This presentation summarizes key topics related to geriatric nursing. It introduces the speaker and defines geriatrics as the branch of medicine focusing on healthcare for elderly individuals. The document then outlines several theories of aging, including programmed, error, biological, and psychological theories. It also discusses common physiological changes in cardiovascular, pulmonary, and other body systems associated with aging. The presentation provides an overview of important concepts and trends in geriatric nursing.
A man's life is normally divided into five main stages namely infancy, childhood, adolescence, adulthood and old age. In each of these stages an individual has to find himself in different situations and face different problems. The old age is not without problems. In old age physical strength deteriorates, mental stability diminishes; money power becomes bleak coupled with negligence from the younger generation.
what is positive aging and what are the key issues that can lead to positive aging
the ppt covers basic concept, the theories and what can help positive aging
The Aging process is a broad topic. This power point hopes to help you understand the process and what can be done to help you age gracefully and positively.
Biologist & gerontologist used concept of senescence to explain biological aging
Senescence or normal aging refers to a gradual, time related to biological process that takes places as degenerative processes overtake regenerative or growth processes.
or
senescence: a change in the behavior of an organism with age leading to a decreased power of survival and adjustment
this slides contain about the detailed information about the definition, introduction, classification, types, concept of aging, chronologic aging, biological aging, psychological aging, social aging, cognitive aging.
A man's life is normally divided into five main stages namely infancy, childhood, adolescence, adulthood and old age. In each of these stages an individual has to find himself in different situations and face different problems. The old age is not without problems. In old age physical strength deteriorates, mental stability diminishes; money power becomes bleak coupled with negligence from the younger generation.
what is positive aging and what are the key issues that can lead to positive aging
the ppt covers basic concept, the theories and what can help positive aging
The Aging process is a broad topic. This power point hopes to help you understand the process and what can be done to help you age gracefully and positively.
Biologist & gerontologist used concept of senescence to explain biological aging
Senescence or normal aging refers to a gradual, time related to biological process that takes places as degenerative processes overtake regenerative or growth processes.
or
senescence: a change in the behavior of an organism with age leading to a decreased power of survival and adjustment
this slides contain about the detailed information about the definition, introduction, classification, types, concept of aging, chronologic aging, biological aging, psychological aging, social aging, cognitive aging.
Geriatric nursing is the specialty that concerns itself with the provision of nursing services to geriatric or aged individuals.
Aging can be defined as the time-related deterioration of the physiological functions necessary for survival and fertility.
Aging process is the process of growing old or developing the appearance and characteristics of old age.
The theories of aging are classified into -
Biologic theories
Psychosocial theories
Developmental theories
Prof. Serge Jurasunas Biological Aging vs. Chronological Aging Part 1.pdfSheldon Stein
Biological Aging VS. Chronological Aging - How to Build a Healthy Longevity - An Important Role for the Mitochondria
Part I
Professor Serge Jurasunas, M.D. (hc) N.D. M.D (Hom)
Topics in Part 1:
A Longer Lifespan No Longer Means a Healthier Lifespan
What are the Causes of Normal Aging or Premature Aging?
Mitochondria, Oxidative Stress, and Premature Aging
What are Mitochondria?
Brain Neurons
The Brain and Alzheimer’s
Basic of geriatrics and internal medicine for physiotherapistDoha Rasheedy
collection of lectures for physiotherapy undergraduate students including notes of common health issues (frailty, sarcopenia, osteoporosis, neuropsychiatric issues, constipation, metabolic syndrome and its components, orthostatic hypotension, CLD, CKD, anemia, immobilization, dizziness, falls, fatigue) and how to handle in practice.
summary of age related changes and geriatric pharmacology, safe analgesic prescription in elderly
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
2. CONTENT
INTRODUCTION
MEANING/DEFINITION
CONCEPTS
TRENDS & ISSUES
THEORIES OF AGEING
HEALTH PROBLEMS AND NEEDS
PSYCHO PHYSIOLOGICAL STRESSORS AND
DISORDERS
MYTHS AND FACTS OF AGING
HEALTH ASSESSMENT.
3. INTRODUCTION
Declining fertility rates combined with steady
improvements in life expectancy over the
20th century produced dramatic growth in the
world’s elderly population .People aged 65
yrs and over now comprise a greater share of
the world’s population than ever before. Since
1950 there is a tremendous increase more
than three fold.
The number of elderly is now increasing by 8
million /day :by 2030 this increase will reach
24 million /year.
4. DEMOGRAPHY
As we enter twenty first century, population aging has
emerged as a major demographic trend world wide.
High birth rates and low death rates led to two
unpredicted changes in the demography of humans.
Indian Scenario
Current population of India is more than 1.21
billion (according to census of India 2011)
The population of the nation is growing at the rate
of 1.41%
In India, elderly population is over 82 million and
this figure is expected to reach the mark of 177
million, almost double by the year 2025.
5. GERIATRICS
The term geriatrics comes from the Greek
‘’geron’’ meaning “old man” and “iatros”
meaning “healer.” However, geriatrics is
sometimes called medical gerontology.
Geriatric nursing is the specialty that
concerns itself with the provision of nursing
services to geriatric or aged individuals.
6. GERIATRICS
Definition
Geriatrics is a sub-specially of internal medicine
that focuses on health care of elderly people. It
aims to promote health by preventing and treating
diseases and disabilities in older adults.
7. THEORIES OF AGEING:-
2 theories are there ……
1.Programmed theories
1.Error theories
1.Programmed senescence theory
2.Endocrine theory
3.Immunology theory.
1.Wear and tear theory
2..cross-linking theory
3.Free radical theory
4.Error catastrophic theory
5.Somatic mutation theory
A. BIOLOGICAL
THEORIES:-
9. 1.PROGRAMMED THEORIES OR
NON-STOCHASTIC THEORIES
1.Programmed Senescence Theory/Hay flick
Limit Theory
In this theory, it is proposed that there is
impairment in the ability of the cell to continue
dividing.
