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ACUTE CARE FOR OLDER PERSONS Assisted living facilities (ALFs) are residential care facilities designed for older adults who need Acute care is a branch of secondary...

ACUTE CARE FOR OLDER PERSONS Assisted living facilities (ALFs) are residential care facilities designed for older adults who need Acute care is a branch of secondary help with activities of daily living (ADLs) but do not health care where a patient receives active but short- require the level of medical care provided in a nursing term treatment for a severe injury or episode of home.(Allowing residents to live independently with illness, an urgent medical condition, or during minimal assistance) recovery from surgery. Hospice Care: This type of care provides comfort Acute care may require a stay in a hospital and support for individuals who are in the final stages emergency department, ambulatory surgery center, of a terminal illness. It focuses on managing pain and urgent care center or other short-term stay facility, other symptoms and providing emotional and along with the assistance of diagnostic services, spiritual support for both the patient and their loved surgery, or follow-up outpatient care in the ones. community. Goal: To provide pain management and emotional Geriatric Acute Wards support provide dedicated acute care spaces for the older person and provide multidisciplinary team approaches to improve the management of the older CONDITIONS THAT LAND OLDER PERSONS IN patient by providing specialized aged care early to THE EMERGENCY ROOM improve patient outcomes. Acute care is being a patient in a hospital. 1. Abdominal Pain Critical care is a unit for serious cases that need Digestive disease, food poisoning and infection can more one on one care....Critical care is also part of all cause abdominal pain or nausea; so, can kidney emergency room care. stones, which may result from dehydration, malnutrition or other medical conditions. Different types of abdominal pain that older LONG-TERM CARE FACILITIES adults may experience: Continuing Care Retirement Communities Crampy pain: This type of pain is often described as - are residential complexes designed to offer a a sharp, cramping sensation and may be associated spectrum of housing, services, and healthcare with diarrhea or constipation. It can be caused by options for older. conditions such as irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), or gastroenteritis. Nursing Home- Nursing homes, also known as Colicky pain: Colicky pain is a type of pain that skilled nursing facilities , These facilities provide 24- comes and goes in waves and is often associated hour medical care and assistance with activities of with conditions such as gallstones or kidney stones. daily living. They are designed for individuals who require significant medical attention and supervision. Burning pain: Burning pain is often described as a hot, burning sensation and may be caused by Independent Living Communities conditions such as peptic ulcer disease, These communities are designed for active, self- gastroesophageal reflux disease (GERD), or sufficient seniors who want to live in a community of gastritis. their peers. Residents typically live in private apartments or homes and have access to various GERD- avoid spicy foods; small frequent meals; best amenities and services. position for GERD –left side; medication-antacid Rehabilitation Hospitals or Facilities. Referred pain: Referred pain is pain that is felt in a Special facilities exist to provide subacute care to different location than where the problem is. For patients with complex health needs. These patients example, a heart attack may cause pain that is felt in may be head-injured or on ventilators, require the abdomen aggressive rehabilitation after injury or surgery, or 2. Accidents and Injuries require the services and intensive treatments from Exhaustion, falls, injuries, traffic accidents — these specialists such as PT, OT, dietitians, and are the types of acute issues that most often land physiatrists. seniors in the emergency room. Falls: Falls are a common cause of injury among Types of chest pain that older adults may older persons. They can result in fractures like hip experience fracture(serious type), head injuries, and other Angina: serious injuries that require emergency medical care. This is a type of chest pain that occurs when the Motor vehicle accidents: Older drivers may be at heart muscle doesn't get enough blood and oxygen. higher risk of motor vehicle accidents due to age- It can feel like pressure or tightness in the chest, and related declines in vision, hearing, and reaction time. may also be accompanied by shortness of breath, These accidents can result in serious injuries that sweating, and nausea. require emergency medical care. Heart attack Assault: Older persons may be at risk of assault, A heart attack occurs when a blockage in the particularly in cases of elder abuse or neglect. coronary arteries reduces or stops blood flow to the Assault can result in physical injuries such as heart muscle. Chest pain is often the most common bruises, cuts, and fractures. symptom of a heart attack in older adults, and it may feel like a squeezing or crushing sensation. 