the chapter on attitude does not include suggestions on how to cope with the depression that frequently accompanies physical changes. The author seems to overlook other reputable recent theories of pain, such as those of Agate in Rossman's Clinical Geriatrics. Colvita maintains that there is no evidence of changes in pain in the elderly, whereas Agate has found that the elderly do not experience pain in the same intensity as do younger age groups. This clinically important factor may mean the difference in whether the elderly seek medical attention, and is equally important for their families and health providers to know. It is an example of gerontology and geriatrics as a science and as a clinical specialty, inasmuch as credence must be given to opposing theories of pain.

The book contributes to the literature of gerontological nursing in that…

Sensory Changes in the Elderly by Francis B. Coivi ta. Springfield, Illinois, Charles C. Thomas, 1978. 142 pp. $13.00.

This book, directed to "the intelligent lay reader," presents Colvita's inquiry into the question of the unrecognized degree of control people may actually have over the way culture will perceive them after they have lived for a long time. Specifically, he discusses the possibility that an aging person's sight, hearing, smell, taste, touch, and other senses are programmed to fail, asks why sensory changes accompany aging, and asks why withdrawal and lack of involvement are so characteristic of the aged.

The book is based on the premise that knowledge of how the senses function is important not only for understanding the behavior of the elderly, but also is important for understanding all behavior. The author points out that, because behavior is the result of how one perceives the environment and because the senses are one's primary means for perceiving, correct responses to environmental stimuli depend upon correct perceptions.

The volume's organization follows the normal sequence of the anatomy and physiology of the senses, including illustrations, common changes in aging that may affect perception, and suggestions about how to adapt to changes. Suggestions include such simple but important pointers as how to increase the available light by using larger Iightbulbs, and how to wear assistive devices without embarrassment.

For the "educated layman" the book provides a good introduction to age-related changes in the senses, particularly the gustatory and olfactory senses. The attitude chapter contains recipes for healthy living, such as some dos and don'ts about learning to live with changes. Relationships, such as that between the role of nutrition and osteoporosis, are discussed in the chapter on attitudes toward sensory deficiencies, rather than in the chapters that describe the changes.

The author omits consideration of the following five significant matters: (1) he raises but does not answer the question of whether aging is due to a biologic time clock that includes programmed functioning, with organs aging according to a time plan; (2) he does not answer the question of whether others will perceive him as old or whether, on the contrary, he will be seen as old only if he behaves "old"; (3) there is no mention of the disengagement theory of aging nor of the activity theory of aging, to compensate partially for the lack of discussion of other possible reasons for withdrawal that include, but are not limited to, an individual's lifestyle, degree of social participation, and energy level; (4) there is no reference to the fact that although one's attitude may be positive, and one may understand one's sensory changes, still medical science is limited in its ability to correct the changes, as human ability to adapt is limited; (5) the chapter on attitude does not include suggestions on how to cope with the depression that frequently accompanies physical changes. The author seems to overlook other reputable recent theories of pain, such as those of Agate in Rossman's Clinical Geriatrics. Colvita maintains that there is no evidence of changes in pain in the elderly, whereas Agate has found that the elderly do not experience pain in the same intensity as do younger age groups. This clinically important factor may mean the difference in whether the elderly seek medical attention, and is equally important for their families and health providers to know. It is an example of gerontology and geriatrics as a science and as a clinical specialty, inasmuch as credence must be given to opposing theories of pain.

The book contributes to the literature of gerontological nursing in that it supports and contributes to the current trend toward making people more knowledgable about themselves and more responsible for their own care. Those who will find the book useful include registered nurses and students of nursing and health-related studies as well as education and arts and sciences students who focus on gerontology, in addition to relatives of elderly persons who are contributing to those persons' support systems - and, of course, the elderly themselves.

In regard to the book's physical appearance, the middleaged and "young" elderly will be able to read the average sized type easily; an asset would have been to print it in a larger type more easily readable by "elder" elderly. Also, because older people frequently experience decreased color sensitivity, particularly for the blue/violet portion of the color spectrum, a better choice of cover color might have been one in the red or orange ranges instead of the green used, which contrasts inadequately with the gold lettering for effective readability by older persons.

Finally, the fact that there are no references in the entire book seems disrespectful to elderly readers, the primary readership for whom the book was written.

10.3928/0098-9134-19810401-10

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