Introduction to Geriatric Nursing.pdf

GERIATRIC NURSING GERONTOLOGICAL NURSING Course Objectives On successful completion of this course students will be able to: Understand the social changes and requirements posed by an aging society Identify current changes in the elderly population and the impact on health care delivery, health care...

GERIATRIC NURSING GERONTOLOGICAL NURSING Course Objectives On successful completion of this course students will be able to: Understand the social changes and requirements posed by an aging society Identify current changes in the elderly population and the impact on health care delivery, health care policy and health care utilization. Describe the concepts related to geriatric nursing Describe the physical, psychological, social changes and problems of the elderly Identify physical, psychological, and social factors influencing the health of the elderly Make a comprehensive geriatric assessment Know health-promoting activities for elderly people Discuss health services for the elderly Discuss the roles and responsibilities of geriatric nursing service in all areas of health care services Critically discuss the nursing care needs of elderly people Geriatric nursing- Focus of the course  Demographic changes in the population and population aging  Health and well-being of older adults  Theories of aging  Impact of aging on body systems, the biological, physical, cognitive and psychological changes associated with aging  Physical, psychological, social factors influencing the health of elderly,  Evaluation of functional performance  Health promotion and wellness community health services for the elderly INTRODUCTION In the world, individuals aged 65 years or older are an important and growing segment of the population. Life expectancy is increasing; thus, larger numbers of people are reaching 65 years of age and older. There’s a need of Gerontology Nurses/Geriatric nurses. Gerontology is the scientific study of individuals in later maturity and the aging processes from physiologic, pathological, psychologic, sociologic, and economic points of view. It includes: oThe study of physical, mental, and social changes in older people as they age. o The investigation of the changes in society resulting from our aging population. o The application of this knowledge to policies and programs o Geriatrics- is a medical specialty concerned with physiologic, and pathologic changes of the individuals in later maturity and includes study and treatment of the health problems of this age group. Age-related changes, illnesses/ diseases that increase in prevalence with age are the subject of study. Geriatrics- The study of health and disease in later life; and the comprehensive health care of older persons and the well-being of their informal caregiver. Gerontological nursing Gerontological nurses work in collaboration with older adults, their families, and communities to support healthy aging, maximum functioning, and quality of life. Gerontological nursing, which replaced the term geriatric nursing in the 1970s, is seen as being more consistent with the specialty's broader focus on health and wellness, in addition to illness T ouhy, Theris A.; Jett, Kathleen F. (2014). Eliopoulos, Charlotte (2014). Gerontological nursing is important to meet the health needs of an aging population. Due to longer life expectancy and declining fertility rates, the proportion of the population that is considered old is increasing. Between 2000 and 2050, the number of people in the world who are over age 60 is predicted to increase from 605 million to 2 billion. The proportion of older adults is already high and continuing to increase in more developed countries. In 2010, seniors (aged 65 and older) made up 13% and 23% of the populations of the US and Japan, respectively. By 2050, these proportions will increase to 21% and 36%. Gerontological nursing Gerontology nursing is a unique field in nursing that requires nurses to focus their care on the older population. This population tends to have more comorbidities such as high blood pressure, diabetes, heart conditions, etc. This field requires complex and individualized care to fulfill their needs. Nurses use evidence-based practice in their care to educate and promote well-being in the gerontological population. Geriatric nursing Geriatric nurses are expected to be skilled in patient care, treatment planning, education, mental health, and rehabilitation. They also take on many roles in the workplace. The main responsibility is as a caregiver. They can also be advocates, counselors, and educators for their patients. Gerontology vs Geriatrics The terms Gerontology and Geriatrics are often used interchangeably, but there are differences between the two. Gerontology is the study of the social, cultural, psychological, cognitive, and biological aspects of aging. Geriatrics, or geriatric medicine, is a specialty that focuses on the health care of elderly people. Gerontological Nurses need to know how to care for illnesses that affect aging, the other factors that affect aging, and how these impact people. Gerontological nurses work in a variety of settings including Acute hospitals, Long-term care homes and skilled nursing facilities (rehabilitation, nursing homes), Assisted living facilities, retirement homes, community health and home care agencies, The conditions of the geriatric patient's health determine what type of facility one should reside in. Gerontological nurse A gerontological nurse is a nurse who works predominantly with older people, providing nursing care, as a full member of the multidisciplinary health and social care team, in a variety of settings where older people are cared for. Gerontological nurse The gerontological nurse will have successfully completed specialist post-qualification education in gerontological nursing which builds upon initial generalist nursing education. Gerontologic/Gerontic Nursing Field of nursing that specializes in the care of the elderly Emphasis of care is focused promoting, maintaining, & restoring health & independence Aging oAging – defined as a universal, internally predictable biologic process following maturity. o It is characterized by changes accumulated over time that increase disease susceptibility and ultimately lead to death. CONCEPT OF AGING The older adult