Health promotion is the process of enabling people to increase control over & improve their health by developing their resources to maintain or enhance well being.
medical surgical nursing , nursing care of elderly patient with disease conditions and different care given to them,it contain introduction , definition, nursing care, patient teaching, diet management, research.
medical surgical nursing , nursing care of elderly patient with disease conditions and different care given to them,it contain introduction , definition, nursing care, patient teaching, diet management, research.
All vital organs begin to lose some function as you age during adulthood. Aging changes occur in all of the body's cells, tissues, and organs, and these changes affect the functioning of all body systems. Living tissue is made up of cells. There are many different types of cells, but all have the same basic structure.
Here you get all update about care of elderly like introduction, definition, the normal aging process, factors affecting aging process, theories, , health problem in old age and their nursing care and health promotion in elderly.
Ethical issues of Care of elderly patients:-
Decision making capacity.
Informed consent.
Refusal of treatment.
Advance directive.
Major ethical principles.
Psycho-social aspects of aging.
Old age is a sensitive phase; elderly people need care and comfort to lead a healthy life without worries and anxiety. Lack of awareness regarding the changing behavioral patterns in elderly people at home leads to abuse of them by their children.
All vital organs begin to lose some function as you age during adulthood. Aging changes occur in all of the body's cells, tissues, and organs, and these changes affect the functioning of all body systems. Living tissue is made up of cells. There are many different types of cells, but all have the same basic structure.
Here you get all update about care of elderly like introduction, definition, the normal aging process, factors affecting aging process, theories, , health problem in old age and their nursing care and health promotion in elderly.
Ethical issues of Care of elderly patients:-
Decision making capacity.
Informed consent.
Refusal of treatment.
Advance directive.
Major ethical principles.
Psycho-social aspects of aging.
Old age is a sensitive phase; elderly people need care and comfort to lead a healthy life without worries and anxiety. Lack of awareness regarding the changing behavioral patterns in elderly people at home leads to abuse of them by their children.
Chemical Toxicity and Weight Loss; The Facts Every Weight Loss Practitioner M...Sonja Bella
2013 Annual Australian & New Zealand Weight Loss Leaders Summit - Gold Coast - www.weightlossinstitute.com.au
Philip Barham is an entrepreneur, speaker and Chiropractor. During Phils’ insightful presentation you will discover:
Why chemical toxicity needs to be addressed for safe and sustainable weight loss.
The four key indicators of a toxic system, and how to address them.
The toxic “chain reaction” and how to finally break these chains for good!
Chemical toxicity and absorption – the surprising facts and it’s effect on gut function.
Cleansing versus weight loss … helpful or harmful? Important precautions you need to know.
Food and nutrition are the way that we get fuel, providing energy for our bodies. We need to replace nutrients in our bodies with a new supply every day.
Nutrition is eating meals (quantity and type) that is appropriate to your age and physiological condition. That made body gets all its needs of materials and nutrients in order to prevent the incidence of diseases and enjoy health and wellness.
https://tryhealthfitness.com/nutrition-need-know
this presentation will give you basic understanding about Nutrition , Wellness, Diet, and supplements. this slides are important for trainers of MLM & Direct selling companies, for first hand basic understanding of Nutrition & Wellness this is a good presentation
Mechanical ventilation uses endotracheal intubation and a ventilator to replace spontaneous respiration and ventilation.
The ventilator provides the function of the respiratory muscles, endotracheal tube establishes a patent and unobstructed airway and the exogenous oxygen source gives a patient a therapeutic concentration of the gas.
Pulmonary edema can be defined as an abnormal accumulation of extravascular fluid in the lung parenchyma.
This process leads to diminished gas exchange at the alveolar level, progressing to potentially causing respiratory failure.
Endotracheal (ET) intubation involves the oral or nasal insertion of a flexible tube through the larynx into the trachea for the purposes of controlling the airway & mechanically ventilating the patient and is Performed by doctors, anesthetist, respiratory therapist or nurse practitioner in the procedure . it is emergency procedure.
A drug is a substance used in the diagnosis, treatment, or prevention of health problems.
A drug is a chemical substance derived from different sources –living or non living , which alter or change the function of cells, by reacting with them.
A route of administration is the path by which a drug, fluid, poison or other substance is brought into contact with the body.