3. Adverse Effects of Medication and Complications of Medical Treatment Managing an older person with chest pain who Adverse drug reactions are a shockingly common landed in ER cause of emergency room visits in the elderly, Initial assessment: The medical team will first including unexpected side effects, interaction with assess the patient's vital signs, oxygen levels, and other drugs, or inappropriate self-medication. perform an electrocardiogram (ECG) to check for Adverse effects or overdose can lead to confusion, signs of a heart attack. They will also take a detailed falls, dizziness, and other serious symptoms medical history and ask about any other symptoms. requiring ER attention. Pain management: Depending on the severity of the 4. Delirium and Altered Mental Status pain, the patient may be given pain medication such Older persons who are hospitalized or treated in the as nitroglycerin, morphine, or other pain-relieving emergency room may be at risk of delirium, a state medications. of confusion and disorientation that can be caused Diagnostic tests: Additional diagnostic tests, such by medications, infections, or other factors. as blood tests, chest X-rays, CT scans, or 5. Surgical complications echocardiograms may be performed to identify the Older persons who undergo surgery may be at higher cause of the chest pain. risk of complications such as infections, bleeding, or Treatment: Treatment will depend on the underlying anesthesia-related complications. cause of the chest pain. For example, if the patient is 6. Acute Pain diagnosed with a heart attack, they may undergo Severe pain from conditions like arthritis, fractures, emergency angioplasty or receive clot-busting kidney stones, or shingles may require ER visits, medications to restore blood flow to the heart. especially if pain management at home is Monitoring: The patient will be closely monitored for inadequate. any changes in their condition, including changes in 7. Cardiovascular Issues vital signs or symptoms. Heart Attack (Myocardial Infarction): Symptoms in 9. Chronic Obstructive Pulmonary Disease older adults may differ from classic chest pain and According to the Center for Disease Control, COPD include fatigue, shortness of breath, or covers number of conditions including bronchitis, gastrointestinal discomfort. chronic airway obstruction and emphysema. Congestive Heart Failure: Fluid overload can lead Coughing, fatigue and shortness of breath are some to shortness of breath, swelling, and fatigue, often possible symptoms. requiring emergency care. Primary cause –cigarette smoking 8. Chest Pain Signs and symptoms of COPD may include chest pain can be a symptom of heart disease; it can also be caused by other problems such as blood Shortness of breath, especially during physical clots, gastrointestinal issues, heart attacks, injuries activities or even respiratory infections.  Wheezing Viruses: Viral pneumonia is another common cause Chest tightness of pneumonia in older adults, particularly during flu A chronic cough that may produce mucus season. (sputum) that may be clear, white, yellow or Aspiration: Aspiration pneumonia can occur when greenish food, drink, or other materials are inhaled into the Frequent respiratory infections lungs. Older adults with swallowing difficulties or Lack of energy other conditions that affect their ability to swallow are Unintended weight loss (in later stages) at an increased risk of developing aspiration Swelling in ankles, feet or legs pneumonia.( place in side-lying position) Diagnostic exam for Pneumonia Heart Disease – 1st leading cause of death in US Some of the most common symptoms reported by Chest X-ray: An imaging test that can show the seniors in emergency room visits are chest pain and presence of fluid or inflammation in the lungs. shortness of breath, both potential indicators of heart disease, which is still the leading cause of death in ( common diagnostic exam for older adults) the U.S., as reported by Discovery Health. Sputum test Blood tests: These tests can help determine the 10. Respiratory Infection severity of the infection and whether it is bacterial or viral. Pneumonia Pneumonia is one of the most common upper Bronchoscopy: A procedure in which a thin, flexible respiratory infections to land seniors in the ER. Signs tube with a camera is inserted into the lungs to look may be milder in older adults, and can include for abnormalities and collect a sample of lung tissue shortness of breath, coughing and confusion or for further testing. delirium, according to WebMD. Cause by Streptococcus pneumoniae 11.Spinal Disorders Back pain is another symptom that commonly brings seniors to the ER, whether the pain is due to an injury Older adults are at increased risk of developing to the back or neck, a vertebral disc disorder, or an various types of heart disease inflammatory condition such as arthritis. Coronary artery disease (CAD): This is a common 12. Stroke – third leading cause of death in US type of heart disease that occurs when the blood Stroke is the third leading cause of death in the U.S. vessels that supply the heart muscle become It has a distinct pattern of symptoms, which means a narrowed or blocked by a buildup of plaque. CAD can vigilant caregiver can often prevent long-term cause chest pain, shortness of breath, and can lead damage if the patient is treated quickly enough, to a heart attack. according to the CDC. Arrhythmias: Arrhythmias are irregular heart 13. Urinary Tract Infection rhythms This is yet another reason why seniors should make sure they’re getting enough fluids — 31% of seniors (medication-beta-blockers, are chronically dehydrated, and one of the best calcium/sodium channel blockers) Amiodarone ways to prevent urinary tract infection is to drink Heart failure: Heart failure is a condition in which the plenty of water, as reported by the CDC. heart is unable to pump enough blood to meet the body's needs. 14. Dehydration and Malnutrition Common causes of Pneumonia in Older person can lead to serious health complications, especially Bacteria: Bacterial pneumonia is the most common among older adults who might have difficulty with cause of pneumonia in older adults. Streptococcus food intake or maintaining adequate hydration. pneumoniae is the most common bacterial strain 15. Mental Health Emergencies: causing pneumonia in older adults.