NCM 114 FINALS PDF

NCM 114: FINALS Roles of a Gerontological Nurse Technicians, Nursing Students, A. Provider of Care and other Unlicensed assistive - Older adults often present with Personnel (UAP)...

NCM 114: FINALS Roles of a Gerontological Nurse Technicians, Nursing Students, A. Provider of Care and other Unlicensed assistive - Older adults often present with Personnel (UAP) atypical symptoms that D. Advocate complicate diagnosis and - As an advocate, the treatment. Thus, the nurse as a gerontological nurse acts on care provider should be behalf of older adults to educated about the common promote their best interests and disease processes seen in the strengthen their autonomy and older population. This includes decision making. Advocacy knowledge of the backgrounds may take many forms, including and statistics, risk factors, signs active involvement at helping to and symptoms, usual medical explain medical or nursing treatment, nursing care through procedures to family members evidence-based practice, and on a unit level. Whatever the rehabilitation if applicable situation, gerontological nurses B. Teacher remember that being an - An essential part of all nursing advocate does not mean making is teaching. Gerontological decision for older adults, but nurses focus their teaching on empowering them, helping them modifiable risk factors. Many remain independent diseases of aging can be E. Research Consumer prevented through lifestyle - This involves gerontological modification such as a healthy nurses being aware of current diet, smoking cessation, research literature, continuing to appropriate weight maintenance, read and put into practice the increased physical activity, and results of reliable and valid stress management studies. Using evidence-based C. Manager practice, gerontological nurses - Gerontological nurses act as can improve the quality of managers during everyday care patient care in all settings as they balance the concerns of the patient, family, nursing, and Geriatric Healthcare Team the rest of the interdisciplinary Geriatricians team. Nurse managers need to - Fully trained physicians, M.D.s or develop skills in staff D.O.s, who specialize in treating the coordination, time management, health problems of elderly patients assertiveness, communication, - To become a geriatrician, a doctor must and organization. Nurse first complete a three-year residency and managers may supervise other become board-certified in either internal nursing personnel including medicine or family medicine Licensed Practical Nurses (LPNs), Certified Nursing Gerontologists Assistants (CNAs), Nurse Percila | BSN 3E NCM 114: FINALS - Gerontology is the scientific study of - An allied health profession that involves aging, as well as its effect on individuals the therapeutic use of everyday and cultures. It's a multidisciplinary activities, or occupations, to treat the field, including aspects of medicine, physical, mental, developmental, and biology, psychology, sociology, and emotional ailments that impact a other sciences patient’s ability to perform daily tasks - Also designed to assist individuals with Gerontology Nurse valuable skills they can use to remain - Is a nursing specialist who works independent directly with older adults to provide - To provide some helpful insight into them with specialized care and a high how OT operates, consider the scenario quality of life of someone who has suffered from a stroke (What does an occupational Similarities therapist do?) - Gerontologists and geriatricians might - An article by the American work side-by-side in research or Occupational Therapy Association elder-care facilities. Each bringing (AOTA) demonstrated that stroke specialized knowledge and skills to the victims who receive regular OT are far plan of care more likely to regain their independence - Between the two professions is that and ability to perform everyday geriatricians are fully-trained physicians functions following treatment and provide direct treatment for - As mentioned in another AOTA article, age-related disorders many patients who participate in occupational therapy programs also Differences suffer from some degree of depression - Geriatricians, registered nurses, social - The therapist’s role is to facilitate the workers, psychologists and other reintegration process, and to help the caregivers can earn credentials in person get back to a healthy physical, gerontology through coursework and mental, and emotional state continuing education, broadening and - Family caregivers can play a vital role in deepening their skills in caring for the a loved one’s recovery by encouraging elderly parents who may be reluctant to join OT - Gerontologists, play a more supportive sessions because of misconceptions and educational role, though applied concerning its importance gerontologists might build long-term - One of the most important things you relationships with their clients that and your loved one can do before include coordinating diet, exercise and signing up for geriatric occupational cognitive therapies therapy is to have realistic expectations about how long a successful recovery Geriatric Occupational Therapy for Older will take Adults: Treatment Idea 5 Types of Occupational Therapy Activities Occupational Therapy (OT) for Older Adults Percila | BSN 3E NCM 114: FINALS 1. Relaxation Techniques: Tensing and with maximizing function, preventing releasing muscle groups decline, decreasing pain, and treatment 2. Physical Exercises: Range of movement, medicine ball training, and Responsibilities of a Physical Therapist squatting - Consulting with patients to learn about 3. Personal Activities: Personal care, their physical condition and symptoms dressing and undressing, and household - Diagnosing movement dysfunction and tasks therapeutics exercise techniques 4. Cognitive Exercises: Loud reading, - Providing stimulation or massage to dual task activity, and neurobic exercise promote healing 5. Recreational Activities: Playing indoor games, storytelling, and social events Circumstances where Physical Therapy can be valuable are those: Physical Therapists - Recovering from injuries such as a - Plays an important in the care of older broken hip adults who have physical disabilities - Osteoarthritis - Highly trained healthcare professionals, - Pain in all parts of the body such as with an expertise in movement and knee, back, shoulder, wrist, etc exercise. Physical therapy training - Diabetes includes assessment, exercise - Parkinson’s Disease prescription, and progression, all with - Alzheimer’s Disease appropriate monitoring. All these skills - Stroke can be utilized for older adults before - Vertigo injury happens - Incontinence - Treatment is individualized and goal - Multiple Sclerosis driven, with appropriate precautions - Cerebral Palsy being followed - And many other conditions - Gait training is an integral part of the treatment process for many older adults with disabilities, and various assistive Speech Therapist devices may be used to ensure safe - The goal of speech therapy for seniors is mobility to increase functional communication, - Goal of Physical Therapy is for seniors cognitive skills and teach safe to make daily tasks and activities easier, swallowing by introducing diet and to make seniors as independent as modifications and special feeding possible techniques - The first goal is to reduce pain and - Seniors may lose their ability to talk or swelling if there is any understand language a condition known - Then a PT will apply various techniques as aphasia) due to ailments like stroke, to increase flexibility, strength, Alzheimer’s disease, Parkinson’s disease coordination and balance or brain injury - Physical Therapy has an important role in health care delivery, and is connected Nursing Interdisciplinary Care Conference Team Percila | BSN 3E NCM 114: FINALS - An interdisciplinary approach involves - Because the elderly tend to withdraw team members from different disciplines from others, communication may not be working collaboratively, with a common as naturally prevalent in their lives as purpose, to set goals, make decisions necessary and share resources and responsibilities Solution: - Morning coffee and social groups Therapeutic Recreation: - Current event discussions - The skilled nursing facility must provide - Reading and writing groups an ongoing program directed by a - One to one visits qualified professional, of