Nurses must administer numerous drugs daily in a safe and efficient manner. The nurse should administer drugs in accord with nursing standards of practice and agency policy. The safe storage and maintenance of an adequate supply of drugs are other responsibilities of the nurse.
The nurse documents the actual administration of medications on the medication administration record. The MAR is a medical record form that contains the drug’s name, dose, route, and frequency of administration
A health history is a collection of data that provides a detailed profile of the patient's health status.
Nurses use therapeutic communication skills and interviewing techniques during the health history to establish an effective nurse-patient relationship. Physical examination is an important tool in assessing the client’s health status.
Approximate 15 % of the information used in the assessment comes from the physical examination.
Imbalances of fluids occurs when body’s compensatory mechanisms are unable to maintain a homeostatic state.
hypovolemia (fluid volume deficit)
hypervolemia (fluid volume excess)
Roy conceptualizes the human system in a holistic perspective, as holism stems from the underlying philosophic assumption of the model. Holism is the aspect of unified meaningfulness of human behaviour in which the human system is greater than the sum of individual parts.
This system model provides a comprehensive, flexible, holistic and system based perspective for nursing.
It deals with stress and stress reduction and is primarily concerned with the effects of stress on health.
This model provides a total approach to client problems by providing a multidimensional view of the person as an individual.
Lung cancer is the leading cause of cancer incidence and cancer death for both men and women.
Malignant chest tumor can be primary, arising within the lung, chest wall, or mediastinum, or it can be a metastasis from a primary tum or site elsewhere in the body.In approximately 70 percent of the patient with lung cancer disease has spread to regional lymphatic and other sites by the time of diagnosis
Comparison between qualitative and quantitative research design.pptxSapana Shrestha
The key difference between quantitative and qualitative research paradigm is related to methods is their flexibility. There is difference in research concept, sources of information, methodology, sampling technique, scope, findings and interpretation
Ensure that the right medications given to the right patient in the right dose through the right route at the right time for the right reason based on the right (appropriate) assessment data using the right documentation and monitoring for the right responses by the patient with right education, ensuring that patient receive accurate and through information about the mediation and considering the right to refuse, acknowledging that patients can and do refuse to take medication (Elliot&liu,2010; Macdonald, 2010; Kee et al.,2012).
Nurses and midwives are responsible to provide their clients/patients with the high-quality care. They are undoubtedly confronted with various
ethical challenges in their professional practice, so they should be familiar with ethical codes of conduct and the essentials of ethical decision making. The ethical tradition of nursing/midwives is self-reflective, enduring, and
distinctive. A code of ethics for the nursing/midwives profession makes
explicit the primary obligations, values, and ideals of the profession that inform every aspect of the nurse’s life.
Nursing is both an art and a science. The science of nursing examines the relationship among person, health and environment. The art of nursing is embedded in caring relationship between nurse and client.
As an increasingly emerging profession, nursing is now deeply involved in identifying its own unique body of knowledge that is essential to nursing practice.
Theory of self care includes of self-care, self-care agency, self-care requisites and therapeutic self-care demand. This theory promotes the goal of self-care
Self-Care: Activities performed independently by an individual to promote and maintain personal well-being throughout life.
The term diagnosis is a statement or conclusion regarding the nature of phenomenon.
A nursing diagnosis is a clinical judgment concerning a human response to health conditions/life processes, or a vulnerability for that response, by an individual, family, group or community. A nursing diagnosis provides the basis for selection of nursing interventions to achieve outcomes for which the nurse has accountability.
Assessment is the first step of nursing process.
Assessing is the systematic and continuous collection, organization, validation and documentation of data.
This includes data about person’s physical and psychological status or study of the patient as a whole to identify his strengths and weakness and his needs and problems
Nursing assessment does not focus upon disease as do medical assessment. It is based on a board scientific knowledge, keen observation and purposeful listening.
The nursing process is cyclical; that is, its component follows a logical sequence, but more than one component may be involved at one time. At the end of the first cycle, care may be terminated if goals are achieved, or the cycle may continue with reassessment, or the plan of care may be modified.
