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CARE OF OLDER PERSON LEC Ma’am Maria Lailani Llamas | NCM1531L CARE OF OLDER PERSON FOUR OLDER AGE GROUPS GERONTOLOGY IS THE STUDY OF THE AGING PROCESS. ❖ YOUNG OLD (65-74) GERIATRICS IS THE CARE OF AGING PEOPLE. IT IS THE ❖ MIDDLE OLD...

CARE OF OLDER PERSON LEC Ma’am Maria Lailani Llamas | NCM1531L CARE OF OLDER PERSON FOUR OLDER AGE GROUPS GERONTOLOGY IS THE STUDY OF THE AGING PROCESS. ❖ YOUNG OLD (65-74) GERIATRICS IS THE CARE OF AGING PEOPLE. IT IS THE ❖ MIDDLE OLD (75-84) MEDICAL SPECIALTY DEDICATED EXCLUSIVELY TO ❖ OLD OLD (85-99) PROVIDING HIGH-QUALITY, PATIENT-CENTERED CARE ❖ CENTENARIANS ( >100) (RA 11982) FOR OLDER ADULTS. DEMOGRAPHICS OF AGING AGING IS NORMAL. ❖ NORMAL CHANGES OCCUR IN BODY 2018: 8,013,059 FILIPINOS OVER 60 YEARS OLD (8.2%)– STRUCTURE AND FUNCTION. 5,082,049 WILL BE 65 YEARS OLD AND OLDER ❖ PSYCHOLOGICAL AND SOCIAL CHANGES ALSO OCCUR. PROJECTIONS THE OLDER PERSON ❖ PHILIPPINES WILL ENJOY THE BENEFITS OF A YOUNG POPULATION UNTIL 2030 ❖ SOMEONE OVER THE AGE OF 65 IS ❖ GROWTH: CONSIDERED AN OLDER PERSON. 4.9% (2020) ❖ BEFORE PEOPLE LIVE LONGER THAN EVER 5.6% (2025) TODAY. 6.3% (2030) ❖ RETIREMENT IS THE REWARD FOR A LIFETIME OF WORKING. INCREASED LIFE EXPECTANCY ❖ NOT ALL PEOPLE ARE LUCKY ENOUGH TO HAVE THE MONEY OR HEALTH TO ENJOY IT. AVERAGE AGE: 68.5 (2017) TO 74 (2018) ❖ CHRONIC ILLNESS IS COMMON IN OLDER PERSON. PSYCHOLOGICAL CHANGES IN AGING ❖ DISABILITY OFTEN RESULTS. ❖ COGNITIVE AND MENTAL HEALTH LIKE SHORT ❖ MANY HAVE AT LEAST ONE DISABILITY TERM MEMORY IN COGNITION LIKE SLOWER REACTION TIMES AND REDUCED PROBLEM AGING SOLVING ABILITIES ❖ ASSOCIATED WITH BEING “OLD” OR REACHING ❖ ONE IN FOUR OLDER ADULTS EXPERIENCES A “OLDER ADULTHOOD.” MENTAL HEALTH PROBLEM SUCH AS ❖ MOST WIDELY HELD VIEW AS JUST A PART OF DEPRESSION, ANXIETY, SCHIZOPHRENIA OR THE LIFE CYCLE DEMENTIA. ❖ PROGRESSIVE PHYSIOLOGICAL CYCLE LEADING TO SENESCENCE, OR A DECLINE OF BIOLOGICAL FUNCTIONS AND OF THE BODIES ABILITY TO ADAPT TO METABOLIC STRESS. AGEISM – A PERSONAL REVULSION AND DISTASTE FOR GROWING OLD, DISEASE, DISABILITY; AND FEAR OF POWERLESSNESS, “USELESSNESS,” AND DEATH SENESCENCE REFERS TO THE PROGRESSIVE DETERIORATION OF BODY SYSTEMS THAT CAN INCREASE RISK OF MORTALITY; A PROCESS BY WHICH A CELL AGES AND PERMANENTLY STOPS DIVIDING BUT DOES NOT DIE. MNVR | 1 CARE OF OLDER PERSON LEC Ma’am Maria Lailani Llamas | NCM1531L SOCIAL CHANGES PHYSICAL CHANGES ❖ DECREASED SOCIAL CONTACT WITH FRIENDS ❖ PHYSICAL CHANGES OCCUR WITH AGING AND FAMILY PERSON MAY WITHDRAW. ❖ THESE HAPPENS TO EVERYONE. ❖ RECONCILIATION WITH PAST-RESOLVING ❖ THE RATE AND DEGREE OF CHANGE VARY WITH CONFLICTS, LOSSES, ACCEPTANCE. EACH PERSON. ❖ CHANGES IN PHYSICAL APPEARANCE MAYBE ❖ THEY DEPEND ON DIET, HEALTH, EXERCISE, DIFFICULT. STRESS, ENVIRONMENT, HEREDITY, AND OTHER ❖ CHANGES IN ROLES/ TASKS THAT PEOPLE CAN FACTORS. MANAGE AND CAN MAKE THEM FEEL THEY HAVE ❖ QUALITY OF LIFE DOES NOT HAVE TO DECLINE. LESS TO CONTRIBUTE. INTEGUMENTARY SYSTEM THE SKIN LOSSES ITS ELASTICITY, STRENGTH, AND FATTY TISSUE LAYER. SECRETIONS FROM OIL AND SWEAT GLANDS DECREASE-DON’T NEED BATHS AS OFTEN. BLOOD VESSELS ARE FRAGILE-BRUISE EASILY. BROWN SPOTS APPEAR ON SUN-EXPOSED AREAS. LOSS OF THE SKIN’S FATTY TISSUE LAYER AFFECTS BODY TEMPERATURE-TEND