Learning Module in NCM 114 Final
Learning Module in NCM 114 Final
1
Lecture Notes
2
EFFECTIVE COMMUNICATION HAS PRACTICAL BENEFITS IT CAN:
Help prevent medical errors
Lead to improved health outcomes
Strengthen the patient-provider relationship
Make the most of limited interaction time
TIPS FOR IMPROVING COMMUNICATION WITH OLDER PATIENTS
3
Introduce yourself clearly and do not speak too quickly. Show
from the start that you accept the patient and want to hear his
or her concerns. If you are in a hospital setting, remember to
explain your role or refresh the patient’s memory of it.
In the exam room, greet everyone and apologize for any
delays. With new patients, try a few comments to promote
rapport: "Are you from this area?" or "Do you have family
nearby?" With returning patients, friendly questions about
their families or activities can relieve stress.
3. TRY NOT TO RUSH
4
4.AVOID INTERRUPTING
Face the patient, maintain eye contact, and when he or she is talking,
use frequent, brief responses, such as "okay," "I see," and "uh-
huh." Active listening keeps the discussion focused and lets patients
know you understand their concerns.
5
6.DEMONSTRATE EMPATHY
6
plan in his or her own words—this can help with recall, as well.
You may want to spell or write down diagnoses or important terms
to remember.
h
ttps://www.google.com/search?q=verbal+communication+with+elderly+patients&hl=en&sx Retrieved on November 12, 2020
htt
ps://www.google.com/search?q=verbal+communication+with+elderly+Retrieved on November 12, 2020
9
whether or not you care, if you’re being truthful, and how well
you’re listening.
When your nonverbal signals match up with the words you’re saying,
they increase trust, clarity, and rapport. When they don’t, they can
generate tension, mistrust, and confusion.
If you want to become a better communicator, it’s important to
become more sensitive not only to the body language and nonverbal
cues of others, but also to your own.
How to Use Non-Verbal Communication in Seniors with Alzheimer’s
If you’re a caregiver for someone with Alzheimer’s1, you know how
challenging this condition can be.
Problems with memory loss, personality changes, and a host of
behavioral symptoms can make every day a battle.
Often, these issues are compounded by the fact that former
communication methods may no longer work with the patient,
especially in the later stages of the disease. This is why it’s crucial to
learn about non-verbal communication when looking after seniors
with Alzheimer’s.
10
Use good touches. Although suddenly touching an Alzheimer’s patient can
startle them, a gradual approach can convey warmth and support. For
instance, placing your hand on their upper arm, or gently taking their hand,
can make them feel more relaxed and at ease.
Smile. This may seem like an obvious suggestion, but it’s not easy to
remember in between all your caretaking responsibilities! Still, a genuine
smile is one of the simplest ways to express love and a sense of well-being.
Laugh. Similar to a smile, laughing increases “feel good” endorphins, and
lets your loved one experience a brief burst of joy. Watching funny videos
(that rely on slapstick or non-verbal humor) are a great way to loosen you
both up and have a happy afternoon – no talking required!
There are several ways nonverbal communication can support your ability
to communicate effectively in the workplace, including:
Conveys feelings. You can also use nonverbal communication to show your
feelings, such as disappointment, relief, happiness, contentment and more.
Offers support. Nonverbal cues are also a great way to show support.
Whether it's a simple smile or pat on the back, action may speak louder
than words in many cases.
Deescalates tension. Using a calm tone of voice, open body language, and
directive gestures may help to resolve a difficult situation.
Types of nonverbal communication
There are several types of nonverbal communications you should be aware
of, including:
1. Body language
Body language is the way someone situates their body naturally depending
on the situation, the environment and how they are feeling.
Example: Someone might cross their arms if they are feeling angry or
nervous.
2. Movement
The way you move your arms and legs such as walking quickly or slowly,
standing, sitting or fidgeting, can all convey different messages to
onlookers.
Example: Sitting still and paying attention in a meeting conveys respect and
attention.
3. Posture
The way you sit or stand can also communicate your comfort level,
professionalism and general disposition towards a person or conversation.
Example: Someone might slouch their shoulders if they feel tired,
frustrated or disappointed.
4. Gestures
While gestures vary widely across communities, they are generally used
both intentionally and unintentionally to convey information to others.
Example: Someone in the United States might display a “thumbs up” to
communicate confirmation or that they feel positively about something.
5. Space
Creating or closing distance between yourself and the people around you
can also convey messages about your comfort level, the importance of the
conversation, your desire to support or connect with others and more.
Example: You might stand two to three feet away from a new contact to
respect their boundaries.
6. Paralanguage:
Paralanguage includes the non-language elements of speech, such as your
12
talking speed, pitch, intonation, volume and more.
Example: You might speak quickly if you are excited about something.
7. Facial expressions
One of the most common forms of nonverbal communication is facial
expressions. Using the eyebrows, mouth, eyes and facial muscles to convey
can be very effective when communicating both emotion and information.
Example: Someone might raise their eyebrows and open their eyes widely
if they feel surprised.
8. Eye contact
Strategically using eye content (or lack of eye contact) is an extremely
effective way to communicate your attention and interest.
Example: Looking away from someone and at the ground or your phone
may convey disinterest or disrespect.
9. Touch
Some people also use touch as a form of communication. Most commonly,
it is used to communicate support or comfort. This form of communication
should be used sparingly and only when you know the receiving party is
okay with it. It should never be used to convey anger, frustration or any
other negative emotions.
Example: Placing your hand on a friend’s shoulder may convey support or
empathy.
Focus Questions
13
Assessment Activities
Directions: Answer the following essay questions with rubrics provided via
Google Classroom
1. Differentiate verbal and non- verbal communication
2. Discuss the different tips to use in verbal and non-verbal communication
REFERENCES
https://www.indeed.com/career-advice/career-development/nonverbal-
communication-skills
https://blog.ioaging.org/home-care/how-to-use-nonverbalcommunication-
with-seniors-with-alzheimers/
https://www.nia.nih.gov/health/tips-improving-communication-older-
patients
LET’S BEGIN!
The more you look into nursing careers, the more you realize that a day in
the life of a nurse is rarely boring. You recently came across the
term nursing intervention, which sounds like even more drama than the TV
shows “Grey’s Anatomy” and “Intervention” combined!
Nurses can certainly experience their share of excitement during work, but
nursing interventions aren’t quite as dramatic as they might sound. Unlike
what you might be thinking, a nursing intervention isn’t just for patients
struggling with addiction, and they definitely don’t always end in gut-
wrenching emotional confrontations.
14
If it’s not a tension-filled scene in which a nurse confronts a patient,
what is a nursing intervention? Join us as we learn more about how nursing
interventions work in the real world, including everything aspiring nurses
need to know about this facet of patient care.
