NURS 3540 Gerontological Nursing Module 2 Active Learning Guide PDF
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Harding University
Sean Whitfield
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This document is an active learning guide for a gerontological nursing course. It covers biological and psychosocial theories of aging, examining culture from a nursing perspective and provides cultural assessment tools.
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NURS 3540 – Gerontological Nursing Module 2 Active Learning Guide Module 2 Active Learning Guide Chapter 3 & 4 Purpose/Overview Active learning guides help students to focus their study time by using knowledge-level information, then focusing on application and analysis of information to provide con...
NURS 3540 – Gerontological Nursing Module 2 Active Learning Guide Module 2 Active Learning Guide Chapter 3 & 4 Purpose/Overview Active learning guides help students to focus their study time by using knowledge-level information, then focusing on application and analysis of information to provide context in relation to the course and career skills. Students should review the active learning guide before beginning to engage with the module content, then work to complete the guide during and after to engage with the content. An active learning guide is not the same as a study guide or a test blueprint. It serves as a guide to help the student navigate the course and content. Instructions Review the active learning guide before you begin reading and engaging with other content in the module. Looking at the questions beforehand will give you a preview of the information you will be learning, including the key concepts and takeaways. As you work through the module content, complete the active learning guide. Some questions may be reflective and require that you finish all content prior to responding. The completed learning guide will be turned in one week before the exam. There are a possible 5 points for this learning guide. Reading Focus Areas In the text, you will see essential boxes, such as Safety Alerts which discuss issues related to care of older adults. Research Highlights which contain a summary of pertinent current research related to chapter topics. Resources for Best Practice provide suggestions for further information for chapter topics and tools for practice. Healthy People boxes refer to goals cited in Healthy People 2023. Clinical judgment and next generation NCLEX examination style questions are located at the end of every chapter. Please review these questions as they are good practice for the exam. 1. Define the following theories of aging A. Biological aging: a. Free Radicals → Unstable molecules that are missing an electron within the cell. Free Radicals are also formed spontaneously during cell metabolism with Reactive Oxygen Species. Both these types are necessary for some cells to perform activities, they can also damage lipids, macromolecules and proteins. b. Inflamm-aging → Caused by inflammation. Can lead to rapid accelerated biological aging. This lead to reduced immunity and increase the chances of any number of age associated diseases, such as the rapid aging of cells (senescene) and increase cytokine production. c. Mitochondrial Dysfunction → Mitochondrial Dysfunction and damage comes with aging. The aging can cause mutations and errors when replicating. These types of errors can be related to diseases like Alzheimer’s. B. Psychosocial Theories of Aging NURS 3540 – Gerontological Nursing Module 2 Active Learning Guide a. Role Theory → Place in the world and society is determined by role in society. Successful aging is that one’s role is complete and replaced by another one. b. Activity Theory→ The want and ability to stay young and active. It is best to stay active. Inactivity can be detrimental to well being. c. Disengagement Theory→ As one generation ages, they withdraw and slowing hand over power to the generation behind them. It is good to keep the balance in society and this relinquishing of power is good for the older adult. d. Continuity Theory→ A consistent pattern of behavior during a lifetime. Successful aging is when an individual is able to maintain behaviors or find replacement behaviors. e. Social Exchange Theory→ Successful aging while participating in society while one must have control and maintain it over their financial resources. f. Modernization Theory→ As an individual ages they maintain their status, kinship groups remain intact and skills are valued. g. Gerotranscendence→ The process of moving from birth to death. This is defined by time becoming less of valued community as we age. This is similar to the withdrawal theory, even though withdrawal is for self-reflection. Thinking about the meaning of life and getting away from the material world. 2. Culture and Aging a. What is the definition of culture? Culture are shared or learned beliefs, values, and expectations of a particular group of people. b. Examine your cultural beliefs. As a nurse it is important for us to know where we came from and what beliefs and values are important to us. We must know our own beliefs before we can help others. My shared and learned beliefs are based in the Judeo-Christian belief system. Love thy neighbor as thy love thyself is a founding principle. 