Gerontological Nursing - Objective 1 2023 PDF

G E RO N T O L O G I C A L NURSING Instr uctor : Megan Steele BNRN Objective 1: Ag ing Trends & Societal Views on Ag ing Discuss aging trends and societal views on aging. Discuss factors that influence caring for older adults. Discuss factors that influence health and wellness of older adults. Dis...

G E RO N T O L O G I C A L NURSING Instr uctor : Megan Steele BNRN Objective 1: Ag ing Trends & Societal Views on Ag ing Discuss aging trends and societal views on aging. Discuss factors that influence caring for older adults. Discuss factors that influence health and wellness of older adults. Discuss common age-related changes. Discuss health promotion, health maintenance and associated health challenges experienced by older adults. Discuss common chronic illnesses and chronic illness management. COURSE OBJECTIVES Discuss the nursing considerations associated with safe medication administration in older adults. Discuss the concept of pain as it affects older adults. Discuss cognitive impairment and associated disorders. Discuss sensory age-related changes and conditions affecting older adults. Discuss mobility challenges and environmental safety affecting older adults. Discuss the nature of relationships, transitions and intimacy in older adults. Discuss abuse and neglect pertaining to the older population. Discuss end-of-life care. C O U R S E E VA L U AT I O N Assessment Term Test 1 Term Test 2 Group Activity Reflective Essay Final Exam Total Date of Evaluation September 27th October 25th November 8th November 8th November 28th Weighting 20% 20% 15% 5% 40% 100% Students must receive an overall grade of 65% to pass A G I N G T R E N D S & S O C I E TA L V I E W S O N AG I N G Objective #1 Required Readings: Ch 1 (p. 1-4), Ch 3 (p.24 – 26) G E RO N T O L O G Y The holistic approach to care for older adults encompassing all dimensions of a person Why study gerontology as a separate course? Geriatrics Nursing Vs. Gerontological Nursing • Illness/Problem focused vs. holistic focus AGING Aging beings when you are born Meaning of ‘aging’ is influenced by many factors including culture, society, history, and gender • Example: Eastern cultures valued older adults for their wisdom • Not always the case for Western cultures Historically, aging was viewed as a ‘disease’ DEFINING AGE Chronological Age: Age in years • • • • Young Old: 65-74 years Middle Old: 75-84 yeats Old Old: 85+ years Centenarians: Those 100 years & older Developmental Age: Age according to maturation level – determined by assessing whether or not an individual is at the appropriate developmental stage for their age CANADIAN DEMOGRAPHICS • Percentage of Canadians 65 & older 2006: 13.2% 2031: 23.4% • Percentage of Newfoundlanders 65 & older 2006: 12.1% 2031: 29.5% • This increase has many implications for health care services • In 2016, for the first time ever seniors out numbered children (5.9 million vs. 5.8 million 14 and under) S O C I E TA L FAC T O R S T H AT I N F L U E N C E AGING • Aging in Canada Gender Considerations Diversity Economics/Financial status Health Services • Global Aging Number of older adults is expected to double in 2050 Life expectancy dramatically increased Global fertility decreased substantially Ratio of older to younger people is increasing More developed countries have older populations Ex: Over 25% of people in Japan over 60 years of age. Africa has a fairly young population – 9% population 60+ in 2050. MYTHS R E L AT E D T O AGING • http://faculty.webster.edu/woolflm/myth .html • https://www.youtube.com/watch?v=SY_ axJ-yvHE • Do any of these surprise you? MYTHS OF AGING  Depression  Getting  Older  Old  All is a normal part of aging older inevitably leads to weakness, frailty and dependency adults should limit physical activity age means the end of sex older adults lose their teeth McMaster University, 2020https://www.mcmasteroptimalaging.org/blog/detail/hitting the-headlines/2017/02/17/5-aging-myths-debunked AGEISM • Stereotyping and discriminating against people because they are ‘old’ • A way of thinking that contributes to a prejudice in society against older adults • Often stems from a lack of or limited knowledge about the older population • Can you think of any examples of ageism that you have noticed? • What impact do you feel ageism has on the delivery of health care? • https://www.youtube.com/watch?v=lY dNjrUs4NM This Photo by Unknown Author is licensed under CC BY-ND AG E I S M & C O M M U N I C AT I O N Elderspeak: Form of ageism in which younger people alter their speech based on the assumption that older adults have difficulty understanding and comprehending • • • • • Speaking slowly or loudly or both Using a singsong voice Using the pronouns “we,” “us,” and “our” in place of “you” Using pet names such as “honey,” “dearie,” or “sweetheart” Answering questions for the older person (e.g., “You would like your dinner now, wouldn't you?”) Nurses may not even know they are using elderspeak. Therefore, it is important to be aware. C O M M U N I C AT I N G : O L D E R A D U LT S Avoid Elderspeak Listen Be present & respectful Consider cultural differences Do no rush/be patient Be aware of non verbal cues Avoid speaking to the family instead of the person Ensure a nonjudgemental attitude Positioning at eye level Recall of the past, life review Helps one remember their past, reframe their life, and extract meaning from it Useful in assessment, tells us a great deal about a person VA L U E O F REMINISCENCE Important to help fulfill Erikson’s Developmental task ‘Ego Integrity vs. Despair’ Once seen as a sign of senility, now realized to be an important psychological task Pleasurable experience that can comfort and improve quality of life, socialization, and cognitive stimulation • Box 3.11: Therapeutic Implications of Reminiscence • Box 3.12: Suggestions for Encouraging Reminiscence C U LT U R E , E T H N I C I T Y & A G I N G Attention to culture and health care is increasing • Gerontological Explosion – rapid increases in total number of older persons and immigration • Impact of Canadian policies of multiculturalism • Recognition of health disparities for members of ethnocultural minorities Canada is a multicultural society • Over 6 million are visible minorities, and 1.4 million are indigenous people • Approx.. 1/3 Canadian over 65 years old are immigrants Nurses are required to provide culturally competent care. This is especially important in gerontological nursing, because many older persons are immigrants to Canada. • C U LT U R E & AGING: ISSUES Health disparities exist in Canada Example: Indigenous people have higher rates of chronic illness, disability, death by injury, lower life expectancy, etc. Box 4.1: Residential school system • Socio-economic challenges for immigrants presenting barriers to accessing health care • Language barriers • Culture affects views on aging, health beliefs, roles in families, and communities C U LT U R A L LY C O M P E T E N T C A R E • Involves cultural awareness, knowledge, and skills • Cultural Awareness: Need for openness and self reflection. Being aware of ‘isms’. Nurses should pause and self reflect on their own personal biases/beliefs and how that may affect their care for each patient • Cultural Knowledge: Knowledge of different cultures (beliefs, ways of thinking, practices, etc). Caution not to stereotype • Cultural Skills: Ability to work with patient instead of on patient. Considering implications when communicating and providing care Working with interpreters: Box 4.13