TO BE COLD. DRY SKIN CAUSES ITCHING AND SKIN IS EASILY DAMAGED-(USE MILD SOAP AND APPLY LOTION.) PSYCHOLOGICAL-SOCIAL CHANGES NAILS BECOME THICK AND TOUGH. ❖ PHYSICAL REMINDERS OF GROWING OLD CAN FEET USUALLY HAVE POOR CIRCULATION. THREATEN SELF ESTEEM AND INDEPENDENCE. THE SKIN HAS FEWER NERVE ENDINGS-LESS ❖ SOCIAL ROLES CHANGE-SOME ARE NOW BEING ABLE TO FEEL PAIN. CARED FOR BY THEIR CHILDREN. WHITE OR GRAY HAIR IS COMMON. HAIR LOSS OCCURS IN MEN. ❖ HOW PEOPLE COPE WITH AGING DEPENDS ON: HAIR THINS ON MEN AND WOMEN. HEALTH STATUS FACIAL HAIR MAY OCCUR IN WOMEN. LIFE EXPERIENCES HAIR IS DRIER FROM DECREASES IN SCALP FINANCES OILS. EDUCATION SKIN DISORDERS INCREASE WITH AGE. SOCIAL SUPPORT SYSTEM MUSCULOSKELETAL SYSTEM MUSCLE CELLS DECREASE IN NUMBER. HOUSING OPTION MUSCLES ATROPHY(SHRINK) AND DECREASE IN ❖ ONLY 5% OF THE 65+ ELDERLY LIVE IN NURSING STRENGTH. HOMES BONES LOSE MINERALS, ESPECIALLY CALCIUM. BONES LOSE STRENGTH, BECOME BRITTLE AND LIVE WITH FAMILY BREAK EASILY. ADULT DAY-CARE CENTERS DURING VERTEBRAE SHORTEN. THE DAY JOINTS BECOME STIFF AND PAINFUL. NURSING CENTERS MOBILITY DECREASES. ASSISTED LIVING RESIDENCES ACTIVITY, EXERCISE AND DIET HELP PREVENT CONTINUING CARE RETIREMENT BONE LOSS AND LOSS OF MUSCLE STRENGTH. COMMUNITIES (CCRC) BOARD AND CARE HOMES NERVOUS SYSTEM CONGREGATE HOUSING (SENIOR NERVE CELLS ARE LOST. CITIZEN HOUSING) NERVE CONDUCTION AND REFLEXES SLOW. BLOOD FLOW TO THE BRAIN IS REDUCED. CHANGES OCCUR IN BRAIN CELLS. MNVR | 2 CARE OF OLDER PERSON LEC Ma’am Maria Lailani Llamas | NCM1531L SLEEP PATTERNS CHANGE BLADDER SIZE DECREASES. TOUCH AND SENSITIVITY TO PAIN AND IF MEN, THE PROSTATE GLAND ENLARGES. PRESSURE ARE REDUCED. URINARY TRACT INFECTIONS ARE RISKS. TASTE AND SMELL DULL MALE REPRODUCTIVE SYSTEM EYE CHANGES THE HORMONE TESTOSTERONE DECREASES BLUE AND GREEN COLORS ARE DIFFICULT TO SLIGHTLY. SEE. IT AFFECTS STRENGTH, SPERM PRODUCTION, EYELIDS THIN AND WRINKLE. AND REPRODUCTIVE TISSUES. TEAR SECRETION IS LESS. AN ERECTION TAKES LONGER. THE PUPIL BECOMES SMALLER AND RESPONDS THE PHASE BETWEEN ERECTION AND ORGASM LESS TO LIGHT. IS LONGER. CLEAR VISION IS REDUCED. ORGASM IS LESS FORCEFUL THAN WHEN THE LENS OF THE EYE YELLOWS. YOUNGER OLDER PERSONS BECOME MORE FARSIGHTED ERECTION ARE LOST QUICKLY. UNABLE TO SEE CLOSE ITEMS. WOMEN REPRODUCTION EAR CHANGES MENOPAUSE OCCURS IN WOMEN. CHANGES OCCUR IN THE ACOUSTIC NERVE. THE WOMAN CAN NO LONGER HAVE CHILDREN EARDRUMS ATROPHY-HIGH PITCHED SOUNDS FEMALE HORMONES(ESTROGEN AND ARE HARD TO HEAR. PROGESTERONE) DECREASE. WAX SECRETION DECREASES. THE UTERUS, VAGINA AND GENITALIA ATROPHY WAX BECOMES HARDER AND THICKER. VAGINAL WALLS THIN AND THERE IS VAGINAL DRYNESS. CIRCULATORY SYSTEM AROUSAL TAKES LONGER. THE HEART MUSCLE WEAKENS. ORGASM IS LESS INTENSE. ARTERIES NARROW AND ARE LESS ELASTIC. THE PRE-EXCITEMENT STATE RETURNS MORE SOMETIMES CIRCULATORY CHANGES ARE QUICKLY PRESENT. REST IS NEEDED DURING THE DAY. THEORIES OF AGING OVEREXERTION IS AVOIDED. SOCIOLOGICAL THEORIES RESPIRATORY SYSTEM ARE EXPECTED PROGRESSIONS FROM MIDLIFE TO RESPIRATORY MUSCLES WEAKEN OLDER LIFE BASED ON SOCIAL FACTORS. IT FOCUS ON LUNG TISSUE BECOMES LESS ELASTIC THE ROLES AND RELATIONSHIPS WITHIN WHICH THE PERSON MAY LACK STRENGTH TO COUGH INDIVIDUAL ENGAGE IN LATER LIFE. AND CLEAR THE AIRWAY SECRETIONS. 