Geriatric nursing, sensory deficits Flashcards
Ageism
the prejudice against the elderly, which we all have to some degree, in which we categorize older adults as “senile, old-fashioned”. Allows young people to”other” OA, so we don’t see them as human and feel more comfortable neglecting and disliking them
Effects of ageism in health care
- HCP are likely to have negative attitudes towards OA’s b/c they seem them at their worsts (frail, falls, sick). Ageist sterotypes and prejudice leads to barriers in quality of care and quantity of care.
- “Bed blockers”; GOMER; Pleasantly confused; Elderspeak; Non-specific diagnosis “failure to cope”; – less likely to be referred for surgery, get help for suicidal patients, and not involve them in health care decisions
Geriatric syndomes
a categorical term used to capture those clinical conditions common in OA that do not fit into 1 category.
- Multiple underlying factors involve multiple organ systems- the accumulation effects of impairments render the OA vulnerable to situational challanges
Common geriatric syndromes
- fraility
- pressure injuries
- incontinence
- falls
- functional decline
- delirium, depression, dementia
- nutrition and weight loss
- sacropenia
- dizziness and syncope
Shared risk factors for geriatric syndromes
- older age
- cognitive impairment
- impairment mobility
- poor nutritional status
- female gender
- depressive symptoms
How does it differ when a young person gets sick vs an OA
in a young person it is more of a linear experience. you get sick, they identify the single cause, you get worse of better.
- In OA, it is more complex b/c it involves multiple systems and risk factors. often the chief complaint is not the underlying cause. Risk factors can also influence other risk factors
How many adults older than 70 years have clinically significant hearing impairments?
2/3 of OA over 70 yrs
- doubles every decade
Presbycusis
what is it?
what is the effect?
Sensorineural hearing loss common in elderly. caused by degeneration of hair cells in inner ear (cochlea) or CNIII. causes a loss of transmission.
- harder to hear: consonant sounds, women/children voices, hear the phone, in noisy environment
What are risk factors of presbycusis
- older age
- Caucasian
- exposure to loud noises
- ear structure damage
What are impacts of hearing loss?
- reduces QOL for the affected person, family, and caregiver
OA: - decreases ability to care for self (health teaching, self-advocate),
- loss of independence increases chances of hospitalization
CAREGIVER: - communication barriers restrict social life, increase burden of communication, lead to poorer QOL and relationship satisfaction
What health outcomes are associated with sensory impairments?
increased risk of:
- disability
- depression
- cognitive impairments
- dementia
Hearing intervensions: technological devices
- Pocket talker: works with smartphones, person wears ear phones and speaker talks into microphone
- Hearing aids: improves hearing by 50%
- Cochlear implanted surgery: for those who are profoundly deaf
- Text message phones with closed captioning
How many people who need hearing aids wear them?
15%
How many people over 65 years old require classes for close vision?
95%
Why do OA need glasses for close vision as they age
Functional and structural changes
- Extraocular: lower lid turns inward or outward = dry eye
- Ocular: glaucoma, light fractures, external glare is a problem, colour perception reduced
- Intraocular: less rod reduction in peripheral vision, colour clarity reduced
What is the impact on a seniors ability to see
reduces QOL
increases chances of mortality and institutionalization
Vision impairments in OA - interventions
- glasses (often broken, out of date, lost)
- technology devices for low vision (talking clocks, read out loud devices)
- audiobooks, podcasts
- cutlery that is bright red or orange
- adequate lighting in room
Dual sensory loss in OA.
Risk factors compared to single sensory loss
hearing and vision loss is related to higher chances (than a single sensory loss) of poorer QOL, depression, and increased mortality rate
Generational Power
What is it
members of a generation are linked through their life experiences in their formative years (teens and early 20’s)
What was life like in 1950’s, 60’s?
1950’s
- Korean war, Vietnam war - 30,000 Canadians served
- The civil rights movement speaking out against inequality and injustice
- Elvis Presley/Rock and Roll
- Communist regime in China
1960’s
- Cuban missile crisis
- JFK assassination
- MLK assassination
- Woodstock
- Man on the moon
Clinical Communication Strategies with OA
- Ask Permission (Even though interaction may make them feel vulnerable, asking promotion hands over the control)
- Show you Care (increases pt engagement, trust, improves outcomes
- Work Together (patient-centered care)
- Agree on Next Steps (ex-come up with 3 options together, OA often scared to disclose thinking they can’t go back home)
