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"There are children playing in the streets who could solve some of my top problems in physics, because they have modes of sensory perception that I lost long ago."

—J. Robert Oppenheimer


By the end of this chapter, readers will be able to:

  1. Describe major health conditions that affect sensory systems functions, and cause pain in older adults.

  2. Explore how health conditions may cause smell, taste, and nutritional consequences.

  3. Determine what aspects of sensory impairments due to health conditions are barriers to performing activities of daily living and instrumental activities of daily living.

  4. Describe impairments in swallowing associated with health conditions.

  5. Identify the how interprofessional health-care teamwork may help older adults improve functional performance and lifestyle issues despite health conditions that affect the sensory systems.

Clinical Vignette

Mr. Oscar Reyes, a 79-year-old retired long-haul truck driver, lives at home with his wife. His two adult children reside about 30 kilometers away and visit two to three times a month. Mr. Reyes has had bilateral hip replacements at age 70 and bilateral knee replacements at age 59. In addition, Mr. Reyes has glaucoma and has been diagnosed with stress-induced peripheral neuropathy secondary to his long hours sitting in the truck and other postural demands from his job. Mr. Reyes has fallen when participating in community activities. Fortunately, he has not experienced injuries from the falls but now fears walking in new places. Mrs. Reyes reports that Mr. Reyes constantly groans, even in his sleep, and cannot divert his attention away from the pain. Mr. Reyes finds the pain more distressing lately. The pain is affecting his appetite, so he rarely wants to eat. His physician had been hesitant but has finally given him pain medication. However, the medication makes Mr. Reyes want to sleep more, and consequently, he is less active. Furthermore, the pain medication is making Mr. Reyes nauseated. Mr. Reyes is noticeably weaker and has less endurance. In addition, glaucoma has made Mr. Reyes fearful of moving, as he understands his environment less and less. His wife is thinking of assisted living. However, this is not really affordable for the family.

  1. What additional information do you need to gather? What immediate next steps might you need to consider?

  2. Considering the diagnosis of glaucoma, how might Mr. Reyes present? What difficulties might Mr. Reyes have in day-to-day function and occupational performance?

  3. Considering Mr. Reyes's age, would there be any point to implementing therapy interventions to address the pain?

This chapter explores how some health conditions of older adults affect the sensory systems and how these affect functional performance, activity, and occupational demands. Older adults, who have one or more health conditions associated with aging or as the result of poor lifestyle choices, may lead productive and satisfying lives with interventions of multiple health-care providers and motivation (Massof, 2006).

Pathological Changes in the Visual System


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