activities designed to meet the interests and the The form and function of communication physical, mental, and psychosocial vary with the basic personality types and age well-being of each resident characteristics of the persons involved Different personalities prefer to communicate in Communicating with the Elderly different ways, and therefore, different Key Points communication mediums should be offered. - Communication is the cohesive force in Introverts are imaginative, creative and sensitive every human culture and the dominant and tend to express their emotions more freely. influence in the personal life of every They prefer reading, writing, and listening to one of us others. Extroverts are more social and prefer the - The form and function of company of others. They choose objective communication vary with the basic subjects over abstract thoughts, and they prefer personality types and age characteristics to talk and be active of the persons involved - The mental facilities of the elderly change as a person ages, especially those that pertain to communication, Application in the Field like senses to memory - Both groups need and want communication, it's just a matter of how Communication is the cohesive force in every Solution: human culture and the dominant influence in - Reading Groups and Book Clubs the personal life of every one of us - Offers quiet reading and social The elderly tend to withdraw and disengage, but discussion this can be made better through interpersonal - Story Circle or Reminisce communication. Communication is therapeutic - Each resident has the and it gives people a kind of strength, linking opportunity to share a story or them to their environment and helping to memory, and others can simply regulate their own behaviors. It helps human listen and enjoy cope, it helps us maintain alertness, and it helps us establish relationships with people in our The mental facilities of the elderly change as lives a person ages, especially those that pertain to communication, like sense to memory Application in the Field Older adults change a lot as they age, both physically and mentally. They can lose their Percila | BSN 3E NCM 114: FINALS major sense, like sight, smell, hearing, and taste, - Though communication with family can and lose their ability to move affecting their be difficult, including them in activities sense of touch. Their mental abilities decline as and offering them support and education well, from memory recall abilities, to the can help retention of new memories. Because of this, they Solutions: need a lot of repetition and extra time to absorb - Family Education Events and learn new things - Invite family members to everyday activities Application in the Field - Family/Caregiver Appreciations Events - The loss of senses affects the way things - Facility Orientation so family feels must be presented to older adults, and comfortable in the environment the necessity of repetition and extra time to learn makes repeating instructions Physical changes in vocal patterns and often and offering learning groups hearing abilities can add stress to important communicating for an elder Solution: Aging not only affects articulation, but - Utilize subtitles on movies shown, use a phonation, pitch, and timing as well. Weak microphone when speaking to a group, speech muscles, dentures, and receding gums bring simple activities to those ed can change the way an older person speaks, bound, offer large print for books or causing them to lose acuity of diction and hymnals making them cut out certain sounds altogether. - Offer instruction groups often for things Voice tremors can become more pronounced, like technology or other hobbies stuttering can become an issue, and the speed - Repeat instructions for activities even if and rhythm of speech is affected. Presbycusis is it is offered frequently also a common problem for the aging, causing a large gap between what is being said and what is Family members and friends are an being heard important part of an older adult’s healthcare, but institutionalized care can make these Application in the Field relationships difficult - Simply because someone is losing the Disagreement is common between families of ability to speak clearly or hear well residents and staff, centering on the way to care should not exclude them from for the older adult. Family members can feel that socialization they can’t communicate suggestions or Solutions: complaints without affecting the care given to - Work with the family’s speech therapist their loved ones, and many relatives may feel - Include exercises to strengthen they are bothering staff or that they’ll appear speech muscles in daily stupid when they ask questions. They often don’t activities share enough information about their loved one - Writing groups and charades to allow the staff to care for them the best way - Allow emotions and thoughts to possible be expressed without the need for verbal communication Application in the Field - Subtitles on movies - Whiteboards, pictures, diagrams Percila | BSN 3E NCM 114: FINALS - Allows the hard of hearing to - Though incredibly important to participate in programs and well-being, developing relationships discussions through new interactions are intimidating and risky for older adults Perception is basic to interaction Solutions: Humans behave based on their perception of - Social/Interest Groups themselves and others. The Tennessee - Offer regular social activities as Self-Concept Scale includes 5 ways elderly view an opportunity for elders to themselves: physical self (physical attributes), connect with others with similar moral-ethical self (developed during earlier life), interests personal self (self-esteem, health), family self - New Resident Night/”Get to Know Me” (once head of house, now dependent), social self Events/Speed Friend-ing (speed dating (many become withdrawn). Elders with a health method to getting to know someone) self perception display healthier behaviors in - Encourage new interactions by everyday interactions getting introductions out of the way Application in the Field - The elderly can struggle with a positive Interviewing and Interacting Emphatically self image as they age Interviewing is important in the healthcare Solutions: industry to get pertinent information from - Beauty/Spa/Salon days residents. To do so effectively, conduct - Help elderly women feel interviews in a quiet and private environment, positively about their physical ask open-ended questions, encourage more appearance thorough answers, and use language familiar - Focus on positive elder achievements in with the interviewee. Display empathy- too movies and programs formal or professional and you won’t get the - Reminisce thorough information you’re looking for. Show - Remember times when they respect, be reflective and validating, and were in charge of the family welcome feedback - Social Groups/Interest Groups - Encourage interactions and Application in the Field friendships through frequent - Interviewing is an important skill to social interactions master in the care planning process Solutions: A close relationship is crucial to the “will to - Staff role-playing to practice proper live” interview techniques Though they tend to withdraw from many social - Frequent one-to-one visits prior to relationships as they age, the elderly are much interview to make sure both parties are happier with a confidante; they have a strong compatible with one another before need to confide emotions in another individual. asking important questions Research shows that friends are more important to psychological well-being than family Communication disorders constitute the nation’s number one handicapping disability Application in the Field Percila | BSN 3E NCM 114: FINALS Several age-related conditions can cause or keeping an eye on theirs. Slow down your contribute to poor communication. Natural speaking pace, using a nice, relaxed tone, and physiologic changes in hearing, sight, voice, and lower the tone of your voice, but don’t speech processing take place as a person gets necessarily raise your volume. Develop an older, even if they had no difficulty ability to rephrase, act out, and simplify what communicating before. Among these, declining you’re trying to express. Make sure you are in a hearing and sight may be the most obvious, such quiet and comfortable environment. A common as macular degeneration or presbycusis, but