The Hay flick limit theory of aging(So called after
its discover Dr. Leonards Hay flick) suggest
that the human cell is limited in the number of
times it can divide. Dr. Hay flick Theorized that the
human cells ability to divide is limited to
approximately 50 times after which they simply
stop dividing ( and hence die).
10. He showed that nutrition has an effect on cells
with overfed cells dividing much faster the an
underfed cells. As cells divide to help repair and
regenerate themselves we may consider that the
DNA and genetic theory of aging may play a role of
here.
The Hay flick limit indicates that there is a need to
slow down the rate of cell division if we want to live
long lives. Cell division can be slowed down by diet
and lifestyle, etc.
11. 2.Endocrine Theory or Neuro-
endocrine Theory
First proposed by Professor Vladimir Dilman and
Ward Dean MD
The theory states ,as we age ,the endocrine system
becomes less efficient and eventually leads to the
effects of aging.
The endocrine system secretes hormones from
glands that deliver messages to cells containing
information and instructions .
The cells are programmed to receive specific
messages from the many hormones that circulate
through the body.
Hormone levels are affected by factors such as
stress and infection.
12. 3.Immunologic Theory
It proposes declining functional capacity of
immune system as the basic for the aging
process. It suggests that aging is not passive
wearing out of systems but an active self-
destruction mediated by immune system.
This theory is based on observing an age
associated decline in T-cell functioning
accompanied by a decrease in resistance and
increase in autoimmune disease with
aging.
13. Studies reveal that cell division suggest that cells of
the immune system become more diversified with
age and demonstrate a progressive loss of self-
regulatory patterns. The result is an autoimmune
phenomena in which cells normal to the body are
mistaken as foreign and are attacked by the person’s
own immune system
14. 2.ERROR THEORIES
Wear and Tear Theory
Early theory on aging proposed that there is a
fixed store of energy available to the body
as time passes, the energy is depleted and
because it cannot be restored, the person
dies
Later, other theories emerged. The wear and
tear theory stated that the body is like a
machine that wears out its parts with
repeated use and comes to a grinding valt.
This is not widely accepted.
15. Cross-linked Theory
Proposed by Johan Bjorksten in 1942.
According to this theory the aging of living
organisms depends on casual formation of
chemical bonds or across links between
protein molecules .Repair enzymes of the
cell cannot break those bonds.
Protein molecules are more particularly binds
one to another by means of glucose molecule
16. The process of cross links formation between
protein molecules in a human organism is very
similar to the process that takes during leather
tanning.
As we age ,progressive accumulation of cross
links occurs in most tissues of our organism –in
arteries cartilages ,muscles. The main
consequence of this process is the decline in
the tissue elasticity,
17. Free-radical Theory
Proposed by Denham Harman in 1956
It states that organisms age because cells
accumulate free radical damage over time .
A free radical is any atom or molecule that
has a single unpaired electron in an outer shell
18. Free radical are unstable, short lived and highly
reactive, as they attack nearby molecules in
order to steal their electrons and gain stability,
causing radical chain reactions to occur.
Free radicals are known to attack the structure of
cell membranes, which then create metabolic waste
products such toxic accumulations interfere with cell
communications.
Further disturbing DNA ,RNA and protein
synthesis ,lower energy levels and generally
impede vital chemical processes.
19. Error catastrophe
Proposed by Leslie Orgel in 1963.
This theory states that over time an error or
mistake occurs in our DNA map or proteins
and it begins to produce cells that are not
correct
It’s like going from producing a high quality
product to producing a lesser quality product.
This deterioration results in ageing and
eventually over a lifetime &death .
20. Somatic theory or gene
mutation theory
The somatic mutation and intrinsic
mutagenesis theories postulates that aging is
a result of lifelong genetic damage which
may include the progressive accumulation of
faulty copying in divining or accumulation of
errors in information containing molecules
21. PSYCHOSOCIAL CHALLENGES
OF OLDER ADULTHOOD
Widowhood
It’s a state or period of being widow or widower
Common additional consequences include the
following:
Loss of companionship and intimacy
Loss of helper
Loss of sexual partner Feelings of grief,
loneliness, and emptiness
Increased responsibilities
Increased dependence on others
22. Loss of income and less efficient financial
management
Changes in relationships with children, married
friends, and other family members.
The impact of the loss can be tremendous, and the
feelings of grief, loneliness, and emptiness may be
overwhelming.
23. Ageist Attitudes
Ageism can lead to prejudices, fear of aging, and
feelings of devaluation and degradation.
Negative age-based stereotypes include impaired
memory and decreased cognitive performance,
declining will to live and diminished positive affect,
negative effects on physical health, and behavioral
changes such as decreased walking speed and
shaky handwriting .
When negative ageist stereotypes are pervasive in
a society, people with a good self-acceptance of
being old may feel that it is socially unacceptable to
admit that it is okay to be old.
24. Retirement
The age of 60 years is the traditional
retirement age; however, there is a growing
trend toward “bridge employment” involving a
transition from full-time to part-time
employment before retirement.
25. When people retire, they inevitably cope with a
change in social status, and the psychosocial
challenge may be the greatest for people whose self-
esteem and self-concept are based on job status.
The following factors commonly influence the
decision to retire: health, financial assets, job
conditions, pension availability, family
circumstances, opportunities for continued
employment, and continued ability to perform
job responsibilities.
26. Chronic Illness and Functional
Impairments
Another major life adjustment for many older
adults is coping with chronic illnesses and
functional limitations, particularly limitations
that curtail their independence.
