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Questions and Answers

What is the primary benefit of using brief pauses of silence during communication?

To distract the client from their issues

To allow thought and reflection on the message (correct)

To signal the end of the conversation

To fill the space with more information

What may happen if silence is prolonged during a therapeutic communication?

It will always enhance the therapeutic relationship

It encourages clients to share more information

It may create an atmosphere of comfort

It could be interpreted as a lack of interest by the nurse (correct)

What does the focusing technique aim to prevent during communication with a client?

Distractions related to the client's social life (correct)

Focusing too much on the client's emotional state

Overloading the client with information

Encouraging the client to keep talking

What does the legal term 'capacity' refer to in healthcare decisions?

The ability to understand consequences of decisions (C) Signup and view all the answers

In what scenario are closed-ended questions particularly beneficial?

When the client struggles to provide detailed feedback (A) Signup and view all the answers

What is the primary role of a power of attorney (POA)?

To designate someone to make decisions for another person (A) Signup and view all the answers

How should a nurse approach distractions during a conversation with a client?

Redirect the conversation back to relevant health topics (A) Signup and view all the answers

Who appoints guardians and conservators for individuals lacking capacity?

The court system (C) Signup and view all the answers

What role do open-ended questions play in therapeutic communication?

They enable clients to provide detailed and meaningful responses (C) Signup and view all the answers

What is the primary focus of Occupational Therapists?

To help patients develop skills for daily living. (C) Signup and view all the answers

What is a common risk faced by individuals needing assistance from caregivers?

Mistreatment or neglect by caregivers (C) Signup and view all the answers

What might indicate that a client is not fully engaged in the therapeutic conversation?

Frequent interruptions with unrelated topics (B) Signup and view all the answers

Long-term care typically involves which of the following services?

Support for independent living activities (B) Signup and view all the answers

Which of the following best describes the role of Physical Therapists?

They evaluate movement and manage pain for recovery. (B) Signup and view all the answers

What is a primary responsibility of a Case Manager?

To evaluate health care plans and provide effective medical care. (B) Signup and view all the answers

Why might focusing on a subject at hand be crucial in nurse-client communication?

To facilitate a thorough understanding of healthcare plans (D) Signup and view all the answers

Which setting is most commonly associated with the provision of long-term care?

Home by family members (B) Signup and view all the answers

What is the primary focus of palliative care?

To improve quality of life for patients (A) Signup and view all the answers

What is the role of Speech and Language Therapists primarily concerned with?

Evaluating and treating difficulties with communication and swallowing. (D) Signup and view all the answers

What aspect of patient care does the Interdisciplinary Care Team primarily focus on?

Collaborative management of physical, psychological, and spiritual needs. (C) Signup and view all the answers

What is a key characteristic of palliative care in terms of patient needs?

It is focused on the patient's holistic well-being (C) Signup and view all the answers

What is the primary purpose of Republic Act No. 9994?

To provide additional benefits and privileges to senior citizens (B) Signup and view all the answers

Which law addresses accessibility requirements for public buildings for older persons?

Republic Act No. 334 (B) Signup and view all the answers

What does Republic Act No. 7876 focus on?

Creating Senior Citizens Centers in all cities (D) Signup and view all the answers

What does Presidential Proclamation No. 470 declare?

The first week of October as Elderly Filipino Week (C) Signup and view all the answers

Which executive order provides for group homes and foster homes for older persons?

Executive Order No. 105 (B) Signup and view all the answers

What does polypharmacy refer to in the context of older adults?

The use of multiple medications simultaneously (B) Signup and view all the answers

Why is understanding legal issues important in gerontological nursing?

It addresses common legal issues that may arise when working with older adults (D) Signup and view all the answers

What is the common accepted threshold for polypharmacy in older adults?

At least five medications (B) Signup and view all the answers

What is a consequence of using false reassurances during nurse-client interactions?

They can inhibit future communication and increase anxiety. (D) Signup and view all the answers

Why is disagreeing with clients considered unacceptable in therapeutic communication?

It undermines the client's feelings and opinions. (C) Signup and view all the answers

How do judgments affect nurse-client relationships?

They negatively influence the interpretation of messages. (C) Signup and view all the answers

What is the impact of rejection and minimization in therapeutic relationships?

They can lead to feelings of worthlessness in clients. (B) Signup and view all the answers

Which of the following statements correctly describes stereotyping?

It creates barriers by relying on generalized assumptions. (D) Signup and view all the answers

What distinguishes a geriatrician from a gerontologist?

