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Care of Elderly.pptx..care of elderly...
The document discusses elderly care, defining elderly as individuals over 65 and emphasizing the importance of tailored nursing care that addresses their unique physical, psychological, and social needs. It outlines various components of geriatric assessment, the aging process, the role of nurses in providing care across different settings, and the prevalence of elder abuse. Additionally, it highlights the impact of aging on health, including physiological changes, psychosocial aspects, and the significance of maintaining independence and dignity for senior citizens.
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Care of Elderly.pptx..care of elderly...
- 2. Contents ■ History ■ PhysicalAssessment ■ Aging Process ■ Age related body changes ■ Stress and Coping in elderly patients ■ Psychosocial aspects ■ Sexual abuse of elderly ■ Role of family ■ Use of Aids and Prosthesis ■ Legal and ethical issues ■ National Programmes for elderly ■ Privileges ■ Community programs ■ Health Services ■ Home and Institutional Care
- 3. Introduction to careof elderly o ELDERLY is an individual over 65 years old who have a functional impairments. o Elderly care is the fulfilment of the special needs and requirements that are unique to senior citizens. This broad term encompasses such services as assisted living, adult day care, long term care, nursing homes, hospital care, and In-Home care. o Providing nursing care for older people is a major area of responsibility in the caseloads of nurses in almost all health care settings. o Nurses are accustomed to a multidisciplinary approach in giving care. In the field of geriatrics and gerontology, nurses will undoubtedly continue to assume multidisciplinary roles, particularly in home care and long term care settings. o When caring for older patients, we need to take into account the physiologic and biologic changes that normally occur during aging and to understand older adults’ special health requirements. Also, the effects of drugs on older patients should be understood.
- 5. TERMINOLOGY Geriatrics- Geriatrics comefrom the Greek word GERAS- Old age and IATRIKQS- Branch of Medical. Hence, it is defined as “the branch of medicine concerned with medical problems and care of old people.” Gerontology: Gerontology is the study of all aspects of the aging process and its consequences in humans. Gerontology achieves a level of wellness consistent with the changes of aging. Aging: It is defined as a maturational process that creates the need for individual adaptation because of physical and psychological declines that occur during a lifetime.
- 6. Geriatric Nursing Geriatric Nursing isthe specialty that concerns itself with the provision of nursing services to geriatric or aged individuals. This is an outline of the state of art for geriatric care that are useful to a nurse practitioner who encounters aging person in practice. Due to their complexity, aged people always deserve personal attention. Nurses address physical, psycho-social, cultural and family concerns as well as promoting health and emphasizing successful aging.
- 7. Assessment of theolder adult Careful assessment is the foundation of care for all patients, regardless of age. To identify the problems and needs of older adults, nurse must integrate a sound theoretical knowledge of the geriatric population with best assessment skills. ■ Components of geriatric assessment 1) Functional Assessment – it is the measurement of patient’s ability to complete functional tasks and are used to evaluate the older adult’s overall well-being & self care abilities.
- 8. Assessment tools a) KATZ INDEX b) BARTHE L INDEX c) LAWTON SCALE d)OARS Social Resource s Scale To rank the patient’s ability to perform 6 functions: • Bathing • Dressing • Toileting • Transfer • Continence • Feeding To evaluate their needs to support independent living: • Use telephone • Shop • Do laundry • Manage finances • Take medications • Prepare meals To assess a patient’s self care capacity such as : • Feeding • Moving here and there • Bathing • Going up and down the stairs • Dressing • Controlling bladder, etc. It is a multidimensional assessment tool to evaluate 5 areas: • Social resources • Economic resources • Physical health • Mental health • ADL
- 9. 2) Physical Examination-It is the second component of the health assessment. It focuses on several aspects: Obtaining health history Current health status Medical history Review of body systems 3) Nutrition Assessment: It includes evaluation of medical diagnosis, measurements of anthropometric parameters and biochemical indices, and review of medications. Clinical data •Coexisting medical diagnoses •Bio-chemical indices •medications a.Nutritional history •Usual food choices •Use of alcohol •Vitamin/mineral supplements •Drug-nutrient interactions •Weight history •Calorie intake and nutrient needs Other components •Activity/ exercise •Psychological issue •Knowledge of nutrition
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- 11. Normal aging hasfour aspects: 1.Biological aspects of aging 2.Psychological aspects of aging 3.Sociocultural aspects of aging 4.Sexual aspects of aging
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- 13. Individuals are uniquein their psychological and physical aging process. As the individual ages, there is a quantitative loss of cells and changes in many of enzymatic activities within cells. Age related changes occurs at different rate in different people. NERVOUS SYSTEM • Decreased speed of neural conduction • Decreased number of brain cells • Decrease in cell of the nerve fibers • Decreased neurotransmitters • Decline in memory for recent events • Decreased rapid eye movement sleep
- 14. SENSORY CHANGES Eye: • Diminishedability to focus on close objects. • Decreased visual acuity • The eye’s external changes give evidence of advancing age. These changes result from loss of orbital fat, loss of elastic tissue and decreased muscle tone. • The cornea flattens which reduces the refractory power • The retina of older individual becomes thinner because of fewer neural cells and receives only 1/3rd of the amount of light that of a younger person. Due to this problem in reading, not able to see in dim light and also have difficulty in color perception. • The lens of the eye loses its elasticity and increases in density.
