challenges to health and healing pertaining to respiratory diseases in elder adults.

1. CHALLENGES TO HEALTH AND HEALING PERTAINING
TO RESPIRATORY DISEASES IN ELDER ADULTS
PRESENTEE: Mr. GAURAV
M.Sc. Nursing(Psychiatric Nursing)
B.Sc. Nurisng
R.N. R.M.

2. BACKGROUND OF THE GERONTOLOGY
• GERIATRICS: It is branch of medicine that deals with the diseases and problems of old age.
• GERONTOLOGY
Geron + logy = {geron= old age} + study
It is the field of developmental biology that deals with the process and problems of ageing .
• Dr. Ignatz Nascher was the father of geriatrics and majory warren was the its mother
• The 1st geriatric services was started in U.K. In 1947
• Geriatric department at chennai was established in 1978.

3. THE ELDERLY POPULATION – INDIAN SCENARIO
• According to Population Census 2011 there are nearly 104 million elderly persons
in India.
• It is 8.6% of the total population.
60 years
and
Above
Reside Literacy
rate
Common
Disabilities
Marital
status
Old age
depende
cy rate
Male
51 million
Rural
71%
Male
59%
Locomotor Married
76%
Male
13.6%
Female
53 million
Urban
29%
Female
28%
visual Widowed
22%
Female
14.9%

4. OBJECTIVES OF ELDERLY CARE
• To recognize patient and environment at risk
• To identify sources of safety issues and to prevent or report
• To discover ways of altering the environment to prevent unsafe events and
situations.
• To outline the advantages of modifications in practice to accommodate
geriatric changes.

5. INTRODUCTION OF RESPIRATORY CHALLENGES
• Chronic lower respiratory diseases such as COPD, are the 3rd most
common cause of death among people 65 years and older with 124,693
deaths in 2014.
• Among these people, about 10% of men and 13% of women are living with
asthma and 10% of men and 11% of women are living with a chronic
bronchitis and emphysema.
• Although having a chronic respiratory disease increases health risks which
leads to Tuberculosis, pneumonia etc.

6. DEFINITION
Chronic respiratory diseases are a group of chronic diseases affecting the airway and
other structure of the lungs
Common respiratory diseases in elder adults includes:-
 COPD
 Sleep disordered breathing
 Pulmonary embolism
 Bronchial asthma
 Tuberculosis
 Lung cancer
 Respiratory infections

7. RISK FACTORS
• SMOKING
• LACK OF PHYSICAL ACTIVITY
• POOR NUTRITION
• TOBACCO USE
• EXCESSIVE ALCOHOL CONSUMPTION
• AGE
• HEREDITARY
• POOR SOCIO ECONOMIC STATUS

8. SIGN AND SYMPTOMS
• DYSPNEA
• CHRONIC COUGH
• STRIDOR
• WHEEZING
• HYPER VENTILATION
• SNEEZING
• PAIN IN THROAT AND CHEST
• SPUTUM PRODUCTION
• EPISTAXIS
• HEMOPTYSIS

9. DIAGNOSIS
• HISTORY COLLECTION
• PHYSICAL EXAMINATION
• PULMONARY FUNCTION TEST
• BLOOD EXAMINATION
• CHEST X-RAY
• ALLERGY TEST

10. MEDICAL MANAGEMENT
 FAST ACTING DRUGS
 SHORT ACTING BETA-ADRENOCEPTOR AGONIST (SABA). e.g. SALBUTAMOL
 ANTICHOLINERGIC MEDICINES e.g. IPRATOPIUM BROMIDE
 BRONCHODIALATORS e.g. ALBUTEROL
 LESS SELECTIVE ADRENERGIC AGONIST e.g INHALED EPINEPHRINE
 LONG TERM CONTROL
 INHALED CORTICOSTEROIDS e.g FLUTICASONE
 LONG ACTING BETA ADRENOCEPTOR AGONIST (LABA) 12 HRS EFFECT
 OTHER DRUGS
 OXYGEN INHALATION
 MAGNESIUM SULPHATE , I/V BRONCHODIALATOR
 I/V SALBUTAMOL IN EXTREME CASES
 METHYLXANTHINES e.g THEOPHYLINE
 INHALATION DEVICES
 METERED DOSE INHALER
 DRY POWDER INHALER
 NEBULIZER
 STEAM INHALATION

11. NURSING MANAGEMENT
 Monitor dyspnea and hypoxia.
 Encourage high fluid intake to liquefy secretions.
 Instruct client in directed or controlled coughing
 Eliminate pulmonary irritants
 Instruct client in effective breathing techniques
 Encourage client to avoid emotional disturbances and stressful situations.
 Recommend the client to adopt a lifestyle of moderate activity, ideally in a climate with
minimal shifts in temperature and humidity.
 Instruct client and family about signs and symptoms of infection or other complications and
to report changes in physical and cognitive status

12. NURSING DIAGNOSIS
• Ineffective breathing pattern related to decreased lung
compliance, decreased energy as characterized by dyspnea,
and cyanosis.
• Impaired gas exchange related to diffusion defect as
characterized by hypoxia, hypercapnia, tachycardia and
cyanosis

13. • Risk for decreased cardiac output related to positive
pressure ventilation.
• Impaired physical mobility related to monitoring
devices, mechanical ventilation, decreased muscle
strength and limited range of motion.
• Knowledge deficit related to health condition, new
equipment and hospitalization

14. PREVENTIONS
1. PREVENTIVE HEALTH CARE
i. PRIMARY PREVENTION
 HEALTH PROMOTION E.G. HEALTHY LIVING, HEALTHY DIET AND EXERCISE,
WATER FLUORIDATION
 MODIFICATION IN HABITS e>g> QUIT SMOKING. MAINTAINING B.P. AND
CHOLESTROL LEVEL
 IMMUNIZATION
 INJURY PREVENTION
 OSTEOPOROSIS PREVENTION
ii. SECONDARY PREVENTION
 SCREENING AT RISK POPULATION
iii. TERTIARY PREVETNTION
 REHABILITATION

15. 2. CURATIVE
i. MEDICAL TEST PROTOCOL
ii. PHYSIOTHERAPY
iii. OCCUPATIONAL INTERVENTION
3.SOCIAL AND MENTAL CARE
i. INVOLVEMENT IN THE MAINSTREAM OF SOCIETY
ii. DESIGNATING SOCIAL ROLES AND RESPONSIBILITIES
iii. UTILIZING THEIR EXPERIENCE AND WISDOM
iv. COMBINING OLD AGE HOME AND ORAPHANAGES

16. HEALTH EDUCATION
• Wash hands often with soap and water for 20 seconds or use an
alcohol based hand sanitizer
• Cover your nose and mouth with a tissue when you cough and
sneeze
• Avoid touching your eyes, nose and mouth with unwashed hand
• Avoid personal contact with sick people
• Cleanse and disinfect frequently touched surfaces and objects such
as doorknobs.

17. LISTEN TO THE AGED……..