I Concepts about Humans and Human Functions 4. Late Adulthood 4 Late Adulthood P OINTS 1. 高齢になると生じる身体的変化にはどのようなものがあるでしょう。 2. 高齢者の身体的変化は体の機能や生活にどのような影響をもたらすでしょう。 3. 高齢者の治療に際し、医療従事者はどのような配慮が必要でしょうか。 Key Words 次の各語句の意味として適切なものを右から選ぴ( 入れなさい。 1. 2. 3. 4. 5. 6. 7. 8. 1 2 3 4 life expectancy ( metabolic rate ( atrophy1 ( 2 osteoporosis ( 3 musculoskeletal ( disorder ( gerontology4 ( geriatrics ( c g h b d a f e ) ) ) ) ) ) ) ) a. b. c. d. e. f. g. h. )の中に記号を疾患、機能不全骨組懸症平均余命筋肉と骨格の老年医学老年学代謝速度萎縮、退化 atrophy ..................................................... 萎縮、退化（a-；非，無、欠如、tropho-；栄養） osteoporosis ........................................ 骨組懸症（osteo-；骨 bone、pore；孔、-osis；状態） musculoskeletal .........................筋肉と骨格の（musculo-；筋肉 muscle、skeletal；骨格の） gerontology.................................................... 老年学（geronto-；老齢、老人、-logy；学問） 1 Health Care Today The New Edition Asahi Press I Concepts about Humans and Human Functions 4. Late Adulthood Reading Due to5 advances in medical science and health protection, the number of people living to an advanced age 6 is increasing. In fact, here in Japan, life expectancy7 has been the highest in the world since 1985 for women, and 1994 for men. This, however, does not mean that an aging8 adult can expect an easy transition9 to late adulthood10. As a person ages11, a number of physical changes occur, some are obvious, such as those in the skin, hair, and nails, but some are not. Physical changes Body temperature12 is lower in the elderly13 due to a decrease in the metabolic rate14. An older person may have an average body temperature of 35˚C. This means a temperature of 37.5˚C could be dangerous for an elderly person whereas it would only be a mild fever for a younger person. Elderly adults are also more susceptible to15 extreme cold or heat since their circulatory16 and sweating17 mechanisms have slowed and there is a 5 6 7 8 9 10 11 12 13 14 15 16 17 due to................................................................................................. ∼のせいで、∼の理由で advanced age ........................................................................................................................高齢 life expectancy.............................................................................................................. 平均余命 aging......................................................................................................................年老いてきた transition...............................................................................................................................移動 late adulthood .......................................................................................................................晩年 age................................................................................................................................ 年をとる body temperature ..................................................................................................................体温 the elderly..................................................................................................................... 中高年層 metabolic rate ............................................................................................................... 代謝速度 susceptible to ......................................................................................... ∼の影響を受けやすい circulatory................................................................................................................. 血液循環の sweating............................................................................................................................ 発汗の 2 Health Care Today The New Edition Asahi Press I Concepts about Humans and Human Functions 4. Late Adulthood decrease in subcutaneous fat18. A slight decrease in stature19 occurs due to atrophy20 of the discs21 between the spinal vertebrae22. Accompanied by muscular weakness, atrophy in the back results in a stooping posture23. Osteoporosis24, a decrease in bone density25, makes the elderly adult prone to26 serious fractures27, some of which are spontaneous28. Degeneration29 of the joints30 makes movement stiffer31 and more restricted32. Musculoskeletal33 changes in the chest34 reduce respiratory35 efficiency. Weaker expiratory36 muscles cause a greater volume of residual air37 left in the lungs after expiration38 and decrease the elderly's capacity to cough39 efficiently. Elderly adults are thus more susceptible to respiratory 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 subcutaneous fat............................................................................................................ 皮下脂肪 stature...................................................................................................................................背丈 atrophy ..................................................................................................................... 退化、衰弱 discs ............................................................................................................................. 椎間円板 spinal vertebrae................................................................................. 脊椎骨（vertebra：単数） stooping posture.....................................................................................................前屈みの姿勢 osteoporosis .................................................................................................................. 骨粗鬆症 bone density...................................................................................................................... 骨密度 prone to .................................................................................................................... ∼しがちな fracture .................................................................................................................................