301 Nursing Care of the Postmenopausal Woman, 3rd Edition
can cause ringing or buzzing in the ear (tinnitus), increased sensitivity to sound, and hearing loss. The best prevention for hearing loss is avoiding noisy situations, but if one cannot avoid noise, wearing hearing protection is the next best thing. One can help prevent hearing loss by turning down the volume of the TV or ra- dio, especially when wearing headphones or earbuds; taking listening breaks; and using hearing protection such as earplugs or earmuffs when around loud sounds (CDC, 2019). Vision loss affects more than 3.4 million Americans age 40 and older, and it ranks among the top 10 causes of disability (CDC, 2020b). The major causes of vision loss are cataracts, age-related macular degeneration, diabetic retinopathy, and glaucoma. Vision loss can also be relat- ed to depression, falls, and cognitive de- cline. Vision loss compromises quality of life, as people who have decreased ability to see may be unable to drive, read, or move around at will. Ways to prevent vi- sion loss include regular vision screening, removal of cataracts, and early diagnosis and treatment of glaucoma (CDC, 2020b). Some chronic conditions can cause new chronic conditions, for example, high blood pressure can lead to heart failure or stroke. Chronic illnesses are frequent- ly treated with medications, which can lead to taking several different types of medication. (This is discussed later in this chapter.) Chronic illnesses can lead to healthcare crises and can result in phys- ical, cognitive, or emotional disability (NCOA, 2022). If a woman becomes un- able to care for herself and there is no one to assist her in her home, she may need to move to an assisted living or long-term care facility. Research has shown that older adults need formal care when they
are no longer able to dress themselves, use the toilet, or bathe themselves (NIA, 2017). There are now many levels of res- idential care, from nearly independent assisted-living apartments to full nursing care. (The definition of disability and lev - els of impairment are discussed later.) The primary goal of screening for chronic health conditions is to keep the woman functional and independent for as long as possible, while preventing fur- ther deterioration and keeping her safe. Stretching exercises can be done while she is sitting in her chair. If she is in a location with others nearby, most wom- en prefer to exercise in groups, whether stretching, walking together, or doing an all-out exercise class together (NIA, 2020). Education and lifestyle changes can improve an older woman’s ability to function, whether in her own home or in a nursing facility. Most agencies for old - er adults have educational programs that focus on relaxation techniques, making changes toward a healthy diet, manag- ing sleep and fatigue, taking medications correctly, exercising, and communicating with healthcare providers. They may also stress quitting smoking, reducing alcohol intake, improving nutrition, and practic- ing weight control. It is important to give older adults self-management education that focuses on living with chronic condi- tions, which helps them to preserve their ability to function and reduces healthcare costs (NIA, 2020). There are several types of long-term care, depending on the type of help the woman needs. The most common type is personal care. This is when someone helps the woman with everyday activi- ties such as bathing, dressing, grooming, eating, and moving around. This can be done in the woman’s home. The next lev-
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