Eldely
- 1. Meeting theHealth Needs
of Older Clients
Copyright ©2008 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Community Health Nursing, 5/e
Mary Jo Clark
- 2. Community Health Nursing, 5/e
Mary Jo Clark
Copyright ©2008 by Pearson Education, Inc.
Gerontological Nursing Con
•Gerontological Nursing: contributes to and
often leads the interdisciplinary and multi-
agency care of older people.
- 3. Community Health Nursing, 5/e
Mary Jo Clark
Copyright ©2008 by Pearson Education, Inc.
Myths related to aging
• Most of the myths surround the concept of
aging affect the psychological status of the aged
person
– Older persons cannot learn, change or grow
emotionally
– They are negative
– Stooped posture
- 4. Community Health Nursing, 5/e
Mary Jo Clark
Copyright ©2008 by Pearson Education, Inc.
Myths related to aging
– Forgetfulness
– Rigid helpless dependent and others that younger
individuals try to joke about
– Poor health
– Unproductive and unattractive.
- 5. Community Health Nursing, 5/e
Mary Jo Clark
Copyright ©2008 by Pearson Education, Inc.
Factors that influence the elderly health
status
1. Human biology
• Maturation and aging that affect all body systems
(eg. cardiovascular changes)
1. Environment Considerations
• Physical
• Psychological
• social
- 6. Community Health Nursing, 5/e
Mary Jo Clark
Copyright ©2008 by Pearson Education, Inc.
Factors that influence the elderly health
status
3. Behavioral Considerations
4. Health system Considerations
- 7. Community Health Nursing, 5/e
Mary Jo Clark
Copyright ©2008 by Pearson Education, Inc.
Psychological environment Considerations
• To evaluate the cognitive status the nurse:
– Evaluate long and short term memory
– Power of concentration and judgment
– Ability to engage in mathematical calculations
• To evaluate affective status the nurse:
– Presence of depression
– Presence of dementia
– Saddened mood status
- 8. Community Health Nursing, 5/e
Mary Jo Clark
Copyright ©2008 by Pearson Education, Inc.
Physical Environmental Considerations
• Safety hazards in the home or the community
• Adequate housing
• Availability of necessary goods and services
• Neighborhood shopping facilities
- 9. Community Health Nursing, 5/e
Mary Jo Clark
Copyright ©2008 by Pearson Education, Inc.
Socio-cultural Environmental
Considerations
• Changes in family roles and responsibilities
• Social support
• Economic and employment factors
• Abuse and violence
– Increased incidence of financial and physical abuse
- 10. Community Health Nursing, 5/e
Mary Jo Clark
Copyright ©2008 by Pearson Education, Inc.
Socio-cultural Considerations
• Social net work
– Include number and frequency of contacts, the
durability of network, geographical proximity and
reciprocity( mutual help)
- 11. Community Health Nursing, 5/e
Mary Jo Clark
Copyright ©2008 by Pearson Education, Inc.
Behavioral Considerations
• Diet and consumption patterns
• Physical activity
• Sexuality
• Medication use
- 12. Community Health Nursing, 5/e
Mary Jo Clark
Copyright ©2008 by Pearson Education, Inc.
Behavioral Considerations
• Client independence
– Personal activities
•Bathing
•Dressing
•Ambulation
– Instrumental activities
•House keeping
•Taking medication
•Use of transportation
- 13. Community Health Nursing, 5/e
Mary Jo Clark
Copyright ©2008 by Pearson Education, Inc.
Health System Considerations
• Demand on health care services
• Health care access
• Costs of health care for uninsured
• Lack of appropriate medical services
• Societal response to high costs of medications
• Client-provider interaction
- 14. Community Health Nursing, 5/e
Mary Jo Clark
Copyright ©2008 by Pearson Education, Inc.
Health System Considerations
• Are health services sought to promote health as
well as to cure illness?
• Are health services used effectively?, the CHN
will explore the distance to health facilities used
and the means of transportation
- 15. Community Health Nursing, 5/e
Mary Jo Clark
Copyright ©2008 by Pearson Education, Inc.
Changing Dynamics in Families
• More older people are raising grandchildren
• Increased incidence of health problems for
caregivers
• Impact of economic factors
– Diminished access to care
– Less utilization of health services
– Employment and workforce retention of older
population
- 16. Community Health Nursing, 5/e
Mary Jo Clark
Copyright ©2008 by Pearson Education, Inc.
Nurse’s Role in Meeting the Health Needs
of the Older Client
• Identify community resources
• Identify financial assistance resources
• Identify support networks
- 17. Community Health Nursing, 5/e
Mary Jo Clark
Copyright ©2008 by Pearson Education, Inc.
Changes With Aging
• Heart conditions (hypertension, vascular disease, congestive
heart failure, high blood pressure and coronary artery disease)
• Dementia, including Alzheimer's disease
• Depression
• Incontinence (urine and stool)
• Arthritis
• Osteoporosis
• Diabetes
• Breathing problems
• Frequent falls, which can lead to fractures
- 18. Community Health Nursing, 5/e
Mary Jo Clark
Copyright ©2008 by Pearson Education, Inc.
• Parkinson's disease
• Cancer
• Eye problems (cataracts, glaucoma, Macular Degeneration)
• As the body changes, other things to be aware of
are:
• A slowed reaction time, which is especially important when
judging if a person can drive.
• Thinner skin, which can lead to breakdowns and wounds that
don't heal quickly
• A weakened immune system, which can make fighting off
viruses, bacteria and diseases difficult
• Diminished sense of taste or smell, especially for smokers,
which can lead to diminished appetite and dehydration
- 20. Community Health Nursing, 5/e
Mary Jo Clark
Copyright ©2008 by Pearson Education, Inc.
Educational Considerations
• Multi-sensorial presentations
• Multiple repetitions
• Reinforce verbal materials with written
• Memory aids
• Endurance or time considerations
- 21. Community Health Nursing, 5/e
Mary Jo Clark
Copyright ©2008 by Pearson Education, Inc.
Thus You Have To:
• Screen for changes that may impair learning
• Adapt to alterations in cognitive processes
– Before planning a teaching session, find out what
the patient already knows about the topic
Encourage her to provide examples of how she can
make appropriate behavior changes.
- 22. Community Health Nursing, 5/e
Mary Jo Clark
Copyright ©2008 by Pearson Education, Inc.
• Mental capacity generally declines with aging
due to a loss of neurons and decreased cerebral
blood flow. This affects what's known as "fluid
intelligence"— the ability to think abstractly and
to see relationships across topics. Thus, watch
for these behaviors: prolonged processing time,
after-imaging (fixating on a word or idea after
the other person has moved on to another
topic), limited short-term memory, and "test
anxiety."
- 23. Community Health Nursing, 5/e
Mary Jo Clark
Copyright ©2008 by Pearson Education, Inc.
• Start by giving an overview of what you will
cover prior to each teaching session.
• let the patient control the time the teaching
session is held
• Allow sufficient time for processing
• Take after-imaging into account
• Promote the formation of short-term memory
• Avoid creating "test anxiety.
- 24. Community Health Nursing, 5/e
Mary Jo Clark
Copyright ©2008 by Pearson Education, Inc.
• Use short, simple words and sentences.
• Speak slowly, clearly and loudly.
• Avoid visual or auditory distractions.
• Stick to one topic at a time
• Simplify and write down your instructions
• Use charts, models and pictures
• Frequently summarize the most important
points
• Sit face to face with the patient.
• Listen without interrupting the patient.
• Give the patient a chance to ask questions.