Geriatricians provide direct care for elderly patients. (B) Signup and view all the answers

What type of training do geriatric nurses receive that differs from traditional nursing roles?

They acquire skills specifically addressing the needs of aging populations. (D) Signup and view all the answers

What is the primary focus of a gerontologist's role in healthcare?

To educate about the aging process and wellness strategies. (A) Signup and view all the answers

What is the primary purpose of an Advance Directive?

To inform healthcare providers and family about a patient's medical care preferences. (D) Signup and view all the answers

In which situation would an Advance Directive be particularly important?

When a person cannot express their medical wishes due to being in a coma or having severe dementia. (B) Signup and view all the answers

What does a Do Not Resuscitate (DNR) order indicate?

The patient does not wish to have CPR performed if their heart stops. (C) Signup and view all the answers

What is one of the primary goals of intervention in end-of-life care?

Assist individuals or families in adjusting to loss and reestablishing equilibrium. (B) Signup and view all the answers

What is essential when nurses begin to establish rapport with elders in crisis?

Introducing themselves and explaining their roles. (C) Signup and view all the answers

What role might nurses play in helping grievers find meaning?

Providing factual information and facilitating spiritual searches. (D) Signup and view all the answers

Loss associated with aging is primarily linked to which of the following?

Loss of physical flexibility and mobility. (A) Signup and view all the answers

What factors should nurses consider to ensure a supportive environment for elderly patients?

Create an environment that ensures basic needs are met and emotional support is provided. (D) Signup and view all the answers

Study Notes

Ethico-Legal Considerations in Communicating with Older Persons

Geriatric healthcare teams must consider ethical principles when caring for the elderly.
Effective communication is crucial for the well-being of older adults and is a vital life skill.
Learning proper communication skills enables healthcare professionals to offer high-quality care.
Understanding and applying ethical principles in the care of older adults is essential.
Knowledge of legal issues in gerontological nursing is vital for appropriate care.
Key legal considerations for older adults include consent, standards of care, and supervision.
Treatment of elderly individuals must align with respect for their autonomy.
Beneficence, nonmaleficence, and justice are essential ethical considerations.
The Philippines has several laws protecting senior citizens.

Learning Outcomes

Students can identify ethical dilemmas and practices in caring for the elderly.
Students can describe communication skills and techniques used in the healing process.
Students can explain the roles of the geriatric healthcare team in holistic care.

Introduction

Ethics in geriatrics guides the determination of morally acceptable actions.
Effective communication with the patient and the healthcare team is crucial for safety and quality care.
Strong verbal and nonverbal communication skills are highly valued professional and personal skills.

The Lived Experience (A Patient's Perspective)

Aida, a 74-year-old, shares a personal narrative about the struggles of healthcare access in her youth.
Her story highlights the significant difference in healthcare access for senior citizens now compared to when she was young.

Ethico-Legal Considerations in the Care of Older Adults

Ethical considerations are crucial for effective communication.

Key Legal Considerations

Consent, standards of care, and supervision are fundamental legal considerations in elder care.

Care for the Aged

Care for the elderly resembles healthcare in some respects, respecting autonomy, and considering beneficence, nonmaleficence, and justice.

Laws Affecting Senior Citizens

Several Philippine Republic Acts (RA) grant benefits and privileges to senior citizens.
RA 7432, RA 9257, and RA 9994 are specific laws that affect Filipino senior citizens.
RA 334 ensures accessibility for elderly individuals with disabilities.
RA 7876 mandates establishing senior centers in every city.
Presidential Proclamations (e.g., No. 470) declare a week of October as "Elderly Filipino Week".
Executive Order No. 105 establishes programs for neglected and abused elder citizens and persons with disabilities.

Medications of Older Adults

Polypharmacy, or the use of multiple medications, is a common concern for older adults.
A threshold of five or more medications is often considered polypharmacy.

Ethical Principles/Dilemmas: Legal Issues in Gerontological Nursing

Knowledge of legal issues is as important as financial considerations in caring for older adults.
Legal concerns often center on an individual's ability to make decisions as it relates to medical care or research.

Ethical Principles/Dilemmas: Competence and Capacity

Competence and capacity are interchangeable terms indicating a person's ability to make decisions.
Individuals' ability to make decisions and choices is assumed unless proven otherwise.

Ethical Principles/Dilemmas: Power of Attorney (POA) and Guardians/Conservators

Power of attorney (POA) designates another person to act on behalf of an individual.
Guardians and conservators manage the personal and financial affairs of persons found to lack capacity.