Key Terms
15
Lecture Notes
16
https://www.google.com/search?q=reminiscence+therapy&hl=en&sxsrf=ALeKk03 Retrieved on November 13, 2020
CLASSIFICATION OF INTERVENTIONS
1.SUPPORTIVE INTERVENTIONS
Supportive care involves the provision of emotional support
informally or through structured interventions.
Support interventions include activities such as general counseling
17
https://www.google.com/search?q=the+general+guidelines+to+care Retrieved on November 13, 2020
18
https://www.google.com/search?q=THE+GENERAL+GUIDELINES+TO+CARE+FOR+THE+ELDERLY& Retrieved on November 13, 2020
19
2.GENERATIVE INTERVENTIONS
h
ttps://www.google.com/search?q=nursing+interventions+classification&hl=en&sxsr Retrieved on November 13, 2020
http
s://www.google.com/search?q=THE+GENERAL+GUIDELINES+TO+CAR Retrieved on November 13, 2020
20
therapy, occupational therapy, speech and language therapy,
cognitive therapy, and mental health rehabilitation services.
h
ttps://www.google.com/search?q=examples+of+rehabilitative+health+care& Retrieved on November 13, 2020
https:/
/www.google.com/search?q=protective+nursing+intervention&tbm= Retrieved on November 13, 2020
21
complications and disease sequel (Bower 1972).
22
GENERAL GUIDELINES TO CARE FOR THE ELDERLY
23
https://www.google.com/search?q=THE+GENERAL+GUIDELINES+TO+CARE+FOR Retrieved on November 13, 2020
Focus Questions
https://www.ons.org/node/4181?
display=pepnavigator&sort_by=created&items_per_page=5
https://online.husson.edu/nursing-interventions-nic-system/
Jennifer Kim and Sally Miller ( 2017 ). Geriatric Syndrome Geriatric Society
Maree, Bernoth ( 2016 ). Healthy Ageing and Aged Care
Assessment Activities
Directions: Answer the following essay questions with rubrics provided via
Google Classroom
https://www.indeed.com/career-advice/career-development/nonverbal-
communication-skills
https://blog.ioaging.org/home-care/how-to-use-nonverbalcommunication-
with-seniors-with-alzheimers/
https://www.nia.nih.gov/health/tips-improving-communication-older-
patients
https://www.ons.org/node/4181?
display=pepnavigator&sort_by=created&items_per_page=5
https://online.husson.edu/nursing-interventions-nic-system/
https://www.rasmussen.edu/degrees/nursing/blog/nursing-intervention-
beginners-guide/
25
Jennifer Kim and Sally Miller (2017). Geriatric Syndrome Geriatric Society
Maree, Bernoth ( 2016 ). Healthy Ageing and Aged Care
26
https://www.google.com/search?q=priority+of+goals+in+elderly& Retrieved on October 7,2020
27
frequent reaching.
10. Orient the patient to the surroundings. Avoid re-arranging the furniture
in the room.
RATIONALE:
The patient should be familiarized with the bed, location of the bathroom,
furniture, and other environmental hazards that can cause older patients to
trip or fall.
28
These changes in the sensorium can indicate decreasing oxygen levels. To
comprehensively monitor pulse oximetry, the hemoglobin (Hgb) must be
determined.
5. Encourage increased fluid intake (greater than 2.5 liters daily) unless
contraindicated by a renal or cardiac condition.
RATIONALE:
Adequate hydration promotes mobilization of secretions.
RATIONALE:
Knowledge about this equipment promotes adherence to the treatment.
C.HYPERTHERMIA
RELATED FACTOR
Age-related changes in thermoregulation and environmental
exposure
NURSING INTERVENTIONS
1. Monitor temperature through the use of a low-range thermometer if
available.
RATIONALE:
This assessment will indicate the presence of hypothermia. The normal
temperature of an older adult is 35.5°C (96°F).
2. Monitor oral temperature by placing the tip of the thermometer far back
in the patient’s mouth.
RATIONALE:
29
Oral temperature provides the most accurate reading of a patient’s core
temperature.
6. Warm the patient internally by providing warm oral or IV fluids if the
patient’s temperature drops below 35°C (95°F).
RATIONALE:
This method is done to reverse moderate to severe hypothermia. Other
methods include warmed saline gastric or rectal irrigations or introduction
of warmed humidified air into the airway.
RATIONALE:
Causes aside from environmental factors may be responsible for the
hypothermia.
9. Administer antibiotics as prescribed for sepsis, glucose for hypoglycemia,
or thyroid therapy.
30
RATIONALE:
Treating the underlying condition will help the patient’s temperature to
return to normal.
4. Identify the patient’s typical night time routine and try to follow it.
RATIONALE:
Emulating the typical night time rituals may promote sleep.
6.Refrain the patient from drinking caffeinated coffee, cola, and tea after 6
pm.
RATIONALE:
The effect of stimulants includes increase alertness, insomnia and frequent
nighttime awakenings to urinate
31
may facilitate sleep.
E.CONSTIPATION
RELATED FACTOR
Changes in diet, decreased activity, and psychosocial factors
NURSING INTERVENTIONS
1. During admission, assess and record the patient’s normal bowel
elimination pattern (frequency, time of day, associated habits, and previous
measures to manage constipation). Discuss with the patient’s significant
others or caregiver if the patient cannot provide this information.
RATIONALE:
This assessment sets a baseline and identifies the normal bowel elimination
pattern of the patient.
5. Educate the patient about the connection between fluid intake and
constipation. Encourage fluid intake (2500 ml/day) unless contraindicated.
Assess and record bowel movements (amount, date, time, consistency).
RATIONALE:
Increase consumption of fluids can make the stool soft and lessens the risk
of constipation. Patients with renal, cardiac, or hepatic diseases may have a
fluid restriction.
32
6. Instruct the patient to include roughage in every meal when possible. For
patients with low tolerance to raw foods, encourage intake of bran via
cereals, bread, and muffin.
RATIONALE:
Having roughage (raw fruits and vegetables, whole grains, legumes, nuts,
fruits with skin) in the diet adds bulk in the stool, therefore, minimizes
episodes of constipation.
7. Educate the patient about the connection between activity level and
constipation.
RATIONALE:
Regular exercise stimulates peristaltic movement thus it can reduce or
prevent constipation.
9. Try to use the patient’s previously effective measures. Follow the maxim
“start low, go slow” (i.e., apply the lowest level of non-natural intervention
and progress gently to a more powerful intervention).
RATIONALE:
Aggressive measures done may lead to rebound constipation and can
hinder with subsequent bowel movements.
33
https://www.google.com/search?q=POTENTIAL+FOR+RECOVERY+FOR+ADULTS Retrieved on October 7, 2020
There may come a point in time when a senior can no longer live on
their own, though, so as members of their families, we must make
difficult decisions regarding how we handle this situation.
