Older Adults Flashcards
Age range of older adults
65+
Key to older adults for nurses
Help them live longer but fulfilled lives with dignity and independence
Society misconception #1 about older adults
Disease is normal and unavoidable
Society misconception #2 about older adults
Health promotion is not important for older adults since their lives are almost older
Society misconception #3 about older adults
Damage to health resulting from inactivity or poor nutrition is irreversible
Society misconception #4 about older adults
Ageist beliefs about older adults
By decreasing risk factors and increasing healthcare, it is possible to…
Postpone/delay onset of chronic diseases until an age closer to death
How is it possible to delay disease?
Exercise and diet
No smoking
Prevent falls
Preventative care
The decline in health in old age is primarily due to…
Unhealthy life choices in earlier years
Why are there so many older adults? (4)
Improved standard of living
Improved nutrition
Progress in medical care
Increase in health consciousness
__ men and __ women are 65 years or older
23%, 15%
Continued growth represents
Aging baby boomers
Minority populations will represent __% by year 2050
38%
By 2050, __ people will be 100+ years old
1 million, fastest growing population
People use most healthcare dollars in the last __ years of life
7
In older adults, screen for… (5)
Dementia, hearing, sleep, respiratory disease, vision
Biology and genetics: key is identifying
normal age related changes from pathological processes
Common chronic conditions
HTN, arthritis, CVD, cancer, DM, asthma, stroke
Loss of cognition is…
NOT a normal part of the aging process
Incontinence is…
NOT a normal part of the aging process
Incontinence is often caused by __ and __
UTIs and rectocele/OBGYN problems
4 outcomes of full assessment of older adults
Identify strengths/weaknesses
Develop POC that corrects problems
Maintain health
Increase quality of life
Elder adults assessment is a (4) assessment
Function, physical, social, mental
Older adult assessment needs to involve
caregivers, family, and look at the environment
4 goals of health assessment for older adults
Minimize hospitalizations
Establish diagnosis frequently overlooked
Decrease over prescribed medications
Maintain health and health practices
Key principles of health assessment (6)
Individualize Include caregivers Focus on functional ability Multidisciplinary Normal changes Lab values
Health perception/management key
remember motivation!!
Health promotion includes weight, diet, activity, fall prevention, and… (4)
maintaining relationships
regular checkups
flu shot, pneumonia shot
screenings
Important screenings
Breast cancer Colon cancer Lipid disorders osteoporosis Smoking cessation
Respiratory health assessment includes smoking cessation, daily exercise…
Immunizations, SOB, can they tolerate fluids?
Cardiovascular health assessment includes exercise, static hypertension,
Rest when tired or SOB
Wear socks to bed
Elastic stockings
Use screening tools tailored for seniors because…
Allows for early detection
Predicts service needs
Fulmer SPICES overall assessment tool for older adults
S- sleep disorders P- problems with eating I- incontinence C- confusion E- evidence of falls S- skin breakdown
Proper __ prevents cancer, obesity, GI disorders, and provides energy
nutrition
Risk factors for poor nutrition
Decreased social support
Decreased income
Doesn’t drive and buys bad food
Problems GI
Function slows down
Difficult swallowing
Poor nutrition causes…
decreased smell, vision, taste
Nutritional screening (5)
Health history, physical exam, labs, diet data, functional status
Nutrition interventions (3)
assess contributing factors
Educate about nutrition
Food assistance programs
Commodity (food assistance) program barriers
Embarrassed to apply
Unaware of the programs
Commodity programs and nursing homes use a lot of
Institutional foods (unhealthy/processed)
Bladder retains more but __ decreases
Capacity
Incontinence leads to… (3)
UTI, depression, skin breakdown
Elimination pattern management (6)
Kegel exercises, pilates, scheduling, intake management, decreased caffeine, disposable wear
Women’s colons are __ than males causing increased tendency for __
longer, constipation
Reasons for constipation
Decreased motility
Sedentary lifestyle
Medications
Nurse interventions for elimination patterns
Teach strategies Exercise Increase fiber Increase fluid Caution against daily laxative use
Goals for exercise…
decrease falls, arthritis pain, DM, CVD, BP, cholesterol, and depression
__ % complain they don’t sleep as well as they used to
20-40%
Sleep problems cause… (4)
Stress, medications, poor habits, sleep disorders
Sleep DOs
Schedule, exercise, ritual, quiet, dark, use the bed
Sleep DON’Ts
Nap, late exercise, caffeine late, alcohol late, sleep meds, tobacco
Confusion in older adults is often associated with..
physiological problem such as a UTI or pneumonia
Goals with dementia
Increased quality of life
Decrease morbidity and cost
Managing dementia (4)
keep routine
calm and gentle
encourage self care
reduce sensory overload
It’s very important to allow older adults to…
Reminisce, and review their life
Benign forgetfulness = __ loss in short term memory
modest
Modest loss in short term memory (3)
Forgets then remembers
Forgets unimportant events
Repeats stories
3 benign forgetfulness
Uses mental retracings, reminders, notes to compensate
Some decrease in abstraction, word fluency,
spacial orientation
inductive reasoning
Not normal part of aging include…
confusion, disorientation, inappropriate behaviors, decreased ability to follow directions, decreased concentration
Impaired hearing IS normal, but encourage
periodic hearing evaluations and use of hearing aids
Teach methods to improve communication (3)
eliminate background noise
doin’t shout
face the patient
Visual decrease is normal but encourage
annual eye exam and glaucoma screening
Visual changes tips
Use bright, glare free lights
decrease night driving
Erikson: Stage VIII
Integrity versus despair
Positive end result – accept past and present, openness to life
serenity, wisdom
acceptance of death
Self-perception changes due to role change
Independent children
Death of significant others
retirement
grand parenting
Sexual reproduction: recognize sensitivity and approach as…
A normal and healthy aspect of daily life
Older adults need intimacy, love as an
integral part of sexuality
Depression is not normal and may occur with…
chronic illness, loss of function, and death/losses
Suicide is high in the USA, high in men than women, and risk factors are…
social isolation, alcohol and substance, psychosis, bereavement, medical illness
__ of older adults fall each year and lead to serious injury
1 in 3
Falls often lead to…
nursing home admission
Who is at risk for abuse?
women dependent on a caregiver
Causes death every year, need to vaccinate
Influenza
Increased rate within 1 year of hospitalization. Doesn’t matter what for
Pneumonia, vaccinate age 65
More than __ of cancers in this age group
half
1 in 3 of older adults take…
5 or more prescriptions
Ploy pharmacy and __ __ is an increasing problem
substance abuse
Alcoholism is…
underestimated, under diagnosed, and they are more vulnerable to effects
Challenge to nurses
Correct misconceptions
Separate normal from pathological
Recognize increased risk for chronic disorders and disabilities
Nursing care can determine whether an older adult…
maintains health, recovers, maintains independence, and achieves a peaceful death
Nursing interventions should support…
self-care abilities, practices that foster health while aging