1. ACTIVITY THEORY - SUGGESTS THAT THE DIGESTIVE SYSTEM AGING PROCESS IS SLOWED OR DELAYED, AND SALIVARY GLANDS PRODUCE LESS SALIVA. QUALITY OF LIFE IS ENHANCED WHEN THE DYSPHAGIA IS A RISK. ELDERLY REMAIN SOCIALLY ACTIVE TASTE AND SMELL DULL. 2. DISENGAGEMENT THEORY – IT IS NATURAL TO LOSS OF TEETH AND ILL-FITTING DENTURES WITHDRAW FROM SOCIETY CAUSE CHEWING PROBLEMS. 3. SUBCULTURE THEORY- AS PEOPLE AGE, THEY PERISTALSIS DECREASES. DEVELOP THEIR OWN DISTINCT SUBCULTURE FEWER CALORIES ARE NEEDED. THAT IS SEPARATE FROM THE DOMINANT CULTURE. URINARY SYSTEM 4. CONTINUITY THEORY - OLDER ADULTS WILL KIDNEY FUNCTION DECREASES USUALLY MAINTAIN THE SAME ACTIVITIES, KIDNEYS ATROPHY BEHAVIORS, PERSONALITY TRAITS, AND BLOOD FLOW TO THE KIDNEYS IS REDUCED. RELATIONSHIPS THE URETERS, BLADDER AN URETHRA LOSE TONE AND ELASTICITY. MNVR | 3 CARE OF OLDER PERSON LEC Ma’am Maria Lailani Llamas | NCM1531L 5. AGE STRATIFICATION THEORY - IS A SYSTEM OF BIOLOGICAL THEORIES CONFERRING POWER AND RESPECT ONTO AGING FOLLOWS A BIOLOGICAL TIMETABLE AND MAY CERTAIN AGE GROUPS. REPRESENT A CONTINUATION OF THE CYCLE THAT 6. PERSON-ENVIRONMENT FIT THEORY - THE REGULATES CHILDHOOD GROWTH (PROGRAMMED); IS INTERACTION BETWEEN THE ABILITIES OF AN THE AGE-RELATED CHANGES OF THE CELL'S ABILITY TO OLDER ADULT AND THE PARTICULAR TRANSFER CHEMICALS, HEAT AND ELECTRICAL ENVIRONMENT IN WHICH THEY LIVE THAT PROCESSES THAT IMPAIR IT. CREATE THE CONDITIONS FOR OVERALL WELL-BEING 1. STOCHASTIC THEORIES - THE BODY'S INABILITY 7. GEROTRANSCENDENCE THEORY - TO REPAIR ITS SYSTEMS AND DELAY THE PSYCHOSOCIAL THEORY THAT PROPOSES ONSET OF AGING IS THE RESULT OF MINOR OLDER ADULTS EXPERIENCE A MINDSET SHIFT CHANGES THAT OCCUR GRADUALLY OVER IN MULTIPLE DIMENSIONS (COSMIC, TIME. COHERENCE, SOLITUDE) BASED ON RANDOM EVENTS THAT CAUSE CELLULAR DAMAGE THAT PSYCHOLOGICAL THEORIES ACCUMULATES AS ORGANISM AGES IS A SET OF STATEMENTS THAT SUMMARIZES AND EXPLAINS MENTAL AND BEHAVIORAL PATTERNS WITHIN ❖ FREE RADICAL THEORY THE CONTEXT OF SOCIETY AND CULTURE: EXPLAIN MEMBRANES, NUCLEIC ACIDS, AGING IN TERMS OF MENTAL PROCESSES, EMOTIONS, AND PROTEINS ARE DAMAGED ATTITUDES, MOTIVATION AND PERSONALITY BY FREE RADICALS WHICH DEVELOPMENT THAT IS CHARACTERIZED BY LIFE STAGE CAUSES CELLULAR INJURY AND TRANSITIONS AGING 1. HUMAN NEEDS THEORY - FIVE BASIC NEEDS ❖ ORGEL/ERROR THEORY MOTIVATE HUMAN BEHAVIOR IN A LIFE-LONG ERRORS IN DNA AND RNA PROCESS TOWARD NEED FULFILLMENT; THE SYNTHESIS OCCUR WITH AGING NEEDS ARE PRIORITIZED SUCH THAT MORE BASIC NEEDS TAKE PRECEDENCE BEFORE THE ❖ WEAR & TEAR THEORY COMPLEX NEED CELLS WEAR OUT AND CANNOT 2. THEORY OF INDIVIDUALISM - PERSONALITY FUNCTION WITH AGING CONSISTS OF AN EGO AND PERSONAL AND COLLECTIVE UNCONSCIOUSNESS THAT VIEWS ❖ CONNECTIVE LIFE FROM A PERSONAL OR EXTERNAL TISSUE/CROSS-LINK THEORY PERSPECTIVE. OLDER ADULTS SEARCH FOR WITH AGING PROTEINS IMPEDE LIFE MEANING & ADAPT TO FUNCTIONAL & METABOLIC PROCESSES AND SOCIAL LOSSES CAUSE TROUBLE WITH 3. LIFE COURSE (LIFE SPAN) PARADIGM - BLEND GETTING NUTRIENTS TO CELLS KEY ELEMENTS IN PSYCHOLOGICAL THEORIES AND REMOVING CELLULAR (LIFE STAGES, TASKS, & PERSONALITY WASTE PRODUCTS DEVELOPMENT) WITH SOCIOLOGICAL CONCEPTS (ROLE BEHAVIOR & 2. NONSTOCHASTIC THEORIES - BASED ON INTERRELATIONSHIP BETWEEN INDIVIDUAL & GENETICALLY PROGRAMMED