Hemodialysis: management of chronic kidney diseaseSapana Shrestha
Hemodialysis is a mechanical process of removing waste products (toxic nitrogenous substances) and replacing essential substances by the process of diffusion and removal of excess water from body by the process of osmosis by means of artificial kidney (made with modified cellulose or synthetic) through semi-permeable membranes.
peritoneal dialysis, management of chronic renal failureSapana Shrestha
Peritoneal dialysis is a technique of dialysis in which solute and fluid exchange occurs between peritoneal capillary blood and dialysis solution in the peritoneal cavity via peritoneal layer with the help of peritoneal catheter.
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
Explore our infographic on 'Essential Metrics for Palliative Care Management' which highlights key performance indicators crucial for enhancing the quality and efficiency of palliative care services.
This visual guide breaks down important metrics across four categories: Patient-Centered Metrics, Care Efficiency Metrics, Quality of Life Metrics, and Staff Metrics. Each section is designed to help healthcare professionals monitor and improve care delivery for patients facing serious illnesses. Understand how to implement these metrics in your palliative care practices for better outcomes and higher satisfaction levels.
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
ICH Guidelines for Pharmacovigilance.pdfNEHA GUPTA
The "ICH Guidelines for Pharmacovigilance" PDF provides a comprehensive overview of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines related to pharmacovigilance. These guidelines aim to ensure that drugs are safe and effective for patients by monitoring and assessing adverse effects, ensuring proper reporting systems, and improving risk management practices. The document is essential for professionals in the pharmaceutical industry, regulatory authorities, and healthcare providers, offering detailed procedures and standards for pharmacovigilance activities to enhance drug safety and protect public health.
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
Empowering ACOs: Leveraging Quality Management Tools for MIPS and BeyondHealth Catalyst
Join us as we delve into the crucial realm of quality reporting for MSSP (Medicare Shared Savings Program) Accountable Care Organizations (ACOs).
In this session, we will explore how a robust quality management solution can empower your organization to meet regulatory requirements and improve processes for MIPS reporting and internal quality programs. Learn how our MeasureAble application enables compliance and fosters continuous improvement.
1. Health promotion for the elderly
Health promotion is the process of enabling
people to increase control over & improve their
health by developing their resources to maintain
or enhance well being.
Health promoting is an action for health using
knowledge, communication & understanding
2. Health promotion for elderly
Health promotion involves making lifestyle and
behavior changes in order to move toward optimal
health. Health promotion efforts include:
• Increasing awareness of health issues
• Promoting healthier behaviors
• Creating supportive environments
• Developing preventive strategies
• Encouraging early detection and treatment
3. Objectives of health promotion
• Increase quality and years of healthy life
• Maintain function
• Eliminate health disparities and promote
independency
• Improve (enhance) quality of life
• Extend life expectancy → ↓ premature
mortality caused by chronic& acute diseases
4. Component of health promotion
1. Exercise
2. Nutrition
3. Rest & sleep
4. Periodic medical check up
5. High risk behavior
6. Spiritual well-being
7. Psychosocial well-being
8. Safety measures
9. Stress management
6. Physical benefits of exercise
1) Consumption of body fat
2) Improve cardio-vascular capacity( by↑ blood flow----
- keep tissue healthy
3) Control hypertension& blood sugar
4) Improve respiratory function
5) Improve joint flexibility
6) Improve pattern of sleep & rest
7) ↑ independency
8) Improve sense of well –being & relaxation
9) Maintain mind’s function
10) Promote sense of normality
11) Peristaltic movement
7. Psychological benefits of exercise
1. Improve mood state
2. Improve self-image
3. Reduce stress & anxiety
4. Enhance sleep
5. Improve depressive state of elderly
6. Improves Cognitive Function
7. Helps with memory and concentration
8. Improves mood
8. Social benefits of exercise
• Improve social
interaction &
relation with other
• Improves Social
Function
• Increases
independence
• Increases social
networks and
involvement
• Enables person to
participate in and
enjoy social activities
more
10. Role of the nurse during exercise
I- Assessment done at the beginning of exercise
program include:
1. History & physical examination (CVS, resp,
musculoskeletal & neurological system)
2. Renal & liver function tests
3. ECG,& exercise stress test
4. Assess range of motion & use of assistive
devices.