age-related barrier is hearing loss (presbycusis), changes in voice (tremor, pitch, rate of speech) affecting how well older adults hear what you’re and language impairment caused by cognitive saying and how you're saying it, and vision loss loss, dementia, illness, disease, or accidents (presbyopia) , affecting how they “hear” your causing brain damage, (such as stroke, cancer, or nonverbal communication-gestures, facial degenerative neurological diseases) as well as expressions, and body language, as well as conditions like aphasia, agnosia, apraxia or reading written messages and seeing signs and dysarthria may also cause major difficulties symbols. Possibly the most frustrating communication barrier occurs when the message Application in the Field is heard, understood, and simply ignored. - Illness and disease can cripple an older Attitude issues due to a poor relationship person’s ability to effectively between the two communications can cause this communicate Solutions: Application in the Field - Work with the facility’s speech therapist - As caregivers, we must do our best to - Include exercises to strengthen make the older adult feel comfortable speech muscles in daily and respected activities Solutions: - Writing groups and charades - Frequent one-to-one visits - Allow emotions and thoughts to - Group conversation activities, including be expressed without the need staff for verbal communication - Resident council meetings - One-to-One if group activities are - Offers a safe, comfortable uncomfortable environment for residents to voice concerns Communication is a two-way street, and you - Informal visits must be a good listener and recognize the - Residents often see staff only as challenges your speaker faces caregivers, but they want to see When communicating with the elderly, you must us as friends. Not very listen, pay attention, maintain eye contact, and interaction needs an official display an active posture. You have to find a purpose; sometimes, we can reason for listening (so you naturally show a real visit as a friend and simply sit interest in what they are saying), show respect and chat through maintaining personal space, and get on eye level with the person you’re speaking with. Conclusion: Be aware of your own non-verbal - Though several things can get in the communication and body language, as well as way of healthy, effective, natural Percila | BSN 3E NCM 114: FINALS communication, many things can be - Competency. Legal determination by a done to ensure that residents of a long judge as to mental disability or term care facility feel at home and get incapacity; whether a person is legally the interaction they need and desire. I, as fit and qualified to give testimony or a staff member of an Activity or execute legal documents Recreation Therapy Department, can - The law presumes that all adults are ease the struggles common in competent to make healthcare decisions communicating with the elderly and can - May fluctuate over time promote healthy interactions with the - Cognitive impairment can lead to residents i care for through thoughtful automatic incapacity programming and meaningful activities - No “gold standard” for capacity Ethical Issues on Care of Older Adult determination Ethics Terminologies: - Ethics: Declarations of right or wrong Verification of Decision-Making Capacity and what out to be - Required when a person is refusing or - Bioethics: Application of ethics to giving consent for treatment and/or matters of life and death executing an advance directive - Ethical Dilemma: A difficult problem, - Ability to voice a choice or seemingly incapable of a satisfactory preference solution; situation involving two equally - Adequate disclosure unsatisfactory alternatives - Understanding of information, - Nursing Ethics: Application of ethical recall information, manipulate principles in nursing practice information, appreciate situation - Voluntary consent Ethical Issues of Elder Age - Consistency - Decision-Making Capacity - Informed Consent Informed Consent - Refusal of Treatment - Can make a choice - Advance Directive - Understand and appreciate the issues - Major Ethical Principles - Rationally manipulate information - Psycho-Social Aspects of Aging - Make a stable and coherent decision - Age-related factors: Decision-Making Capacity - Hearing and visual impairments - Implies the ability to understand the - Impaired communication: nature and consequences of different written and verbal options, make a choice among those - Values and beliefs options, and communicate that choice - Fluctuating or diminished - Clinicians assess decision-making decision-making capacity capacity - Required to give informed consent Refusal of Treatment - May fluctuate over time from transient - The right to refuse treatment even if changes in ability to comprehend and refusal hastens or results in their death communicate - Requisite capacity must be determined: - Can make a choice Percila | BSN 3E NCM 114: FINALS - Understand and appreciate the This person can be a spouse, partner, issues parent, friend, or someone you trust to - Rationally manipulate make health decisions for you information - Make a stable and coherent decision Do Not Resuscitate - In the event of a cardiopulmonary arrest, Advance Directive cardiopulmonary resuscitation is - Patient Self-Determination Act (PSDA) administered to every patient unless a mandates: DNR order is written in the medical - Provide all adult patient with record by the physician written information concerning - When Advance Directives exist and care decisions qualifying conditions are present, these - Ask patients whether they have directives are followed by the physician an Advance Directive - The attending physician discusses the - Maintain policies regarding decision with the patient, family discussions of Advance members, or others involved in the care Directive of the patient - Honor Advance Directive - If the patient can not validly participate - Educate patients about Advance in the decision making, the physician Directive attempts to obtain consensual opinions - Conduct community education of all interested parties concerning what - Do not discriminate the patient’s wishes would be - Consent of the family is not necessary if Why is an Advance Directive important? the decision is made by the patient- - An Advance Directive is important family disagreement is not sufficient to when you’re badly hurt or have a serious override the patient’s choice illness that keeps you from making - The physician writes the DNR order on medical decisions for yourself. It tells the patient’s medical record by your doctor and other healthcare completing the “Resuscitative workers what type of care you would Treatment” like to have - When orders have been written to limit specific resuscitative treatments, the What is an Advance Directive? patient continues to receive full and - Two parts of an Advance Directive: consistent medical and nursing efforts in - Part 1: Living Will - A form that states all other aspects of healthcare the type of medical treatment you want management to receive as you near the end of your - If the patient is mentally incompetent, life and if you can no longer speak for decisions not covered by the advance yourself directives are reached by appropriate - Part 2: Health Care Power of surrogate decision makers as identified Attorney (POA) - Allows you to name by Arkansansas Law a person to make treatment decisions for you when you can't speak for yourself. Percila | BSN 3E NCM 114: FINALS - If conflict or dilemmas arise, the Ethics Committee assists in clarifying available Justice options and improving communications - Obligation to fair to all people - Nurses communicates DNR status during shift reports and verifies by Beneficence checking the medical record - Duty to act for the benefit of others - Place a “DNR” on the MedAct - Doing Good Theory - Nursing shift supervisor is notified of all patients with a DNR status Nonmaleficence - Place the purple DNR armband on the - Do no harm; protect patient from harm patient if they cannot protect themselves - The order to limit resuscitative - Patient abandonment (The desertion of treatments is subject to regular review an older person by an individual who and is amended or rescinded at any time has assumed responsibility for providing as deemed appropriate by the physician care and support for an individual, or by - When a DNR is written on the