( antibiotics) Conditions like severe depression, anxiety, acute *** expected outcome if elderly recover from confusion, or behavioral changes might prompt older pneumonia-he can perform ADL without dyspnea adults or their caregivers to seek emergency have access to needed community services to psychiatric care. maintain independent living Older adults may also present with suicidal thoughts or confusion due to mental health challenges. HEALTH PREVENTION AMONG OLDER PERSON HEALTH PROMOTION & HEALTH PREVENTION Nurses in preventative health care are tasked with AMONG OLDER PERSONS improving the health of patients through evidence- Health promotion activities - those activities of an based recommendations while encouraging individual able to proactively engage individuals to receive preventative services such as screenings, counseling and precautionary Health promotion -refers to the process of enabling medications. individuals to improve and enhance their overall health and well-being. Regular exercise: Nurses promote regular activity (preferably 30 minutes of exercise at least five days Disease prevention is a procedure through which a week within tolerance level) to combat heart individuals, particularly those with risk factors for a conditions, high blood pressure and other diseases disease, are treated order to prevent a disease from such as stroke, diabetes and arthritis. occurring. Illness behavior refers to the various actions and Avoidance of smoking and drug abuse: Aside attitudes that individuals exhibit when they perceive from the addiction threat associated with smoking themselves to be ill. This can include seeking and drug use, there is the risk of lung cancer, medical care, adhering to treatment regimens, and emphysema and other forms of cancer. altering one's lifestyle to manage the illness. Vaccinations: Vaccines such as the flu vaccine, Health promotion according to World Health pneumonia vaccine, flu vaccine, and others can help Organization-denotes the practice of educating and prevent serious illnesses and complications that can encouraging individuals to take greater care of their be particularly risky for older individuals with own health by effectively managing any chronic weakened immune systems. conditions they may have and taking lifestyle steps to reduce the risk of illness. Moderated alcohol use: Education about the effects Health is a state of complete physical, mental of alcohol consumption, as well as early screening and social well-being and not merely the for diseases such as liver disease, stroke or high absence of disease or infirmity (WHO) blood pressure, can significantly increase the chances of illness prevention. Health education- refers to the process of providing individuals, groups, or communities Control of existing diseases: Nurses involved with with information and skills to make informed preventative health care work to identify existing decisions about their health and well-being. conditions in the early stages. Modifying an individual’s behaviors can control or minimize the effects of a particular ailment. Goals of Prevention for older Persons Provide information on stress management: maintain an active social life, including work Chronic stress can increase the risk of chronic engage in regular physical activity (appropriate illness. Encourage older adults to practice stress- exercise) reducing activities such as meditation, yoga, or deep maintain a nutritious, well-balanced diet; breathing. undergo periodic health check-ups for specific preventable and diagnosable conditions, review Fall Prevention: Falls are a leading cause of injuries and minimize medications in older persons. Falls are a significant risk for older consult physicians about immunization against adults. Taking steps to create a safe home pneumococcal pneumonia and influenza; environment, using assistive devices, and improve home safety to prevent falls and other maintaining balance and strength through exercise injuries can help prevent falls. Bone Health: Osteoporosis is common in older Examples: Regular cancer screenings (e.g., adults, particularly in postmenopausal women. mammograms, colonoscopies), blood pressure Adequate calcium and vitamin D intake, along with monitoring, and diabetes management. weight-bearing exercise, can help maintain bone health. Tertiary prevention Medication Management: Older individuals often take multiple medications. Ensuring proper Focus: Tertiary prevention is directed at individuals medication management, including regular reviews who already have a diagnosed health condition or by healthcare providers, is essential to prevent drug disability. interactions and side effects. Goals: It aims to minimize the impact of the condition, prevent complications, and improve Mental Health: Mental health is a crucial aspect of overall quality of life, chronic diseases or disabilities. overall well-being, and older individuals are at increased risk of conditions such as depression, Strategies: Tertiary prevention includes disease anxiety, and cognitive decline. Regular mental health management, rehabilitation, and support services. It screenings and seeking professional help when also encompasses efforts to prevent the progression needed can support good mental health in older of a condition and enhance functional abilities. persons. Examples: Rehabilitation for individuals who have had a stroke, management of chronic diseases to prevent complications, and support for individuals THREE LEVELS HEALTH OF with disabilities. PROMOTION/DISEASE PREVENTION Primary prevention FACTORS AFFECTING THE HEALTH STATUS OF Focus: Primary prevention targets healthy older OLDER PERSONS individuals who have not yet developed specific health problems. Factors include : 1. Aging effects Goals: It aims to prevent the onset of disease or 2. Presence of chronic disease injury and promote overall health and well-being. 