Other consequences of chronic illnesses
include the following:
Threats to self-esteem and altered self-
concept
27. Changes in lifestyle
Unpredictability about one’s ability to do what one
wants
Expenditures for assistance, medications, and
medical care
Frequent trips to health care providers
Adverse medication effects, which sometimes cause
further functional impairments
Increased vulnerability to personal crimes and fear of
crime
28. Relocation
Another common psychosocial adjustment
for older adults is the decision to move from
the family home.
Increased dependence on others because of
health problems.
Older adults whose adult children have
moved to another location may relocate to be
closer to them.
29. Problems also arise for older homeowners
Relocation to a nursing home is a significant life
event for some older adults. Nurses caring for older
adults in hospitals and nursing homes have
important roles in assisting older adults and their
families with relocation decisions and adjustments.
Nurses can ensure that older adults are involved as
much as possible in decisions and that these
decisions are periodically reviewed as the older
adult’s needs change.
30. Death of Friends and Family
The loss of friends and family becomes
inevitable with each year because meaningful
social relationships are an important predictor
of well-being for older adults, loss of family
and friends is likely to have a negative impact
on psychosocial wellness.
31. However, older adults who are able to adjust their
expectations and do not feel a sense of social
isolation may fare better than those who perceive
themselves as socially isolated and disconnected .
Nurses have many opportunities to promote
healthy psychosocial function during the usual
course of caring for older adults. For example, they
can incorporate communication techniques and
other interventions to enhance self-esteem,
promote a sense of control, and fostering social
support
32. Nursing interventions to
promote healthy psychosocial
function
1.Enhancing Self-Esteem
Self-esteem enhancement is an essential
component of nursing care for older adults
because self-esteem is an important coping
resource and a factor that influences well-
being. Self-esteem refers to the feelings one
has about one’s self.
33. Many factors that are threats to self-esteem are
associated with staff and environments of
institutional settings and can be addressed through
relatively simple nursing interventions.:-
Ensure easy access to their usual assistive devices
Provide privacy.
Asking food preferences.
34. Asking open-ended questions, such as, “Is
there anything that we can do to help you
manage better while you’re here?”
Asking, “Is there anything you’re worried about
that I can help you with?”
Ensuring that staff members address persons
by their preferred names
Involving older adults as much as possible in
decisions that affect them
35. 2.Promoting a Sense of Control
Nurses address psychosocial needs of older
adults with interventions that promote a
sense of control and that involve older adults
in decisions.
Nursing interventions to promote a sense of
control for older adults include involving them
as much as possible in organizing their
schedule and providing information about
their plan of care.
36. Nursing interventions also address factors that can
threaten perceived control, such as lack of privacy
and loss of individuality, which commonly occur in
institutional settings.
Nurses can show respect for privacy by knocking on
bedroom doors and asking permission before
entering, by closing doors when privacy is
desired, by asking permission before pulling bed
curtains open, and by being careful about
moving personal belongings without permission
from the older person.
Encouraging the person to have personal belongings
37. 3.Fostering Social Supports
Nurses have many opportunities to foster the
development of social networks for older
adults, and this is an appropriate intervention
for addressing social isolation.
Social isolation is likely to occur because of
any of the following factors that commonly
occur in older adulthood:
Hearing impairments and other communication
barriers
38. Chronic illnesses that limit activity or energy
Lack of social opportunities because of care giving
responsibilities
Mobility limitations, including the inability to drive a
vehicle
Mental or psychosocial impairments that interfere
with relationships
Loss of spouse, friends, or family through death,
illness, or physical distance.
In long-term care settings, nurses can foster
positive social interactions in group settings, such
as dining and activity rooms.
39. A very simple intervention, such as positioning
chairs (including wheelchairs) so that people can
interact with each other, can significantly influence
social contacts, either positively or negatively.
In home settings, nurses can identify community
resources, such as volunteer friendly visitor and
meal programs, to decrease social isolation.
Support and education groups that primarily focus on
coping with a chronic illness (e.g., stroke clubs, or
better breathing groups) also provide excellent
opportunities for social contact and the development
of friendships with people who are in similar
situations.
40. PHYSIOLOGICAL CHANGES
ASOCIATED WITH AGING
1.Cardiovascular changes
Heart rate diseases and it takes longer for heart
rate and blood pressure to return normal after
exertion
The aorta and other arteries become thicker and
stiffer which may bring a moderate increase in
systolic blood pressure with aging
The valves between the chambers of the heart
thicken and become stiffer
The baroreceptors which monitor blood pressure
become less sensitive. Quick changes in position
may cause dizziness from orthostatic hypotension
41. Parameters of Cardiovascular Assessment
Cardiac assessment: ECG; heart rate, rhythm,
murmurs, heart sounds
Assess BP (lying, sitting, standing) and pulse for
symmetry.
Palpate carotid artery and peripheral pulses for
symmetry.
Nursing care Strategies for cardiovascular problems
Safety precautions for orthostatic hypotension
Encourage lifestyle practices to attain a healthy body
weight (BMI 18.5-24.9 kg/m2). And normal blood
pressure
Healthful diet
Physical activity
42. 2.Changes in the
Pulmonary System
The lungs become stiffer, muscle strength
diminishes, and the chest wall becomes more
rigid
Total lung capacity remains constant but vital
capacity decreases and residual volume
increases
The alveolar surface area decreases by up to 20
percent. Alveoli tend to collapse sooner on
expiration
There is an increase in mucus production and a
decrease in the activity and number of cilia
43. Parameters of Pulmonary Assessment
Assess respiration rate, rhythm, regularity, volume,
depth, exercise capacity. Auscultate breath sounds
throughout lung fields
Inspect thorax, symmetry of chest expansion. Obtain
smoking history
Monitor secretions, breathing rate during sedation,
positioning, arterial blood gases, pulse oximetry
Assess cough, need for suctioning
44. Nursing care strategies
Maintain patent airways through upright positioning/
repositioning, suctioning, and bronchodilators
Provide oxygen as needed
Maintain hydration and mobility.