5. Assess environmental hazards
II-Set a regular time to exercise each day
11. III- Before starting exercise the nurse should advice the
elderly about:
1. Document baseline resting function status (ht &resp
rate, bl.sugar)
2. 10 minutes warms up stretching exercise
3. Drink water before and after exercise is important as
water will be lost during exercise
4. Clothes worn during exercise should allow for easy
movement and perspiration.
5. Athletic shoes provide both support and protection
6. Outdoor exercise should be avoided in extremely hot
or cold weather.
12. 1. Enclosed shopping malls are sheltered places
for walking during the extreme weather or
when there are concerns about neighborhood
safety.
2. Exercising with a partner provides both
encouragement to continue exercising and
safety.
3. Nurse should advice the older adults to stop
exercising and seek help if they experiences
chest pain or tightness, shortness of breath,
dizziness, or palpitation during exercise.
13. During exercise
• Monitor heart & resp. rate
• Stop exercise if elderly has fatigue , chest pain
or ↑heart & resp. rate
After exercise:
• 10 minutes cooling up at end of exercise
• Monitor pulse rate during cooling for
returning to resting ht. rate
14. 2- Nutrition
It is neglected especially those living alone or
with low income.
Factors affecting nutritional status:
1) Age related changes
2) Psychosocial factors
3) Economic factors
4) Cultural factors
15. Age related changes
• ↓ Taste & smell
• ↓ Visual acuity
• Loss of teeth & poor fitting denture
• ↓ Gastric secretion→ influence in absorption
of B12, folic acid& iron.
Food remain longer time in stomach + ↓
gastric secretion will lead to indigestion
&feeling of fullness.
16. Psychosocial factors
• Depression is common ( losses, death,
retirement, change of body appearance,
impaired vision &poor physical fitness) this
will lead to lack of interest in eating&
anorexia and ↓ food intake.
• Living alone also will lead to lack of
incentive to cook &eat.
17. Economic Factors
• Low income
• Limited access to food and food
choices
• Inadequate facilities to food storage
and preparation
19. Important of nutrition
• It has been estimated that 10 to 25 percent of elderly
people suffer from poor nutrition
• Poor nutrition can contribute to:
– Heart disease
– Cancer
– Diabetes
– Depression
– Anemia
– Frailty
– Obesity
– Osteoporosis
– Isolation
20. Barriers to Good Nutrition
• Disability
• Changes in appetite
• Nausea
• Medication side effects
• Dental problems
• Difficulty shopping
• Difficulty cooking
• Swallowing problems
• Poor vision
• Financial problems
• Depression or anxiety
• Social isolation
• Transportation
problems
• Other medical
conditions
21. Overcoming Barriers to Good Nutrition
• Chewing problems – juices, canned fruits, creamed
or mashed vegetables, eggs, cooked cereals
• Difficulty shopping – Look into grocery delivery or
shopping services, ask friends, family, church
members for help
• Difficulty cooking – Try microwaveable meals, group
dining programs
22. Overcoming Barriers to Good Nutrition
• Poor appetite – Eat with others, ask doctor if
medicine side effects could be causing problems, try
different spices
• Financial concerns – Use coupons,share with
someone, try low-cost options such as beans, bean
soups, whole grain cereals, look into food bank
programs or other community assistance
• For expert help – Talk to doctor about a referral to a
registered dietician
23. Nutritional requirement of elderly
1- Calories
• Caloric requirement diminished by 10% in age
51-75 years and by 20-25% in age more than
75 years.
• N.B: Fat yield 9 cal/gram, CHO and protein
yield 4 cal/gram, mineral and water yield no
calories
24. 2- Protein requirement
• 0.8 g/kg body wt
• A balanced diet of a healthy elderly should
contain 12-14% of total caloric intake.
• During infection, stress, trauma protein ↑ to
1.6 or 1.5 g/kg body wt
25. 3-Fat requirement
• Fat either saturated or unsaturated
• Total fat intake limited to 30 % or less of
total energy intake
• Saturated fat limited to 10-15% of total
energy intake
• Dietary cholesterol intake limited to 300mg/
day or less
26. 4- Carbohydrates requirement
• CHO is essential for maintaining normal bl.
glucose level.
• 50% of total calories---- CHO
• Simple CHO as sugar, honey ( avoided)
• Complex CHO as vegetables, grains, fruits
• Complex CHO has vit, minerals, fibers which
help in bowel elimination& ↓ bl. cholesterol
level.