It’s emotionally taxing to see someone you love not be able to take
care of themselves when they used to be the one taking care of you.
34
But on the other hand, there’s only so much you can do to take care
of a senior in your family until it becomes overbearing and inhibits
your ability to live a normal life.
There’s a middle ground that can often be found when it’s necessary.
That’s particularly true at a certain point where it makes sense for
both the senior and the caregiver to develop a plan for senior care.
But this is an expansive industry, so it’s important to determine
which type of care you or a loved one may need.
Focus Questions
Assessment Activities
Directions: Answer the following essay questions with rubrics provided via
Google Classroom
1. Enumerate and discuss the identified nursing diagnoses among elderly.
2. Explain the recovery process as this related to older adult.
3. Describe how often should nurses render time with older adult in
providing care?
REFERENCES
https://www.google.com/search?
q=nursing+diagnosis+identified+in+elderly&o
35
https://www.samhsa.gov/find-help/recovery
https://aging.com/knowing-when-it-may-be-time-for-assisted-living/
Introduction
As individuals age, they are at risk for diseases and disabling conditions, use
more medical care services, and incur medical expenses. While there is no
doubt that age is a predictor of morbidity and mortality, its predictive value
is limited. The health status of the elderly is better than generally assumed,
varies remarkably among individuals, and is changing as successive cohorts
progressively challenge the definition of old age.
This unit will focus on the definitions of interest and any other terms
related. It also deals with the basic concept of simple interest and discount.
Please proceed immediately to the “Unlocking of Difficulties” part since
the first lesson is also definition of essential terms.
Unlocking of Difficulties
KET TERMS
Anxiety- is your body's natural response to stress. It's a feeling of fear or
apprehension about what's to come.
Custodial care is non-medical care that helps individuals with their daily
basic care, such as eating and bathing.
Grief is the response to loss, particularly to the loss of someone or
something that has died, to which a bond or affection was formed.
36
Cognitive impairment is when a person has trouble remembering, learning
new things, concentrating, or making decisions that affect their everyday
life.
Social anxiety disorder (also called social phobia) is a mental health
condition. It is an intense, persistent fear of being watched and judged by
others. This fear can affect work, school, and your other day-to-day
activities.
Disengagement is a process by which people gradually stop being involved
in a conflict, activity, or organization.
Lecture Notes
1.ANXIETY
2.CONFUSION
38
activities, available to the majority of people across the varied and
multiple domains of society.
4.DISENGAGEMENT
5.MOURNING
Loss is inevitable for the elderly, and with loss comes grief.
Losses are not just the deaths of loved ones, friends, and
acquaintances. The elderly also experience loss and grief as they
39
begin to have a diminished ability in activities of daily living.
This then can cause the elderly to lose a sense of purpose.
Many elderly also have difficulty when they can no longer live
independently. They struggle with the loss of their homes, their
possessions, their health, body parts, their vocations, not to mention
their independence.
40
https://www.google.com/search?q=non+compliance+of+treatment+in+elderly Retrieved on October 9, 2020
8. PAIN
41
Therefore, primary care physicians will face a significant challenge in
pain management in older adults. The elderly are more likely to have
arthritis, bone and joint disorders, cancer, and other chronic
disorders associated with pain. Between 25% and 50% of
community-dwelling elderly have important pain problems.
Geriatric nursing home residents have an even higher prevalence of
pain, which is estimated to be between 45% and 80%.3
The elderly are often either untreated or undertreated for pain and
consequences of under treatment for pain can have a negative
impact on the health and quality of life of the elderly, resulting in
depression, anxiety, social isolation, cognitive impairment,
immobility, and sleep disturbances.
Reasons that physicians often cite for inadequate pain control
include lack of training, inappropriate pain assessment, and
reluctance to prescribe opioids.
Functional status and the ability to care for oneself have a significant
impact on a senior’s quality of life.
Changes in ADLs can be caused by underlying medical conditions,
failing to recognize these growing needs can also contribute to a
cycle of physical and mental health problems.
Unmet needs for help with activities of daily living can lead to
malnutrition, poor personal hygiene, isolation, illnesses like urinary
42
tract infections (UTIs), and falls.
Studies have shown that ADL disabilities are associated with an
increased risk for mortality.
Ensuring a senior has the daily care they need can help prevent new
and worsening health issues, keep overall costs down, and delay or
eliminate the need for institutional care. Therefore, a senior’s
functional abilities are often factored into important care decisions
along with their medical needs.
The ability to perform ADLs is often used to determine what types of
care and senior living settings are suitable for an elder. For example,
independent living facilities do not provide any assistance with ADLs.
This type of unskilled care is usually referred to as personal care or
custodial care.
If a resident requires help, he or she will have to get it from a family
caregiver, hire in-home care or move to a higher level of care where
ADL support is provided (e.g. an assisted living facility, a memory
care unit, a nursing home).
10.IMPAIRED MOBILITY
https://www.g
oogle.com/search?q=impaired+mobility+in+elderly&tbm=Retrieved on October 9, 2020
https://www.google.c
om/search?q=impaired+nutrition-+hydration+status+in+elderly Retrieved on October 9, 2020
Poor nutritional status is not a normal part of aging and may result in
adverse outcomes such as increased risk and delayed healing of
pressure injuries, decline in function, dehydration, and increased risk
of death. Causes of low food intake and impaired nutritional status
include depression, inability to eat independently, chewing and
swallowing difficulties, pain, medications that inhibit appetite, and
cognitive or functional impairments.
Organizations that do not take steps to ensure residents' adequate
nutrition and hydration put their residents at severe risk of adverse
outcomes and leave themselves prone to liability and citations for
44
regulatory noncompliance.
Aging services organizations can improve residents' nutritional status
by conducting nutritional assessments, by developing individualized
care plans that focus on improving nutrition and hydration, by
implementing appropriate interventions, and by monitoring
interventions for effectiveness
12.IMPAIRED SKIN INTEGRITY
The skin is the largest organ of our body, covering 18 square feet and
weighing approximately 12 pounds.
Despite positive characteristics, the skin is always susceptible to and
at risk of injury and breakdown.
Maintaining skin integrity equals maintaining skin health, and this
includes people of any age.
Older adults are at a higher risk because of the skin aging process. As
skin ages, the junction between the epidermis and dermis thins and
flattens, reducing circulation.
Moisturizing factors in older adults also reduce, thus causing dry,
flaky skin and increased risk of skin breakdown.
45
https://www.google.com/search?q=Impaired+Sensory+Process+in+elderly&tbm Retrieved on October 10,2020
15. INSOMIA
47
they have limitations.
Newer agents currently under investigation for insomnia hold
promise for good efficacy and safety in the elderly population.