medical a person who has guardianship and record no resuscitative treatment is done administration responsibilities for an such as CPR or ACLS older person) - All other care is consistently delivered - Personal relationships with patient to all patients - Impaired practice - Limited resuscitative interventions are indicated on the “Resuscitative Team” Veracity order form - Honest and trustworthy in dealing with - DNR orders for those undergoing people anesthesia require complete explanation and set guidelines for the patient, family, Substituted Judgment Standard and staff prior to the scheduling of a - Surrogate decision-maker surgical procedure - Orders for DNR must be rewritten Best Interest Standard following surgery - Decision based on what healthcare providers and/or families decide is best Major Ethical Principles for that person - Autonomy - Justice Values and Codes of Ethics - Beneficence - Personal Values - Nonmaleficence - Professional Values - Veracity - Code of Ethics - Substituted Judgment Standard - Best Interest Standard The ICN Code of Ethics for Nurses is a guide for action based on social values and needs. It Autonomy will have meaning only as a living document if - Right to self-determination, applied to the realities of nursing and healthcare independence, and freedom in all settings in which nursing care is delivered Percila | BSN 3E NCM 114: FINALS To achieve its purpose the Code must be judgment when accepting and delegating understood, internalised and used by nurses in responsibility all aspects of their work. It must be available to students and nurses throughout their study and 2.4 Nurses value their own dignity, well-being work lives and health. To achieve this requires positive practice environment, characterised by Nurses can therefore: professional recognition, education, reflection, - Study the standards under each element support structures, adequate resourcing, sound of the Code management practices and occupational health - Personally reflect on what each standard and safety means. Think about ways to apply ethics to the personal domain of nursing 2.5 Nurses maintain standards of personal practice, education, research, conduct at all times. They reflect well on the management, leadership or policy profession and enhance its image and public development confidence. In their professional role, nurses - Discuss the Code with co-workers and recognise and maintain personal relationship others boundaries - Use a specific example from experience to identify ethical dilemmas and 2.6 Nurses share their knowledge and expertise standards of conduct as outlined in the and provide feedback, monitoring and Code. identify ways in which the Code supporting the professional development of guides in the resolution of dilemmas student nurses, novice nurses, colleagues and - Work in groups to clarify ethical other healthcare providers decision making and reach a consensus on standards of ethical conduct 2.7 Nurses are patient advocates, and they - Collaborate with the National Nurses maintain a practice culture that promotes ethical Association, co-workers, and others in behaviour and open dialogue the continuous application of ethical standards in nursing practice, education, 2.8 Nurses may conscientiously object to management, research and policy participating in particular procedures or nursing or health-related research but must facilitate Nurses and Practice respectful and timely action to ensure that 2.1 Nurses carry personal responsibility and people receive care appropriate to their accountability for ethical nursing practice, and individual needs for maintaining competence by engaging in continuous professional development and 2.9 Nurses maintain a person’s right to give and lifelong learning withdraw consent to access their personal, health and genetic information. They can protects the 2.2 Nurses maintain fitness to practice so as not use, privacy and confidentiality of genetic to compromise their ability to provide quality, information and human genome technologies safe care 2.10 Nurses take appropriate actions to 2.3 Nurses practice within the limits of their safeguard individuals, families, communities individual competence and regulated or and populations when their health is endangered authorised scope of practice and use professional Percila | BSN 3E NCM 114: FINALS by a coworker, any other person, policy, practice and relevant communities to engage in the or misuse of technology ethical creation, conduct and dissemination of peer reviewed and ethically responsible research 2.11 Nurses are active participants in the and practice development as they relate to promotion of patient safety. They promote patient care, nursing and health ethical conduct when error or near misses occur, speak up when patient safety is threatened, 3.6 Nurses engage in the creation, dissemination advocate for transparency, and work with others and application of research that improves to reduce the potential of errors outcomes for individuals, families and communities 2.12 Nurses are accountable for data integrity to support and facilitate ethical standards of care 3.7 Nurses prepare for and respond to emergencies, disasters, conflicts, epidemics, Nurses and Profession pandemics, social crises and conditions of scarce 3.1 Nurses assume the major leadership role in resources. The safety of those who receive care determining and implementing and services is a responsibility shared by evidence-informed, acceptable standards of individual nurses and the leaders of health clinical nursing practice, management, research systems and organizations. This involves and education assessing risks and developing, implementing and resourcing plans to mitigate these 3.2 Nurses and nursing scholars are active in expanding research-based, current professional ICN Code of Ethics for Nurses knowledge that supports evidence-informed Advocate practice - Actively supporting a right and good cause, supporting others in speaking for 3.3 Nurses are active in developing and themselves or speaking on behalf of sustaining a core of professional values others who cannot speak for themselves. Advocacy is ultimately carried through 3.4 Nurses, through their professional with consent from the person themself organizations, participate in creating a positive and constructive practice environment where Competence practice encompasses clinical care, education, - The integrated knowledge, skills, research, management and leadership. This judgment and attributes required of a includes environments which facilitate a nurse’s nurse to practice safely and ethically in a ability to practice to their optimal scope of designated role and setting practice and to deliver safe, effective and timely healthcare, in working conditions which are safe Confidentiality as well as socially and economically equitable - Confidentiality refers to the duty of the for nurses nurse to refrain from sharing patient information with third parties unrelated 3.5 Nurses contribute to positive and ethical to the patient’s care. Confidentiality is a organizational environments and challenge limited duty, sometimes it may be ethical practices and settings. Nurses collaborate overridden by law or regulation (ex: with nursing colleagues, other health disciplines mandate reporting of specific diseases) Percila | BSN 3E NCM 114: FINALS social, community or individual level. It Conscientious Objection also addresses broad social issues such - Refusing to participate in required as human rights, global cooperation, action, or seeking exemption from climate change, global pandemics, participation in classes of interventions social-structural disparities (ex: abortion, gender reassignment surgery, organ transplantation) that Evidence-Informed Practice threaten a person’s sense of moral - Evidence-Informed Practice (EIP) is a integrity. It also includes refusal to process for making informed clinical participate in an action or intervention decisions. Research evidence is perceived to be inappropriate for a integrated with clinical experience, specific patient or it ignores the patient’s patient values, preferences and wishes circumstances. (Woodbury & Kuhnke 2014) Co-workers - Nurses and other health and non-health Family related workers and professionals - A social unit composed of members connected through blood, kinship, Environmental Justice emotional or legal relationships - Environmental Justice seeks an equitable