3. What 6 major ethno-racial groups does the US refer to when discussing diversity? 1. African-American or Black 2.White 3.Asian 4.Native Hawaiian and Pacific Islander 5.American Indian and Alaskan Native NURS 3540 – Gerontological Nursing Module 2 Active Learning Guide 6.Hispanic and Latinx 4. Define: a. Health Inequities → Avoidable differences and unjust differences in healthcare outcomes between advantaged and disadvantaged groups. b. Disparities → These are the results of the healthcare inequalities. 5. Obstacles to Cross - Cultural Caring. Define the following: a. Ethnocentrism → The belief that one particular culture is better than another. b. Stereotyping → Using narrow knowledge of a particular group and applying it to one individual. 6. How do I provide cross-cultural health care? View the Model of Cross Cultural Caring. Think about the following sub components and how we as nurses can change the way we view people. As nurses we can give cross-cultural healthcare by disregarding our own personal biases and judgments, while being willing to get to know others that are from their own pov. a. Cultural Destructiveness → The systematic elimination of another culture. Genocide. b. Cultural Blindness → Happens when one only see’s the differences and continues to act with a bias and stereotyping towards a group. c. Cultural Pre-Competence → The person has to be aware of one’s personal biases, attitudes, behaviors and prejudices towards others that are from different cultures. d. Cultural Competence – Please read this section thoroughly and define the following term: race → Phenotype, genes that have particular traits that are observable objectively. These are a persons eye color, facial features, skin tone and texture of hair. Ethnicity → Is the cultural group that a person self identifies with and belongs to that is based on nationality, language, religion, migratory status or geographical location. Biomedical health belief → The invasion of a germ or a mutated genetic disease, without disease is homeostasis or health. Magico-religious health belief → The acts of the supernatural or a correction, punishment for not following rules will cause illness. God’s gift is health. Naturalistic-holistic → Psychological, physical or spiritual imbalance resulting is disharmony. Balance is health. e. Cultural Proficiency → The ability of a nurse to go between two different environments to execute and promote healthy aging, compassionate care, be respectful and give relevant care. NURS 3540 – Gerontological Nursing Module 2 Active Learning Guide 7. Cultural Assessment Tools Please describe the following Cultural Assessment Tools a. The LEARN Model Listen → Actively listen to what the client is saying. This will increase perception of the client, situation, desired goals and ideas for treatment or interventions. Explain → Explain the perception you are getting from your pov of the situation or problem. Acknowledge → Acknowledge the differences and similarities between my perception and my goals and those of the elder and their support group or system. Recommend → Recommend an intervention that takes both points of view or perspectives into account. Negotiate → Negotiate a plan or deal that will be mutually accepted and able to be executed. Audio/Video Focus Areas Please watch this video “Cultural Diversity in Aging”: https://youtu.be/bz33gTVBQcM The video is divided in to three categories. Where we have been, where we are now and where we are going. Answer the following questions regarding the three sections of the video assigned. 1. Where we have been: a. Past concepts of aging came from which ethnic group? White, middle America, middle class, retired individuals b. Ethnic groups see aging as what? Ethnic groups see aging as a way of survival, particularly Black Americans 2. Where are we now? Diversity among the elderly. How does each group look as the aging process begins? a. The current generation of elderly is known as the __the quiet revolution__? b. The oldest group of individuals have the broadest range of ethnic, _cultural__, _regional_, __religious___, ___political__, __racial____ and socioeconomic diversity ever witnessed in society. Ethnic Groups: Please jot down information about these groups as they are discussed in the video. a. Blacks → The largest group of minorities living among older Americans. They are less likely to reach out for help that is not a family member. Social secondary is the main source of retirement income. Higher instances of living in public housing, in decaying cities. Higher rate of being cared for in home and not a nursing home. The life expectancy is six years less than other groups. Higher risk of hypertension, arthritis, heart disease. And forty percent of elderly African American women live in poverty. NURS 3540 – Gerontological Nursing Module 2 Active Learning Guide b. Hispanics → This group is a culturally and socioeconomically diverse group. The men have a higher rate of living alone. This is the fastest growing minority group and the largest