BROAD OBJECTIVEBy the end of this presentation, students must acquire knowledge on how to manage special groups in the community.
Specific objectives• Define the following terms; geriatrics, gerontology, aging and senescence• Describe some theories related to aging• Describe the physiology changes that take place during the aging process• Describe the effects of aging on an individual, family and the community• Discuss the level of prevention in relation to aging• Role of the community health nurse in delivery of care to elders
IntroductionAging is the normal process characterized by intrinsic cellular and tissue changes that can be influenced by extrinsic factors• Care of the elderly is the social responsibility and the nation as the elderly population gets larger and larger
Definition of termsGeriatrics – this is the study of old age. It includes the physiology, pathophysiology, diagnosis and management of the diseases of the elderly.Gerontology – the study of the aging process. Includes biologic, psychologic, sociologic sciences.geriatrics is also included in gerontology.Aging – a normal process of the time related changes that begin from birth and continues throughout life.
Senescence- the irreversible, gradual process of body deterioration into loss of function of the aging person. This is natural and not due to external factors
Theories related to aging WEAR AND TEAR THEORY• Proposed that the cumulative damage to vital irreplaceable body parts leads to the death of cells , tissues, organs and finally the whole body. Cumulative DNA damage leads to decline in cell function.
• The problem with theory is that there is no research model that give credible support at this time.
2. FREE RADIAL THEORY• It proposes that there is a progressive accumulation of high oxygen energy species that progressively and irreversibly damages cellular components such as membranes and the genetic apparatus. The accumulation damage leads to aging.• There is some research evidence to support this theory.
3. GENETIC THEORY• Genetic factors are important determinants of aging, however the exact mechanism is unknown. For instance , the life expectancy of identical twins is more similar than in fraternal twins or other sibling with the same two parents.
4. POLYGENIC THEORY• This is the theory that most researchers are starting to accept as the reason for changes related to aging• In this theory , the powerful influence of the both genetic apparatus and the environments impact on the cells of the body add up to direct aging and life expectancy.
• This theory basically embraces all the above theories and give evidence to all this factors playing a role in aging
PHYSIOLOGICAL CHANGES ASSOCIATED WITH AGING• Pulmonary function, liver function, cardiac output, kidney function diminish by the age of 70• Decrease in skeletal muscle mass due to low blood output• Change in body composition due to decrease in lean mass and an increase in body fat percentage• Decrease in sexual activities due to decrease in hormones, diminished vaginal lubricant, decline in erection and ejaculatory function, decreased sexual organ sensitivity.
EFFECTS OF AGING ON INDIVIDUAL• Fear of death• Isolation• Sexual dysfunction• Immobility• Depression• Lowered self esteem
• Poor communication• ON FAMILY• Increase in workload• pressure on family resources
• They bring conflict in the family• Economy dwindlesON COMMUNITY• Un productive• Know most of traditional medicine• Helps to solve problems and give advice• Difficult for them to adapt new technologies they always refer to backwards things
LEVELS OF PREVENTION IN RELATION TO AGING• 1. PRIMARY PREVENTIONOBJECTIVES• To prevent geriatric problems caused by inability to adapt to the aging process.INTERVENTIONS• Education: to bring awareness to individual and community
• Counselling on health promotion activities such as advise the client to eat balanced diet.• Encourage support systems for the elderly• Encourage participation in community activities• Mobilize communities to establish support progression
cont• Motivates government to contribute towards the welfare of the elderly• Discourage bad habits such as alcoholism and smoking which puts elderly at risk of infections such as hepatitis and cancer
SECONDARY PREVENTION• OBJECTIVES• To diagnose and treat early problems of the aged• Provide treatment of acute problems such as renal failure in order to prevent chronicity of the problem• Encourage regular checkups for early detection of ploblems e.g breast examination
• Provide detailed information in order to allay anxienty
TERTIARY PREVENTION• OBJECTIVES• To rehabilitate the elderly• Refer them to community health nurses who will provide care to them in collabration with family members and community groups• Follow up or home visiting to see if they are progressing
ROLES OF A COMMUNITY NURSE IN DELIVERY OF CARE TO ELDERSCommunity nurses do the following :1. EDUCATOR AND COUNSELOR They focus on three levels of prevention:- They inform health promotion strategies e.g – maintaining an active life style – belonging to a social network – Feeling independent, useful and valued – Having good nutrition – Believing in God
1. Primary prevention2. Secondary prevention(screening)3. Tertiary prevention Wellness• It is not merely the absence of disease or illness. It includes physical, emotional, mental and spiritual.
2. CASE MANAGERNurses work with clients with special needs.Case management is the process in which services are organized and coordinated to meet patients needs and to use scarce resources effectively.• They are crucial in preventing and resolving confusion that can arise when patients have multiple members on there health care teams.
• They ensure that needed services are used and care plans are modified to reflect changes.• They ensure that effective case management has a broad knowledge base on nursing roles, formal resources and informal community support networks and an innate ability for integration of all three.
1.GERIATRIC NURSINGThey care for the elderly, focusing on the development and implementation of treatment plan for chronic illnesses.