distribution of benefits (ex: Fitness to practice pure water, green spaces, clean air) and - Having the skills, knowledge, health and a safe and equitable distribution of character to do one’s job safely and burdens (ex: toxic waste disposal, nose, effectively (UK NMC 2021) factory air pollution). It includes sustainability, representative, Genetics participation, and the avoidance of - The stud of single genes, genetic environmental discrimination variation and heredity in organisms Genomics Equity - The study of the complete set of a - Equity is an aspect of social justice. It person’s genes, the genome, to find refers to an absence of systematic variations that affect health, drug disadvantages that result in health response, interactions among genes or disparities for particular segments of with the environment society. Equity is essential to the full recognition of human rights Human Rights - Human rights are inherent to all Ethics person’s, regardless of nationality, sex, - A branch of philosophy. Applied national or ethnic origin, colour, normative ethics is most commonly used religion, language, or any other status. in healthcare and professional ethics. It They range from the most helps to determine the “ought” at the fundamental-the right to life- to the Percila | BSN 3E NCM 114: FINALS rights of food, education, work, health, Personal Information healthy living conditions, and liberty - Information obtained during (Adapted from OHCHR n.d.) professional contact that is private to an individual or family, and which, when National Nurses Associations (NHAs) disclosed, may violate the right to - Any professional national nursing group privacy, cause inconvenience, that clarifies, researches, educates and embarrassment, or harm to the promotes the continued development of individual or family nurses and nursing Person-Centered Care Nurse - Valuing and respecting the - The nurse is a person who has characteristics, attributes and completed a programme of basic, preferences of the patient, such as generalized nursing education and is cultural and religious beliefs, and authorized by the appropriate regulatory incorporating them into the planning and authority to practice nursing in his/her implementation of nursing care, services country. Basic nursing education is a or programmes design formally recognized programme of study providing a broad and sound Professional Relationship foundation in the behavioural, life and - A professional relationship is an nursing sciences for the general practice ongoing interaction between two people of nursing, for a leadership role, and for that observes a set of established post-basic education for specialty or boundaries or limits that is deemed advanced nursing process. The nurse is appropriate under governing ethical prepared and authorized (1) to engage in standards the general scope of nursing practice, including the promotion of health, prevention of illness, and care of physically ill, mentally ill, and disabled Primary Health Care people of all ages and in all healthcare - Primary Health Care is a and other community settings; (2) to whole-of-society approach to health and carry out healthcare teaching; (3) to well-being centered on the needs and participate fully as a member of the preferences of individuals, families and healthcare team: (4) to supervise and communities. It addresses the broader train nursing and healthcare auxiliaries; determinants of health and focuses on and (5) to be involved in research (ICN the comprehensive and interrelated 1987) aspects of physical, mental and social health and well-being (WHO 2019) Nurse Manager - A nurse manager is responsible for the Privacy daily operations of a nursing unit and - Privacy is the right to freedom from supervising the nursing personnel in a intrusion into one’s personal matters, particular unit or department information, or one’s physical body Percila | BSN 3E NCM 114: FINALS Related Groups Social justice applies to all persons, - Other nurses, healthcare workers or whether citizen or non-citizen other professionals providing service to an individual, family or community and Social Media working toward desired goals - Social media is an umbrella term used to describe social interaction through Self-determination technology-based tools, many of which - The right to have one’s autonomous are online. This includes, but is not decisions respected. Self-determination limited to internet forums, blogs, and is not absolute. It may be limited by networking sites such as Facebook, cognitive or affective incapacity, age of Instagram, Twitter and LinkedIn majority, potential for harm to oneself or (Institute of Business Ethics 2019) others, or the infringement of the liberty of others Sustainable Development Goals - The Sustainable Development Goals are Self-reflection the blueprint to achieve a better and - The ability to evaluate one’s own more sustainable future for all people. thoughts, plans and actions in relation to They address the global challenges we ethical responsibilities and ethical face, including those related to poverty, guidelines inequality, climate change, environmental degradation, peace and Social Determinants of Health justice. The 17 goals are all - The conditions in which people are interconnected and, in order to leave no born, grow, live, work and age. These one behind, it is important that we circumstances are shaped by the achieve them all by 2030 (UN n.d.) distribution of money, power and resources at global, national and local Values levels. The social determinants of health - Values in nursing are those ends sought are mostly responsible for health by both the profession and in inequities, i.e. the unfair and avoidable nurse-patient relationships. These differences in health status seen within include, for example, health, dignity, and between countries (WHO 2020) respect, compassion, equity, inclusivity. Note that some values (ends) are also Social Justice obligations (actions) and attributes of - Achieving equity and equality for character (virtues) society and the profession (ICN Strategic Plan 2019-2023). Social justice Ethical Dilemmas Decision-Making Model is a form of fairness requiring an - Collect, analyze, and interpret the data impartial distribution of social goods - State the dilemma and benefits and an equally impartial - Consider the choices of action distribution of social burdens and - Analyze advantages and disadvantages affirms universal human rights. Social of each course of action inequities may exist only in order to - Make the decision benefit the least advantaged in society. Percila | BSN 3E NCM 114: FINALS - Evaluate the effectiveness of the Senior Citizens are entitled to the following: decision a. Discount Privileges b. Free Services Psycho-Social Aspects of Aging c. Exemptions - Fear of aging, change in roles d. Incentives - Retirement and perceived e. Government Financial Assistances non-productive sense of negative f. Priority in Express Lanes feelings - Common stressors of old age- normal Discount Privileges granted to Senior aging changes that impairs physical Citizens: functioning, activities and appearance, a. 20% discount on the purchase of certain disabilities due to chronic illness, social goods and services and environment losses related to loss of b. Special 5% discount on prime income and decreased ability to perform commodities and basic necessities precious roles and activities lack of c. 5% utility discount on electric and water social interaction consumption d. 50% discount on electric, water and Summary telephone consumption of senior - Concept of decision-specific capacity citizens centers and residential or group - Verification of decision-making capacity homes - Informed consent What transactions by Senior Citizens are - Refusal of treatment covered by the 20% discount and - Advance directives VAT-exemption? - Ethics, bioethics, ethical dilemmas, a. The purchase of medicines nursing ethics b. The professional fees of attending - Seven major ethical principles; physician decision-making model for ethical c. The professional fees of licensed dilemmas professional health workers providing home healthcare services Laws Affecting Senior Citizens/Older Person d. Medical and dental services, diagnostic and laboratory fees Republic Act No. 9994 (Expanded Senior e. Actual fare for land transportation travel Citizens Act of 2010) f. Actual transportation fare for domestic air transport