Focus Questions
https://www.mhanational.org/anxiety-older-adults#:~:text=Like%20depr
https://www.aafp.org/afp/1998/0315/p1358.html#:~:text=Confusion%20in
%20the%20elderly%
https://www.google.com/search?
q=emotional+deprivation+in+elderly&sxsrf=ALeKk
https://www.thoughtco.com/disengagement-theory-3026258
https://www.caringfortheages.com/article/S1526-4114(06)60298-9/fulltext
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5296451/
https://www.google.com/search?biw=1280&bih=578&sxsrf=ALeKk025-
ckAC
https://www.agingcare.com/articles/activities-of-daily-living-why-this-
measure-matter
https://www.prestige-nursing.co.uk/mobility/mobility-in-the-
elderly/https://www.ecri.org/components/CCRM/pages/rescare5.aspx#:~:t
ext=Nutrition%20and%20Hydration%
https://www.woundsource.com/blog/maintaining-skin-integrity
https://www.google.com/search?
biw=1280&bih=578&sxsrf=ALeKk032wgfw3F4O
https://www.google.com/search?biw=1280&bih=578&sxsrf=AL
https://www.google.com/search?biw=1280&bih=578&sxsrf=ALe
48
Assessment Activities
Directions: Answer the following essay questions with rubrics provided via
Google Classroom
REFERENCES
https://www.mhanational.org/anxiety-older-adults#:~:text=Like%20depr
https://www.aafp.org/afp/1998/0315/p1358.html#:~:text=Confusion%20in
%20the%20elderly%
https://www.google.com/search?
q=emotional+deprivation+in+elderly&sxsrf=ALeKk
https://www.thoughtco.com/disengagement-theory-3026258
https://www.caringfortheages.com/article/S1526-4114(06)60298-9/fulltext
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5296451/
https://www.google.com/search?biw=1280&bih=578&sxsrf=ALeKk025-
ckAC
https://www.agingcare.com/articles/activities-of-daily-living-why-this-
measure-matter
https://www.prestige-nursing.co.uk/mobility/mobility-in-the-
elderly/https://www.ecri.org/components/CCRM/pages/rescare5.aspx#:~:t
ext=Nutrition%20and%20Hydration%
https://www.woundsource.com/blog/maintaining-skin-integrity
https://www.google.com/search?
biw=1280&bih=578&sxsrf=ALeKk032wgfw3F4O
https://www.google.com/search?biw=1280&bih=578&sxsrf=AL
https://www.google.com/search?biw=1280&bih=578&sxsrf=ALe
49
4.MAINTAINING CONTINENCE
5.GROOMING
51
To maintain a healthy diet and balanced nutrition. To prevent
complications such as aspiration pneumonia induced by choking. To
encourage and assist elders with eating problems so as to maximize
their independence and self-care ability. To make eating an
enjoyable experience to improve their quality of life.
Elders with chronic illness and impaired mobility may suffer from
various degrees of feeding problems. It is therefore important for
carers of these elders to provide appropriate assistance according to
the elders' individual needs.
7.TRANSFERRING
52
https://www.google.com/search?q=shopping+for+grocer Retrieved on September 6, 2020
Groceries are a necessity for everyone, but shopping for groceries
can be one of the most difficult types of shopping for the elderly. It
requires a drive to and from the store, bending to reach items on low
shelves, pushing a heavy shopping cart, and lugging heavy bags into
the house upon returning home
53
10.USING THE TELEPHONE
11.PERFORMING HOUSEWORK
54
While it may be hard to accept, most of us will require some type of
care assistance after the age of 65. You may be used to handling
everything yourself, dividing up duties with your spouse, or relying
on family members for minor help around the home. But as you get
older and your circumstances change, getting around and taking care
of yourself can become more and more difficult. If the idea of moving
to a retirement community, assisted living facility, or nursing home
doesn’t appeal, home care services may be able to help keep you
living in your own home for longer.
Home repairs and modifications help seniors live in their homes for
as long as possible.
Making your older adult’s home safer and more accessible reduces
fall risk, prevents accidents, and increases independence.
In addition, home updates can reduce energy usage, which lowers
utility bills.
55
https://www.google.com/search?q=preparing+meals+for Retrieved on September 6, 2020
If you care for a senior loved one, your days are probably very busy.
It isn’t uncommon for caregivers to work outside the home while
also raising a family of their own. When time is short, eating a well-
balanced diet becomes more difficult to do. Convenience foods and
fast food restaurants are a quick solution, but they are not usually
very healthy.
Caregivers are often also responsible for creating menus and making
meals for their older family member. One solution that makes it
easier on you and your senior loved one is to make and freeze
healthy entrees that you can pull out of the freezer and serve as
needed.
14.DOING LAUNDRY
Focus Questions
57
Instructions: Answer the following questions in complete sentence with
rubrics provided via messenger.
1. What is the role of Health Care Provider in patients’ ADL?
Related Readings
For Supplemental readings on the Care of Older Adults, please refer to
these sources provided.
https://www.google.com/search?
q=medication+safety+for+older+adults&oq=&aqs=
https://www.google.com/search?q=taking+medicatio
https://www.google.com/search?q=doing+laundry+for+elderly&
https://www.google.com/search?q=elderly+meal+plan+samples&
https://www.google.com/search?q=functional+status&oq
Assessment Activities
Directions: Answer the following essay questions with rubrics provided via
Google Classroom
1. Categorize the different activities of daily living of adult persons.
2. Enumerate and discuss the most chronic illness affecting elderly.
References
https://www.google.com/search?
q=medication+safety+for+older+adults&oq=&aqs=
https://www.google.com/search?q=taking+medicatio
https://www.google.com/search?q=doing+laundry+for+elderly&
https://www.google.com/search?q=elderly+meal+plan+samples&
https://www.google.com/search?q=bathing+for+elderly+purpose
https://www.google.com/search?sxsrf=ALeKk02tCLhu9Xi7dmI8k-Xnh7
https://www.google.com/search?sxsrf=ALeKk00DWTaqnAzYHgJgfCj71w
https://www.google.com/search?sxsrf=ALeKk02arscr-DoDTYFM
https://www.google.com/search?sxsrf=ALeKk03L28Cps6
58
Intended Learning Outcomes ( Week 8-9-ILO )
Introduction
Chronic disease: A disease that persists for a long time. A chronic disease is
one lasting 3 months or more, by the definition of the U.S. National Center
for Health Statistics. Chronic diseases generally cannot be prevented by
vaccines or cured by medication, nor do they just disappear. Eighty-eight
percent of Americans over 65 years of age have at least one chronic health
condition (as of 1998). Health damages behaviours - particularly tobacco
use, lack of physical activity, and poor eating habits - are major contributors
to the leading chronic diseases.
This unit will focus on the definitions of interest and any other terms
related. It also deals with the basic concept of simple interest and discount.