EVENTS CAUSED SOCIETY); GOAL ACHIEVEMENT IS ASSOCIATED BY CELLULAR DAMAGE THAT ACCELERATES WITH LIFE SATISFACTION AGING OF THE ORGANISM 4. SELECTIVE OPTIMIZATION WITH COMPENSATION THEORY - INDIVIDUAL COPES ❖ PROGRAMMED THEORY WITH THE FUNCTIONAL LOSSES OF AGING CELLS DIVIDE UNTIL THEY ARE THROUGH ACTIVITY/ROLE SELECTION, NO LONGER ABLE TO; THIS OPTIMIZATION, & COMPENSATION; CRITICAL TRIGGERS APOPTOSIS OR CELL LIFE POINTS ARE MORBIDITY, MORTALITY, & DEATH QUALITY OF LIFE; FACILITATES SUCCESSFUL AGING MNVR | 4 CARE OF OLDER PERSON LEC Ma’am Maria Lailani Llamas | NCM1531L ❖ GENE/BIOLOGICAL CLOCK THEORY CELLS HAVE A GENETIC PROGRAMMED AGING CODE ❖ NEUROENDOCRINE THEORY PROBLEMS WITH THE HYPOTHALAMUS-PITUITARY ENDOCRINE GLAND FEEDBACK SYSTEM CAUSES DISEASE; HEALTHY AGING AND LONGEVITY INCREASED INSULIN GROWTH FACTOR INCREASES AGING HEALTHY AGING IS A CONTINUOUS PROCESS OF OPTIMIZING ❖ IMMUNOLOGICAL THEORY OPPORTUNITIES TO MAINTAIN AND IMPROVE PHYSICAL AGING IS DUE TO FAULTY AND MENTAL HEALTH, INDEPENDENCE, AND QUALITY OF IMMUNOLOGICAL FUNCTION LIFE THROUGHOUT THE LIFE COURSE. WHICH IS LINKED TO GENERAL WELL BEING LONGEVITY IS THE STATE IN WHICH YEARS IN GOOD HEALTH NURSING THEORIES OF AGING APPROACH THE BIOLOGICAL LIFE SPAN, WITH PHYSICAL, COGNITIVE AND SOCIAL FUNCTIONING, FUNCTIONAL CONSEQUENCES THEORY ENABLING WELL-BEING ACROSS POPULATIONS; ❖ FOCUSES ON THE NEEDS THAT ARE UNIQUE TO MAXIMIZATION OLDER INDIVIDUALS. ❖ MILLER'S FUNCTIONAL CONSEQUENCES GERONTOLOGICAL NURSING THEORY (2008) PROVIDES A FRAMEWORK FOR GERONTOLOGICAL NURSING IS THE SPECIALTY OF WELLNESS PROMOTION IN OLDER ADULTS BY NURSING PERTAINING TO OLDER ADULTS. HELPING NURSES TO RECOGNIZE THEIR POTENTIAL FOR GROWTH AND USING GERONTOLOGY IS MULTIDISCIPLINARY AND IS WELLNESS NURSING DIAGNOSES TO FOSTER A CONCERNED WITH PHYSICAL, MENTAL, AND SOCIAL SENSE OF VALUE AND DIGNITY ASPECTS AND IMPLICATIONS OF AGING. ❖ IT PROPOSES THAT THE ABILITY OF OLDER ADULTS TO MAINTAIN MAXIMAL SELF CARE IS GERIATRICS IS A MEDICAL SPECIALTY FOCUSED ON AFFECTED BY THE INTERACTION OF NORMAL CARE AND TREATMENT OF OLDER PERSONS. AGE-RELATED CHANGES AND ADDITIONAL RISK FACTORS THE INDIVIDUAL ENCOUNTERS. GERONTOLOGICAL NURSES, ALSO CALLED GERIATRIC NURSES, CARE SPECIFICALLY FOR ELDERLY PATIENTS; THEORY OF THRIVING SPECIALIZING IN THIS AREA OFTEN WORK IN ❖ FAILURE TO THRIVE RESULTS FROM A DISCORD REHABILITATION CENTERS, HOSPICE FACILITIES, BETWEEN THE INDIVIDUAL AND HIS OR HER NURSING HOMES, GERIATRICIANS' OFFICES AND ENVIRONMENT OR RELATIONSHIPS. NURSES PATIENTS' HOMES FOR ONE-ON-ONE CARE IDENTIFY AND MODIFY FACTORS THAT CONTRIBUTE TO DISHARMONY AMONG THESE HISTORY OF GERONTOLOGICAL NURSING ELEMENTS ❖ THE AMERICAN NURSING ASSOCIATION (ANA) ❖ CRITICAL ATTRIBUTES OF THRIVING ARE FORMED A SPECIALIZED GROUP FOR DEFINED AS SOCIAL CONNECTEDNESS, ABILITY GERIATRIC NURSES IN THE 1960S TO TO FIND ENVIRONMENT, ADAPTATION TO RECOGNIZE GERIATRIC NURSING. PHYSICAL PATTERNS, AND POSITIVE ❖ THE SPECIALTY OF GERONTOLOGICAL NURSING COGNITIVE/AFFECTIVE FUNCTION. EMERGED BEGINNING IN THE 1950S, WITH THE PUBLICATION OF THE FIRST GERONTOLOGICAL NURSING TEXTBOOK. MNVR | 5 CARE OF OLDER PERSON LEC Ma’am Maria Lailani Llamas | NCM1531L ❖ ESTABLISHMENT OF NGNA & SCOPE AND ❖ THE HISTORY AND DEVELOPMENT OF STANDARDS OF GERONTOLOGICAL NURSING