Incentive spirometry as indicated, particularly if
immobile or declining in function
Education on cough enhancement, and smoking
cessation.
45. 3. Changes in the
Genitourinary system
Kidney mass decreases by 25-30% and the
number of glomeruli decrease by 30 to 40%.
These changes reduce the ability to filter and
concentrate urine and to clear drugs
With aging there is reduced hormonal
response and an impaired ability to conserve
salt which may increase risk for dehydration
46. Bladder capacity decreases and there is an increase
in residual urine and frequency
These changes increase the chances of urinary
infections, incontinence, and urinary obstruction
Parameters of Renal and genitourinary
assessment
Assess the renal function (creatinine clearance)
Assess need/dose of nephrotoxic drugs
47. Assess for fluid/ electrolyte and acid/ base
imbalances
Evaluate nocturnal polyuria, urinary incontinence,
BPH. Assess UTI symptoms.
Nursing-care Strategies
Monitor nephrotoxic and renal cleared drug levels
Maintain fluid/electrolyte balance. Minimum 1.5-
2.5mL/day from fluids and foods for 50 to 80 kg
adults to prevent dehydration
For nocturnal polyuria: limit fluids in evening, avoid
caffeine, use prompted voiding schedule.
48. 4.Changes in
gastrointestinal system
Decreased in strength of muscles of
mastication, taste and thirst perception
Decreased gastric motility with delayed
emptying. Atrophy of protective mucosa
Malabsorption of carbohydrates, vitamin B12
and D, folic acid , calcium
Impaired sensation to defecate
Reduced hepatic reserve
Decreased metabolism of drugs
49. Stomach
Atrophic Gastritis
Achlorhydria refers to an insufficient production of
stomach acid
Gastric ulcers (ulcers in the stomach) are more
common after the age of 60 and can be benign or
malignant.
Liver
Reduced blood flow
Altered clearance of some drugs,
A diminished capacity to regenerate damaged
liver cells.
50. Intestines
The prevalence of diverticulosis increases with age
Studies of motility in older adults show reduced
peristalsis (intestinal muscle contractions) of the
large intestine.
Parameters of Gastrointestinal Assessment
Assess oral cavity; chewing and swallowing capacity,
dysphagia (coughing, choking with food/fluid intake) ,
Monitor weight, calculate BMI, compare to
standards.
Determine dietary intake, compare to nutritional
guidelines.
Assess for GERD, constipation and fecal
incontinence; fecal impaction by digital examination
51. Nursing-care Strategies
Monitor drug levels and liver function tests if on
medications metabolized by liver
Assess nutritional indicators
Educate on lifestyle modifications
Educate on normal bowel frequency, diet,
exercise, recommended laxatives
Encourage mobility; provide laxatives if on
constipating medications.
Encourage participation in community-based
nutrition programs; educate on healthful diets.
52. 5.Changes in the
Muscular Skeletal System
Muscles generally decrease in strength, endurance, size
and weight
Loss of about 23 percent of muscle mass by age 80 as
both the number and size of muscle fibers decrease
Lose of an average of about 2 inches of height
Compression of vertebrae, changes in posture, and
increased curvature of the hips and knees.
Bones: Bone mass begins to gradually decline as aging
disrupts the balance between the cells that produce
bone and the cells that absorb bone. Bones become
thin and become more porous. Women have a more
rapid rate of bone loss than men, with 1 most rapid
losses occurring in the 5 years following menopause.
53. Parameters of Musculoskeletal
system Assessment
Assessment includes general observation of
posture, stance, and walking. Observations
focus on whether a patient is favoring one side
of the body or another while walking.
The Timed Up-and-Go Test provides a quick
assessment of an older adult’s overall mobility
and function.
54. For patients with existing disabilities, an inquiry is
made to assure the patient has been evaluated in
physical therapy for the correct fitting and teaching of
the proper use of existing and assessment for any
new assistive devices.
Osteoporosis can be assessed by additional
questioning of the patient regarding any back pain,
joint pain, and loss of height. Bone mineral
density (BMD) testing can also be completed, with
results comparing the patient’s bone mass to
individuals in their age range, or previous results if
the patient has had a previous baseline BMD test
56. 6.Changes In
Integumentary System
Skin
Wrinkling, pigment alteration and thinning of the skin
A thinning of the area between the dermis and
epidermis by about 20%
Elastin and collagen decrease
Reduction in size of cells
Loss of subcutaneous layers of fatty deposits
Inability of skin to retain moisture
57. Hair
Hair grays because of a gradual decrease in the
production of melanin, the pigment cells in the hair
bulbs. The graying of hair is also influenced by
heredity and hormones
• Fewer hair follicles on the scalp and the growth rate
of hair decreases
• Older women often have an increase in facial hair
as their estrogen levels decrease.
58. Parameters of Integumentary
System Assessment
Identifying Opportunities for Health Promotion
Assessment questions are aimed at identifying the
person’s perception of any problems, any risk
factors that may contribute to skin problems, and
the person’s personal care behaviors that
influence hair and skin status.
Nurses obtain information about medications and
other risk factors as part of the overall
assessment, and they incorporate this information
into the skin assessment.
Comprehensive assessment, such as information
about fluid intake, nutritional status, and
mobility and safety, is applicable to the
assessment of the skin.
59. Observing Skin
, Hair, and Nails
Close inspection of the skin in a warm, private, and
well-lit environment is an essential component of
skin assessment. Examination of the skin is
particularly important because older adults may
focus on benign conditions, such as xerosis, but not
notice more serious conditions such as skin cancer.
Nurses observe skin color, turgor, dryness, overall
condition, and any growths or pathologic conditions.
