“Specific age-related changes include loss of elastic recoil, stiffening of the chest wall, inefficiency of gas exchange, and increased resistance to airflow ( Ebersole and Hess, 1998, p. ).” As individuals age, their gas exchange in the respiratory system decreases. Therefore, natural aging makes them more prone to respiratory problems and infections. It also makes them tired much more quickly when performing daily activities. The other adult's heart muscle is extended and contraction of the heart muscles is diminished. Although this does happen, it usually does not affect them unless they are suffering from some type of physical or mental illness. In the musculoskeletal system of the elderly, bone density is reduced due to loss of calcium. Thus, this leads to poor posture, joint pain and brittle bones which can lead to an increased risk of falls or accidental injuries. In the elderly person's health history, two things to include are their elimination and rest habits. It is important to assess the availability of toilets and the time required to reach the area. Any medications the client is taking, prescription or over-the-counter, and how this affects their elimination process. The person's physical mobility and exercise program capacity. The nutritional status of the elderly person also plays a key role in the elimination habit. The nurse may ask the client how many hours he sleeps. It is also important to know if they wake up several times during the night to go to the bathroom. Whether they take naps during the day or fall asleep at night. The Fulmer SPICES assessment tool is used to help evaluate certain ...... middle of paper ...... response. St. Louis: Mosby.Carolan Doerflinger, CRNP, PhD, Inova Fairfax Hospital, Falls Church, Virginia, DM (2007). Mental state assessment of older adults: The Mini-CogTM - Google Search. Accessed November 24, 2013, from https://www.google.com/search?q=Mental+Status+Assessment+of+Older+Adults%3A+The+Mini-CogTM&ie=utf-8&oe=utf-8&aq=t&rls. =org.mozilla:en-US:official&client=firefox-a&channel=fflbFulmer, PhD, APRN, GNP, FAAN, Bouve College of Health Sciences, Northeastern University and Meredith Wallace, PhD, APRN, CS, Fairfield University School of Nursing, T (2012). Fulmer SPICES: A Comprehensive Assessment Tool for Seniors - Google Search. Accessed November 24, 2013, from https://www.google.com/search?q=Fulmer+SPICES%3A+An+Overall+Assessment+Tool+for+Older+Adults&ie=utf-8&oe=utf-8&aq=t&rls. =org.mozilla:en-US:official&client=firefox-a&channel=fflb