27. 5-Fluid intake
Elderly at high risk for dehydration due to:
1. ↓ Thirst sensation
2. Inadequate fluid intake (2000-3000 cc/day) required
3. Some medications, such as for high blood pressure or
anti-depressants, and diuretic
4. Some medications may cause patients to sweat more
5. Frail seniors have a harder time getting up to get a
drink when they’re thirsty,
6. As we age bodies lose kidney function and are less able
to conserve fluid (this is progressive from around the
age of 50, but becomes more acute and noticeable over
the age of 70)
7. Illness, especially one that causes vomiting and/or
diarrhea, also can cause elderly dehydration
28. 6- Vitamins & mineral requirements
• Calcium:---for mineralization of bone &has a role
in blood & cardiac function.
• Daily requirement 1200 mg./day if there is no
contraindications
• Vitamin D :------ needed for calcium absorption&
metabolism.
• Exposure 15 minutes/day to sun is enough
29. Nurse Role
• Assessment involves: nutritional history,
physical examination, anthropometric
measurements, biochemical evaluation,
cognitive & mood evaluation
• Health history related to nutrition
• Anthropometric measurement
• Client and family education
30. Dietary guideline for old persons
• Eat a variety of food
• Maintain a healthy wt
• Choose a diet low in fat,
saturated & cholesterol
• Choose a diet plenty of
vegetables, fruits & grain
products
• Use sugar & salts in
moderate
• Drink 2000-3000cc/daily
31. Quick Tips for Healthier Eating
• Eat more fruits and vegetables
• Eat whole grains, nuts, beans
• Get enough calcium
• Get enough protein from
low fat sources
• Cook with less fat
• Minimize foods high in sugar
• Drink enough water
32. 3- Rest& sleep
• Person spend 1/3 of his life in sleep
• Sleep is time for cell growth& repair
• Elderly need 5-7 hrs at night
Importance of Rest& sleep:
1) Conserve energy
2) Provide organ respite (rest)
3) Restore the mental alertness& neurological
efficiency
4) Relieve tension
5) Emerge feeling of well being
33. • Important Things to Know About Ageing and Sleep
• Older people usually sleep as much each day
as younger adults.
• Older people often take daytime naps as well
as sleeping at night.
• Age increases the risk of some sleep disorders.
• Medical conditions that arise with ageing can
disrupt sleep.
• Sleeping pills are best used only for short
periods of time.
• Try to go to bed and get up at the same time
each day
34. Why is older people's sleep different?
• At night, our body makes a hormone that promotes
sleep, called melatonin.
• Older people make less of it so they find it more
difficult to get off to sleep.
• Other factors may interfere with sleep and cause
wakenings during the night.
• These include hot flushes in postmenopausal women
(see Menopause and Sleep), the need to go to the
toilet during the night and other medical problems
such as arthritis that make it difficult to stay in one
position for the whole night.
• In addition, after retirement many people find it
convenient to take a short nap during the day.
35. • How do older people sleep differently?
• Most people sleep between 7 and 9 hours each day.
• However older people may not have all their sleep at
night, around 4 in 10 older people have at least one nap
every day.
This is usually for at least half an hour.
Most people over the age of 80 nap for more than one
hour each day.
At night, some older people take more than half an hour
to get to sleep.
• This is the case for about 1 in 3 women and 1 in 6 men.
Older people also tend to wake up more at night and
spend less time in deep, refreshing sleep.
36. Factors affecting sleeping patterns
• Age related changes in sleep patterns
• Internal factors
• External factors
37. Internal factor
Many diseases can make it harder to sleep. Some that
are common in older people are arthritis, osteoporosis,
Parkinson’s disease, incontinence, indigestion, heart
disease and lung diseases such as asthma or COPD. The
drugs used to treat these conditions may also interfere
with sleep. Some sleep disorders are more common in
older people, including sleep apnoea and periodic limb
movement disorder.
38. Sleep Disorders and Aging
• The sleep disorders that increase with age are
sleep apnea and periodic limb movements in
sleep (PLMS). Periodic limb movement
disorder is also called nocturnal myoclonus.
39. • Sleep apnea is the interruption of breathing
during sleep.
• It is commonly caused by obstruction
(blockage) of the airway.