3. Living arrangements Strategies: This level includes activities like health education, vaccination, regular physical activity, Aging effects: limited physical function, cognitive nutrition, and lifestyle modifications to reduce risk impairment, sensory deficiency and decrease organ factors (e.g., smoking cessation). reserves 1. Functional Status Examples: Encouraging older adults to get regular 2. Cognitive impairment exercise, eat a balanced diet, and avoid smoking and 3. Sensory deficiency excessive alcohol consumption. 4. Decrease organ reserves Aging effects Secondary prevention Aging does not happen overnight It is a process that starts from the beginning of life- Focus: Secondary prevention focuses on individuals these changes are manifested in the skin texture, who may have risk factors or early signs of a disease flexibility of joints, eyesight, etc. or condition but are not yet clinically diagnosed. Aging does not happen at the same rate for all Goals: It aims to detect and address health issues in individuals their early stages to prevent progression and Many studies have proven that good nutrition, complications. regular exercise, being tobacco free and lack of stress, decrease chronic illness in later life Strategies: This level includes regular screenings and diagnostic tests to identify conditions like cancer, 1. Functional Status hypertension, or diabetes, as well as interventions to Functional status-refers to the ability of a manage and control these conditions. person to perform basic self-care or activities of daily living (ADL) and domestic self care tasks or instrumental activities of daily living (IADL)  ADL includes: bathing, dressing, transferring presbyopia (difficulty focusing on close objects) from bed to chair , toileting, personal hygiene, and changes in their glasses prescription. grooming and ambulation IADL includes: traveling, shopping, preparing Hearing Impairment in Older Person meals , housework, taking medicines, managing Presbycusis: gradual decline in hearing money and using telephone sensitivity, especially for high-pitched sounds. Tinnitus: Tinnitus is the perception of noise or 2. Cognitive Impairment: Memory Loss and ringing in the ears,---it may be a symptom of an confusion states underlying condition or exposure to loud noise Cognitive ability may be defined as a “mental over the years. capability that involves the ability to reason, plan, Difficulty Hearing in Noisy Environments: solve problems, think abstractly, comprehend Older individuals may find it challenging to hear complex ideas, learn quickly and learn from and understand conversations in noisy settings experience” (Gottfredson, 1997). due to difficulty filtering out background noise. A cognitive state of thought processes and state Earwax Buildup: Accumulation of earwax in the of mind. ear canal can be more common in older Cognitive state is important in the health of individuals and may cause hearing problems. older person- this may have big effect on their Sensorineural hearing loss: hearing health maintenance behavior such as forgetting impairment occurs when there is damage to the to eat, take a bath and taking of medication inner ear or the auditory nerve. Meniere's disease: is a chronic inner ear 3. Sensory deficiency: Visual and hearing condition that affects the balance and hearing impairment functions of the ear- can cause vertigo, tinnitus, Sensory deficiency such as visual and hearing and fluctuating hearing loss, often affecting older impairment also affect health status of older individuals. persons Otosclerosis: This condition involves abnormal Older persons may also be prone to accidents or bone growth in the middle ear, which can lead to falls due to visual impairment conductive hearing loss in older adults. Communication may difficult due to hearing impairment 4. Decrease organ reserve As people age, their bodies gradually lose Visual Impairment in Older person "organ reserve," which refers to the extra Presbyopia: vision where the eye's ability to capacity that organs and physiological systems focus on close objects diminishes- as a result, must handle stress or sudden increases in older individuals may have difficulty reading or demand. performing tasks that require close-up vision. This reserve acts as a buffer, allowing organs to Cataracts: Cataracts are cloudy areas in the function normally even when faced with illness, lens of the eye that can cause blurry or hazy injury, or other stressors. vision. Glaucoma: Glaucoma is a group of eye Implications: conditions that can damage the optic nerve and Higher Vulnerability to Illness: With a lead to vision loss. decreased reserve, even minor illnesses or stress Macular Degeneration: Age-related macular can lead to more significant health declines. degeneration (AMD) affects the central part of Longer Recovery Times: Healing from injuries or the retina and is a leading cause of vision loss illness is slower as organ systems have less among older adults. capacity to "bounce back." Decreased Night Vision: Older adults may Increased Risk with Surgery and experience decreased ability to see in low-light Hospitalization: Reduced reserve means the conditions, which can impact activities like body has less ability to handle the stress of driving at night. surgery or intensive treatments. Retinal detachment: is a serious eye condition where the light-sensitive layer of tissue at the CHRONIC ILLNESS IN OLDER PERSON back of the eye, known as the retina, pulls away Chronic illness include the following: hypertension, from its normal position. arthritis, heart diseases and diabetes mellitus With aging effects, older persons become Refractive errors: Older individuals may experience changes in their vision due to more susceptible to chronic illness-due  decrease functional reserves and cumulative