GERONTOLOGICAL NURSING IS RICH IN PRACTICE (1980’S) DIVERSITY AND EXPERIENCES ❖ ESTABLISHED HARTFORD FOUNDATION ❖ FOCUS IS ON INCREASING LIFE EXPECTANCY INSTITUTE OF GERIATRIC NURSING AT NYU ❖ INCREASING NUMBERS OF ACUTE & CHRONIC DIVISION OF NURSING (1990’S) HEALTH CONDITIONS ❖ THE GERONTOLOGY NURSES ASSOCIATION OF ❖ NURSES PROVIDE DISEASE PREVENTION & THE PHILIPPINES (GNAP) WAS OFFICIALLY HEALTH PROMOTION LAUNCHED ON AUGUST 28, 2008 AT THE ❖ PROMOTE POSITIVE AGING PHILIPPINE GENERAL HOSPITAL. WE BELIEVE THAT OLDER PERSONS HAVE SPECIAL NURSING ROLES OF THE GERONTOLOGICAL NURSE NEEDS AND CONCERNS. NURSES HAVE TO HAVE THE KNOWLEDGE AND SKILLS TO ASSIST OLDER ADULTS IN A BROAD RANGE OF PIONEERS OF GERONTOLOGICAL NURSING NURSING CARE ISSUES, FROM MAINTAINING HEALTH AND PREVENTING ILLNESSES, TO MANAGING COMPLEX, FLORENCE NIGHTINGALE OVERLAPPING CHRONIC CONDITIONS AND ❖ FIRST GERIATRIC NURSE PROGRESSIVE, PROTRACTED FRAILTY IN PHYSICAL AND ❖ IN THE 19TH CENTURY THROUGH HER WORK MENTAL FUNCTIONS, TO PALLIATIVE CARE.“ CARING FOR OLDER HELPERS AND MAIDS (CARE OF SICK GENTLEWOMEN ) PROVIDER OF CARE TEACHER DOREEN NORTON MANAGER ❖ FOCUSED CAREER ON CARE OF THE AGED ADVOCATE ❖ DESCRIBED ADVANTAGES OF LEARNING RESEARCH CONSUMER GERIATRIC CARE IN BASIC EDUCATION. SCOPE AND STANDARDS OF LEARNING PATIENCE, TOLERANCE, GERONTOLOGICAL NURSING PRACTICE UNDERSTANDING AND BASIC NURSING SKILLS SCOPE WITNESSING THE TERMINAL STAGES OF ❖ Assessment DISEASE AND IMPORTANCE OF SKILLED ❖ Diagnosis NURSING CARE ❖ Outcome Identification PREPARING FOR THE FUTURE ❖ Planning RECOGNIZING THE IMPORTANCE OF ❖ Implementation REHABILITATION ❖ Evaluation BEING AWARE OF THE NEED TO UNDERTAKE RESEARCH STANDARDS ❖ Quality of Care ❖ Performance Appraisals ❖ Education ❖ Ethics ❖ Collaboration ❖ Research ❖ Research Utilization PRACTICE SETTINGS 1. ACUTE CARE HOSPITAL 2. LONG-TERM CARE ❖ ASSISTED LIVING ❖ INTERMEDIATE CARE -SERVICES ARE PROVIDED TO PATIENTS, USUALLY MNVR | 6 CARE OF OLDER PERSON LEC Ma’am Maria Lailani Llamas | NCM1531L OLDER PEOPLE, AFTER LEAVING STRIATED MUSCLES, SUCH AS THOSE HOSPITAL THAT MOVE THE SKELETON (ALSO ❖ SUBACUTE OR TRANSITIONAL CARE CALLED VOLUNTARY MUSCLE) ❖ SKILLED CARE ❖ ALZHEIMER’S CARE SMOOTH MUSCLES (ALSO CALLED ❖ HOSPICE INVOLUNTARY MUSCLE), SUCH AS THE MUSCLES CONTAINED IN THE STOMACH 3. REHABILITATION AND OTHER INTERNAL ORGANS LIKE THE FEMALE UTERUS 4. COMMUNITY ❖ HOME HEALTH CARE CARDIAC MUSCLE, WHICH MAKES UP ❖ FOSTER CARE OR GROUP HOMES MOST OF THE HEART WALL (ALSO AN ❖ INDEPENDENT LIVING INVOLUNTARY MUSCLE) ❖ ADULT DAY CARE 4. NERVE TISSUE IS MADE UP OF NERVE CELLS MORTALITY AND MORBIDITY IN OLDER ADULTS (NEURONS) AND IS USED TO CARRY MESSAGES TO AND FROM VARIOUS PARTS OF THE BODY. THE BRAIN, SPINAL CORD, AND PERIPHERAL NERVES ARE MADE OF NERVE TISSUE. COMMON CHRONIC ILLNESS BIOLOGICAL ASPECTS OF AGING VITAL ORGANS BEGIN TO LOSE SOME FUNCTION AS WE AGE. CHANGES OCCUR IN ALL OF THE BODY'S CELLS, TISSUES, AND ORGANS, AND THESE CHANGES AFFECT THE FUNCTIONING OF ALL BODY SYSTEMS. HYPERTENSION - IS WHEN THE PRESSURE IN THE CHANGES IN THE FOUR BASIC TYPES OF TISSUE: BLOOD VESSELS IS TOO HIGH (140/90 MMHG OR HIGHER). IT IS COMMON BUT CAN BE SERIOUS IF NOT 1. CONNECTIVE TISSUE SUPPORTS OTHER TREATED. TISSUES AND BINDS THEM TOGETHER. THIS HB IS A COMMON CONDITION THAT