services and sea shipping Who are considered as Senior Citizens? vessels - Any Filipino citizen who is a resident of g. The utilization of services in hotels and the Philippines, and who is 60 years old similar lodging establishments, or above restaurants and recreation centers - It may apply to senior citizens with h. Admission fees charged by theaters, “dual citizenship” status provided they cinema houses and concert halls, prove their Filipino citizenship and have circuses, carnivals, and other similar at least six months of residency in the places of culture, leisure and amusement Philippines i. Funeral and burial services for the death of senior citizens Percila | BSN 3E NCM 114: FINALS be considered as medicine or drug How can Senior Citizens avail of the Discount purchases subject to the 20% discount Privileges from Business Establishment? - The FDA came out guideline that - A senior citizen, or a duly authorized classified health supplement such as representative, must present an food and therefore are not covered by ORIGINAL and VALID senior citizens the senior citizen discount privilege identification card issued by the Office - Food supplements that are prescribed by of Senior Citizens Affairs (OSCA) in the doctors to senior citizens should also be city or municipality where he/she subject to a 20% discount since this will resides, with the necessary purchase provide full support to the improvement booklet for medicines, or the purchase of the total well-being of the elderly booklet for basic necessities/prime commodities, when applicable Government Assistance that will directly benefit Senior Citizens: Can Bedridden or Incapacitated Senior a. Monthly Social Pension of ₱500 to be Citizens avail of Discount Privileges through given to indigent senior citizens a Representative? b. Death Benefit Assistance of ₱2,000 to - Yes, but senior citizens can send their be given to the nearest surviving relative duly authorized representative to who cared for the deceased senior purchase their medicines and grocery citizen until his/her death items only. However, the representative c. Mandatory PhilHealth coverage must carry the senior citizen’s OSCA ID, the senior citizen’s purchase booklet, Indigent senior citizen refers to any elderly a document specifically authorizing the who is frail, sickly or with disability, and representative, and a doctor’s without pension or permanent source of income, prescription when necessary compensation or financial assistance from - However, discounted food purchases his/her relatives to support his/her basic needs, cannot be by proxy or through a as determined by the Department of Social representative owing to the limitation Welfare and Development (DSWD) in that it should be for the exclusive use consultation with the National Coordinating and and enjoyment, or “personal Monitoring Board consumption” of the senior citizen only - Based on the law, indigent senior citizens or those 60 years old and above Does the 20% discount apply to food are entitled to monthly pension, supplements prescribed by an attending however, due to limited government physician? resources only those 77 and above were - No, the 20% discount on drug and covered by the law up to 2014 medicine purchases does not extend to - A series of administrative orders issued food or food supplements, even if by the Department of Social Welfare and prescribed by a doctor for an elderly Development (DSWD) since 2010-2014 - Vitamins and minerals specifically prioritized only those who are 77 years prescribed by an attending physician for old and above an elderly for the prevention, treatment - In 2012, DSWD issued AO No, 4 or diagnosis of a disease or illness can classifying indigent seniors aged 76 and Percila | BSN 3E NCM 114: FINALS below as “potential social pensioners”. employment shall conform with the The releasing of the ₱500 pension is provisions of the Labor Code, as subject to “availability of funds” amended, and other laws, rules and - Senior citizens from remote areas can regulations” hardly avail of the pension - For SSS pensioner below 65 years old, - Starting April 2015, indigent senior re-employment means stoppage of citizens aged 65 and above will now pension receive the Social Pension - Only indigent senior citizens are HB-1449 mandatorily covered by the national - An act increasing the subsidy and health insurance program of PhilHealth benefits accorded to senior citizens of the Senior Citizens Act of 2010 and Penalties amending Sections 4 and 5 thereof for - For the first violation, a fine not less the that purpose ₱50,000 but not exceeding ₱100,000 - It includes grocery items which are not and imprisonment for not less than 2 covered by doctor’s prescription but are years but not more than 6 years necessary for the caregiving of the frail, - For any subsequent violation, a fine not bedridden and/or ailing senior citizen less than ₱100,000 but not exceeding such as but not limited to milk. Adult ₱200,000 and imprisonment for not less diapers, underpads, bed pans, alcohol, than 2 years but not more than 6 years cotton, tissue, wet wipes, and other - If the offender is an alien or a foreigner, similar items he/she shall be deported immediately after service of sentence without further HB-639 deportation proceedings - An act providing for free legal - Proper authorities may also cause the assistance for senior citizens, amending cancellation or revocation of the for the purpose Republic Act No. 7342, business permit, permit to operate, as amended by Republic Act No. 9994, franchise and other similar privileges otherwise known as “an act to maximize granted to any person, establishment or the contribution of senior citizens to business entity that fails to abide by the nation building, grant benefits and provisions of this Act special privileges and for other purpose” - If the offender is a - This bill recognizes the need of senior corporation/organization, the official/s citizens to be provided free legal directly involved shall be liable services Sec. 5 Par. (a) of RA 9994 provides HB-595 Government Assistance on Employment of - An act directing public hospital owned Senior Citizens: by the national government to grant free - “Senior citizens who have the capacity hospitalization to indigent and qualified and desire to work, or be re-employed, senior citizens shall be provided information and - This proposal provides free matching services to enable them to be hospitalization to qualified senior productive members of society. Terms of Percila | BSN 3E NCM 114: FINALS citizens who are 70 years old and above, decision-making on matters concerning provided, that they are indigents poverty alleviation National Policies on Older People Republic Act No. 10155 - “The General Appropriations Act of 2012” Republic Act No. 334 or the Accessibility Law - Under section 28 mandates that all of 1982 government agencies and - Provides for the minimum requirements instrumentalities should allocate 1% of and standard to make building, facilities, their total agency budget to programs and utilities for public use accessible to and projects for older persons and person with disability, including older persons with disabilities persons who are confined to wheelchairs and those who have difficulty in walking Presidential Proclamations and Executive or climbing stairs, among others Orders Republic Act No. 7876 - “An Act Establishing Presidential Proclamation No. 470, Series of a Senior Citizens Center in all Cities and 1994 Municipalities of the Philippines and - Declaring the first week of October of Appropriating Funds Therefore” every year as “Elderly Filipino Week” - Provides for the establishments of Senior Citizens Centers to cater to older Presidential Proclamation No. 1048, Series of person’s socialization and interaction 1999 needs as well as to serve as a venue for - Declaring a “Nationwide Observance in the conduct of other meaningful the Philippines of the International Year activities. The DSWD in coordination of Older Persons” with other government agencies, NGOs and people’s organizations shall provide Executive Order No. 105, Series of 2003 the necessary technical assistance in the - Approved and directed the form of social and recreational services, implementation of the program health and personal care services, providing for group homes and foster spiritual services, livelihood services homes for neglected, abandoned, and volunteer resources