Every year, many elderly people sustain injuries at their homes. In United States of America, the Consumer Product Safety Commission estimates that most of the people admitted and treated in the hospital room’s emergency rooms for injuries arising from products they live with and use every day are the elderly. At times, death normally occurs as a result of sustained injuries. Age related changes that affect safety and mobility include loss of neurological functions such as visual and hearing (Dreeben, 2012).When the elderly loss their hearing ability, they become prone to more accidents such as fall. Loss of hearing affects the elderly in that   they are unable to hear any approaching danger such as oncoming vehicles when closing roads or falling objects in the house. Another factor that is age related that affect mobility and safety in the elderly is osteoporosis and most significantly arthritis. One important risk factor for osteoporosis is age. As an individual grows older, the risk of osteoporosis also increases. At the age of over thirty five years, the rate at which bone are made is reduced and the rate at which bone dissolve and is absorbed by the body slowly increase. A family with a record or history of osteoporosis    increases the chances of an individual in such a family having osteoporosis (Dreeben, 2012). Other risk factors of osteoporosis are lifestyle factors like smoking, alcohol use and poor dieting where a person takes very little calcium and vitamin D. osteoporosis influence the mobility and safety of the elderly by in that it affects their joints, this makes physical exercises impossible and this may lead to heart conditions. Osteoporosis also decreases neurological functions in the elderly. Senses like hearing, sight, smell and hearing are impaired (Miller, 2009).                                                                                                              

Diminished Musculoskeletal Function, Increased Susceptibility to Fractures, and increased                  

Musculoskeletal is the system of tendons, muscles, bones, ligament and joints that are involved in the body movement and at the same time maintain its shape. A diminished musculoskeletal function increases an individual’s susceptibility to fractures in that the bones become weakened.  This fracturing of bones is further enhanced by Osteoporosis (Dreeben, 2012). A weakened or diminished musculoskeletal function also means that an individual vulnerability to falls increases. The ligaments become weak and therefore supporting body movements is considerably compromised.

Psychosocial and Long-term Consequences of Falls, Fractures, and Osteoporosis

Psychosocial effects of osteoporosis include anxiety, anxiety may come before a person knows he or she have osteoporosis. The person thus starts fearing falling and the consequences of fractured bones. The person anxiety is also heightened by the fear of deformity, restricted activities and pain. This feeling of anxiety may lead to stress and inactivity (Miller, 2009). Depression is also a consequence that the elderly may experience. This is because one tends to become dependent on others. Other consequences include lowered self-esteem and failure to provide social support to the family.

Nursing assessment of Musculoskeletal Performance can be established by assessing by strength, gait, balance and endurance. Patients can be evaluated by examining ability to stand with their feet together in the side by side, tandem positions, semi tandem, and time taken to rise from a chair or returning to seated position five times (Miller, 2009). This kind of assessment can help in determining or predicting short term mortality and nursing home admission for the elderly with emergency needs. Those at the high end of the functional spectrum, the assessment can distinguish the gradient of risk for risks for falling, and osteoporosis. One importance this assessment is that performance methods can validly illustrate older persons across a wide-ranging spectrum of lower extremity function (Miller, 2009) 

Most of the intervention can be home based or policy issues. They include; arranging the house in a systematic way to avoid falls and fractures, adapting healthy lifestyle, Comprehensive assessment and caring of the elderly and bringing together all professional in the health care (Miller, 2009) 

Sensory assessment

The performance of many daily activities such as protecting oneself from danger, communicating and music enjoyment is usually dependent on the good hearing. In aged adult, changes that are age related act together to affect the hearing wellness of this population (Resnick, 2011). Nurses improve the quality of life among the aged population through the use of health promotion intervention measures that improve communication and hearing.   

There are various age related changes that normally affect the hearing among the elderly population. The pinna of the elderly adult normally undergoes changes in shape, size and flexibility, and the growth of hair increases with age (Miller, 2009). These changes affect the transmission of the sound waves in the older adults. Another change is the increase in production of wax, which is a natural substance that cleanses, protect and lubricate the ear canal. Wax builds up in order adults due to increased concentration of the keratin especially among the men (Miller, 2009). Accumulated wax in the ear reduces the hearing ability among the aged. Collapsed ear canal is another age related change that impact on the hearing ability. It affects the perception and localization of high-frequency sounds. Other changes include; loss of hair cell, diminution of the endolymph production, reduction in blood supply and decrease in the basilar membrane flexibility. All these changes are age related. 

There are various risk factors that affect the hearing wellness especially among the aged adult. The most prevalent factor is the exposure to noise. Prolonged exposure to noise especially due to the nature of occupation or leisure activities causes damages to the auditory system. Genetic disorder such as otosclerosis also increases the risk of hearing loss among the aged. Another risk factor is the consumption of chemotherapy and antibiotics, these drugs cause damage to the auditory system hence increasing chances of hearing loss among the aged (Miller, 2009). Diseases are also another risk factor, especially those that causes blockage of blood flow. Diseases such as atherosclerosis, meningitis and Meniere normally changes the nature of fluid inside the ear hence they increase the hearing loss possibility among the aged. 

There are functional consequences of age related changes that affect the hearing wellness. A Presbycusis functional consequence is normally the loss of the ability to hear sibilant consonants and high pitched sounds. This makes the affected to deduce wrong interpretation of the statements.  Furthermore, as the hearing loss progress, an explosive consonant such as b, k, t and p becomes distorted (Miller, 2009).   Thickening of the hair and increase of the keratin in the outer ear normally impair the sound transmission. In the middle ear, hardening of the ear ossicles, weakened resiliency of the tympanic membrane also impairs the conduction of the sound.

Nursing assessment on hearing normally aims at identifying the factors that interfere with hearing wellness, hearing deficit and the impact of the deficit on the person’s quality of life and safety. The nursing assessment begins identifying whether there is family hearing impairment history, or personal history of a prolonged exposure to risk factors (Forbes, 2005). The nursing assessment need to prompt the affected person to acknowledge the presence hearing problem in order to identify effective ways to enhance the hearing wellness. The nurse identifies hearing deficit through prompt examination of the client responses the questions. In a situation where no hearing impairment is present, question about the lifestyle need should not be included in the assessment. It is also essential to assess the older person attitude toward assistive devices since it influences the acceptability of the intervention (Forbes, 2005).      

Numerous nursing intervention measures can be adopted in order to promote hearing wellness for older adults. These include; teaching the aged-adult about the risk factors that pre-dispose them to hearing loss, factors such as noise, certain medications and disease among others. Older adult with accumulated wax needs to be referred to the audiologist in order to remove the wax. (Forbes, 2005) Those people with established hearing loss should be provided with assistive devices such as hearing and listening aids devices. Training should also be done in order to equip the victim of hearing loss with new communication techniques so as to improve communication and social interaction (Forbes, 2005).