Week 1 Post (5) Nursing Care for Older Adults PDF

Welcome to N2270: Nursing Care for Older Adults David Reid RN MN Week 1 Foundations of Aging and Course Introduction Land Acknowledgement We acknowledge that Western University is located on the traditional territories of the Anishinaabek, Haudenosaunee,...

Welcome to N2270: Nursing Care for Older Adults David Reid RN MN Week 1 Foundations of Aging and Course Introduction Land Acknowledgement We acknowledge that Western University is located on the traditional territories of the Anishinaabek, Haudenosaunee, and Lūnaapéewak Nations, on lands connected with the London Township and Sombra Treaties of 1796 and the Dish with One Spoon Covenant Wampum. This land continues to be home to diverse Indigenous Peoples (First Nations, Métis and Inuit) whom we recognize as contemporary stewards of the land and vital contributors of our society. Class Outline Introduction Course orientation Aging Theories of aging Ageism  UWO email (not OWL/BSpace) [email protected] Please include course # in subject line Classroom Book an appt (FNB rm 3309) or Zoom stuffAsk a question after break/class Class confidentiality Success & Role of Relationships Learn from your teachers…over my career, I tend to repeat important phrases a lot … University/nursing success = relationships (with who?) Ask (me) questions  Strategies for Success read, attend, study Engage Posting of ppt Pay attention, clarify muddy points Technology/multitasking Campus resources Teaching & Learning Modalities  Lectures  Readings  Reflections  Drawing on lived experiences  Case studies  Discussion  Use of a wide range of resources  Course Description Aging is a major factor impacting healthcare delivery in the 21st century, and older adults are the core consumers of health care. In this course, students apply clinical decision-making by correlating physiologic, psychological and environmental interactions with older adults while focusing on cultural, social, ethical, and legal concepts of care. Evaluation 1. Reflection #1 2. Test #1 3. Test #2 4. Reflection #2 5. Final Exam  Plagiarism Student work is expected to be original. Plagiarism is a serious academic offence and could lead to your expulsion from the nursing program. You are plagiarizing if you insert a phrase, sentence or paragraph taken directly from another author without acknowledging and appropriately citing the author to whom the work belongs. You are plagiarizing if you paraphrase or summarize another author’s ideas without acknowledging that the ideas belong to them. You are plagiarizing if you present your own work, otherwise used for other course(s)/purposes, as original material in current course work. At the discretion of the instructor, you may be required to submit your work through Turnitin.com to verify originality and are responsible for acting on the report generated For further information, please see the BScN Program Manual for the academic policy on plagiarism. Relevance What has the biggest affect on health, and therefore the health care system? i.e. if we treated these things well, the gains would be huge. 1. 2. 3. (4.) (5.)  Some Points about Reflection Assignment Every moment is opportunity to learn (this course and course assignments) Include a personal experience/moment/interaction etc. Do you plan on working in some aspect of gerontology? Why or why not? Class goals (for today) learn about course expectations and opportunities to demonstrate learning develop an understanding of the experience and demographics of aging learn how ageism can impact upon the care of the older adult develop an understanding of the evolution of the health care system related to the care of the older adult gain an understanding of the landscape of aging care Demographics (WHO) All countries face major challenges to ensure that their health and social systems are ready to make the most of this demographic shift. In 2050, 80% of older people will be living in low & middle income countries. The pace of population ageing is much faster than in the past. In 2020, the number of people aged 60 years and older outnumbered children younger than 5 years. Between 2015 and 2050, the proportion of the world's population over 60 years will nearly double from 12% to 22% Demographics – Canada Proportion > 65 has been steadily increasing since 1970s  1966 older adults (over 65) = 7.7% of the population  2015 older adults (over 65) = 16.1% of the population  Due to a relatively low fertility rate and an increased life expectancy in the 1900s (Statistics Canada, 2016a) Female Canadians born today have a life expectancy of ____ years, and males have a life expectancy of ____ years (Statistics Canada, 2018) By 2031, at least 1 in 4 Canadians will be an immigrant, and about 1 in 3 will belong to a visible minority (Stats Can, 2015) Relatively small proportion (8%) of Indigenous peoples are seniors (Statistics Canada, 2016b). However, Indigenous seniors have a high prevalence of chronic health conditions and poor access to services (Fruch et al., 2016) Evolution of Health Care (Being Mortal, Gawande) What did health care look like before hospitals? When did it begin to change? Scientific advances has turned aging & dying into medical experiences managed by health care professionals Notably, patients were expected to be passive and submissive Nursing homes entered the landscape to shift care of the elderly away from hospitals (Gottlieb) Longevity (Wikipedia) Estimated in 2015 that between 150 and 600 living people had reached the age of 110. The true number is uncertain, as not all supercentenarians are known to researchers at a given time, and some claims cannot be validated or are fraudulent. Tomiko Itooka (born 23 May 1908) of Japan is the world's oldest living person whose age has been validated. John Tinniswood (born 26 August 1912) of the United Kingdom is the world's oldest living man whose age has been validated. How we age has changed…  Societal Changes Veneration of _______ replaced by veneration of ____________ How does ageing change life views and goals? Loss Love Trauma The Big ‘R” Trave University Famil Healt l Employme y h nt Crisis When you hear "elderly" what do you think of? Types of Aging People age in several ways: Aging can be viewed in terms of chronological age, biological age, psychological age, and social age Chronological age is measured by the number of years lived. Biological age is predicted by the person’s physical condition and by how well vital organ systems are functioning. Psychological age is indicated by the person’s ability and control in regard to memory, learning capacity, skills, emotions, and judgement. Maturity and capacity direct the manner in which a person is able to adapt psychologically over time to the requirements of the environment. Social age is measured by age-graded behaviours that conform to an expected social status and social roles within a particular culture or society. These different types of aging within a person do not necessarily match Theories of Aging The biological theories of aging today evolved from the early study of changes over the lifespan of the organism. It is important for the nurse to understand that the exact cause of aging is unknown. Two related viewpoints form the foundation of the biological theories:  Stochastic theories: describe changes that occur because of errors within cells DNA, such as oxidative stress (i.e., free radicals)  Non-stochastic theories: describe changes that occur because of predetermined or preprogrammed processes. Both viewpoints agree that cells in the body become disorganized, are no longer able to replicate, and cellular death occurs. When enough cells die, so does the organism. Aging is a wholly unique and individual experience  depends significantly on _______  Aging – SDOH Well-being for those older than 60 years is related to functional status but is also affected by determinants of health—the underlying causes of illness or wellness. How many determinants of health? Is age just a number? Physical changes of aging Ageing results from the impact of the accumulation of a wide variety of molecular and cellular damage over time, with a gradual decrease in physical & mental capacity, growing risk of disease & ultimately death. These changes are neither linear nor consistent, and they are only loosely associated with a person’s age in years.  What is your nursing response? Integument Endocrine Musculo-skeletal Reproductive Cardiovascular GI Respiratory Neurological Renal Immune Implications nursing and healthy aging Nurses are responsible for assisting older adults with achieving the highest level of wellness. Through knowledge and affirmation, the nurse can empower, enhance, and support the older adult’s movement toward the highest level of wellness possible. This means, don’t assume! Maximize function and potential… explores the underlying situations that may be interfering with the achievement of wellness…Healthy Aging! Ageism TED Talk – what did you think? Ageism is a term used to express prejudice toward older adults through attitudes and behaviour (Ebersole) Ageism refers to the stereotypes (how we think), prejudice (how we feel) and discrimination (how we act) directed towards people on the basis of their age. It can be institutional, interpersonal or self-directed (WHO) Although ageism is cross-cultural, it is especially prevalent in the Western world, where aging is viewed with depression, fear, and anxiety Ageism toward older adults has also resulted in negatives attitudes about working in areas such as long-term care (LTC) homes, making it challenging to recruit and retain health care providers in this growing field (Ebersole) Elderspeak The ageist attitudes of the public, as well as those of health care providers, present barriers to communicating effectively with older adults. Elderspeak, often referred to as “baby talk” directed toward older adults, is a form of ageism in which younger people alter their speech on the assumption that all older adults have difficulty comprehending what is said to them. When communicating with older adults who are in a bed or wheelchair, it is important to position oneself at their level rather than talking over a side rail or standing above them Examples Speaking slowly or loudly or both Using a singsong voice Using the pronouns “we,” “us,” and “our” in place of “you” Using pet names such as “honey,” “dearie,” or “sweetheart” Answering questions for the older adult (e.g. “You would like your dinner now, wouldn’t you?”) See https://changingaging.org/elderhood/elderspeak-babytalk-directe d-at-older-adults/ Impact (WHO) Serious and far-reaching consequences for people’s health, well- being and human rights. Associated with a shorter lifespan, poorer physical and mental health, slower recovery from disability and cognitive decline Reduces older people’s quality of life, increases their social isolation and loneliness, restricts their ability to express their sexuality and may increase the risk of violence and abuse against older people. Can also reduce younger people’s commitment to the organization they work for Contributes to poverty and financial insecurity in older age, and one recent estimate shows that ageism costs society billions of dollars Strategies to reduce ageism 1)Policy and Law The Ontario Human Rights Code protects people from discrimination based on age, for those 18 and older 2)Education To dispel myths, reduce prejudice, and limit discrimination 3)Intergenerational contact Can reduce stereotypes and prejudice In Reflection (and for Reflection 1) 1. How do you view the elderly? Considering this class, have you made any assumptions? 2. How does the thought of growing old make you feel? 3. How can ageism affect your practice? 4. How can you use this in LTC?  Review! Success! (after class) Read with intent: Look for links between class and readings Read syllabus Reflect/review…and write it down, or otherwise get into your memory