services abused, detached, and poor older persons and persons with disabilities Republic Act No. 8425 - “An Act Institutionalizing the Social Reform and DSWD Administrative Order No. 4, Series of Poverty Alleviation Program” 2010 - Provides for the institutionalization and - “Guidelines on the Home Care Support enhancement of the social reform Services for Senior Citizens”, agenda by creating the National establishing community based Anti-Poverty Commission (NAPC). healthcare service for older persons Through its multi-dimensional and cross-sectoral approach, NAPC provides Current Trends and Issues in the Care of a mechanism for older persons to Elderly participate in policy formulation and Percila | BSN 3E NCM 114: FINALS Home Care: Living in their own homes - Have structured activities and older - The care provided should be people are given time to socialize with person-centered. Catering to the unique others needs of older adults might be difficult - “You matter because of who you are. however, we must remember that they You matter to the last moment of your need our help. Dignity is important, life, and we will do all we can, not only especially to them so make it a point to to help you die peacefully but, but also understand them and be a confidant to live until you die” (Dame Cicely, - Report all forms of abuse accordingly as Founder of the First Modern Hospice) older adults may be quick-tempered. One way to help them open is to explore Hospice Care ways to understand communication - Coordination Care. inpatient facility, disabilities as they are having a hard doctors, nurses, pharmacists, clergy and time and remember that old people funeral directors. Basically, team of desire a good quality of life healthcare professionals - Respite Care. To provide short term Advantage of Home Care Services for relief for primary caregivers. This can Families be arranged for just an afternoon, - Home health care is a beneficial several days or weeks so that the direct choice for many families. Always caregiver can also rest remember that older adults want to be - Bereavement Care. Bereavement is the with family time of mourning after a loss. The - Personalized care. It will cater to their hospice care team works with surviving unique needs. The treatment will be loved ones, help them through the focused on the patient grieving process - Faster recovery. Older adults recover faster in the presence of family members Drop in/Day Care Centers - Comfort. Older adults need comfort - Some day care centers offer limited from family members as it can be lonely medical and alternative health such as at their age music, art therapy, support group and - Peace of mind. The family will not counseling, nursing care is also worry about their older adult family as provided, with that in day care centers, they can see the care that is being given caregiver drop in their elderly relatives in their own home. They will feel secure and pick them up at the end of the day that their relative is being cared of - Family involvement. The family will be there every step of the way regarding their older adult’s care. They will have Cost of Care updates on the status and can participate Type of Senior Care Average Monthly in giving care Cost Hospice Facilities Skilled Nursing Care $7,441 to $8,365 Assisted Living $4,000 Percila | BSN 3E NCM 114: FINALS nutrition to depression and increase the In-home Care $4,004 to $4,195 risk of dementia Adult Day Care $1,560 - Additional access to crucial services. It makes it easier for older adults to take What Services and Amenities are provided in care of their health issues an Adult Day Care? - Music or art therapy Retirement Living/Home/Village - Support group or counseling - In retirement, always remember that - Nursing care staying at home as you age has an - Physical, occupational and speech advantage of keeping you in a familiar therapies place when you know your neighbors - Dental care and the community. You can take - Vision and hearing care advantage of sometimes a home care - Foot care services to make modification or repairs to make your life easier and safer Drop in/Day Care Centers Benefits - Respite from caregiving. Help relieve In the Philippines, sometimes it is really a stress, exhaustion, anxiety related to reality that we must question do we have: caregiving. Not only will you get to take - Better housing? Can an old individual a break from caregiving, you can have in such housing live comfortably? predictable hours where you can work, - Better hygiene? Is it very risky? attend to your personal needs or run (pertaining to dirty toilets, showers, etc) errands - Better water source? How safe is the - Remedy for boredom. One of the chief water for the elderly? benefits for older day care is that it will allow them to participate in stimulating 3 Elements of Successful Aging activity and stretch their wings. The brain likes change and outside programs Self-acceptance In the sense that whatever disabilities offer an option for families and loved this older individual ones must also be considered has, they need to - An antidote to loneliness. Second accept as this is a reason that day care may bring a smile normal process of to your loved ones face is the aging opportunity to interact with others. Positive relationship There must be a Seniors who seldom see anyone outside with others positive relationship of their family often feel loneliness, a with others. Mingling condition associated with depression with friends, families, - Cure for aimlessness. Retirement can neighbors, etc be a curse for elderly adults who no longer have concrete reason to leave the Personal growth They also read magazines, house. As days bleed together it is easy newspapers, attend for older adults to fall into rot which seminars, etc may lead to everything from poor Percila | BSN 3E NCM 114: FINALS Social Assessment several days - Clock We need to assess if they can still socialize, drawing. because if not, it is do detrimental to their Person draws health numbers and arms pointed Cognitive Assessment at a specific time on the Mini Mental State A brief 30-point paper clock Examination questionnaire test that Despite that, (Folstein Test) is used to screen for Mini-Cog is cognitive impairment. extremely accurate at It is commonly used predicting whether in medicine to screen someone has for dementia. In dementia about 10 minutes, sample’s functions including arithmetic, Advocacy Programs Relevant to the care of memory and Older Persons and Mental Health orientation - Effective What is advocacy in aged care? normal. Any - An advocate is an impartial person who score greater than or equal can help you understand and stand up to 25 for your rights in the aged care system - Severe - Nurse advocates support the patient’s cognitive best interests while respecting the impairment. family’s important role Below or - We must give assistance and support, equal to 9 points making sure that they have a say in - Moderate decision-making which may affect the cognitive management of the healthcare, impairment. providing them options to have 10-20 points patient-care needs where it can be met - Mild and helping one’s complaints and cognitive concerns impairment. 