Osteoarthritis causes cartilage — the hard, effects of lifestyle habits such as eating salty slippery tissue that covers the ends of bones and fatty foods, living sedentary lifestyle, where they form a joint — to break down smoking, etc.. (crepitus). Rheumatoid arthritis is a disease in which the Hypertension immune system attacks the joints, beginning with Persons who are hypertensive are likely to the lining of joints such as knees, hip and hand develop congestive heart failure or heart Treatments vary depending on the type of arthritis. attack and cerebrovascular accident or stroke The main goals of arthritis treatments are to Hypertension is another name for high blood reduce symptoms and improve quality of life. pressure. Family history increases your risk in HPN Symptoms The most common signs and symptoms of arthritis Symptoms Severe Hypertension involve the joints. Depending on the type of arthritis No symptom you have notice-common symptom you have, signs and symptoms may include: headaches Pain shortness of breath Stiffness nosebleeds Swelling flushing Redness dizziness Decreased range of motion chest pain visual changes Risk factors of Arthritis blood in the urine Family history Some types of arthritis run in families, so you may be more likely to develop Medical Diagnosis arthritis if your parents or siblings have the 24-hour urine test-check for excess sodium in disorder. Your genes can make you more the urine susceptible to environmental factors that may cholesterol screening and other blood tests trigger arthritis. heart’s electrical activity with an Age. The risk of many types of arthritis — electrocardiogram (EKG/ECG) including osteoarthritis, rheumatoid arthritis and Echocardiogram (to assess the heart's structure gout — increases with age. and function), Sex. Women are more likely than men to develop imaging studies (such as ultrasound or CT scan) rheumatoid arthritis, while most of the people who to assess organs like the kidneys, which play a have gout, another type of arthritis, are men. role in blood pressure regulation. Previous joint injury. People who have injured a joint, perhaps while playing a sport, are more likely Treatment for HPN to eventually develop arthritis in that joint. Reduce sodium in the diet Obesity. Carrying excess pounds puts stress on Reduce caffeine intake joints, particularly your knees, hips and spine. Control blood pressure People with obesity have a higher risk of Regular visit to doctor developing arthritis. Regular physical exercises-aerobic exercises Stress reduction Treatment lifestyle modification and medication Medications (topical pain medicines and oral ( antihypertensive drugs) analgesics including nonsteroidal anti- inflammatory medications like Tylenol, NSAIDs or Arthritis aspirin). Arthritis is the swelling and tenderness of one or Exercise (land- and water-based). more of your joints ( mostly affected hands, knees Intermittent hot and cold packs (local modalities). and hips). The main symptoms of arthritis are joint Physical, occupational, and exercise therapy. pain and stiffness, which typically worsen with Weight loss (if overweight). age. The most common types of arthritis are Healthy eating, managing diabetes and osteoarthritis and rheumatoid arthritis. cholesterol. Supportive devices such as braces, orthotics, shoe inserts, cane, or walker.  Intra-articular injection therapies (steroid, Diabetes Mellitus hyaluronic acid “gel”). Diabetes mellitus, is a chronic medical condition Complementary and alternative medicine that affects how the body regulates blood sugar, or strategies, including vitamins and supplements. glucose. Type 1 diabetes - body produces very little or no Heart Disease insulin, which means that you need daily insulin Heart disease is the principal cause of death injections to maintain blood glucose levels under among older persons control Heart disease describes a range of conditions Type 2 diabetes body does not make good use of that affect your heart. Diseases under the heart the insulin that it produces, require oral drugs disease umbrella include blood vessel diseases, such as coronary artery disease; heart rhythm People with Type 1 diabetes must use insulin problems (arrhythmias); and heart defects are injections to control their blood glucose. born with (congenital heart defects), among In Type 2 diabetes treatment is healthy lifestyle, others. including increased physical activity and healthy The term "heart disease" is often used diet. interchangeably with the term "cardiovascular disease." most common type of diabetes Cardiovascular disease generally refers to Gestational Diabetes: This type of diabetes conditions that involve narrowed or blocked blood occurs during pregnancy when a woman's body vessels that can lead to a heart attack, chest pain cannot produce enough insulin to meet the (angina) or stroke. increased demands. It typically resolves after While cardiovascular disease can refer to childbirth, but it increases the risk of developing different heart or blood vessel problems, the term Type 2 diabetes later in life. is often used to mean damage to your heart or blood vessels by atherosclerosis , a buildup of Causes fatty plaques in your arteries The causes of diabetes are not known. The following risk factors may increase your chance of Causes getting diabetes: High blood pressure and cholesterol, smoking Family history of diabetes or a personal history of ,overweight and obesity, diabetes ,family history, gestational diabetes. a diet of junk food, age ,a history Injury to the pancreas (such as infection, tumor, of preeclampsia during pregnancy surgery or accident). Staying in a stationary position for extended Autoimmune disease. periods of time, such as sitting at work Age (risk increases with age). Having any of these risk factors greatly increases Physical stress (such as