- 15. Ear: • Hearing problem •Cerumen gland are reduced in number dry and hard ear wax, along with itching. • Degenerative changes occur in ossicles contributing to hearing loss • Presbycusis is the term used to describe hearing loss associated with normal aging. Taste and Smell: • Decreased ability to taste and smell • Very rarely the capacity to smell diminishes. • Taste perception and taste discrimination decreases as the age advances.
- 16. CARDIOVASCULAR SYSTEM • Decreasedphysical demands and activity of heart. • Slower heart rate and reduce cardiac output • Decreased contractility • Impaired coronary artery blood flow • Less oxygen and blood supply to organ so that it affects the function of organ • Decreased altered preload and after load • Increased atherosclerotic plaques and blood pressure • Diminished ability to respond to stress
- 18. MUSCULOSKELETAL SYSTEM • Decreasedbone density • Decreased muscle size and strength • Decreased joint cartilage • In aging, the increased parathyroid hormone, decreased vitamin D and calcitonin also play role in calcium loss in older people. • In women, estrogen deficiency, calcium malabsorption, lifestyle factors can result in bone loss. • Aging brings decline in numbers of muscles resulting in reduced muscle mass. • The muscle strength also reduces
- 19. INTEGUMENTARY CHANGES ■ changesare reductions in cell division, metabolic activity, blood circulation, hormonal levels, and muscle strength. In the skin, these changes are reflected in decreased mitosis in the stratum basale, leading to a thinner epidermis. The dermis, which is responsible for the elasticity and resilience of the skin, exhibits a reduced ability to regenerate, which leads to slower wound healing. The hypodermis, with its fat stores, loses structure due to the reduction and redistribution of fat, which in turn contributes to the thinning and sagging of skin.
- 20. Thermo-regulation ■ Normal bodytemperature are lower in later life. Rectal and auditory canal temperatures are the most accurate indicators of body temperature in older adults. Reduced ability to respond to cold temperature exists.
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- 22. Memory Functioning Shortterm memory deteriorate with age, long term memory does not show similar changes. A well educated and mentally active person does not exhibit such changes in faster rate. The time required for memory scanning is longer for both recent and remote recall among older people. This can be attributed to social or health factors (stress, fatigue, illness), but it can also occur with certain physiological changes due to aging.
- 24. Intellectual functioning ■ Fluidabilities or abilities involved in solving novel problems, tend to decline from adult period to old age. ■ High degree of regularity in intellectual function present on most of the old age people. ■ Intellectual abilities of older people do not decline, but do become obsolete. ■ Their formal educational experience is reflected in their intelligence performance.
- 25. Learning ability Theability to learn is not decline by age. The slowing of reaction time with age and over arousal of CNS are noted in old age. It may lead to lower levels of performance in tasks which requires high efficiency. Ability to learn continue throughout the life, although strongly influenced by personal interests and preferences. Accuracy of performances diminishes,
- 28. Loss and grief oBy the individuals reach 60-70 yrs of age, they have experienced numerous losses and mourning has become a life long process. o It is impossible for some of the older age people to complete the grief process in response to one loss before the other loss occurs. o This can further predispose to depression. Dealingwith death • Death anxiety among the elderly is more of a myth than reality. • The feeling of abandonment, pain and loss may lead to fear or anxiety in elderly.
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- 39. • Old agebrings many important socially induced changes. • Some of them have potential for negative effect on both the physical and mental well-being of older persons. • They want protection from hazards and weariness of every day tasks • They want to be treated with respect and dignity and also want to die with respect and dignity. • In developing countries and Asian countries the aged are awarded a position of honour, that place emphasize on family cohesiveness. • In industrialized countries many negative stereotyped perspectives on aging still persisting, aged are always tires or sick, slow and forgetful, isolated and lonely, unproductive, etc. • The status of elderly may improve with time as the number of elder person increases world wide.