20-24 points - The best way to serve the patients is to have that sincerity and compassion in Mini-Cog A rapid screening test dealing with elderly clients for Alzheimer’s disease that takes 6 Ways Nurses can Advocate for Patients only 3-5 minutes to 1. Ensure Safety administer. This test measures only two: a. One of the nurses primary - Short term responsibilities recall. b. Ensure that the patient is safe Recalls 30 when being treated in the seconds to healthcare facility and by the Percila | BSN 3E NCM 114: FINALS time they are discharged by a. Double cheek so they can catch, communicating with public stop and be able to fix errors, health nurses or social worker flag conflicting who will continues in delivering orders/information or some continuity of care so it can be oversights by physicians and arranged before they go home other caring for the patient 2. Give Elderly a Voice 6. Connects Elderly to Resources a. Take note that they are a. There are times when our client vulnerable, especially when needs they are sick collaboration/coordination b. Must be present when the doctor outside, particularly when they explains their diagnosis and are already due for discharge treatment options for us to help b. Important to assist them in them ask questions, give looking on where to go in feedback, and translate finding some support or information from medical resources inside or outside jargons c. Nurses are the best resource of c. Sometimes, because of their the community so one must be condition, they can’t aware of the sources that we can comprehend right away so the recommend like financial nurse acts as a communicator support, manpower, 3. Educate transportation needs, etc a. It is important to give health education to the elderly Hence, elderly need to be advocated because particularly how to manage their they also have rights and many older people current chronic condition to need the support of an advocate to get the improve the quality of their services they need and have their rights everyday life respected b. Example: Nurses can teach how Support Services for Older Adults to take their prescribed - Institutional living arrangements. medication in a way it will be Such facilities are not well-developed most effective for them and will here in the Philippines. Hence, the allow them to feel better during concept of home for the aged which is treatments commonly used in Wester country is 4. Protect Seniors Rights very used in the Philippines a. Protecting the rights by - A few geriatric-care homes cater to knowing their wishes. It older people. Statistics from DSWD in includes communicating those 2019 shows that around 33 homes for difficult family members who the aged- 4 are government- owned might disagree with the patient’s facilities and 29 are accredited choices and could upset the non-governmental organization or patient private social welfare agencies 5. Double Check for Errors - There are also under the barangay or local government units who manages a Percila | BSN 3E NCM 114: FINALS temporary shelter which is attached to decline of complications, and achieving DSWD highest possible quality of life - Despite the disproportionate ratio of - Sarcopenia - Age-related loss of muscle homes for the aged and the number of mass older Filipinos, this is not yet a major problem since the family continues to be The prevalence of disability among the primary provider of support for its older adults is increasing as greater numbers of member as it is one of our practices as a people survive on fatal conditions that leave closely-tied family them with residual disabilities. Some will need - There is a stigma attached to the rehabilitation, which involves therapies institutionalization of older patients in developed by physicians and therapists focused home-care facilities as intergenerational on returning individuals to their previous level family solidarity remains strong and of functions. Restorative care falls within the co-residents with family members is still scope of nursing and can be provided in any the most common living arrangement in setting the Philippines Disability can have an impact on every facet of a person’s life. The nurse’s role is to Rehabilitative and Restorative Care provide support by educating patients, providing Terminologies: assistance with exercises, providing and guiding - Activities of Daily Living (ADLs) - patients in therapeutic activities, and assuring Activities such as toileting, feeding, patients properly with the use of equipment dressing, grooming, bathing, and ambulating Rehabilitative and Restorative Care - Assistive Technology - Technological - Rehabilitative Care involves therapies tools that enable a person to maximize developed by physicians and therapists independence focused on returning individuals to their - Disability - Inability to perform previous level of function. Usually the activities normally need for rehabilitative services after a - Frailty - Condition in which a person problem has occurred that affected has poor endurance and weakness function, such as stroke, fracture, or - Handicap - Limitation to fulfill a role prolonged state of immobility - Instrumental Activities of Daily - Skilled rehabilitative care involves Living (IADLs) - Tasks required for services offered by physical, community living such as shopping, occupational, and speech therapists meal preparation, laundry, - Many of the effects of aging and housekeeping, use of telephone, money disabilities cannot be eliminated or management, medication management significantly improved. Damaged lungs, - Rehabilitative Care - Therapies amputations, cannot be eliminated or developed by physicians and therapists significantly improved. For these focus on returning individuals to their individuals, restorative care is beneficial previous level of function - Restorative Care is primarily offered - Restorative Care - Care that assists by nursing staff and does not require a people in maintaining or improving medical order. It can occur in any setting current level of function, avoiding, and includes efforts to help individuals: Percila | BSN 3E NCM 114: FINALS - Maintain their current level of function - Improve their functional ability - Prevent decline and complications - Promote the highest possible quality of life Frailty - It describes a clinical state in which the person has poor endurance, fatigue, low activity level, reduced speed in ambulation , weak grip strength, and increased risk for adverse outcomes Living with Disability (Buchink et al., 2015) - An accident or stroke may bring sudden - Some of the frailty is the result of disability to a previously independent, sarcopenia- age related changes to the functional adult, or perhaps a chronic skeletal muscle tissue condition progressively worsens and its - The following factors can contribute disabling impact is more acutely to sarcopenia: realized - Immobility and lack of exercise - Relationships, roles, and responsibilities - Poor blood flow to the muscles are disrupted; disfigurement and - Increased levels of dysfunction alter body image and proinflammatory cytokines self-concept. Losses and limitations - Increased production of oxygen cause a new vulnerability to emerge and free radicals or impaired make death seem more real and close detoxification - Disability can be an extremely difficult - A decline in anabolic hormones and devastating mountain to climb - Malnutrition - Reduced neurological drive Importance of Attitude and Coping Capacity - Older adults who are frail are at high - The severity of the disability can be less risk for falls, disability, hospitalization, important to rehabilitation efforts that nursing home admission, and death. attitude and coping capacity of disabled Early recognition and intervention for patients and their families symptoms of frailty (e.g., correcting - Previous attitudes, personality, and weight loss and assisting with lifestyle have a strong influence on muscles-strengthening exercises) can reactions to disability. Individuals who prevent or delay some of the frailty relish independence and refuse to let older adults experience illness slow their lifestyles will respond to disability differently from those who Terminology Used to Describe Functional use real or exaggerated ills for other Status gains Percila | BSN 3E NCM 114: FINALS - The family’s response to the disabled The following guidelines should be person will also influence that person’s remembered in rehabilitative and restorative reactions nursing: - Previous attitudes, personality, - Know the unique capacities and experiences, and lifestyle influence limitations of the individual reaction to a disability - Emphasize function rather dysfunction and capabilities rather than disabilities Losses Accompanying Disability - Provide time and flexibility - Many losses may accompany disability, - Recognize and praise accomplishments such as the loss of function, role, - Do not equate physical disability with income, status, independence, or mental disability perhaps a body part. Disabled persons - Prevent complications mourn these losses, often demonstrating - Demonstrate hope, optimism, and a the same reactions experienced during sense of humor the stages of dying - Keep in mind that rehabilitations is a - They may deny their disabilities by highly individualized process, requiring making unrealistic plans and not a multidisciplinary team effort for complying with their care plans. On one optimal results day they may optimistically state that their disability has give them a new Functional Assessment perspective in life, yet the very next day - When a person suffers from a disability, they tearfully question wh