Ethical Principles/Dilemmas: Elder Mistreatment and Neglect

Elder mistreatment and neglect can occur in any socioeconomic, racial, or ethnic group.

Six Types of Elder Abuse

Includes physical, sexual, emotional, neglect, abandonment, and financial abuse

Profiles of Abused and Abusers

Characteristics of abused and abusive individuals are noted to highlight the issue of elder mistreatment. (Characteristics were mentioned, but not detailed)

Prevention of Elder Abuse and Mistreatment

Nurses should understand elder abuse and mistreatment, actively listening and assessing patients for abuse.
Nurses should create conducive conditions for older adults, including support systems and respite care.

Long-Term Care

Long-term care services cater to an individual's diverse health and personal care needs.
This care may be provided at home, in facilities (e.g., nursing homes), or in community centers (e.g., adult day care centers).

Palliative Care

Palliative care focuses on improving the quality of life for those with serious illnesses.
It is provided by specially trained healthcare professionals and is appropriate regardless of age or stage of illness.
It can be provided alongside curative treatment.

Advance Directive

Advance directive documents personal preferences for healthcare if the individual can't communicate those preferences.
Includes Do Not Resuscitate (DNR) orders for specific medical treatment situations,.

End of Life Care

Dying and death are normal parts of the human experience.
End-of-life care intervention aims to facilitate a healthy adjustment to these transitions.

Spirituality Among Older Persons

Spirituality is a quality of a person rooted in the social and cultural environment, including faith, the quest for meaning, and connections with others, leading to a sense of internal peace and wellbeing.
Spirituality involves a sense of faith, a search for meaning, connection with others, a sense of transcendence, inner peace, and well-being.
Spiritual beliefs and practices are often integral to older adults coping with life challenges.

Privacy is the right to keep health information personal.
Confidentiality is a duty to protect health information entrusted to individuals.

Formal or Therapeutic Communication

Feedback is crucial in formal communication to ensure accurate message interpretation.
Active listening incorporates hearing, processing, and comprehending both verbal and nonverbal communication.
Silence, even prolonged, can be a part of therapeutic communication.
Focusing on the client’s priorities and interests helps to avoid distractions.
Nurses should utilize open-ended questions when appropriate.
Clarification, paraphrasing, restating, reflection, providing leads, and summarizing are therapeutic communication techniques that offer different aspects of the communication process in order to foster healthy communication and relationships with patients.

Informal communication includes everyday conversations, written communication, and nonverbal communication.

Nonverbal Communication

Facial expressions, body language (movement and posture), gestures, eye contact, and touch are all means of nonverbal communication.

Acceptance, Dignity, and Respect in Communication

Active listening, accommodating opinions, and involving the individual in decisions are demonstrations of respectful communication.
Speaking to the person as an adult, recognizing their concerns, and respecting their feelings are all crucial aspects of respecting older adults.

Barriers to Communication

Challenging a client, probing, changing the subject, showing defensiveness, using false reassurances, disagreeing with or imposing judgments on clients, rejecting or minimizing client input, and stereotyping are all examples of communication barriers that negate the therapeutic relationship.

Geriatric Health Care Team

Geriatric health care teams include several professionals—a gerontologist (Geriatrician), Nurse Gerontologist, Occupational Therapists, Physical Therapists, Speech and Language Therapists, and Case Managers, as well as family members and significant others.

Gerontologist (Geriatrician)

These medical professionals focus on the elderly and address their medical concerns.
They educate others and the public about aging issues, processes, and concerns.

Nurse Gerontologist

Geriatric nurses or gerontological nurses care for aging individuals, blending traditional nursing skills with specialized knowledge of elder care.

Occupational Therapists

Occupational therapists treat individuals with disabilities, injuries, or illnesses through everyday tasks and activities for daily living.

Physical Therapists

Physical therapists focus on improving movement, managing pain, and supporting rehabilitation for issues related to chronic conditions.

Speech and Language Therapists (SLTs)

Speech and language therapists treat communication, language, speech, eating, drinking, and swallowing difficulties in clients of all ages.

Case Managers

Case managers supervise patients' health care plans, ensuring effective methods and care coordination.

Family/Significant Others

These individuals play critical roles in the support and wellbeing of older adults.

Nursing and Interdisciplinary Care: Conference Team

Interdisciplinary care teams comprise healthcare professionals from diverse disciplines, focusing on holistic needs for patients and involving families whenever possible.

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