Please proceed immediately to the “Unlocking of Difficulties” part since
the first lesson is also definition of essential terms.
Unlocking of Difficulties
Key Terms
Antirheumatic drug- refers to agents used in the therapy of inflammatory
arthritis, predominantly rheumatoid arthritis.
Major Depression-is a mood disorder that causes a persistent feeling of
sadness and loss of interest and can interfere with your daily functioning.
Insulin -is a hormone made in your pancreas, a gland located behind your
stomach
Benign prostatic hyperplasia (BPH)-also called prostate enlargement, is a
noncancerous increase in size of the prostate gland.
Bradykinesia -means slowness of movement and is one of the cardinal
manifestations of Parkinson's disease.
Limb rigidity- refers to abnormal stiffness in the limbs or other body parts,
which prevents muscles from stretching and relaxing.
59
extends from about 280 to 320 nm in wavelength and that is primarily
responsible for sunburn, aging of the skin, and the development of skin
cancer.
NURSING IMPLICATIONS
Diet control helps regulate weight, which is extremely important in
Type 2 diabetes.
Eating healthy foods and following a diet program if overweight, is
essential and should be stressed in diabetic teaching
Exercise burns calories, which helps control weight.
2.ARTHRITIS
60
https://www.google.com/search?q=arthritis+causes&tbm=isch&ved Retrieved on September 8, 2020
NURSING INTERVENTIONS
Provide a variety of comfort measures (eg, application of heat or
cold; massage, position changes, rest; foam mattress, supportive
pillow, splints; relaxation techniques, diversional activities).
Administer anti-inflammatory, analgesic, and slow-acting
antirheumatic medications as prescribed.
61
cause problems in one or both of your kidneys. It’s a type of urinary
tract infection (UTI).
Your kidneys’ main job is to remove waste and take extra water from
your blood. They’re part of your urinary tract, which makes liquid
waste (urine) and removes it from your body. Like the exhaust
system on your car, you want everything to work like it should so
waste moves in one direction only: out.
Your urinary tract is made up of your: Kidneys. These clean waste
from your blood and make urine (your pee).
SYMPTOMS OF A KIDNEY INFECTION INCLUDE:
NURSING INTERVENTIONS
62
physically active can help prevent constipation.
Keep a healthy weight. Making healthy food choices and being
physically active can help you keep a healthy weight.
Exercise regularly. Physical activity can help prevent bladder
problems, as well as constipation. It can also help you keep a
healthy weight.
Do pelvic floor muscle exercises. Pelvic floor exercises, also known
as Kegel exercises, help hold urine in the bladder. Daily exercises
can strengthen these muscles, which can help keep urine from
leaking when you sneeze, cough, lift, laugh, or have a sudden urge
to urinate.
Use the bathroom often and when needed. Try to urinate at least
every 3 to 4 hours. Holding urine in your bladder for too long can
weaken your bladder muscles and make a bladder infection more
likely.
Take enough time to fully empty the bladder when
urinating. Rushing when you urinate may not allow you to fully
empty the bladder. If urine stays in the bladder too long, it can
make a bladder infection more likely.
Be in a relaxed position while urinating. Relaxing the muscles
around the bladder will make it easier to empty the bladder. For
women, hovering over the toilet seat may make it hard to relax, so
it is best to sit on the toilet seat.
Wipe from front to back after using the toilet. Women should wipe
from front to back to keep bacteria from getting into the urethra.
This step is most important after a bowel movement.
Urinate after sex. Both women and men should urinate shortly after
sex to flush away bacteria that may have entered the urethra during
sex.
Wear cotton underwear and loose-fitting clothes. Wearing loose,
cotton clothing will allow air to keep the area around the urethra
dry. Tight-fitting jeans and nylon underwear can trap moisture and
help bacteria grow.
4.DEMENTIA
63
https://www.google.com/search?q=4.%09Dementia&tbm=isch&v Retrieved on September 8, 2020
NURSING INTERVENTION
5.PARKINSON’S DISEASE
64
Parkinson's disease (PD) is a neurodegenerative disorder that affects
predominately dopamine-producing (“dopaminergic”) neurons in a
specific area of the brain called substantia nigra.
Symptoms generally develop slowly over years.
The progression of symptoms is often a bit different from one person
to another due to the diversity of the disease. People with PD may
experience:
Tremor, mainly at rest and described as pill rolling tremor in hands.
Other forms of tremor are possible
Bradykinesia
Limb rigidity
Gait and balance problems
NURSING INTERVENTIONS
Assess neurological status.
Assess ability to swallow and chew.
Provide high-calorie, high-protein, high-fiber soft diet with small,
frequent feedings.
Increase fluid intake to 2000 mL/day.
Monitor for constipation.
Promote independence along with safety measures.
Avoid rushing the client with activities.
Assist with ambulation and provide assistive devices.
Instruct client to rock back and forth to initiate movement.
Instruct the client to wear low-heeled shoes.
Encourage the client to lift feet when walking and avoid prolonged
sitting.
Provide a firm mattress, and position the client prone, without a pillow,
to facilitate proper posture.
Instruct in proper posture by teaching the client to hold the hands
behind the back to keep the spine and neck erect.
Promote physical therapy and rehabilitation.
Administer anticholinergic medications as prescribed to treat tremors
and rigidity and to inhibit the action of acetylcholine.
Administer antiparkinsonian medications to increase the level of
dopamine in the CNS.
Instruct the client to avoid foods high in vitamin B6 because they block
the effects of antiparkinsonian medications.
Instruct the client to avoid monoamine oxidase inhibitors because they
will precipitate hypertensive crisis.
6.GLAUCOMA
65
https://www.google.com/search?q=6.%09GLAUCOMA&tbm=isch&v Retrieved on September 8,2020
Is a group of eye conditions that damage the optic nerve, the health
of which is vital for good vision.
This damage is often caused by an abnormally high pressure in your
eye.
Glaucoma is one of the leading causes of blindness for people over
the age of 60.
7.LUNG DISEASE
66
Lung diseases are some of the most common medical conditions in the
world. Tens of millions of people have lung disease in the U.S. alone.
Smoking, infections, and genes cause most lung diseases.
Your lungs are part of a complex system, expanding and relaxing
thousands of times each day to bring in oxygen and send out carbon
dioxide. Lung disease can happen when there are problems in any part
of this system.
67
Pneumoconiosis. This is a category of conditions caused by inhaling
something that injures your lungs. Examples include black lung disease
from coal dust and asbestosis from asbestos dust.
NURSING INTERVENTIONS
68
immunized against influenza and S. pneumonia because the patient
is prone to respiratory infection
8.CATARACT
A cataract is a dense, cloudy area that forms in the lens of the eye. A
cataract begins when proteins in the eye form clumps that prevent
the lens from sending clear images to the retina. The retina works by
converting the light that comes through the lens into signals.
