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NRS 104 Lecture 4
Health Promotion for Older Adults
| Question | Answer |
|---|---|
| Older Adult | Older adults – those 65 years of age and older; Young-old adult – 55-75 years of age; Old-old adult – 85 years of age and older; Frail elderly – 75 years of age and older with declining physical health and resources |
| Aging of US Population | 21st Century: Older adults comprise the fastest growing segment of the population - Baby boomers, Post W W II immigrants, Increased longevity: Improved medical care |
| Attitudes toward Aging | Myths and stereotypes; Ageism (is stereotyping and prejudice against individuals or groups because of their age.) |
| Biologic Aging Theories | Stochastic theories – Our body will be changed by chance (radiation, exposures); Nonstochastic theories – Not by chance – every cell will die – different time frame No study confirming theories. |
| Age-Related Physiologic Changes | |
| Special Older Adult Populations | Older adult women; Cognitively impaired older adults; Rural older adults; Homeless older adults; Frail older adults; Chronically ill older adults |
| Health Issues for Older Adults | Health promotion; Self-management - Activities of daily living (ADL’s), Finances, Legal matters; Nutrition; Physical fitness & mobility; Stress management; Accidents; Drug use & misuse; Mental Health; Elder neglect and abuse |
| Health Promotion and Self-Management | Assess (identify problem or diagnose, how do they perform ADL, goal: resolving problem, interventions to reach goal)- ADL abilities, Financial and/or legal concerns; Encourage autonomy, decision making, and productivity; Referrals to appropriate community |
| Table 6-4 | |
| Table 6-5 | |
| Table 6-6 | |
| Culturally Competent Care in Older Adults | Ethno-geriatrics: Specialty area of providing culturally competent care to ethnic elders |
| Table 6-7 | |
| Social Support and the Older Adult | Caregivers - Tasks include assisting with ADLs and IADLs (Instrumental ADL), providing emotional/social support, and managing health care; Elder mistreatment/abuse - Elder abuse (acts of commission), Elder neglect (acts of omission), Institutiona |
| Table 6-8 | |
| Medicare (65 or older or end stage renal disease on dialysis) | Part A (inpatient hospital care) paid by diagnosis; Part B (outpatient treatment and physician’s services) pt. pays partially; Part D (prescription drug benefit program) Pt. enrolls self in B and D. |
| Care Alternatives for Older Adults | Housing - Continuing care retirement communities (CCRCs), Congregate housing – Independent, Assisted living; Assisted-living facilities |
| Care Alternatives for Older Adults (cont'd) | Community-based older adults with special needs - Adult day care programs, Home health care Long-term care facilities Case management |
| Legal and Ethical Issues | Natural death acts - Directives to physicians (DTPs), Durable power of attorney for health care (DPAHC), Medical power of attorney; Areas of ethical concern - To restrain or not restrain, To evaluate patient’s ability to make decisions, Resuscitation |
| Nursing Management Older Adults | Nursing assessment - History using a functional health pattern format, Physical assessment, Mood assessment, Assessment of ADLs and IADLs, Mental status evaluation, Social–environmental assessment |
| SPICES | Sleep Disorders, Problems w/ eating or feeding, Incontinence, Confusion, Evidence of falls, Skin breakdown |
| Nursing Management Older Adults | Nursing diagnoses; Planning; Nursing implementation - Health promotion, Teaching older adults (Lewis, table 6-12, pg.79) |
| Health Promotion Focus For Older Adults | Reduction in diseases and problems; Increased participation in health promotion activities; Increased targeted services that reduce health hazards |
| Health Screening Activities | Functional skills (ADLs & IADLs); Hearing; Fall risk; Stress; Annual eye exam; Cardiac screening (BP, Lipid panel); Blood sugar; Mammograms/breast exam; Prostate evaluation/PSA; Bone density; Sigmoidoscopy or colonoscopy; Mental health; Abuse |
| Nursing Management for Older Adults – Implementation | Acute care - Hospital discharge, Geriatric rehabilitation, Assistive devices, Safety, Medication use (Polypharmacy), Depression, Sleep, Behavioral management, Use of restraints |
| Nursing Management for Older Adults – Evaluation | Focus on functional improvement rather than cure |
| Table 6-16 | |
| Cognitive Impairment | Dementia - slow progressive decline in cognition; could manifest as losses in memory, orientation, attention, language, or judgment or changes in behavior; Delirium - acute state of confusion, usually reversible; Depression - ranges from mild transi |
| Dementia | Dementia is not a norm of aging; Dementia does occur most often in older adults; 60% to 80% of patients with dementia have Alzheimer’s disease |
| Dementia Etiology & Pathophysiology | Immunologic disease or infection (HIV); Neurologic degenerative diseases (Alzheimer’s); Vascular disorder (Mini stroke); Structural disorder of brain tissue (Head Injury, Tumor); Toxic or metabolic diseases (Alcoholism) |
| Dementia Clinical Manifestations | Aphasia (impaired communication); Apraxia (impaired motor activity); Agnosia (impaired ability to recognize objects or people); Agitation at times; Disturbed Abstracting Ability; Early Warning Signs (Lewis, pg 1563) |
| Dementia Diagnostic studies | Physical examination; Mini-Mental State Examination; CT, MRI |
| Alzheimer’s Disease Etiology & Pathophysiology | Genetic factors; Cellular and other factors; Epidemiologic factors |
| Alzheimer’s Disease Clinical manifestations | Memory loss affecting job skills; Difficulty performing familiar tasks; Problems with language; Disorientation to time & place; Poor or decreased judgment; Problems with abstract thinking; Misplacing things; Changes in mood or behavior; Changes in persona |
| Alzheimer’s Disease Diagnostic studies | |
| Alzheimer’s Disease Collaborative care | |
| Alzheimer’s Disease Drug therapy | |
| Alzheimer’s Disease Nursing Management | Nursing assessment; Nursing diagnoses; Planning; Nursing implementation - Health promotion, Acute intervention |
| Alzheimer’s Disease Nursing Management Nursing Implementation (cont’d) | Ambulatory and home care - Behavioral problems, Safety, Pain management, Eating and swallowing difficulties, Oral care, Infection prevention, Skin care, Elimination problems, Caregiver support; Evaluation |
| Other Neurodegenerative Diseases | Lewy body dementia; Creutzfeldt-Jakob disease; Pick’s disease; Normal pressure hydrocephalus |
Created by:
jenbj
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