minority group in the U.S. 2000 census. A high percentage of the community live below the poverty line. They have inadequate healthcare, high illiteracy rates, occupational rates are low and adult children contribute the majority of support to elderly members of the family. c. Asian → American laws have impacted this group for a very long time. The social implications for this minority are a feeling of mistrust and fear of the government. The oldest son traditionally has to take care of the parents. As of late the percentage of older sons doing that is around 66%. This trend has been downward since 2000. d. Native Americans → This group are the most deprived elderly of any minority group. Poor sanitation, health, nutrition, most of the elderly live on a reservation as the young try and find work off of the reservation. But the younger segment will return to retire. High rates of school dropout and work opportunities are low. 3. Where are we going: The year 2020 had the most diversity in the aging population as we know it. a. In 2050 the diversity will be made of the following: 1. African Americans ____20___________% 2. Hispanics __________30____________% 3. White ____________40_____________% Website Focus Areas The Tuskegee Airman were treated poorly just because they were black. These disparities occurred in clinical settings, public hospitals, private hospital and teaching hospitals. See your text Box 4.1 to read about this experiment and refer to the CDC for more information. “The Tuskegee Timeline” www.cdc.gov/tuskegee/timeline.htm What about foreign languages? Many of us will encounter patients where English is not their first language? What about those patients that are hearing impaired or deaf? All these situations arise out of culture. Search the AHRQ website for educational materials regarding foreign languages. https://www.ahrq.gov/ Learning Objects (LOR) Focus Areas Please view the LOR “Age changes and Pathological conditions” https://lor.orbiseducation.com/system/ files/76/story.html NURS 3540 – Gerontological Nursing Module 2 Active Learning Guide Learning Activities 1. Look at the psychosocial theories of aging and make a list of those in your life who are over the age of 55. What theory best describes their aging process? On what do you base your categorization? People Mother Theory Modernization Theory Brother Role Theory Dad Continuity Theory Evidence A retired teacher that continues to teach at the prison in an attempt to keep sending the message that education is way out. Has adapted very well from being a young man to taking care of our father. A retired teacher that has been able to maintain and continue to be the funny guy. 2. Students, research some community activities in your area that are appropriate for or geared toward older adults. List them here. How could these activities encourage older adults to change their views on aging? Example: Square dancing at the country club on Thursday Night Seniors in Bentonville, AR are able to use a renovated mall to utilize the space that was not being used due to empty store fronts. Court games like pickle ball are very popular at the mall. Seniors are able to walk around the inside of the mall, unemcumbered within colored tape to designate lanes. Seniors are also able to take advantage of the movies and the mueseum. Application Questions or Case Studies 1. Harminder Kaur is a registered nurse working in a skilled nursing facility (SNF). The facility cares for residents needing skilled nursing, rehabilitation, and dementia care. Many of the nurses in the SNF are of Indian descent because Harminder is the supervisor and has recruited many of her friends to work with her. She is a strong, compassionate nurse who is highly regarded among her peers. The residents at the SNF are primarily Caucasian, African-American, or Hispanic. Although the families of the residents are happy with the care their loved-ones receive, they have made some complaints in administration about the nurses speaking Hindi amongst themselves in front of the patients. They feel that the nurses should speak English in patient care areas because their speaking Hindi may contribute to increased confusion in the Alzheimer’s and dementia population. NURS 3540 – Gerontological Nursing Module 2 Active Learning Guide 1. Which of the following is the process by which persons from one culture adapt to another? A. B. C. D. Culture Acculturation AdaptationAgeism Ageism 2. The belief that “all old people are forgetful” is an example of which of the following obstacles to cross-cultural caring? A. B. C. D. Ethnocentrism Cultural blindness Stereotyping Disparities 3. True or False: It is an expectation that nurses provide care that challenges ethnocentrism and negative stereotyping. 4. Which of the following behaviors demonstrate cultural proficiency in nursing? Select all that apply. A. B. C. D. E. Speaking one’s native language in presence of a patient of another culture. Use of handshake when greeting all patients. Providing care that is respectful, compassionate, and relevant. Use of cultural knowledge in planning interventions. Recognizing social status as a possible indicator of health disparity.