60. Nurses also observe and document cultural
variations.
Also, when assessing for erythema or pressure
areas, nurses should keep in mind that early skin
changes may be difficult to detect in people with
darkly pigmented skin.
Assessment includes inspecting the skin for brown
actinic keratosis precancerous lesions, commonly
found on the face, neck, and upper extremities.
Untreated, these lesions may progress to squamous
cell carcinomas, which are reddish dome-shaped
lesions.
61. Nursing-care
Strategies
Promoting Healthy Skin
Because the condition of the skin depends largely on
the overall health of the person, the maintenance of
optimal nutrition and hydration is an important
intervention in the skincare of older adults.
Other factors, including smoking, dehydration, sun
exposure, low environmental humidity, and the use
of harsh cleansing products, are likely to contribute
to xerosis in older adults.
62. Preventing Skin Wrinkles
Avoiding too much exposure to sunlight and using
a sunscreen with a sun protection factor (SPF) of
15 or higher when exposure to sunlight is
unavoidable.
Topical products containing alpha- or beta-
hydroxy acids may be beneficial in reversing
wrinkles and promoting the regression of solar
keratoses.
Nurses need to be alert to the possibility that
older adults might develop an allergic or sensitivity
reaction to some of the ingredients in topical
products.
63. Preventing Dry Skin
Petroleum and other emollients are effective in alleviating
dry skin discomfort, because they moisturize and lubricate
the skin.
An emollient agent is most effective when it is applied to
moist skin immediately after bathing.
Detecting and Treating Harmful Skin Lesions
Early detection and treatment of cancerous or precancerous
skin lesions are key factors in preventing serious functional
consequences, because the cure rate for most skin cancers
approaches 100% with early excision.
The nurse’s role is to detect any suspicious-looking lesions
and to encourage or facilitate further evaluation.
Nurses can encourage all older adults to use the following
guide to identify for themselves any skin changes that
require further evaluation:
65. 7.Changes in the
Sensory System
Vision
•. About 95% of individuals aged 65 and older report
wearing glasses or need glasses
to improve their vision
• The pupil decreases in size, by age 60, it is
about 1/3 the size it was at 20
• The lens of the eye becomes yellowed, more
rigid, and slightly cloudy
• The iris, colored part of the eye, becomes more
rigid overtime.
66. Parameters of Vision Assessment
Interviewing About Vision Changes
Identifying Opportunities for Health Promotion
Observing Cues to Visual Function
Using Standard Vision Tests
67. Nursing-care Strategies
Some activity tips to promote productive aging with
older adults with low vision may include:
Color contrasting various areas for easier
identification of transitions or hazards in the home
Maintaining good lighting in pathways and stairways
Using labels and various other organizational
methods to identify small items
Keeping commonly used items in easy-to-access
locations
Avoiding moving quickly into a dark room or lighted
area; giving the eyes time to adjust to changing light
levels
Using large-print books, checkbooks, or magnifying
glasses for reading
68. Hearing
• It contributes significantly to social isolation
• Membranes in the middle ear, including the
eardrum, become less flexible with age
• Small bones in the middle ear, the ossicles,
become stiffer. Weakening sense of balance
• The vestibular apparatus begins to degenerate
with age
69. Equilibrium becomes compromised and older
individuals may complain of dizziness and find it
difficult to move quickly
without losing their balance
• Presbycusis, literally "old man's hearing", is the
most common form of hearing loss with aging
• It is characterized by a decrease in perception of
higher frequency tones and a decrease in speech
discrimination. The magnitude of presbycusis varies
widely and it is hard to determine how much of the
hearing loss is due to aging and how much is due to
exposure to environmental noise, ototoxic drugs, or
chronic age-related conditions such as
hypertension and diabetes.
70. Parameters of Hearing
Assessment
Interviewing About Hearing Changes
Observing Behavioral Cues
Using Hearing Assessment Tools
Nursing- Strategies
Promoting Hearing Wellness for All Older Adults
Preventing and Alleviating Impacted Cerumen
Compensating for Hearing Deficits
Assistive Listening Devices
Hearing Aids
Speak slowly and clearly
71. Smell
• The number of functioning smell receptors
decreases
• There is increase in the threshold for smell. It takes
a more intense smell for it to be identified and
differentiated from other smells.
Taste
• Taste also diminishes with age. A reduced ability to
taste is called hypogeusia. The rare inability to
detect any tastes is called ageusia;
• Atrophy of the tongue occurs with age and this may
diminish sensitivity to taste.
72. 8.Changes in the
Nervous System
• Older nerve cells may have fewer dendrites
(branches) and some may become de
myelinated (lose its coating) which can slow
the speed of message transmission
• Impairment in cognitive capacity can threaten
autonomy and the ability to manage our daily
activities
The incidence of cognitive impairment
increases with age so that by age of 85, up to
I/3rd of older persons have some degree of
cognitive impairment
73. Memory
Poor recall of verbal words
Perform less well on tasks involving encoding,
retention, and retrieval of information.
Conceptualization, mental flexibility and the capacity
for abstraction decline with age.
General intelligence
Performance scores which measure problem solving
ability tend to decline
74. Parameters of Nervous system assessment
Collect health history of past and present
Assess deep tendon reflexes
Assessment Cranial nerves : sensory and motor to
rule out any abnormality
Mini Mental Status Examination
Nursing-Strategies
Assist in performing activity of daily living.
Keep all their needed things in their reach.
Teach fall prevention technique.
75. Cognitive changes
Cognitive function, deterioration leads to a
decline in the ability to perform activities of
daily living:-
Delirium: Delirium or acute confusion state, is
a potentially reversible cognitive impairment
that is due to physiological cause.
Dementia : Dementia is generalized
impairment of intellectual functioning that
interferes with social and occupational
functioning .Un like delirium, dementia is
characterized by gradual, progressive
irreversible, cerebral dysfunction.