INCLUDES BONE, BLOOD, AND LYMPH TISSUES, AFFECTS THE BODY'S ARTERIES. AS WELL AS THE TISSUES THAT GIVE SUPPORT AND STRUCTURE TO THE SKIN AND INTERNAL CAUSES: ORGANS. ADRENAL GLAND TUMORS BLOOD VESSEL PROBLEMS PRESENT AT 2. EPITHELIAL TISSUE PROVIDES A COVERING BIRTH, ALSO CALLED CONGENITAL FOR SUPERFICIAL AND DEEPER BODY LAYERS. HEART DEFECTS THE SKIN AND THE LININGS OF THE PASSAGES COUGH AND COLD MEDICINES, SOME INSIDE THE BODY, SUCH AS THE PAIN RELIEVERS, BIRTH CONTROL GASTROINTESTINAL SYSTEM, ARE MADE OF PILLS, AND OTHER PRESCRIPTION EPITHELIAL TISSUE DRUGS ILLEGAL DRUGS, SUCH AS COCAINE 3. MUSCLE TISSUE INCLUDES THREE TYPES OF AND AMPHETAMINES TISSUE: KIDNEY DISEASE OBSTRUCTIVE SLEEP APNEA MNVR | 7 CARE OF OLDER PERSON LEC Ma’am Maria Lailani Llamas | NCM1531L THYROID PROBLEMS BALANCE OF POTASSIUM IS IMPORTANT RISK FACTORS: FOR GOOD HEART HEALTH. LOW HIGH BLOOD PRESSURE HAS MANY POTASSIUM LEVELS MAY BE DUE TO A RISK FACTORS, INCLUDING: LACK OF POTASSIUM IN THE DIET OR CERTAIN HEALTH CONDITIONS, AGE.THE RISK OF HIGH BLOOD INCLUDING DEHYDRATION PRESSURE INCREASES WITH AGE. DRINKING TOO MUCH ALCOHOL. UNTIL ABOUT AGE 64, HIGH BLOOD ALCOHOL USE HAS BEEN LINKED WITH PRESSURE IS MORE COMMON IN MEN. INCREASED BLOOD PRESSURE, WOMEN ARE MORE LIKELY TO DEVELOP PARTICULARLY IN MEN. HIGH BLOOD PRESSURE AFTER AGE 65. STRESS. HIGH LEVELS OF STRESS CAN RACE.HIGH BLOOD PRESSURE IS LEAD TO A TEMPORARY INCREASE IN PARTICULARLY COMMON AMONG BLACK BLOOD PRESSURE. STRESS-RELATED PEOPLE. IT DEVELOPS AT AN EARLIER HABITS SUCH AS EATING MORE, USING AGE IN BLACK PEOPLE THAN IT DOES IN TOBACCO OR DRINKING ALCOHOL CAN WHITE PEOPLE. LEAD TO FURTHER INCREASES IN FAMILY HISTORY.YOU'RE MORE LIKELY BLOOD PRESSURE. TO DEVELOP HIGH BLOOD PRESSURE IF CERTAIN CHRONIC CONDITIONS. YOU HAVE A PARENT OR SIBLING WITH KIDNEY DISEASE, DIABETES AND SLEEP THE CONDITION. APNEA ARE SOME OF THE CONDITIONS OBESITY OR BEING THAT CAN LEAD TO HIGH BLOOD OVERWEIGHT.EXCESS WEIGHT CAUSES PRESSURE. CHANGES IN THE BLOOD VESSELS, THE PREGNANCY.SOMETIMES PREGNANCY KIDNEYS AND OTHER PARTS OF THE CAUSES HIGH BLOOD PRESSURE. BODY. THESE CHANGES OFTEN INCREASE BLOOD PRESSURE. BEING OVERWEIGHT OR HAVING OBESITY MANAGEMENT: ALSO RAISES THE RISK OF HEART 1. AIM FOR A HEALTHY WEIGHT. DISEASE AND ITS RISK FACTORS, SUCH 2. EXERCISE. -MODERATE ACTIVITY, SUCH AS AS HIGH CHOLESTEROL. BRISK WALKING OR SWIMMING LACK OF EXERCISE.NOT EXERCISING 3. EAT A HEART-HEALTHY DIET. - DASH CAN CAUSE WEIGHT GAIN. INCREASED 4. CUT DOWN ON SALT. 5.DRINK LESS ALCOHOL. – WEIGHT RAISES THE RISK OF HIGH (M) NO MORE THAN TWO DRINKS A DAY; (F) NO BLOOD PRESSURE. PEOPLE WHO ARE MORE THAN ONE DRINK/DAY INACTIVE ALSO TEND TO HAVE HIGHER 5. DON'T SMOKE. HEART RATES. 6. GET A GOOD NIGHT'S SLEEP. 8.MANAGE STRESS TOBACCO USE OR VAPING.SMOKING, CHEWING TOBACCO OR VAPING ARTHRITIS - REDNESS AND SWELLING (INFLAMMATION) IMMEDIATELY RAISES BLOOD OF A JOINT. PRESSURE FOR A SHORT WHILE. TOBACCO SMOKING INJURES BLOOD OSTEOARTHRITIS IS THE MOST COMMON FORM VESSEL WALLS AND SPEEDS UP THE OF ARTHRITIS AMONG OLDER ADULTS.; IS A PROCESS OF HARDENING OF THE DEGENERATIVE JOINT DISEASE THAT HAPPENS ARTERIES. IF YOU SMOKE, ASK YOUR WHEN THE TISSUES THAT CUSHION THE ENDS CARE PROVIDER FOR STRATEGIES TO OF THE BONES WITHIN THE JOINTS BREAK HELP YOU QUIT DOWN OVER TIME. TOO