骨折 spontaneous ...........................................................................................................自然に起こる degeneration .................................................................................................. 変性、変質、退化 joint ......................................................................................................................................関節 stiff ............................................................................................................................... こわばる restricted................................................................................................................... 制限された musculoskeletal .....................................................................................................筋肉と骨格の chest .....................................................................................................................................胸部 respiratory......................................................................................................................... 呼吸の expiratory ...................................................................................................... 息を吐く、呼気の residual air ............................................................................................................................残気 expiration...................................................................................................................... 呼気作用 cough............................................................................................................................ 咳をする 3 Health Care Today The New Edition Asahi Press I Concepts about Humans and Human Functions 4. Late Adulthood infections40, such as influenza41 and pneumonia42. Heart capacity also diminishes with age. Changes in the small arteries43 occur concurrently44. Reduced arterial elasticity 45 often results in diminished blood supply to the legs and the brain, resulting in post-exertion46 calf47 pain and dizziness48, respectively: Sensory and neurologic49 changes While recent research indicates that there is minimal change in the intellectual50 capacity of a healthy elderly person, changes to the senses sight, smell, hearing, touch and taste - do affect a person's perception51 or ability to interpret52 the environment. Perceptual capacity may be affected by changes in the nervous system53 as well. In addition, neurologic changes slow reaction time54 in the elderly. One of the most tragic neurologic conditions affecting the elderly is Alzheimer's disease55, a progressive56 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 infection............................................................................................................................ 感染症 influenza............................................................................................................インフルエンザ pneumonia ..........................................................................肺炎（pneumon-；肺、-ia；病気） artery ....................................................................................................................................動脈 concurrently.......................................................................................................同時に併発して arterial elasticity.....................................................................................................動脈の伸縮性 post-exertion .................................................................................................. 激しい動きの後の calf ........................................................................................................................ふくらはぎの dizziness ........................................................................................................................... めまい neurologic........................................................................................ （=neurological）神経系の intellectual .........................................................................................................知性の、知力の perception .............................................................................................................................知覚 interpret ..................................................................................................... 解釈する、分析する nervous system ................................................................................................................. 神経系 reaction time ................................................................................................................. 反応時間 Alzheimer's disease........................................................................................ アルツハイマー病 progressive ................................................................................................................... 進行性の 4 Health Care Today The New Edition Asahi Press I Concepts about Humans and Human Functions 4. Late Adulthood disorder57 that is characterized by intellectual impairment58, mood changes and confusion. Treatment and consideration Since so many people are living to an old age, health care59 professionals are undergoing changes as well. New fields, gerontology60 and geriatrics61, have opened up62 to investigate the diseases of aging63 and provide better care for the elderly. When treating elderly patients, health care professionals need to be aware that it is important to the elderly to be able to look after 64 themselves even if they have to struggle to do so. Due to physical and physiologic changes with aging, the older person's speed of performance decreases. Yet, it should be noted that this is partly because the elderly are more concerned about the accuracy of performance than the speed. Praise65 and recognition for each accomplishment66, no matter 67 how small, will be appreciated68 by the elderly. These considerations can help older adults maintain a sense of self-respect69 and promote health. 