Respecting Older Adults: Challenges and Strategies

 
The Older Adult
The Older Adult
 
1
 
How old is the older patient?
How old is the older patient?
 
Variability among older adults
Physiological, cognitive, and psychosocial health
Levels of functional ability
Dependence vs. independence
Strengths and abilities
Terms
Geriatrics
Focuses on the diagnosis and treatment of diseases
Gerontology
The study of all aspects of the aging process and its
consequences
Gerontological Nursing
Assessment of health & functional status of older adults.
 
2
 
Myths and Stereotypes
 
Older adults are:
Ill, disabled, and unattractive
Forgetful, confused, rigid, boring, and unfriendly
Unable to learn and understand new
information
Not interested in sex or sexual activities
These ideas demonstrate 
ageism, 
which is
discrimination against people because of
increasing age.
 
 
Nurses’ Attitudes Toward
Older Adults
 
 
Developmental Tasks
Developmental Tasks
Box 14-2
Box 14-2
 
Adjusting to decreasing health & physical
strength
Adjusting to retirement; limited income
Adjusting to death of a spouse, friends
Acceptance of aging
Living environment or change in
Redefining relationships
Seeking quality of life
Teaching: Box 14-1
 
5
 
Older Adult Interview Techniques
 
 
Assessing Older Pts Needs
Assessing Older Pts Needs
 
Focus on Older Adult –
  Selection of a Care Facility
   Home
Care
Family involvement
Environment
Communication  (sensory changes, hearing, vision)
Staff
Quality of life needs are best determined by a
therapeutic nurse-client relationship that
facilitates communication.
 
7
 
Physiological Changes
 
Older clients’ concept of health revolves
around how the perceive their ability to
function.
Not all physiological changes are
pathological.
Nurses need to be cognizant of normal
age-related changes.
 
Physiological Changes 
Physiological Changes 
(cont’d)
(cont’d)
 
Functional Changes
 
Functional status in older adults includes
the day-to-day activities of daily living
(ADLs) involving activities within physical,
psychological, cognitive, and social domains.
Changes are usually linked to illness or to
disease and degree of chronicity.
Performance of ADLs is a sensitive
indicator of health or illness.
Occupational and physical therapists are
your best resources for a comprehensive
assessment.
 
Cognitive Changes
 
Psychosocial Changes
 
Retirement
Social isolation
Sexuality
Housing and
environment
Death
 
Quick Quiz!
Quick Quiz!
 
1. A nurse who has recently graduated has been assigned to be a
primary nurse on a geriatric unit.
 
After completing a review of
development and aging, the nurse recalls that changes for the
older adult include
A. A transition from young adulthood.
B. The ability of the older adult to achieve sexual arousal.
C. A time when cognitive performance begins to peak.
D. Adjusting to decreasing health and physical strength.
 
Healthy People 2020
 Goals: Older Adults
 
Increasing the number with one or more
chronic conditions who report 
confidence
in maintaining their conditions
Reducing
 the number with moderate to
severe functional 
limitations
Reducing
 the number of emergency
department visits resulting from
 falls
 
Healthy People 2020
Healthy People 2020
 Goals: Older Adults
 Goals: Older Adults
(cont’d)
(cont’d)
 
Increasing the number
who live at home but have
unmet long-term services
and support
Increasing the number
with reduced physical or
cognitive function who
engage in leisure-term
physical activities
 
Health Promotion and Maintenance:
Physiological
 
Health Promotion Preventive Measures
 
Participation in screening activities
Regular exercise
Weight reduction, if overweight
Eating a low-fat, well-balanced diet
Moderate alcohol use
Regular dental visits
Smoking cessation
Immunizations
 
Health Promotion and Maintenance:
Psychosocial Concerns
 
Older Adults and the Acute Care Setting
 
Acute care settings pose risks for adverse
events:
Delirium
Dehydration
Malnutrition
Health care–associated infections
Urinary incontinence
Falls
 
Older Adults and Restorative Care
 
Types of ongoing care:
Continues recovery from acute illness
Addresses chronic conditions that affect daily
functioning
Goal
To regain or improve prior level of
independence, ADLs, instrumental ADLs
(IADLs)
 
 
 
 
This work is licensed under a 
Creative Commons Attribution 4.0 International License
.
 
Except where otherwise noted, this content by Southern Regional Technical College is licensed under the Creative Commons
Attribution 4.0 International License. To view a copy of this license, click 
https://creativecommons.org/licenses/by/4.0/
 
Healthcare Careers Work!(HCW) is sponsored by a $2.3 million grant from the U.S. Department of Labor, Employment &
Training Administration. TAACCCT Grant #TC- 26488-14-60-A-13.  Southern Regional Technical College is an equal
opportunity employer and will make adaptive equipment available to persons with disabilities upon request.
 
This workforce product was funded by a grant awarded by the U.S. Department of Labor’s Employment and Training
Administration. The product was created by the grantee and does not necessarily reflect the official position of the U.S.
Department of Labor. The U.S. Department of Labor makes no guarantees, warranties, or assurances of any kind, express or
implied, with respect to such information, including any information on linked sites and including, but not limited to,
accuracy of the information or its completeness, timeliness, usefulness, adequacy, continued availability, or ownership.
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Exploring the misconceptions and challenges faced by older adults, this content highlights the importance of combating ageism in healthcare. It emphasizes the need for nurses to overcome stereotypes, involve older adults in decision-making, and address their unique needs with respect and understanding. The developmental tasks and interview techniques for interacting with older adults are also discussed, along with tips for assessing their needs effectively.