MUCH SALT.A LOT OF SALT — ALSO CALLED SODIUM — IN THE BODY COMMON SIGNS INCLUDE SWELLING AND CAN CAUSE THE BODY TO RETAIN TENDERNESS, STIFFNESS AFTER GETTING OUT FLUID. THIS INCREASES BLOOD OF BED, AND A CRUNCHING FEELING OR SOUND PRESSURE. OF BONE RUBBING ON BONE. LOW POTASSIUM LEVELS. POTASSIUM HELPS BALANCE THE AMOUNT OF SALT THE MOST COMMON CAUSES OF PHYSICAL IN THE BODY'S CELLS. A PROPER DISABILITY AMONG ADULTS. MNVR | 8 CARE OF OLDER PERSON LEC Ma’am Maria Lailani Llamas | NCM1531L DIABETES MELLITUS - IS A CONDITION THAT S/SX : JOINT PAIN, SWELLING, STIFFNESS AND HAPPENS WHEN YOUR BLOOD SUGAR (GLUCOSE) IS LIMITED MOVEMENT TOO HIGH. IT DEVELOPS WHEN YOUR PANCREAS DOESN’T MAKE ENOUGH INSULIN OR ANY AT ALL, OR WHEN YOUR BODY ISN’T RESPONDING TO THE EFFECTS OF INSULIN PROPERLY. CAUSES: INSULIN RESISTANCE AUTOIMMUNE DISEASE HORMONAL IMBALANCES MANAGEMENT: SHORT-TERM TREATMENTS INCLUDE: 1. MEDICATIONS. SHORT-TERM RELIEF FOR PAIN AND INFLAMMATION MAY INCLUDE PAIN RELIEVERS SUCH AS ACETAMINOPHEN, ASPIRIN, IBUPROFEN, OR OTHER NONSTEROIDAL ANTI-INFLAMMATORY MEDICATIONS. 2. HEAT AND COLD. 3. JOINT IMMOBILIZATION. 4. MASSAGE. 5. TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION (TENS). 6. ACUPUNCTURE MNVR | 9 CARE OF OLDER PERSON LEC Ma’am Maria Lailani Llamas | NCM1531L GERIATRIC SYNDROMES PSYCHIATRIC DISORDERS INCLUDE A NUMBER OF CONDITIONS TYPICAL OF, IF NORMAL PRESSURE HYDROCEPHALUS NOT SPECIFIC TO, AGING, SUCH AS DEMENTIA, DEPRESSION, DELIRIUM, INCONTINENCE, VERTIGO, MOST COMMON NON REVERSIBLE DEMENTIAS FALLS, SPONTANEOUS BONE FRACTURES, FAILURE TO MULTI–INFARCT DEMENTIA THRIVE, AND NEGLECT AND ABUSE ALZHEIMER’S DISEASE (AD) MIXED DELIRIUM ❖ IS A SERIOUS CHANGE IN MENTAL ABILITIES. IT RESULTS IN CONFUSED THINKING AND A LACK OF AWARENESS OF SOMEONE'S SURROUNDINGS. ❖ IS A TYPE OF CONFUSION THAT HAPPENS WHEN THE COMBINED STRAIN OF ILLNESSES, ENVIRONMENTAL CIRCUMSTANCES OR OTHER RISK FACTORS DISRUPTS YOUR BRAIN FUNCTION. ❖ MORE COMMON IN ADULTS OVER 65. ❖ IS A SERIOUS AND CAN CAUSE LONG-TERM OR PERMANENT PROBLEMS, ESPECIALLY WITH DELAYS IN TREATMENT. ❖ IS AN ACUTE NEUROPSYCHIATRIC SYNDROME DEMENTIA AND ONE OF THE MOST COMMON PRESENTING A PROGRESSIVE DETERIORATION IN THE INTELLECTUAL SYMPTOMS OF ACUTE MEDICAL ILLNESSES IN ABILITIES IN SUCH A SEVERITY THAT IT INTERFERES OLDER PEOPLE WITH THE PERSON'S SOCIAL AND OCCUPATIONAL PERFORMANCE, THE PREVALENCE INCREASES WITH AGE. IS NOT A SPECIFIC DISEASE BUT IS RATHER A GENERAL TERM FOR THE IMPAIRED ABILITY TO REMEMBER, THINK, OR MAKE DECISIONS THAT INTERFERES WITH DOING EVERYDAY ACTIVITIES. CHARACTERIZED BY: LOSSES IN MEMORY, ABSTRACT REASONING ABILITY, JUDGMENT AND LANGUAGE PERSONALITY CHANGES DETERIORATION OF THE ABILITY TO PERFORM ADLS OVER TIME SYMPTOMS ARE USUALLY SUBTLE IN ONSET PROGRESSING SLOWLY AND EVENTUALLY BECOMING OBVIOUS AND DEVASTATING 3 GENERAL CATEGORIES: COGNITIVE FUNCTIONAL BEHAVIORAL REVERSIBLE CAUSES: ALCOHOL ABUSE POLYPHARMACY MNVR | 10 CARE OF OLDER PERSON LEC Ma’am Maria Lailani Llamas | NCM1531L URINARY INCONTINENCE FALL IN OLDER PEOPLE AROUND 1 IN 3 ADULTS OVER 65 AND HALF OF PEOPLE OVER 80 WILL HAVE AT LEAST ONE FALL A YEAR. MOST FALLS DO NOT RESULT IN SERIOUS INJURY. BUT THERE'S ALWAYS A RISK THAT A FALL COULD LEAD TO BROKEN BONES, AND IT CAN CAUSE THE PERSON TO LOSE CONFIDENCE, BECOME