76. It presents following symptoms:
Deficits of memory
Deficits of language
Disturbed perception
Impaired learning and problem-solving
Impaired judgement
Depression: - 20% older adults may experience late
life depression. Depression reduces happiness and
well –being. It contributes to physical and social
limitations. It increases the risk of suicide.
77. Changes in the
Endocrine System
The endocrine system undergoes many changes
during aging, and these changes affect other body
systems and processes.
Age-related changes in the thyroid gland affect
almost all body functions and include the following:
Decreased secretion and plasma levels of
triiodothyronine (T3), especially in men
Increasingly common hypothyroidism
Decreased secretion of thyroid-stimulating
hormone (TSH)
Decreased responsiveness of plasma TSH
concentration to thyrotropin-releasing
78. Androgen and estrogen secretions diminish with
aging. Declining estrogen levels result in atrophy of
the ovaries, uterus, and vaginal tissue in older
women, which may make sexual intercourse
painful.
Older men may develop firmer testes and
hypertrophy of the prostate gland. These changes,
together with other physical and psychosocial
changes, may decrease sexual capacity.
79. Pancreas: Insulin response. Insulin continues to be
produced in sufficient quantities in older adults but
their muscle cells may become less sensitive to the
effects of insulin. The “normal” fasting glucose level
rises 6 to 14 milligrams per deciliter every 10 years.
Type II diabetes occurs when the body develops
resistance to insulin.
Adrenal glands: Aldosterone levels are 30% lower
in adults aged 70 to 80 years than in younger adults.
Lower aldosterone levels may cause orthostatic
hypotension. Secretion of cortisol diminishes by 25%
with age.
80. Parameters of endocrine assessment
Assessment of endocrine function includes a
physical examination, patient history, blood tests
to check hormonal levels, and assessment of
patient symptoms.
•Sexual function may be assessed with a
physical exam and patient-reported signs and
symptoms .
•libido may be affected by non-physiologic
causes including depression, stress, and other
emotional concerns.
81. Nursing-strategies
Endocrine conditions, such as hypothyroidism, may
be treated with medications to replace the hormones
that are deficient in the body. Correcting
hypothyroidism in people over 60 requires a lower
dose of replacement thyroid hormone than in
younger people.
Replacement should be initiated slowly, particularly
in those with coronary artery disease, to prevent
angina and myocardial infarction.
82. COMMON PROBLEMS IN OLD
AGE
There are certain medical problems which are very
common in old age:
Alzheimer’s Disease
Alzheimer’s disease is a brain disorder and a slow
and gradual disease that begins in the part of the
brain that controls the memory
It affects a greater number of intellectual,
emotional and behavioral abilities. There is no
known cause for this disease.
As a person grows older, he is at greater risk of
developing Alzheimer's.
83. Rheumatoid Arthritis
• Rheumatoid arthritis (RA) is caused by
inflammation of the joint lining in synovial (free
moving) joints
• It can affect any joint, but is more common in
peripheral joints, such as the hands, fingers and
toes. RA can cause functional disability, significant
pain and joint destruction, leading to deformity and
premature mortality.
84. Osteoarthritis
• Osteoarthritis (OA) is the most common form
of arthritis. It is a chronic, irreversible and
degenerative condition ranging from very mild
to very severe. It is characterized by the
breakdown of cartilage in joints, which
causes affected bones to rub against each
other leading to permanent damage.
85. Heart Diseases
• Hypertension has been called the "silent
killer" because it usually produces no
symptoms. Untreated hypertension increases
slowly over the years.
Hypertension can cause certain organs
(called target organs), including the kidney,
eyes, and head deteriorate overtime
86. Diabetes
Diabetes in old age is a serious sickness
Old people in fact are more prone to suffer from
diabetes primarily because of lack of movement
and work
Inability in reduction in weight of the elderly, since
they cannot be made to undergo hard strenuous
exercises
Stroke
There are 15 million people who have a stroke
each year. Stroke is the second leading cause of
death for people above the age of 60, and the fifth
leading cause in people aged 15 to 59 years.
87. Urinary Incontinence
About one-third of women and 10% of all men above
60 years have incontinence. There are four
principal types of incontinence: urge, stress,
overflow, and functional .
88. Social Isolation
• Isolation may be a choice, the result of a desire
not to interact with others
• May also be a response to conditions that inhibit
the ability or the opportunity to interact with
others.
Causes of Isolation
Loss of work role
Health problems, i.e. impaired hearing, diminished
vision and reduced mobility
Feeling of rejection
Feeling of unattractiveness
90. ELDER ABUSE
Also called "elder mistreatment", "senior abuse",
"abuse in later life", "abuse of older adults", "abuse of
older women", and "abuse of older men" is "a single,
or repeated act, or lack of appropriate action,
occurring within any relationship where there is an
expectation of trust, which causes harm or distress to
an older person."
It includes harms by people the older person knows,
or have a relationship with, such as a spouse, partner
or family member, a friend or neighbor, or people that
the older person relies on for services. Many forms of
elder abuse are recognized as types of domestic
violence or family violence since they are committed
by family members. Paid caregivers have also been
known to prey on their elderly patients.
91. Causes of Elder Abuse
Ageism, retaliation, caregiver stress, caregiver
unemployment , environmental condition,
increased life expectancy, resentment of
dependence, lack of community resources,
lack of financial resources, lack of close family
ties, violence as a way of life, a history of
personal and mental problems and a history of
alcohol and drug abuse.
92. Prevention
Avoid isolating elders.
Stay in touch with your elders.
Keep elders active.
Encourage elders to attend religious
services and community activities.
Don’t allow elders to live with someone
who is known to be abusive or violent.