  • Older Adults
  • Ageism
  • Healthcare
  • Nurses
  • Developmental Tasks

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  1. The Older Adult 1

  2. How old is the older patient? Variability among older adults Physiological, cognitive, and psychosocial health Levels of functional ability Dependence vs. independence Strengths and abilities Terms Geriatrics Focuses on the diagnosis and treatment of diseases Gerontology The study of all aspects of the aging process and its consequences Gerontological Nursing Assessment of health & functional status of older adults. 2

  3. Myths and Stereotypes Older adults are: Ill, disabled, and unattractive Forgetful, confused, rigid, boring, and unfriendly Unable to learn and understand new information Not interested in sex or sexual activities These ideas demonstrate ageism, which is discrimination against people because of increasing age.

  4. Nurses Attitudes Toward Older Adults Nurses need to recognize and address ageism by questioning prevailing negative attitudes and stereotypes and reinforcing the realities of aging as they care for older adults in all care settings. It is critical for you to learn to respect older adults and actively involve them in care decisions and activities.

  5. Developmental Tasks Box 14-2 Adjusting to decreasing health & physical strength Adjusting to retirement; limited income Adjusting to death of a spouse, friends Acceptance of aging Living environment or change in Redefining relationships Seeking quality of life Teaching: Box 14-1 5

  6. Older Adult Interview Techniques Sit or stand at eye level, in front of the patient in full view. Face the older adult while speaking; do not cover your mouth. Speak clearly. Provide diffuse, bright, nonglare lighting. Encourage the older adult to use his or her familiar assistive devices such as glasses or magnifiers.

  7. Assessing Older Pts Needs Focus on Older Adult Selection of a Care Facility Home Care Family involvement Environment Communication (sensory changes, hearing, vision) Staff Quality of life needs are best determined by a therapeutic nurse-client relationship that facilitates communication. 7

  8. Physiological Changes Older clients concept of health revolves around how the perceive their ability to function. Not all physiological changes are pathological. Nurses need to be cognizant of normal age-related changes.

  9. Physiological Changes (contd) General Survey Integumentary System Head and Neck Thorax and Lungs Gastrointestinal System and Abdomen Urinary System Heart and Vascular System Breasts Reproductive System Neurological System Musculoskeletal System

  10. Functional Changes Functional status in older adults includes the day-to-day activities of daily living (ADLs) involving activities within physical, psychological, cognitive, and social domains. Changes are usually linked to illness or to disease and degree of chronicity. Performance of ADLs is a sensitive indicator of health or illness. Occupational and physical therapists are your best resources for a comprehensive assessment.

  11. Cognitive Changes Delirium Acute confusional state Dementia Generalized impairment of intellectual functioning A mood disturbance characterized by feelings of sadness and despair Depression

  12. Psychosocial Changes Retirement Social isolation Sexuality Housing and environment Death

  13. Quick Quiz! 1. A nurse who has recently graduated has been assigned to be a primary nurse on a geriatric unit. After completing a review of development and aging, the nurse recalls that changes for the older adult include A. A transition from young adulthood. B. The ability of the older adult to achieve sexual arousal. C. A time when cognitive performance begins to peak. D. Adjusting to decreasing health and physical strength.

  14. Healthy People 2020 Goals: Older Adults Increasing the number with one or more chronic conditions who report confidence in maintaining their conditions Reducing the number with moderate to severe functional limitations Reducing the number of emergency department visits resulting from falls

  15. Healthy People 2020 Goals: Older Adults (cont d) Increasing the number who live at home but have unmet long-term services and support Increasing the number with reduced physical or cognitive function who engage in leisure-term physical activities

  16. Health Promotion and Maintenance: Physiological Cancer Heart disease Stroke Smoking Alcohol abuse Nutrition Dental problems Exercise Falls Pain Sensory impairments Medication use

  17. Health Promotion Preventive Measures Participation in screening activities Regular exercise Weight reduction, if overweight Eating a low-fat, well-balanced diet Moderate alcohol use Regular dental visits Smoking cessation Immunizations

  18. Health Promotion and Maintenance: Psychosocial Concerns Therapeutic communication Touch Reality orientation Validation therapy Body image interventions Reminiscence

  19. Older Adults and the Acute Care Setting Acute care settings pose risks for adverse events: Delirium Dehydration Malnutrition Health care associated infections Urinary incontinence Falls

  20. Older Adults and Restorative Care Types of ongoing care: Continues recovery from acute illness Addresses chronic conditions that affect daily functioning Goal To regain or improve prior level of independence, ADLs, instrumental ADLs (IADLs)

  21. Creative Commons License This work is licensed under a Creative Commons Attribution 4.0 International License. Except where otherwise noted, this content by Southern Regional Technical College is licensed under the Creative Commons Attribution 4.0 International License. To view a copy of this license, click https://creativecommons.org/licenses/by/4.0/ Healthcare Careers Work!(HCW) is sponsored by a $2.3 million grant from the U.S. Department of Labor, Employment & Training Administration. TAACCCT Grant #TC- 26488-14-60-A-13. Southern Regional Technical College is an equal opportunity employer and will make adaptive equipment available to persons with disabilities upon request. This workforce product was funded by a grant awarded by the U.S. Department of Labor s Employment and Training Administration. The product was created by the grantee and does not necessarily reflect the official position of the U.S. Department of Labor. The U.S. Department of Labor makes no guarantees, warranties, or assurances of any kind, express or implied, with respect to such information, including any information on linked sites and including, but not limited to, accuracy of the information or its completeness, timeliness, usefulness, adequacy, continued availability, or ownership.

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