PREVENTION OF CATARACTS
69
https://www.google.com/search?q=osteoporosis&tbm=isch&ve Retrieved on September 9, 2020
Is a bone disease that occurs when the body loses too much bone,
makes too little bone, or both. As a result, bones become weak and
may break from a fall or, in serious cases, from sneezing or minor
bumps. Osteoporosis means “porous bone.” Viewed under a
microscope, healthy bone looks like a honeycomb.
10.ENLARGED PROSTATE
70
An enlarged prostate means the gland has grown bigger. Prostate
enlargement happens to almost all men as they get older.
An enlarged prostate is often called benign prostatic hyperplasia
(BPH). It is not cancer, and it does not raise your risk
for prostate cancer.
NURSING INTERVENTIONS
11.ALZHEIMER’S DISEASE
71
https://www.google.com/search?q=alzheimer%27s+disease&tb Retrieved on September 9, 202
NURSING INTERVENTIONS
72
Label drawers, use written reminders notes, pictures, or color-coding
articles to assist patients.
Allow hoarding and wandering in a controlled environment, as
appropriate or within acceptable limitations.
Provide positive reinforcement and feedback for positive behaviors.
12.DEPRESSION
NURSING INTERVENTIONS
Focus Question
4. How chronic illness does affect the activity of daily living among
elderly?
5. How to combat depression in adult?
Related Readings
For supplemental readings on the Care of Adults please refer to the sources
provided
74
Maree, Bernoth (2016). Healthy Ageing and Aged Care.
Robnette, H.R., Brossoie. N., & Walter,C. ( 2020) Gerontology for the Health
Care Professional ( 4th ed )
Jennifer Kim and Sally Miller (2017). Geriatric Syndrome. Journal American
Geriatric Society
Assessment Activities
Directions: Answer the following essay questions with rubrics thru Google
Classroom.
References
https://www.google.com/search?ei=vydXX5j9FY290PEP8oabkAQ&
https://www.google.com/search?
ei=li5XX8qvH4PAoATegpiYCw&q=adult+diabetes+nursing
https://www.google.com/search?ei=ki9XXOLISu0PEPmyV-
Ag&q=arthritis&oq
https://www.google.com/search?
ei=3i9XXWLAqK70PEPzvmFqAk&q=arthritis+nursing+intervention
https://www.webmd.com/a-to-z-guides/kidney-infections-symptoms-and-
treatments#1
https://www.google.com/search?
ei=ezFXX7LYEcPGmAWCzqqgDA&q=dementia&oq=dementia
https://www.google.com/search?ei=_TFXX7-
hM6OwmAXI4YPQBQ&q=dementia+nursing+interventions&o
https://www.parkinson.org/understanding-parkinsons/what-is-parkinsons
https://www.parkinson.org/understanding-parkinsons/what-is-parkinsons
https://www.google.com/search?ei=mjtXX9TXMtG-0PEPpYymmA0&q=
https://www.webmd.com/lung/lung-diseases-overview
75
https://www.healthline.com/health/cataract#:~:text=A%20cataract%20is
%20a%20dense
https://www.nof.org/patients/what-is-osteoporosis/#:
https://medlineplus.gov/ency/article/000381.htm#:~:text=An%20enlarged
https://www.mayoclinic.org/diseases-conditions/alzheimers-
disease/symptoms-causes/syc-20350447
https://www.mayoclinic.org/diseases-conditions/depression/symptoms-
causes/syc-20356007
https://www.helpguide.org/articles/depression/depression-in-older-
adults.htm
76
https://www.google.com/search?q=
F. Excretory System
G. Musculoskeletal System
77
https://www.google.com/search?q=image+on+musculoskeletal+older+adult Retrieved on August 8,2020
H. Nervous System
6. The nervous system in older adult loses nerve cell mass and shows
78
some brain atrophy. Nerve cells and dendrites decline in number,
which allows transformation, shortens reaction times and weakens
reflexes. Brain weight is said to decrease with age, but this does not
seem to interfere with individual thought process.
I.ENDOCRINE SYSTEM
8. As the body ages, changes occur that affect the endocrine system,
sometimes altering the production, secretion, and catabolism of
hormones. For example, the structure of the anterior pituitary gland
changes as vascularization decreases and the connective tissue
content increases with increasing age.
9. This restructuring affects the gland’s hormone production. For
example, the amount of human growth hormone that is produced
declines with age, resulting in the reduced muscle mass commonly
observed in the elderly.
10.The adrenal glands also undergo changes as the body ages; as fibrous
tissue increases, the production of cortisol and aldosterone
decreases.
11.Interestingly, the production and secretion of epinephrine and
norepinephrine remain normal throughout the aging process.
J.IMMUNE SYSTEM
79
https://www.google.com/search?q=image+on+immune+system+in+older+adult Retrieved on August 8,2020
80
time outdoors.
35.The blood vessels of the dermis become more fragile that leads to:
36.Bruising
37.Bleeding under the skin (often called senile purpura)
38. Cherry angiomas
39.Sebaceous glands produce less oil as you age.
40.Men experience a minimal decrease, most often after the age of 80.
41. Women gradually produce less oil beginning after menopause.
42.This can make it harder to keep the skin moist, resulting in dryness
and itchiness.
43.The subcutaneous fat layer thins so it has less insulation and
padding.
44. This increases your risk of skin injury and reduces your ability to
maintain body temperature because you have less natural insulation,
you can get hypothermia in cold weather.
45.The sweat glands produce less sweat that makes it harder to keep
cool.
46. Your risk for overheating or developing heat stroke increases.
47.Growths such as:
48. skin tags
49. warts
50.rough patches (keratoses)
EFFECT OF CHANGES
51.As you age, you are at increased risk for skin injury.
52. Your skin is:
53.thinner
54.more fragile
55. lose protective fat layer
56.You also may be less able to sense:
57.touch
58.pressure
59.vibration
60.heat
61.and cold
62.Rubbing or pulling on the skin can cause skin tears.
63. Fragile blood vessels can break easily.
64. Bruises, flat collections of blood (purpura), and raised collections of
blood (hematomas) may form after even a minor injury.
65.Pressure ulcers can be caused by:
66.skin changes
67.loss of the fat layer
68.reduced activity
69.poor nutrition
70.and illnesses
81
71.Sores are most easily seen on the outside surface of the forearms,
but they can occur anywhere on the body.
72.Aging skin repairs itself more slowly than younger skin. Wound
healing may be up to 4 times slower.
73. This contributes to pressure ulcers and infections.
Factors Affects Healing:
74.diabetes
75.blood vessel changes
76.lowered immunity
COMMON PROBLEMS
Skin disorders are so common among older people that it is often hard to
tell normal changes from those related to a disorder. More than 90% of all
older people have some type of skin disorder.