surgery or illness). the risk of heart disease. Some, such as age, are unavoidable. For example, once a woman There are risk factors that you might have more reaches 55 years of age, heart disease becomes control over, including: more likely. High blood pressure Abnormal blood cholesterol or triglyceride levels. Prevention Smoking. Lifestyle changes that can improve heart disease, Being overweight. such as: Use of certain medications, including steroids Quit smoking Control other health conditions, such as high Symptoms blood pressure, high cholesterol and diabetes The symptoms of diabetes include: Exercise at least 30 minutes a day on most days Increased thirst. of the week Increased hunger (especially after eating). Eat a diet low in salt and saturated fat Dry mouth. Maintain a healthy weight Frequent urination. Reduce and manage stress Unexplained weight loss(even though you are Practice good hygiene eating and feel hungry). Other symptoms include: Weak, tired feeling. Blurred vision.  Numbness or tingling in the hands or feet. Fall Risk Evaluation: Slow-healing sores or cuts. Falls are the leading cause of injury for seniors. Dry and itchy skin. To reduce fall risk and encourage home safety for Frequent yeast infection or urinary tract infection seniors, one of the most important things to do is to: Remove throw rugs. These may be decorative but Long-term complications of uncontrolled often lack a rubberized backing to better grip the diabetes floor. eyes (diabetic retinopathy) Clean up piled clutter or uneven surfaces. This kidneys (diabetic nephropathy) includes newspapers, loose clothes, and shoes. nerves (diabetic neuropathy) Discard or donate old furniture. cardiovascular system (increased risk of heart Avoid stretching extension cords across the floor. disease and stroke). Accessibility and Mobility: Prevention Assessing the home for accessibility, including the Get at least 150 minutes per week of aerobic presence of steps, narrow doorways, or other exercises, such as brisk walking barriers that may limit mobility or make it difficult for Cut saturated and trans fats, along with refined the older person to move around the home or carbohydrates, out of your diet. access essential areas, such as the bedroom, Eat more fruits, vegetables, and whole grains. bathroom, or kitchen. Eat smaller portions. Recommend ramps, handrails, wider doorways, Try to lose of body weight if you are overweight and stairlifts if necessary to improve mobility within or obese. the home. Make sure that older person wears non-slip Living Arrangement footwear when inside. According to the Philippine Statistics Authority, there were 7.5 million senior Keep emergency numbers handy citizens in the country, as of its latest census in Make it easy for older person to call for help by 2015. posting a note in large letters by every phone and on Living arrangement affect health status of older the back of their cell phone. Make sure to list the person following: Living in isolation lead to illness and decrease 911 quality of life Emergency contacts (family members & friends) Older person in the Philippines lived their Older person professional caregiving service immediate family or with other relatives- it is Recommend an emergency kit with essential seldom they live in isolation supplies, contact information, and a Living arrangements has negative impact communication plan with family members. especially when the family is poor-financial difficulties Around the House Try to keep furniture to a minimum Home Assessment in Older Person Avoid having mats on floor that could cause tripping Be careful of loose cords hanging on telephones or Home assessment for an older person, also known another house implements as a home safety assessment or home modification Keep areas well lit at night: night light, or blue or evaluation, is a comprehensive evaluation of an older green light bulbs give a soft glow at night individual's living environment to ensure that it is If the older person has difficulty getting in and out safe, comfortable, and supportive of their needs and of chairs, encourage him/her to use chairs with arm independence. rests for leverage. Safety at home is primary concern in maintaining the Check whether the older person has access to health of older person clocks, calendars and newspapers that promote Layout of the house, sign of neglect or cleanliness orientation and knowledge of current events and order, presence of help tools or physical barriers are some of the things we check in Bedroom conducting home assessment Check height of bed- it may need to be lowered or raised so that can sit comfortably on the edge of the bed with flat on the floor  Use a nightstand with necessary items within reach, Medication management such as a phone and medications. Medication management services aids with Instruct older person to take time to gain balance managing and administering medications, including when getting up from a chair or bed. prescription medications and over-the-counter Instruct older person to wear shoes or slipper that medications have slip-resistant tread patterns and have low heels with a broad surface Transportation assistance provide seniors with assistance getting to and from Bathroom appointments, running errands, and attending social Remove the bathroom mirror. If older person is events. showing early signs of dementia, seeing an unfamiliar face looking back at them may be Respite care startling. Respite care provides temporary relief for family Install a nightlight in the bathroom. This will help caregivers who need a break from caring for their seniors who may make repeated trips to the loved one. bathroom overnight. Install a nightlight or two on the Respite care can be especially important for route to the bathroom as well so that seniors can family caregivers who are caring