• Rarely sleep apnea is caused by a problem in
the nervous system, which controls breathing.
• Sleep apnea is very common among older
overweight people.
40. Self-Care at Home
cont…….
• Maintain a regular wake-up time.
• Maintain a regular time to go to sleep.
• Avoid or decrease daytime naps.
• Exercise daily but not immediately before
bedtime.
• Use the bed only for sleeping or sex.
• Do not read or watch television in bed.
• Do not use bedtime as worry time.
• Avoid heavy meals at bedtime.
41. Self-Care at Home
cont…….
• Avoid or limit alcohol, caffeine, and nicotine before
bedtime.
• Maintain a routine period of preparation for bed, (for
example, washing up and brushing teeth).
• Control the nighttime environment with comfortable
temperature, quietness, and darkness.
• Wear comfortable, loose-fitting clothes to bed.
• If unable to sleep within 30 minutes, get out of bed
and perform a soothing activity, such as listening to
soft music or reading, but avoid exposure to bright
light during these times.
• Get adequate exposure to bright light during the day.
42. Nursing measures adopted to promote sleep
1. Engage in exercise program
2. Avoid exercise within 3-4 hr. of bedtime.
3. Spend time out door in the sunlight each day but
avoid period between 12 Md to 3 PM sunshine
exposure.
4. Engage in relaxing activities near bedtime.
5. Avoid tobacco at bedtime
6. Avoid drink any caffeinated beverages before mid
afternoon.
7. Limit fluid intake after the dinner hour if nocturia is a
problem.
8. Limit daytime naps to 30 minutes or less.
9. Avoid using the bed for watching TV, writing bills,
and reading.
43. 4- Periodic medical examination
Importance of Periodic medical examination:
1. Assess elderly level of well-being
2. Detect early signs of disease
3. Educate client how to promote his health
4. Reinforce + ve promoting & protecting behaviors
5. If examination done at home, it permit
evaluation of environment ( hazards care
giver…)
44. Types of health screening
Health screening Period
Bl. p Each Dr. visit or 3-6 months
Ht & wt Periodically as part of
comprehensive physical
examination
Dental check up Once / year( annually)
Fecal occult blood&
sigmoidoscopy
( annually)
Vision including glaucoma
test
Every 2 years
45. Health screening Period
Hearing Evaluate periodically
Cholesterol level Every 5 years
Cancer screening Annually
Mammography for
women under 70 y
1-2 years
Digital rectal
examination
Annually
46. Immunizations
Vaccination Period
Influenza (over 65y) Annually (mid October to
mid November)
Tetanus & diphtheria Every 10 years
Pneumococcal
vaccination
Once at age 65y,
revaccination for high risk
fatal pneumonia/6 y
47. 5- High Risk Behavior
• It is behavior that damage physical health.
It includes:
• Over the counter medication (multiple medications )
• Smoking
• Caffeine
48. Smoking
• Nicotine & toxic substances in cigarette has impact
on detoxication process in the body------- cell
damage& variety of diseases as cancer, respiratory,
CVD, ↑ risk of osteoporosis
• Cessation of smoking improves cerebral blood flow&
↑ pulmonary function
49. Multiple medication
• Older people consume many medication--------
↑adverse drug reaction
• The most common over the counter
medication: Analgesics, laxatives& antacids
followed by cough products, eye wash&
vitamins.
50. Caffeine
• Found in coffee, tea, soft drinks, chocolate
• It is mood elevator
• It stimulates sympathetic nervous system
• ↑motor activity
• ↑ muscle capacity & alertness
• ↑ Rapid pulse
• ↑ calcium excretion
51. 6- Spiritual Well- being
• Spiritual well-being is the practice and
philosophy of the integral aspects of mental,
emotional and overall wellbeing.
• Spiritual well-being is a state in which the
positive aspects of spirituality are
experienced, incorporated and lived by the
individual and reflected into ones
environment.
52. Signs of spiritual distress:
• Doubt
• Despair
• Guilt
• Boredom
• Expression of anger toward god
53. Benefits
• The practice and incorporation of Spiritual
Wellbeing into one’s life influences and
includes benefits for ones; Emotional
Wellbeing, Physical Wellbeing, and Mental
Wellbeing.
