Nursing Care for Older Adults

Study Notes

Course Outcome: Describe principles of safe, patient-centered, evidence-based nursing care to adults at the basic level, guided by the Caritas philosophy.
Competency: Describe principles of patient-teaching that reflect developmental, ethnic, social, and cultural considerations.
Concept: Development: The sequential physical and psychological capacities that allow complex adaptation to the environment.
Unit Outcomes:
- Discuss teaching methods based on the adult and older adult developmental levels.
- Discuss theories of aging.
- Describe individualized aging.
Variability Among Older Adults:
- Physiological, cognitive, and psychosocial health
- Levels of functional ability (e.g., ADL: Activities of Daily Living – Paying Bills, Dressing, Grooming, Toileting)
- Dependence vs. independence
- Strengths and abilities

Wear-and-Tear: Repeated insults and accumulation of metabolic wastes cause cell wear-out and cessation of function.
Genetic: Cells have a preprogrammed number of divisions that define their lifespan, leading to natural death.
Cellular Malfunction: Cell malfunction causes DNA changes leading to altered cell replication and impaired normal cell function.
Autoimmune Reaction: The immune system mistakenly identifies some cells as foreign, triggering an immune response to destroy the body's own cells.
Theories of Aging: Most scientists view aging as a combination of the four theories, inherited traits, and responses to environmental stressors.

Genomics: Study of all genes in humans, including interactions with each other, environment, and psychological/cultural factors.
Personalized Healthcare: Tailored medical treatments based on a patient's specific genetic code for a tailored approach; uses preventive, diagnostic and therapeutic interventions based on genetic tests and family history. Goal: improve health outcomes, healthcare delivery system, and individual quality of life.

Communication Strategies: Sit or stand at eye level in front of the patient. Face the patient when speaking and do not cover mouth. Speak clearly. Use appropriate lighting (diffuse, bright, non-glare). Encourage use of assistive devices (e.g., glasses, magnifiers).

Self-perception of Well-being: Defines perspective about quality of life.
Older patients' concept of health: Revolves around their perceived ability to function.

Scenario: When educating an older adult, what example would indicate the nurse has a stereotype against the patient?
Possible examples:
- "I should make sure and tell your husband..." (indicates doubt of patient's memory).
- Statements that assume lack of understanding or interest.