for a loved one find their way. with a chronic illness, dementia, or a disability. Kitchen Skilled nursing care: Skilled nursing care provides Put items for everyday use where they can medical care and treatment for seniors with complex be reached easily medical needs, such as wound care, medication Observe safety precautions with electrical management, and monitoring of chronic conditions. appliances Make sure the floor surface is non-slip and always Rehabilitation services: Rehabilitation services clean up water, food spill, etc.. provide physical therapy, occupational therapy, and Ask for specific gadgets that may help the older speech therapy to help seniors regain or improve person in turning off stove knobs, pouring from their mobility, strength, and communication skills. kettle Encourage the older person to ask help with tasks that might be too risky, such as transferring heavy Disadvantages Of Nursing Homes For Seniors pots and pans etc Nursing homes are expensive-If your loved one does not have plenty of retirement savings set aside to help cover the cost, a nursing home might simply HOME CARE SERVICES AMONG OLDER not be an option your family can afford. PERSONS Definition of Terms Nursing homes can be depressing-Uprooting a Elderly care, or simply eldercare (also known as loved one from the familiarity and comfort of the only aged care), refers to the support and assistance home they have known for years can cause provided to older individuals who may require help depression. Many seniors fear moving into a with daily activities due to related issues, illness or nursing home because they see it as a final step disabilities. before the end of their life. The purpose of home care is to: Lack of privacy: Living in a nursing home means Promote independence sharing living spaces and personal care with others, Personalized care which can limit privacy and personal space. Daily living assistance Safety and security Risk of social isolation While nursing homes offer opportunities for socialization, some seniors may feel Home care setting provide services isolated or lonely if they don't connect well with other Personal care: This type of care aids with daily tasks residents or staff. such as bathing, dressing, grooming, and toileting. Potential for abuse or neglect Unfortunately, Homemaker services aid with tasks such as meal nursing homes can be sites of abuse or neglect, preparation, housekeeping, laundry, and grocery particularly if the facility is understaffed or poorly shopping. managed. Loss of freedom and independence- Older adults Hospital Risks for Older person are accustomed to their own routines and it can be 1. Delirium occurs in 1/3 of hospitalized patients hard for them to adjust to a new schedule in a nursing over the age of 65. Delirium is an acute and home. The loss of freedom and independence can sudden disturbance in consciousness and cause them to lose self-esteem as they are no longer cognition that can manifest as confusion, in control of their own life. disorientation, agitation, and hallucinations. There are several factors that can contribute to Proximity to family the development of delirium in older adults, Depending on where you live, there might not be a including medications, infections, electrolyte quality nursing home facility located close by. A long imbalances, and underlying medical conditions drive to visit on the weekends can take a toll on family such as dementia or stroke. members over time. Even if you can visit regularly, your loved one may still feel a lack of family 2. Pressure ulcers (also known as pressure sores presence, increasing feelings of loneliness and or bedsores) are injuries to the skin and underlying depression. tissue, primarily caused by prolonged pressure on the skin. If an older adult cannot reposition himself, Potential for sub-quality care he is at risk for pressure ulcers (bed sores). We’ve all heard horror stories of poor treatment and neglect of nursing home residents. And, in fact, some 4.Older patients may have multiple medical issues, reports show up to 90 percent of nursing homes are requiring several specialists to be involved in his understaffed, which can cause poor supervision and case. This can be confusing and difficult to increase the risk of accidents. coordinate for any patient. 5. New medications may be introduced, which can Advantage of sending Older person to Nursing lead to side effects. Older patients may already be Homes taking multiple medications, which can lead to Professional care adverse effects. Ensuring clear explanation of Nursing homes have trained professionals on staff, medication purpose and potential side effects. including nurses, therapists, and other healthcare providers, who can provide high-quality care to 6. Older adults are at risk for falls, especially if they seniors with complex medical needs. are sedated or disoriented. Among older adults, falls are the leading cause of injury and deaths. 24-hour supervision Nursing homes provide 24-hour supervision, 4. Older adults can be at risk for malnutrition. ensuring that seniors are always safe, and their Studies cite that 58 percent of patients 65 and older needs are being met, including assistance with have problems eating. This can slow recovery. personal care, meals, medication management, and other activities of daily living. 5. The spread of infectious diseases such as MRSA ( Methicillin resistant staphylococcus Safe and secure environment: Nursing homes aureus)and pneumonia are rampant in hospitals. The provide a safe and secure environment, with staff reason pneumonia acquired in the hospital is more available to respond quickly to emergencies and severe may be due to the more aggressive infecting ensure that residents are not at risk of falls, injuries, organisms, making it harder to treat. or other accidents. 