older adulthood Flashcards
age of older adults
65+
older adulthood
living longer and healthier, they are active and contributing to society, and fastest growing segment in population
key to older adults
help them to live longer and fulfilled lives with dignity and independence
why are there so many older adults?
improved standard of living, improved nutrition, progress in medical care, increased health consciousness
“graying of america”
care will continue to shift from hospitals to community
goal is to maintain functional independence and delay entry into more formalized health care settings such as assisted living and long term care
older adult biology
identify normal age-related changes from pathological processes and illnesses
older adults’ concepts of health generally depend on personal perceptions of functional ability
there is a great variability in age-related changes
common chronic conditions in older adults
hypertension, arthritis, heart disease, cancer, diabetes, asthma, chronic respiratory, stroke
erikson’s developmental stage: integrity vs. despair
leads to acceptance of death, intense period of reflection and places closure on one’s life
positive end result of integrity vs despair
acceptance of past life and life as it is now, reconciliation of what was hopes for and what is now, openness to life, serenity, wisdom, acceptance of death
roles and relationship
self-perception changes due to rol e change
self-perception changes due to role change: role changes
children independent, death or illness of loved ones, retirement, changes in health status, becoming a grandparent
misconceptions about older adulthood
disease is normal and unavoidable
health promotion is not important for older adults since their lives are almost over
damage to health resulting from inactivity or poor nutrition is irreversible
ageist beliefs about older adults
can we impact morbidity?
yes! by decreasing risk factors and improving health care, it would be possible to postpone the onset of chronic disease until an age closer to death
how can we decrease risk factors and improve health care?
exercise and diet, quit smoking, prevent falls, and preventive care
the decline in health in old age is primarily due to unhealthy lifestyle choices in earlier years
true
older adults experience coping and stress when they are adjusting to:
decreasing physical strength and health
retirement and lower/fixed income
death of parents, spouses, friends
new relationships with adult children
slower physical and cognitive responses
keeping active and involved
making satisfying living arrangements
interventions to deal with coping and stress
support during coping and address spirituality
outcomes of comprehensive assessment of older adults
identify individual strengths and weaknesses
develop plan of care that corrects problems
maintain health
improve the quality of life
older adult assessment
a functional, physical, social, and mental assessment of patient, caregiver, and environment
goals of an older adult assessment
minimize hospitalizations
establish complete diagnoses that are frequently overlooked
decreases over-prescription of meds
maintain health and health maintenance practices
key principles of older adult assessments
individualized, person centered approach
client/caregiver as an active partner
focus on functional ability
multidisciplinary
specialized knowledge (normal age related changes, appropriate lab values)
health promotion in older adults
healthy weight, healthy diet, staying active, fall prevention, maintaining relationships, regular medical check ups, flu shot, pneumonia shot, screenings for breast cancer, colon cancer, lipid disorders, osteoporosis, smoking cessation
important key to successful older adult assessment
use of screening tools tailored for seniors
screening tools tailored for seniors use!
allows for early detection and intervention
predicts service needs
instruments should always be evidence-based with good validity and reliability
an overall assessment tool for older adults
fulmer SPICES
fulmer SPICES
Sleep disorders
Problems with eating or feeing
Incontinence
Confusion
Evidence of falls
Skin breakdown
normal physical changes
integumentary, neuromuscular, sensory/perceptual, pulmonary, cardiovascular, gastrointestinal, urinary, genitals, immunological, endocrine
nursing strategies for respiratory system
immunizations
smoking cessation
daily exercise
see health care provider if: short of breath, respiratory infection is > 3 days, and if cannot tolerate fluids >1 day
nursing strategies for cardiovascular system
rest when feel tired or short of breath
daily exercise
wear socks to bed
check for orthostatic changes, instruct to change positions slowly
elastic stockings
nutrition and metabolic patterns
proper nutrition prevents cancer, obesity, GI disorder and provides energy for activities of daily living = individualized diet plan
risk factors for nutrition and metabolic patterns
low social support and low income
problems affecting nutrition patterns
GI function, decreased smell, vision, taste, oral and dental issues and swallowing, medications
nutritional screenings
healthy history, physical exam, labs, diet data, functional status
obesity can cause:
hypertension, diabetes, heart disease
nutrition interventions
assess contributing factors, use nutrition tool
education about nutrition
food assistance programs (barriers to these programs embarrassed to apply, lack of knowledge)
elimination pattern
bladder retains tone but capacity decreases
incontinence can lead to…
depression, UTIs, skin breakdown, use incontinence tool
management of elimination pattern
kegel exercises, pilates, scheduling, intake management, decrease caffeine, disposable undergarments
constipation can cause…
decreased mobility
sedentary lifestyle
medications
education about elimination patterns
exercise
increase fiber
increase fluid
caution against daily use of laxatives
activity and exercise pattern
decrease falls
increase strength
reduce arthritis pain
reduce depression
improve integrity
reduce risks for diabetes and CVD
maintain weight
lowers BP
lowers cholesterol
decreases constipation
sleep better
better digestion increases muscle tone
increases flexibility and balance
opportunity for socialization
stress management
sleep pattern
many older people complain that they do not sleep as well as they used to sleep
difficulty staying asleep, falling asleep, inability to fall back to sleep
causes of sleep patterns
stress, medications, poor habits, sleep disorders
sleep patterns DOs
schedule, exercise, ritual, quiet, dark, bed use
sleep patterns DONTs
nap, activity before bedtime, caffeine after mid-morning, drink alcohol before bedtime, sleep medications, tobacco
cognitive-perceptual pattern
cognitive problems are NOT part of the aging process
confusion often associated with psychological problem
assess and treat
UTI and pneumonia
dementia goal!