WITHDRAWN, AND FEEL AS IF THEY HAVE LOST THEIR INDEPENDENCE. WHAT ARE UNIVERSAL FALL PRECAUTIONS? FAMILIARIZE THE PATIENT WITH THE ENVIRONMENT. HAVE THE PATIENT DEMONSTRATE CALL LIGHT USE. MAINTAIN CALL LIGHT WITHIN REACH. KEEP THE PATIENT'S PERSONAL POSSESSIONS WITHIN PATIENT SAFE REACH. HAVE STURDY HANDRAILS IN PATIENT BATHROOMS, ROOM, AND HALLWAY. TINETTI BALANCE AND GAIT EVALUATION USE FOR PATIENTS WITH PARKINSON DISEASE OR MULTIPLE SCLEROSIS, TRAUMATIC BRAIN INJURY, AND STROKE PATIENTS. USING A STANDARDIZED SCORING SYSTEM, THE TEST ASSESSES A PATIENT'S BALANCE AND GAIT MNVR | 11 CARE OF OLDER PERSON LEC Ma’am Maria Lailani Llamas | NCM1531L NUTRITION AND HYDRATION NUTRITIONAL ASSESSMENT UNIQUE NEEDS OF PEOPLE AGES 60+: A NUTRITIONAL ASSESSMENT IS IMPORTANT BECAUSE INADEQUATE MICRONUTRIENT INTAKE IS COMMON IN VARIETY OF FOODS FROM EACH FOOD GROUP OLDER PERSONS. SEVERAL AGE-RELATED MEDICAL TO HELP REDUCE THE RISK OF DEVELOPING CONDITIONS MAY PREDISPOSE PATIENTS TO VITAMIN CHRONIC DISEASES AND MINERAL DEFICIENCIES. STUDIES HAVE SHOWN CHOOSE FOODS WITH LITTLE TO NO ADDED THAT VITAMINS A, C, D, AND B12; CALCIUM; IRON; ZINC; SUGAR, SATURATED FATS, AND SODIUM. AND OTHER TRACE MINERALS ARE OFTEN DEFICIENT IN GET ENOUGH PROTEIN DURING THE DAY TO THE OLDER POPULATION, EVEN IN THE ABSENCE OF MAINTAIN MUSCLE MASS INCREASE OF 50% CONDITIONS SUCH AS PERNICIOUS ANEMIA OR FOCUS ON THE NUTRIENTS NEEDED, MALABSORPTION INCLUDING POTASSIUM, CALCIUM, VITAMIN D, DIETARY FIBER, AND VITAMIN B12. FOUR COMPONENTS SPECIFIC TO THE GERIATRIC WITH AGE, THEY MAY LOSE SOME OF THEIR NUTRITIONAL ASSESSMENT: SENSE OF THIRST. DRINK OFTEN. LOW-OR FAT-FREE MILK, INCLUDING 1. NUTRITIONAL HISTORY PERFORMED WITH A LACTOSE-FREE OPTIONS OR FORTIFIED SOY NUTRITIONAL HEALTH CHECKLIST; BEVERAGE AND 100% JUICE CAN ALSO HELP 2. A RECORD OF A PATIENT'S USUAL FOOD INTAKE THEM STAY HYDRATED. BASED ON 24-HOUR DIETARY RECALL; MAINTAIN A HEALTHY WEIGHT OR PREVENT 3. PHYSICAL EXAMINATION WITH PARTICULAR ADDITIONAL WEIGHT GAIN. ATTENTION TO SIGNS ASSOCIATED WITH LEARN HOW MUCH TO EAT FROM ALL FIVE INADEQUATE NUTRITION OR FOOD GROUPS AND FIND OUT HOW MANY OVERCONSUMPTION; AND CALORIES YOU NEED EACH DAY TO HELP YOU 4. SELECT LABORATORY TESTS, IF APPLICABLE. MAINTAIN ENERGY ONE SIMPLE SCREENING TOOL FOR NUTRITION IN OLDER PERSONS IS THE NUTRITIONAL HEALTH CHECKLIST NUTRITIONAL HEALTH CHECKLIST: NOTE: THE NUTRITIONAL HEALTH CHECKLIST WAS DEVELOPED FOR THE NUTRITION SCREENING INITIATIVE. READ THE STATEMENTS ABOVE, AND CIRCLE THE NUMBER IN THE “YES” COLUMN FOR EACH STATEMENT THAT APPLIES TO YOU. ADD UP THE CIRCLED NUMBERS TO GET YOUR NUTRITIONAL SCORE. MNVR | 12 CARE OF OLDER PERSON LEC Ma’am Maria Lailani Llamas | NCM1531L SCORING: 0 TO 2 = YOU HAVE GOOD NUTRITION. RECHECK YOUR NUTRITIONAL SCORE IN SIX MONTHS. 3 TO 5 = YOU ARE AT MODERATE NUTRITIONAL RISK, AND YOU SHOULD SEE WHAT YOU CAN DO TO IMPROVE YOUR EATING HABITS AND LIFESTYLE. RECHECK YOUR NUTRITIONAL SCORE IN THREE MONTHS. 6 OR MORE = YOU ARE AT HIGH NUTRITIONAL RISK, AND YOU SHOULD BRING THIS CHECKLIST WITH YOU THE NEXT TIME YOU SEE YOUR PHYSICIAN, DIETITIAN, OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL. TALK WITH ANY OF THESE PROFESSIONALS ABOUT THE PROBLEMS YOU MAY HAVE. ASK FOR HELP TO IMPROVE YOUR NUTRITIONAL STATUS. MNVR | 13