6. Physical decline : For elderly patients, a hospital Access to specialized care Nursing homes may stay can bring new health issues and disabilities to provide specialized care for seniors with specific the forefront. Because hospital patients are typically health conditions or needs, such as dementia care or bedridden for much of the day, they become weaker rehabilitation services. and less able to resume their daily routine after discharge- The psychological effect of that helplessness can be profound among elderly. 7. Lingering stress Hospital stays can be a life- changing event for patients. It's a massive disruption of routine, and it's isolating causes stress 8.Loss of power Seniors who are hospitalized often the patient's physician and primary nurse and ask don't take long to start feeling out of control-- for an evaluation. especially if others are in- charge of making decisions for them 8. Monitor Meals. Sometimes older patients have a difficult time eating and may need assistance. What a Patient Advocate Can Do Hospital workers may be too quick to take away meal trays before the patient has had time or the 1. Have The Patient's Medical History. inclination to eat. Monitor dietary restrictions to Bringing loved ones to complete the medical make sure the patient receives meals the doctor history of the older person. An older patient in the has ordered. hospital may be too ill to gather the information. 9. Prevent Falls. If your loved one is at risk for 2. Have A List of Patient's Medications. Bringing a falling, be always at bedside. You can create a current list of the patient's medications, Family Advocate Team with other loved ones including over-the-counter drugs and any herbs taking shifts. This prevents the need for restraints. and supplements taken. Include any allergies to medications. 10. Prevent Diseases In The Hospital. To prevent the spread of hospital-acquired infectious 3. Bringing Eyeglasses and hearing aids. Be diseases such as MRSA and pneumonia, ask sure the loved one has these essentials handy to everyone who meets the patient to wash their better see and hear what is happening around of hands. An older patient may not be up to this task. the patient. You can create a hand-made sign to be placed on the wall above the patient's bed that says, "Please 4. Make the Patient's Hospital Room Like Home. wash your hands before touching me." Place anti- Older patients do better in the hospital if some of bacterial gel by the patient's bed and ask their routine and sense of familiarity is preserved. everyone to use it.. Bring in the outside world to their hospital room. This includes a cozy comforter, photos of family and friends, a clock to help them keep track of Acute Care for Elders Interdisciplinary Team time, bathrobe, their address book should they Hospitalist-Physicians whose primary professional want to contact loved ones, books, newspapers, focus is the general medical care of hospitalized MP3, CD, DVD or tape players with familiar patients. programs or music. Geriatric Nurse Practitioner-perform a variety of 5. Practice Bed Sore Prevention. If the patient is patient health care tasks including diagnosing, unable to reposition himself in bed, monitor how treating, and helping patients manage acute and many times his body is turned to prevent pressure chronic illnesses. ulcers. Ask the patient's primary nurse to help you with this. Geriatrician-is a doctor who specializes in care of the elderly and the diseases that affect them. 6. Meet The Doctors. Be present during doctors' rounds to have face-to-face interactions with your Psychiatric Nurse Practitioner-Responsible for loved one's physicians. You want these medical helping patients cope with psychiatric disorders professionals to see you as a human being who is involved with the patient. Create a list of questions Psychologist-is a person who studies normal and ahead of time and document the answers in a abnormal mental states, perceptual, cognitive, notebook. emotional, and social processes and behavior by experimenting with, and observing, interpreting, 7. Be Aware Of Behavior And Mood Changes. and recording how individuals relate to one another Document in a notebook how the patient is doing and to their environments. daily basis. Be aware of any sudden mood or cognitive changes in the patient such as Registered Nurse Care Manager-are registered drowsiness, apathy, confusion, little or no speech nurses who are responsible for the coordination of or movement, agitation or hallucinations. If you the various elements that are involved in the care notice a sudden change, bring it to the attention of  of an individual patient. Their role is to use resources and services in the best way possible. Social Worker-assists people within a wide range of settings, from mental health clinics to schools and hospitals. Physical Therapist-help injured, or ill people improve movement and manage pain. Occupational Therapist- treat injured, ill, or disabled patients through the therapeutic use of everyday activities. They help these patients develop, recover, improve, as well as maintain the skills needed for daily living and working. Charge Nurse-is an RN who is essentially 'in charge' of a ward in the hospital or other healthcare facility during their shift. Registered Dietitian- design nutrition programs to protect health, prevent allergic reactions and alleviate the symptoms of many types of disease. Pharmacist- also known as dispensing chemists, are healthcare professionals who focus on the safe and effective use of medications. Pastoral Care Representative- is the provision the school makes to ensure the physical and emotional welfare of the older person Medicaid Representative- provides health coverage for some low-income people, families and children, pregnant women, the elderly, and people with disabilities.