increase quality of life, decrease morbidity and cost
managing dementia
keep routine, calm and gentle, encourage self-care, reduce sensory overload
reminiscence and life review
benign forgetfullness
modest in short term memory
forgets, then remembers, forgets unimportant events, may repeat stories over time
uses mental retracing, reminders, notes to compensate
some decline in abstraction, calculation, word fluency, spatial orientation, inductive reasoning
nursing strategies for aging minds
confusion, disorientation, inappropriate behaviors, loss of ability to follow directions or concentrations are NOT a part of normal aging
changes might have a physical or psychosocial basis and need to be evaluated
true
forgetfullness
attempt recall in calm, quiet place
use memory aids
use memory techniques
cues to impaired hearing
periodic hearing evaluations
use of hearing aids
teach methods of improve communication
methods to improve communication
eliminate background noise
don not shout
face speaker directly
cues to visual changes
annual eye exam and glaucoma screening
use of bright, glare-free lights
limit night driving if poor night vision
sexual and reproductive pattern
recognize sensitivity of topic
approach matter of faculty as a normal and healthy aspect of daily life
discuss normal age related changes and appropriate interventions
susceptible to STIs
older adults need intimacy, love, touch, as an expression of closeness and is an integral part of sexuality
depression
NOT a normal part of the aging process
may occur with chronic illness, impaired functional ability, losses
signs and symptoms of depression
flat affect, anorexia, weight loss, sleep problems, fatigue, decreased ability to think and concentrate, decreased participation in activities and socialization
suicide
high rate in US compared to other countries
highest rate seen in man > 75
risk factors or suicide
social isolation, alcohol and substance abuse, psychosis, bereavement, and serious mental illness
falls
1 in 3 older adults fall each year and are the lead cause to serious injury
often leads to nursing home admission
assess for falls
teach safety interventions
causes of falls
neurological, osteoporosis, stroke, sensory impairment (vision)
biological agents
high rates of cancer in this age group
more than half of cancers in this age group
influenza
death in older adults
vaccinate annually
pneumonia
increased rate within 1 yr of hospitalization
vaccinate at age 65
polypharmacy
use of multiple medication
often duplicate for the same health problem
1/3 of all older adults take 5 or more prescriptions
substance abuse a growing problem
alcohol use
use underestimate/hidden
under diagnosed
elderly more vulnerable to effects of alcohol
tobacco use
cumulative effects over lifetime
promotes multiple chronic health conditions
smoking cessation beneficial > age 65
can lead to COPD, bronchitis, lung cancer, stroke, HTN
older adult abuse
intentional or neglect that leads to harm
physical, emotional, verbal, financial, sexual, and abandonment
highest risk of older adult abuse
older adult women dependent on a caregiver
projections for the future
emerging older adults will be healthier
emerging adults with be healthier if..
creativity and intellectual involvement
experience and the desire to share it
vitality and productivity
compassion for others and concern for the world around them
challenge to nurses
correct misconceptions
separate normal changes of aging from pathological processes and illnesses
recognize high risk for and accumulation of chronic disorders and disabilities
nursing care can determine whether an older adult pt can…
maintain health
recover from an illness
maintains or regains function and independence
achieves a peaceful death
nursing interventions should support..
self care abilities
practices that foster health while aging
health promotion and health maintenance behaviors can impact positively on the quality of life for the older person
true
