Nursing The Older Person in A Variety Settings Flashcards
The changing needs of the elderly
Ageing process Retirement Losing a spouse Large garden Maintenance problems Steps and steep hills Unavle to drive Friend a d family moved Access to public facilities
Where do nurses care for older people
Community
Long term ( residential)
Acute care
What this means
The right choice and the right
While seeking advice from friends and family and health professionals the final decision rest in the elderly
Fears of the elderly
Final days in nursing home Outlived usefulness Loss of living independently Loss of personal belonging Perception of nearing death Fear of rejection by children
In the community
Community nursing
Home care
Day care Center
General practitioner
Residential - long term care
A variety of level of care are provided within this context
Lower level
Higher level
Special care
Lower level
Support with adl’s in a more social level
Higher level
Greater intervention while still in a social model will require higher level if nursing skill and knowledge
Special care
Dementia
Factors that have been found to precipitate admission into a residential aged care facility
Dementia Falls Impaired mobility Falls Urinary incontinence
Attitudes of the elderly to the accommodation
Strong attachment to their own home and neighbourhood
fear of moving to the unknown and smaller accommodation
Threat to their independence and control
Effort of moving, financial and legal issues
Most suitable accomodation that can extend and enhance their independence
Levels of care
Assessed by acat
Lower care
Higher care
Respite care
Lower care
Assistance with showering, dressing, laundry, medications but not continuous in a regular basis, may be required at times of illness
Higher care
Assistance with most ADLs 24 hour care
Respite care
Short stay care for family respite
Factors to consider when selecting a nursing facility
Cost Care Administration Staff Residents activities Meals Family involvement Spiritual needs Special services
Goals of the nursing aged care
Improve physical function Manage illness Prevent complication Delay deterioration Allow to die in peace and with dignity
Implications of institutional care on quality of life
Need for mastery and control of ones own environment
Negatives:” learned helplessness”, outlived usefulness l, no control over behaviour
Leisure activity means independence
Making choices: food, personal care, room decoration, bring satisfaction
Institutional effdcts: apathy, passivity, dependence
Nursing responsibilities in residential cqre facilities
Assist residents/families adjusting to the facilities
Assess and develop individualised plan
Monitor reidents health status , identify changes and take appropriate action
Evaluate effectiveness and appropriateness of care
Communicate with care team
Ensure and promote competency of nursing staff
Protect and advocate for residents rights and quality if life
Use rehabilitation techniques and restorative techniques
Acute care ( hospital)
Roles and responsibilities specialties
Hospitals have specialist age care nurses designed to gerontology ward