A .Major Components
82
101. Refers to the ability to perform activities necessary or
desirable in daily life.
102. Functional status is directly influenced by health conditions,
particularly in the context of an elder's environment and social
support network.
103. Changes in functional status (eg, not being able to bathe
independently) should prompt further diagnostic evaluation and
intervention.
104. Measurement of functional status can be valuable in
monitoring response to treatment and can provide prognostic
information that assists in long-term care planning.
2. FALL RISK
105. The injury rate for older adults falls in the midrange for all age
group, with 196 per 196 per 1000 persons injured among those aged
65 years old and older (Department of Commerce, 2010 ).
106. Older women have a higher rate of injuries than any adult
female age group whereas the rate among men declines through the
years.
107. Accidents rank as the six-leading cause of death for older
adults, with falls leading cause of injury related deaths.
108. Approximately one-third of community-dwelling persons age
65 years and one-half of those over 80 years of age fall each year.
109. Patients who have fallen or have a gait or balance problem are
at higher risk of having a subsequent fall and losing independence.
110. An assessment of fall risk should be integrated into the history
and physical examination of all geriatric patients (algorithm 1). (See
"Falls in older persons: Risk factors and patient evaluation", section
on 'Falls risk assessment' and "Causes and evaluation of neurologic
gait disorders in older adults".)
3.COGNITION
111. It decreases with age due to cumulative nature of lifestyle
choices (e.g., in the realm of nutrition, self- neglect, or substance use
or abuse).
112. The incidence of dementia increases with age, particularly
among those over 85 years, yet many patients with cognitive
impairment remain undiagnosed. The value of making an early
diagnosis includes the possibility of uncovering treatable conditions.
The evaluation of cognitive function can include a thorough history
and brief cognition screens.
113. If these raise suspicion for cognitive impairment, additional
evaluation is indicated, which may include detailed mental status
examination, neuropsychologic testing, tests to evaluate medical
conditions that may contribute to cognitive impairment (eg, B12,
thyroid-stimulating hormone [TSH]), depression assessment, and/or
83
radiographic imaging (computed tomography [CT] or magnetic
resonance imaging [MRI]).
4.MOOD
114. Psychological changes can be influenced by general health
status, genetic factors, educational achievements, activity and
physical and social changes.
115. Depressive illness in the elder population is a serious health
concern leading to unnecessary suffering, impaired functional status,
increased mortality, and excessive use of health care resources.
(See "Diagnosis and management of late-life unipolar depression".)
5.POLYPHARMACY
116. Older persons are often prescribed multiple medications by
different health care providers, putting them at increased risk for
drug-drug interactions and adverse drug events. The clinician should
review the patient's medications at each visit.
117. The best method of detecting potential problems with
polypharmacy is to have patients bring in all of his/her medications
(prescription and nonprescription) in their bottles.
118. Discrepancies between what is documented in the medical
record and what the patient is actually taking must be reconciled.
119. As health systems have moved towards electronic health
records and e-prescribing, the potential to detect potential
medication errors and interactions has increased substantially.
120. Although this can improve safety, record-generated messages
about unimportant or rare interactions may lead to "reminder
fatigue."
121. The high prevalence of health condition in the older
population causes this group to use a large member and variety of
medication. Drug use by older adults has been steadily increasing
every year, most older people use at least one drug regularly.
122. Researchers have found that the number of drugs used by
older persons increase with age.
84
https://www.google.com/search?q=image+on+social+support+in+older+adult Retrieved on August 8,2020
7.FINANCIAL CONCERN
85
important to assess. Elders may qualify for state or local benefits,
depending upon their income.
139. Older patients occasionally have other benefits such as long-
term care insurance or veteran's benefits that can help in paying for
caregivers or prevent the need for institutionalization.
8.GOALS OF CARE
140. Older adult patients who are appropriate for CGA have limited
potential to return to fully healthy and independent lives. Hence,
choices must be made about what outcomes are most important for
them and their families.
141. Goals of care often differ from advance care preferences that
focus on future states of health that would be acceptable,
determination of surrogates to make decisions, and medical
treatments.
142. Generally, advance directives are framed in the context of
future deterioration of health status.
143. By contrast, a patient’s goals of care are often positive (eg,
regaining a previous health status, attending a future family event).
Frequently, social (eg, living at home, maintaining social activities)
and functional (eg, completing ADLs without help) goals assume
priority over health-related goals (eg, survival).
144. They are also patient-centric and individualized. For example,
regaining independent ambulation after a hip fracture may be a goal
for one patient whereas another might be content with use of a
walker.
145. Both short-term and longer-range goals should be considered
and progress towards meeting these goals should be monitored,
including reassessment if goals are not met within a specified time
period. One approach that has been used in CGA is Goal Attainment
Scaling .
86
patient’s health status changes and doctors recommend against
further treatment, or if it becomes too hard for loved ones to keep
them at home.
152. Advance directives help guide therapy if a patient is unable to
speak for him or herself and are vital to caring optimally for the
geriatric population:
153. Advance care planning is one key element to achieving patient
autonomy by allowing patients to participate in decisions about their
medical care.
154. Advance care planning is based on the premise that on-going
discussions about end-of-life issues accompanied by written advance
directives are valuable to help loved ones, physicians, and other
providers better understand and make treatment decisions
consistent with patients' wishes, if the patient becomes
incapacitated.
ADDITIONAL COMPONENTS
1.NUTRITION/ WEIGHT
2.URINARY CONTINENCE
87
159. Emptying of the bladder more difficult; retention of large
volumes of urine may result.
3.SEXUAL FUNCTION
160. Many people want and need to be close to others as they grow
older.
161. It includes the desire to continue an active, satisfying sex life.
162. With aging, that may mean adapting sexual activity to
accommodate physical, health, and other changes.
4.VISION/ HEARING
88
173. Structures inside the ear start to change and their functions
decline. Your ability to pick up sounds decreases.
174. You may also have problems maintaining your balance as you
sit, stand, and walk.
5.Dentition
175. Only in the last decade has the possible effect of oral health on
the general health and mortality of elderly people attracted much
attention.
176. An association between number of teeth and mortality has
been reported in several studies. As people age, many lose teeth.
177. Tooth loss reduces masticatory capacity, which can influence
food selection, nutritional status, and general health.
178. Evidence is also increasing that oral infections play a role in the
pathogenesis of some systemic diseases.
6.Living condition
7.Spirituality
181. Is the essence of our being that transcends and connect us to
the Divine and other living organisms. It involves relationships and
feelings (Eliopoulos, 2014).
89
182. Spiritual Needs
183. Love
184. Meaning and purpose
185. Hope
186. Dignity
187. Forgiveness
188. Gratitude
B. Best Indication for CGA
1. Age
189. Older people admitted for acute inpatient hospital care are at
high risk of adverse events, long stays, readmission and long term
care use.