population is a heterogeneous group. The young-old (aged 65 to 74 years), The middle-old (aged 75 to 84 years), The old-old (aged 85 to 99 years), and The elite-old (more than 100 years old) are four distinct cohort groups CONCEPT OF AGING Aging is a natural process that affects all living organisms. The concept of aging is most often defined chronologically. Chronological age refers to the number of years a person has lived. Life Span Maximum number of years a person can live under the best conditions in the absence of disease Life Expectancy – average number of years that a person can be expected to live. Population Aging Demographic changes Worldwide, demography is changing In virtually every country there is a steady increase in the proportion of elderly people in the population. Advanced technology Availability of new drugs enables older people who become ill to receive treatment, Rehabilitation regimes that were not possible even two or three decades ago. Worldwide, demography is changing Healthcare reforms have had to take into account the resourcing of services to meet the healthcare needs of the increasing number of older people who require hospital and community care and support. The new specialty of gerontology, The study of old age, the process of aging, and of older people’s special needs, has emerged and become a recognized sphere of specialist knowledge and practice. Population aging is increasing worldwide, unlike any time in history. Your professional role will be affected by these demographics. Population aging Older people (often, people aged 65+) are a greater percentage of the population The average age of the population gets older The ratio of older people to younger people increases The population in most /some of the world regions, is living longer and in better health. Since 1960, life expectancy has climbed by eight years, and demographic projections foresee a further five-year increase over the next forty years. This is an historic achievement. There is an increase in the number of people over 60 years and a decline in people under 15 years. Decline in fertilty rates Increasing life span Decreasing mortality Why do populations change? Three basic processes affect who is counted as a member of a group – Fertility People being born – Migration People moving from place to place – Mortality People dying Demographic Transition Model The DTM describes a sequence of changes in the relationships between birth and death rates. It suggests that the population growth rates for all countries can be divided into 4 stages. Stage 1 Birth Rate - Very High Death Rate - Very High Natural Increase - Population Steady Stage 2 Birth Rate - Very High Death Rate - Falling Rapidly Natural Increase - Very Rapid Increase Reasons for change in death rate Improvements in medical care Water Supply and sanitation Fewer children die. Reasons for changes in birth rate: Children needed for farming They die at an early age due to illnesses No family planning and religious and social encouragement. (same as stage 1 Stage 3 Stage 3 Birth Rate: Falling rapidly Death Rate: Falling more slowly Natural Increase: Rapid increase Reasons for change in death rate Improvements in medical care Water Supply and sanitation Fewer children die Reasons for changes in birth rate: Improved medical care and diet Fewer children are needed Stage 4 Stage 4 Birth Rate: Falling more slowly Death rate: Slight fall Natural Increase: Very slow increase Reasons for change in death rate Good health care Reliable food supply People are living much longer Reasons for changes in birth rate: Family planning Good health Later marriages Improving status of women Stage 5 Birth Rate: Slight fall Death Rate: Stable Natural Increase: Gentle decrease Which process do you think usually drives population aging? United States, 1950 United States, 2000 United States, 2050 India, 2000 India, 2025 India, 2050 Russia, 2000 Russia, 2050 Global Aging: Top 10 Oldest Countries which begins at conception and ends at death..... is process of growing older Biological age Social age Psychological age Cognitive age Fonctional age Biological age «begins at conception and ends at death»... is a person’s present position with respect to the potential life span, which may be younger or older than chronologic age, and encompaseses measures of functional capacities of vital organs/systems Social age which results from the person’s life course through various social institutions, refers to the role and habits of the person with respect to other members of society.  Social age may be age-apprpriate or older or younger than that of most people in the social group.  Social age includes such aspects as the person’s type of dress, language usage, social differences to people in leadership positions Psychologicial age refers to behavioral capacity of the person to adapt to changing environmental demands and includes capacities of memory, intelligence, learning, skills, feelings and motivation for exercising behavioral control or self regulation. «begins at conception and ends at death» Cognitive age includes the age the person feels and looks to self and interests in her or his chronologic age «I do most things as if I were..... years old.» Functional age Refers to how well a person functions in a physical and social environment in comparison with others of the same chronologic age The 90-year-old may be functionally younger than the 65-year-old, related to health status. Primary aging- refers to the universal changes that occur with getting older or senescence Secondary aging- refers to consequences of particular diseases, but these health changes maynot be coused by age alone. Senescence Senescence- is the mental and physical decline associated with the aging process. The term describes a group of effects that lead to a decrease in inefficient function. Touhy, Theris A.; Jett, Kathleen F. (2014). Ebersole and Hess' gerontological nursing & healthy aging (4th ed.). St. Louis, Mo.: Elsevier/Mosby. Eliopoulos, Charlotte (2014). Gerontological nursing(8th ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. Canadian Gerontological Nursing Association. "CNGA 2014 Bylaw". Canadian Gerontological Nursing Association. "Gerontological Nursing Competencies and Standards of Practice 2010" (PDF). Canadian Gerontological Nursing Association. CGNA.