- 40. SEXUAL ASPECTS OFAGING
- 41. Changes in females ♀Menopause may begin anytime during the 40s or early 50s. ♀ Gradual decline in the functioning of the ovaries and subsequent reduction in the production of estrogen. ♀ The walls of the vagina become thin and inelastic and vaginal lubrication decreases. ♀ Orgasmic uterine contractions become spastic. ♀ All these changes result in vaginal burning, pelvic aching, irritability, etc ♀ In some women these changes result in avoidance of sexual intercourse. ♀ These symptoms are more likely to occur with infrequent intercourse of only one time a month or less ♀ Regular and more frequent sexual activity result in a greater capacity for sexual performance.
- 42. Changes in males ♂Testosterone production decline gradually as the age increases ♂ As a result of these hormonal changes the erection takes place slowly and requires more genital stimulation to achieve. ♂ The volume of ejaculate decreases and the force of ejaculate lessens ♂ The testis become smaller, but most men continue to produce viable sperm well in to old age.
- 43. Elder Abuse Elder abuseis any form of mistreatment that results in harm or loss to an older person. Elder abuse tends to take place where the senior lives: most often in the home where abusers are apt to be adult children; other family members such as grandchildren; or spouses of elders. The personal losses associated with abuse can be devastating and include the loss of independence, homes, life savings, health, dignity, and security. Victims of abuse have been shown to have shorter expectancies than non-abused older people.
- 44. RISK FACTORS forElder Abuse • Poor health and functional impairment in older person • Cognitive impairment • Substances abuse or mental illness • Dependence of the abuse on the victims • Shared living arrangement • Social isolation • History violence RISK FACTORS among Caregivers Among caregivers, significant risk factors for elder abuse are: o Inability to cope with stress o Depression {common} o Lack of support from other potential caregivers o Substance abuse o The caregiver’s perception that taking care of the elder is burden some and without psychological reward.
- 45. TYPES PHYSICAL EMOTIONAL FINANCIALSEXUAL NEGLECT
- 46. TYPES ■ Physical Abuse-Use of physical force against an older adult that may result in bodily injury, physical pain or impairment. ■ Emotional abuse- Infliction of anguish, pain, or distress on an older adult through verbal or nonverbal acts. ■ Financial abuse- Illegal or improper use of an older adult’s funds, property or assets. ■ Sexual abuse- Non-consensual sexual contact of any kind with an older adult. ■ Neglect- Refusal or failure to fulfil any part of a person’s duties to an older adult. •Anguish-severe mental pain •Infliction- cause •Non- consensual= not agreed to by one
- 47. Use of Aidsand Prosthesis ■ Prosthesis: It is an artificial device used to replace a missing body part, such as a limb, tooth, eye or heart valve. ■ It refers to the replacement of a missing body part with such a device. ■ In medicine, prosthesis is an artificial extension that replaces a missing body part. ■ Dental prosthesis is an artificial appliance which is used as a substitution for the replacement of teeth. A CAST PARTIAL DENTURE
- 48. Hearing aids:It is an electroacoustic body worn apparatus which typically fits in or behind the wearer’s ear, and is designed to amplify and modulate sound for the wearer. They are incapable of truly correcting a hearing loss; they are an aid to make sounds more accessible. Behind the ear In the ear aid Pocket model
- 49. ROLE OF ANURSE IN ELDERLY CARE
- 50. Role of Nursein Geriatric care 1) Acute Care • Gather medical, family and psychological history • Perform patient assessment • Explain diagnosis and treatment to the patient and family • Work closely with patient, family and other health care professionals • Maintain hydration, nutrition, aeration and comfort • Provide medications and treatment and evaluate response • Administer emergency treatment when necessary
- 51. • Initiate dischargeplanning & coordinate referral to community agencies • Serve as patient advocate • Inform doctor of any change in patient’s condition
- 52. 2)Long term Care •Gather medical, family and psychological history • Perform patient assessment • Involve patient and family in preparation & implementation of nursing plan • Promote the atmosphere that emphasizes quality living, not disease and dying • Ensure that patient receives medical, dental, eye care • Maintain hydration, nutrition, aeration and comfort • Provide medications, treatment, rehabilitative exercises and evaluate response • Teach and advise patient and family • Perform emergency measure when necessary • Serve as patient advocate
- 53. 3)Community Care • Identifyhealth, social or economic needs. • Refer elderly person to professional or agency best able to meet needs. • Explain diagnosis and treatment to the patient and family • Evaluate compliance with and response to treatment. • Use clinic and home visits for health promotion. • Teach and advise patient and family • Evaluate elderly person’s ability to live independently • Become advocate for elderly persons • Encourage elderly to become advocate on his own self.