93. Be wary of caregivers or friends
needing financial help, or those who have issues
with illicit drugs.
Elders should be aware of their own financial
affairs. .
Don’t allow a caretaker or family member to
impulsively alter an elder’s will, or add their
names to financial accounts or land titles. .
Inform elders to be wary of solicitations from the
telephone, internet or mail.
94. IMPORTANT CONSIDERATIONS
IN THE CARE OF GERIATRIC
CLIENTS
Assessing the Needs of Older Adults
The inter-relationship between physical and
psychological aspects of life
The effects of disease and disability
The decreased efficiency of homeostatic
mechanisms
The lack of standards for health and illness
norms
Altered presentation and response to specific
diseases.
95. Physiological Concern
Promotion of healthy lifestyle
This includes exercise, sleep and stress
management. All these are needed to be promoted
in life of elderly people. It will prevent the occurrence
of certain medical illnesses common in this age.
Preventive: measures that nurse can recommend
Regular exercise.
Weight reduction, if overweight.
Management of HTN
Smoking cessation
Immunization for influenza, pneumococcol
pneumonia and tetanus.
96. Diet In Elderly
The energy requirements of a person decrease with
increase in age. This is because of a lowered
basal metobolic rate and lessened physical
activity. There is an 8% reduction per decade from
55-75 years.
Composition of diet:
Proteins: In the elderly, up to 12-14% of the total
calories should be from proteins. But, due to
decreased appetite and poor digestion, the elderly
tend to consume less protein.
Fat: Avoid diet with high content of saturated fatty
acids (ghee, butter, coconut oil, unrefined oils)
tends to increase the level of cholesterol in the
blood
97. Carbohydrates: The body needs carbohydrate because
it cannot make it for itself from other nutrients. So, it
should be not less than 100 grams per day.
Certain important minerals need to be included in
diet which are as follows:
Calcium: It is very essential for an average elderly
person. As people become older, the bones become
demineralized. So calcium intake should be not less than
400 mg per day.
Iron: Iron deficiency leads to anemia. So the diet of the
elderly should contain sufficient amount of iron. The
recommended daily allowance is 30 mg per day.
Water: The fluid intake should be at least 1.5-2 liters per
day in a normal elderly person.
Roughage or dietary fiber: The elderlies require
sufficient fiber or roughage in their diet to avoid
constipation.
The tender fiber of vegetables, fruits and whole-grain
cereals will encourage normal bowel movements
98. Foods to avoid
High fat foods:.
High sodium foods:
Refined sugar: Cakes, cookies or candy.
Pressure Injuries
The older people have an aged skin and the skin
appears thin and fragile. The age-related changes
may lead to ulceration. All clinicians working with
older people at risk for, or suffering from pressure
ulcers must be mindful of these varying
relationships in consideration to plan and
implement individualized, comprehensive care.
99. Medication In Geriatric Clients
The elderly are at increased risk of adverse effects with
certain drugs. Increased risk may result from age-related
changes in pharmacokinetics or pharmacodynamics.
Risk of an adverse effect increases exponentially with
the number of drugs used, partly because multiple drug
therapy reflects the presence of many diseases and
increases risk of drug-disease and drug-drug
interactions.
Causes of increased risk are:
Decreased body mass
Decreased hepatic mass
Decreased clearance
Decreased GFR.
100. Nurse's Role
Ensure safe and appropriate use of all
medications
Older adults should be taught the names of all
drugs being taken
When and how to take them, desirable and
undesirable effects of drugs
Examine for potential interaction with food or
other drugs.
101. Communication
One important aspect of elderly nursing is
communicating effectively with the patient or with
family members.
Therapeutic touch
Gentle touch conveys affection and friendliness
It helps comfort the older adult
Provide sensory stimulation
Induce relaxation
Provide physical and emotional comfort
Convey warmth
Communicate interest.
102. Communication technique for visual
impairment
Sit or stand in front of the client in full view
Face the older adult while speaking, do not cover your
face
Provide diffuse, bright, non-glare lighting
Encourage the older adult to use his or her familiar
assistive devices such as glasses.
Communication technique for hearing impaired
Speak directly to the client, do not cover your mouth
Speak in clear, low-pitched tones
Reduce background noises
Ask if there is a good ear and speak toward that ear
Encourage to use assistive devices.
Check the ear canal for cerumen impaction.
103. Reality Orientation
It is a communication technique used to make an older adult
more aware of time, place and person.
Purposes
Restoring sense of reality .
Promoting socialization .
Improving the level of awareness
Elevating independent functioning.
Nurse's Role
Frequent reminders of person, time and place
Use of environmental aids such as clocks, calendars,
personal belongings
Therapeutic communication
Answer questions simply and honestly with sensitivity and a
caring attitude.
104. HOUSING AND ENVIROMENT
Changes in social roles, family
responsibilities and health status influence
older adult's living arrangements. Some
choose to live with family members, other
prefer their own homes or apartments near
their families.
Management
Color contrast should be good
Furniture should be comfortable
Furniture should provide back support
Bed should be comfortable and getting out of bed
should be easier and safer.
105. Nurse's Role
Assess environment, to promote
independence and functional ability
Assess safety, find risks in the environment
and older adult ability to recognize and
respond to the risks
Risk includes factors leading to injury, within
house, such as water heaters set at
excessively hot temperature, throw rugs that
could cause a fall.
106. RESOURCES FOR
THE CARE OF OLDER ADULTS
Association of Gerontology, Banaras Hindu
University, Varanasi, India
It was founded in 1982.
Objectives
To promote advancement of knowledge both by
research and training in biological, clinical and
psycho-social aspects of gerontology
To organize scientific meetings, either under its
own auspices or jointly with other organizations,
and
To publish journals, reviews, abstracts, newsletter,
etc. on gerontology.