57 58 59 60 61 62 63 64 65 66 67 68 69 disorder..............................................................................................................疾患、機能不全 impairment ...........................................................................................................................欠陥 health care ................................................................................................................ 健康管理の gerontology....................................................................................................................... 老年学 geriatrics........................................................................................................................... 老年学 open up..................................................................................................................... ∼を始める aging.....................................................................................................................................加齢 look after ...........................................................................................................∼に注意を払う praise ....................................................................................................................................賞賛 accomplishment ....................................................................................................................完成 no matter ...............................................................................................................たとえ∼でも appreciate ..................................................................................................................... 感謝する self-respect ....................................................................................................................... 自尊心 5 Health Care Today The New Edition Asahi Press I Concepts about Humans and Human Functions 4. Late Adulthood Comprehension 英文の空欄に入る最も適切な語を、下の選択肢の中から選びなさい。その後、テープを聞いて答えを確認しなさい。 An elderly patient requires a constant, comfortable environmental 1) ( e ). The nurse may need to provide extra clothing for an elderly patient who feels 2) ( i ) in a room with a "normal" temperature. Because of 3) ( g ) changes experienced by elderly adults, such as the 4) ( h ) of the joints, a nurse should advice patients to take adequate exercise and include sufficient amounts of protein and calcium in their diets. Prompt treatment at the first sign of 5) ( a ) is a must70. The nurse should teach elderly patients deep breathing and coughing techniques to counteract reduced 6) ( d ). Changes in 7) ( c ) sometimes force the elderly to rely on inexpensive magnifying glasses71 from department stores. The nurse should encourage older adults to have routine 8) ( j ) and to use appropriate eyeglasses. Because of the gradual loss of 9) ( b ) in the elderly, a nurse should face an elderly patient and speak slowly, more loudly and in a lower tone. Nurses should also use facial expressions that convey moods and feelings to aid the patient's 10) ( f ). a. respiratory infection c. vision e. temperature g. musculoskeletal i. cold 70 71 b. hearing d. respiratory efficiency f. comprehension h. degeneration j. eye examinations must....................................................................................................... なくてはならないもの magnifying glasse ............................................................................................................. 拡大鏡 6 Health Care Today The New Edition Asahi Press I Concepts about Humans and Human Functions 4. Late Adulthood Useful Expressions. (老年期に関する表現) 以下の英語表現内の空欄 (1)-(6)に入る適語を下記の語群から選びなさい。 aging (graying) society 高齢化社会 care (1) ( b ) 介護施設 (2) ( f ) 介護者 the elderly 老人 Ministry of Health, labour and Welfare 厚生労働省 home care 家庭介護 (3) ( e ) 養老院 nursing-care insurance system 介護保険制度 public (4) ( a ) 公的福祉 public assistance 公的援助 premium 保険料・ People age 40 and over are required to pay a monthly premium. ・ 40 歳以上の人は毎月保険料を払うように要求されている。・ The aim of this system is to free people who take care of their (5) ( c ) parents at home from the so-called nursing care hell. ・この制度のねらいは、家庭で高齢の両親の世話をしている人達をいわゆる介護地獄から救うことである。・ Foreign residents can participate in the nursing-care insurance system if they hold a valid visa and alien (6) ( d ) card and have been granted a period of stay of one year or longer. ・外国人居住者で有効なビザと外国人登録証明書を持ち、一年以上の居住を認められている人は介護保険制度に加わることができる。 a. welfare d. registration b. facility e. nursing home 7 Health Care Today The New Edition c. elderly f. caregiver Asahi Press I Concepts about Humans and Human Functions 4. Late Adulthood Dialog (A middle-aged72 nurse is talking to Ms. Hara, a 75 year-old patient who is about to 73 be released from the hospital74. The nurse rephrases75 a question the patient did not understand and tries to advise and reassure76 her.) Nurse: Ms. Hara: Nurse: Ms. Hara: Nurse: Ms. Hara: Nurse: Ms. Hara: Nurse: 72 73 74 75 76 77 78 79 80 My, you are looking fine this morning. You must be happy to be going home. Pardon? Are you happy to be going home? Today? Happy? Well, yes. I am looking forward to being in my own home again. But I worry about falling down. You need to take things slowly. And rest. Don't push yourself77 at first. No full exertion78 for a while79. OK. But I think I'm getting absent-minded80 as well. Maybe I have Alzheimer's. I haven't seen anything to indicate you have Alzheimer's. As we get older we tend to forget things. I'm forty, and I've taken to writing lists of things to help me remember. You write lists? Well, now I won't worry so much. Right here I've got a list of things to do when I get home. Good for you. middle-aged 中年の is about to まさに∼しようとしている be released from the hospital 退院を許される rephrase 言い方を変えて述べる reassure 元気づかせる、安心させる push oneself （無理に）努力する full exertion 目一杯のがんばり for a while しばらく absent-minded 忘れっぽい、ぼんやりした 8 Health Care Today The New Edition Asahi Press