190. There is considerable evidence on assessment and co-
ordination of care for older patients with complex needs using
Comprehensive Geriatric Assessment.
2.Medical Comorbidity
3.Psychological Disorders
193. Depression
194. Anxiety
195. Alcohol abuse
196. Hypochondriasis
197.
Specific geriatric condition:
198. Dementia
199. Fall
Focus Question
90
assessment among older adult.
Related Readings
Assessment Activities
Directions: Answer the following essay questions with rubrics provided via
messenger.
References
Books
Robnette, H.R., Brossoie. N., & Walter,C. ( 2020) Gerontology for the Health
Care Professional ( 4th ed )
Jennifer Kim and Sally Miller (2017). Geriatric Syndrome. Journal American
Geriatric Society
Electronic.
1.https://courses.lumenlearning.com/atd-herkimer-
biologyofaging/chapter/development-and-aging-of-the-endocrine-system/.
2. https://www.hindawi.com/journals/jar/2011/156061/
3. https://www.hindawi.com/journals/jar/2018/4086294/
4. https://www.hindawi.com/journals/jar/2018/4086294/
91
5.https://academic.oup.com/ageing/article/47/1/149/4682984
6.https://academic.oup.com/biomedgerontology/article
Introduction
This unit will focus on the definitions of interest and any other terms
related. It also deals with the basic concept of simple interest and discount.
Please proceed immediately to the “Unlocking of Difficulties” part since
the first lesson is also definition of essential terms.
Unlocking of Difficulties
Key Terms
Delirium- is an abrupt change in the brain that causes mental confusion and
emotional disruption.
92
Multifactorial-caused or marked by a polygenic mode of inheritance
dependent on a number of genes at different loci.
Lecture Notes
93
223. Geriatric syndromes can best be identified by a geriatric
assessment.
224. Although the geriatric assessment is a diagnostic process, the
term is often used to include both evaluation and management.
225. Geriatric assessment is sometimes used to refer to evaluation
by the individual clinician (usually a primary care clinician or a
geriatrician) and at other times is used to refer to a more intensive
multidisciplinary program, also known as a comprehensive geriatric
assessment (CGA).
226. The range of health care professionals working in the
assessment team varies based on the services provided by individual
comprehensive geriatric assessment (CGA) programs.
Focus Questions
94
245. What is the impact of health care professionals to geriatric
clients in conducting accurate assessment?
Related Readings
Reference:
Robnette, H.R., Brossoie. N., & Walter,C. ( 2020) Gerontology for the Health
Care Professional ( 4th ed )
Jennifer Kim and Sally Miller (2017). Geriatric Syndrome. Journal American
Geriatric Society
95
Introduction
This unit will focus on the definitions of interest and any other terms
related. It also deals with the basic concept of simple interest and discount.
Unlocking of Difficulties
Lecture Notes
96
251. The assessment of functional abilities in older adults refers to a
comprehensive assessment to determine the level of
independence that older adults have when performing activities of
daily living.
252. This assessment enables the planning of therapeutic
interventions, social care and clinical support, and also supports
clinical reasoning in detecting early signs of dementia.
2.Fall History
253. Falls are defined as an unintentional lowering to rest from a
higher to a lower position, not due to loss of consciousness or violent
impact (Kellogg International Work Group on the Prevention of Falls
by the Elderly, 1987).
254. Falls often go unrecognized by health care professionals
because they are not routinely evaluated while taking a patient’s
history or during a physical exam (unless there is frank injury).
255. Many patients do not admit to falling for fear of losing their
independence.
256. Many factors that contribute to fall risk in older adults. The
World Health Organization Europe (2004) has characterized risks into
two broad categories, intrinsic and extrinsic risk factors for falls.
257. Intrinsic risk factors include a history of falls, age, gender,
medical conditions, impaired mobility and gait, sedentary behavior,
psychological status, nutritional deficiencies, impaired cognition,
visual impairments and foot problems.
258. Many older adults have multiple comorbidities including
neurological, cardiovascular, metabolic, urinary, musculoskeletal,
and psychological disorders that may increase their risk of falls.
97
joints, feet, and legs is increased with age; that pain in the head,
abdomen, and chest is reduced; but back pain frequency varies
widely.7, 8, and 9.
264. The high prevalence of degenerative joint disease overwhelms
any contribution from other causes in all surveys.
Focused Questions
Instructions: Explain each question, before you start answering, read the
related readings for your reference. Please organize your essay with rubrics
provided via messenger.
Related Readings
https://link.springer.com/referenceworkentry
https://www.uth.tmc.edu/hgec/GemsAndPearls/geriatricSyndromes
https://www.sciencedirect.com/topics/medicine-and-dentistry/pain-in-
older-adult
https://www.healthaffairs.org/doi/full/10.1377/hlthaff.20.6.114
Assessment Activities
References
Books
Maree, Bernoth (2016). Healthy Ageing and Aged Care.
Robnette, H.R., Brossoie. N., & Walter,C. ( 2020) Gerontology for the Health
Care Professional ( 4th ed )
Jennifer Kim and Sally Miller (2017). Geriatric Syndrome. Journal American
Geriatric Society
Electronic
https://www.uth.tmc.edu/hgec/GemsAndPearls/geriatricSyndromes_Fall
98
Unit 4- Week( 4) : ELDERLY CLIENTELE DESIRE
Introduction
Older persons receiving care and services at home may have difficulty
articulating their preferences, especially those regarding abstract matters
phrased as safety versus freedom. When that query was put to home care
clients, about one-third preferred to come and go as they pleased and be less
safe; about one-third preferred to be safe and protected even with restricted
freedom; and one-third were ambivalent, undecided, or wanted both safety
and autonomy.
This unit will focus on the definitions of interest and any other terms related.
It also deals with the basic concept of simple interest and discount.
Please proceed immediately to the “Unlocking of Difficulties” part since
the first lesson is also definition of essential terms.
Unlocking of Difficulties
To attend the following intended learning outcomes for the first lesson
of the course, you need to fully understand the following essential knowledge
that will be laid down in the succeeding pages. Please note that you are not
limited to exclusively refer to these resources. Thus, you are expected to
utilize other books, research articles and other resources that are available in
the library e.g. ebrary, search.proquest.com etc.
Key Terms
Self- determination- the process by which a person controls their own life
99
Lecture Notes
Focused Questions
Related Readings
https://www.healthaffairs.org/doi/full/10.1377/hlthaff.20.6.114
Assessment Activities
100
References
Robnette, H.R., Brossoie. N., & Walter,C. ( 2020) Gerontology for the Health
Care Professional ( 4th ed )
Jennifer Kim and Sally Miller (2017). Geriatric Syndrome. Journal American
Geriatric Society.
101