107. Activities
It Works to insure high standards of research
and practice in gerontology, and to maximize
Conducts research in biological, clinical and
psychosocial aspects of gerontology, e
availability of gerontological services.
Indian geronotological association
All india senior citizens confederation.
108. STEPS TAKEN BY
GOVERNMENT
National Policy for Older Persons (NPOP)
It was announced in 1999 by the Ministry of Social
Justice & Empowerment.
Objectives
To enable and support voluntary organizations and
NGOs to supplement the care provided by the family
To provide care and protection to the vulnerable group
To provide healthcare facility to elderly and to promote
research and training facilities to the care givers
To create awareness amongst elderly persons to
develop themselves in to fully independent citizen.
Features
110. GOVERNMENT INITIATIVE PROGRAMME FOR
GERIATRIC CONSIDERATIONS IN INDIA ARE:-
1.Ppradha
n mantra
vaya
vandhana
scheme
2.Indira
Gandhi
national old
age pension
scheme
3national
programme
for health
care of
elderly.
4.Varish
ta
medicla
m policy
5.Ras
htriya
vayos
hri
yojan
a
111. 6. Varistha pension bima yojana
7.Senior citizen’s welfare fund
8.Vayoshrestha samman
9.Reverse mortage scheme
10.Pradhan mantra jan arogya yojana
112. NGO FOR THE WELFARE OF
GERIATRIC POPULATION IN INDIA
1.AISCCON- all India Senior Citizen’s
Confederation
2.FESCOM-The Federation of Senior
Citizens
3.Help Age India set up in 1978
4.Dignity Foundation
5.Harmony
113. 1.AISCCON- All India Senior
Citizen’s Confederation
The All India Senior Citizens’ Confederation (AISCCON) is a
national level organization of senior citizens with affiliate
federation members and individual members numbering more
than 10 lakhs in various states and union territories of the country.
AISCCON VISION
To be a prime organisation in India ensuring purposeful and
dignified life with care and love for Senior Citizens and
To help organise the Senior Citizens in the country and to get
them affiliated through Associations and Federations to the
114. AISCCON MISSION
To be a Civil Society for all ages in India for
welfare of Senior Citizens and in particular to
ensure sustainable quality and dignity of their
life
To create an environment where seniors live
with self-respect dignity and confidence and
participate in overall progress of the society
To utilise rich experience and vast knowledge
of seniors to improve the life style of public in
general and Senior Citizens in particulars both
in rural and urban areas
115. RESEARCH
Comparing Models of Frailty: The Health
and Retirement Study
Abstract
OBJECTIVES: To operationalize and compare
three models of frailty, each representing a
distinct theoretical view of frailty: as
deficiencies in function (Functional Domains
model), as an index of health burden (Burden
model), and as a biological syndrome (Biologic
Syndrome model).
DESIGN: Cross‐sectional analysis
116. SETTING: 2004 wave of the Health and Retirement
Study, a nationally representative, longitudinal health
interview survey.
PARTICIPANTS: Adults aged 65 and older
(N=11,113) living in the community and in nursing
homes in the United States.
MEASUREMENTS: The outcome measure was the
presence of frailty, as defined according to each
frailty model. Covariates included chronic diseases
and socio demographic characteristics.
117. RESULTS: Almost one‐third (30.2%) of respondents
were frail according to at least one model; 3.1% were
frail according to all three models. The Functional
Domains model showed the least overlap with the other
models. In contrast, 76.1% of those classified as frail
according to the Biologic Syndrome model and 72.1%
of those according to the Burden model were also frail
according to at least one other model. Older adults
identified as frail according to the different models
differed in sociodemographic and chronic disease
characteristics. For example, the Biologic Syndrome
model demonstrated substantial associations with older
age (adjusted odds ratio (OR)=10.6, 95% confidence
interval (CI)=6.1–18.5), female sex (OR=1.7, 95%
CI=1.2–2.5), and African‐American ethnicity (OR=2.1,
% CI=1.0–4.4
118. CONCLUSION:-
Different models of frailty, based on different
theoretical constructs, capture different groups of
older adults. The different models may represent
different frailty pathways or trajectories to adverse
outcomes such as disability and death.
119. CONCLUSION
Current trends in demographic show rapid
urbanization and lifestyles changes that have led to an
emergence of a host of problems faced by the elderly
in India.Certain Lacunae in the field of research on
gerontology have been identified ,such as the lack of
attention given toward the aged in rural india ,failure to
view elderly people as active participants in the
economy, the perception of older persons as being
mere recipients of social welfare services and a lack
of focus on policy recommendations,etc.To overcome
these problems and to ensure a good healthy and
quality life,the elderly members of the society can
move a long way with the support of the family
members as well as the other society members
120. BIBLIOGRAPHY
Brar KN. Rawat CH. Textbook of advanced nursing practice,
Delhi: Jaypee; 2015. p. 1057-1070
Miller A, Carol. Nursing care of older adults: theory & practice,
Philadelphia; 1999. p. 613 , 616
Suzzanne SC Brunner & Siddarth’s textbook of Medical
Surgical Nursing.10th edition vol 1,Lippincott publisher
,2004,pp 189-90.
Phipps ,long ,woods “Medical Surgical N ursing’,7TH
Edition,published by Bi Publication,New Delhi
https://www.nursinghomeabusecenter.com/elder-
abuse/prevention/
https://en.wikipedia.org/wiki/Elder_abuse
https://wildirismedicaleducation.com/courses/older-adult-
care-ceu
121.
122. ANY QUESTIONS ?
LETS RECALL
1.DEFINE GERIATRICS
2.WHAT ARE THE THEORIES RELATED TO
AGEING?
3.LIST DOWN SOME GOVERNMENT
INITIATIVE PROGRAMMES FOR
GERIATRIC CONSIDERATIONS IN INDIA.