54. Some of the measurable benefits that people experience
from spiritual wellbeing counseling and groups
include:
• A feeling of being more contented with their life’s
situation
• Greater enjoyment of self time, finding an inner
peace
• Greater ability to take control of and resolve their
life’s issues
• A greater sense of satisfaction in their activities and
life situations
• Ability to take a more active part in life rather than
standing still and watching it pass by
• Ability to build more intimate, loving and lasting
relationships
• A greater feeling of purpose and meaning in their life
55. Measures to increase Spiritual well being
• Identify ways that believes give meaning to life
• Use problem solving to solve any conflict related
to spirituality
• Meeting with religious man at regular intervals
• Presence of religious literatures in the
immediate environment
• Reading in religious books & praying
• Discuss role of spirituality in one’s life
56. 7- Psychosocial Well- being
Psychosocial changes may alter an individual
relationship with others.
Physical wellbeing depend on:
• Psychosocial wellbeing
• Social structure
• Personal relationships
In Later years many adjustment are necessary
57. Role of the nurse in health promotion
• Assessment to his physical health, Psychosocial
Well- being, lifestyle pattern, hobbies, high risk
behaviors, knowledge, believes& attitudes that
affect health & wellbeing.
• Assess health needs
• Assess social , environmental & cultural influences
on health behaviors
• Lifestyle modifications is a comprehensive approach
for effective change in heath promotion behaviors
58. • Nurse role should directed toward helping elderly
to cope with his function level ------delay
disabilities & impairments.
• Nurse identify environmental hazards & make
necessary modifications
• Identify social needs & encourage participation &
social support groups.
• Nurse should inform elderly & caregivers about
aging process, common disorders & disabilities ,
different services available
59. • Encourage elderly to take better care to them,
avoid high risk behaviors,& hazards affecting
their health.
• Regular and continuous evaluation is
important aspect of nurse’s role.
60. Safety measures
• One of the basic needs of elderly
• The old adult who has a mental, sensory or a physical
loss, like poor balance and weak muscles, is a safety
risk.
• Thease losses and the ageing process make older
adults prone to accidents.
• An old person has poor vision and hearing, is confused
and has poor judgement can; slip, fall, get hit by the
car, drink of chemical, cut their hand by saw, overuse of
medicine.
• Safety is a major concern when working with or
peoviding care to older adults.M
61. • Falls, burn, poisoning, accidents are most
common problem.
• General safety measures both at home, and
away from home, are encouraged and
recommended to elderly patients and their
family members.
• Falls and injuries,confusion, adherence to
medical instructions, and future health and
financial planning are among the concerns
pertinent to elderly care.
62. General Home Safety
• Consider a medical alert.
• Keep a fire extinguisher and smoke detector on every floor.
• Use extreme caution when smoking. Never smoke when alone or in
bed.
• Always get up slowly after sitting or lying down. Take your time, and
make sure you have your balance.
• Wear proper fitting shoes with low heels.
• Use a correctly measured walking aid.
• Remove or tack down all scatter rugs.
• Remove electrical or telephone cords from traffic areas.
• Avoid using slippery wax on floors.
• Wipe up spills promptly.
• Avoid standing on ladders or chairs.
63. Bathroom Safety
• Leave a light on in bathroom at night.
• Use recommended bath aids, securely installed
on the walls of the bath/shower stall and on the
sides of the toilet.
• make sure the bath tub has a non-slip bottom.
• To avoid scalds, turn water heater to 120 degrees
Fahrenheit or below
• Use door locks that can be opened from both
sides.
• If possible, bathe only when help is available.
64. Kitchen Safety
• Keep floors clean.
• Mark "on" and "off" positions on appliances clearly and
with bright colors.
• Store sharp knives in a rack.
• Use a kettle with an automatic shut off.
• Store heavier objects at waist level.
• Store hazardous items separate from food.
• Avoid wearing long, loose clothing when cooking over
the stove.
• Make sure food is rotated regularly. Check expiration
dates.
65. Drug Safety
• Review your medicines frequently with your doctor or
pharmacist and when you take new medication.
• Make sure medicines are clearly labeled.
• Read medicine labels in good light to ensure you have
the right medicine and always take the correct dose
• Dispose of any old or used medicines.
• Never borrow prescription drugs from others.
• Check with your doctor or pharmacist before you mix
alcohol and your drugs.