GERONTIC NURSING TEXTBOOK

GERONTIC NURSING

TEXTBOOK

By : Wachidah Yuniartika, S.Kep., Ns., M.Kep.

TEXTBOOK

GERONTIC NURSING

Author : Wachidah Yuniartika, S.Kep., Ns.,M.Kep.

Reviewers : 1. Abi Muhlisin, S.K.M.,M.Kep.

2. Amirullah, S.E., M.M

Layouter : Deddy Saputra

Cover Desain : MUP Team

ISBN: 978-602-361-245-1

First Edition, October 2019

©2019 Copy right is protected by the law

Muhammadiyah University Press

Universitas Muhammadiyah Surakarta

I Building 1st Floor

A Yani St. Pabelan Tromol Pos 1 Kartasura Surakarta

57102 Central Java - Indonesia

Telp: (0271) 717417 Ex. 2172

Email: [email protected]

mailto:[email protected]

FOREWORD

Praise be to Allah SWT, prayer and salutation to our lord the great prophet Muhammad. Because of his blessing we can compile and finish this textbook and print until it reaches all readers. The making of this textbook is sourced from various nursing books,guidelines and basic theories modified by the author in order to facilitate the understanding for not so many books specifically discussing this issue for simple learning for classes and the hospitals to be applied.

This textbook contains subject matters in one semester that is used for nursing undergraduate students. Furthermore, nursing lecturers can also use this book to increase knowledge about one of the theories of the aging process and provision of nursing care in the elderly. In actual fact, not all nursing lecturers have linear qualifications,so there is a need for additional knowledge. Besides, this book can also be used as reading material for nurses or social service employees who work in nursing homes to increase discourse in dealing with problems that occur in the elderly.

This book is completed with examples of nursing care (assessment, diagnosis, intervention, implementation, and evaluation). The presentation of materials in this book provides a clear description and steps for making nursing care straightforward, pleasant to read in a language that is distinctive and easy to be understood. Therefore, there are many requests from various groups of students in tertiary institutions, lecturers, nurses working in the geriatric unit of the hospital, nurses and social service employees in nursing homes willing this book to be widely publicized.

Thus, this book is worth publishing to meet the demands and needs of various groups, hopefully this book is useful for them especially students who are studying gerontic nursing.

Surakarta, 28 September 2019

Author

INTRODUCTION

This textbook contains subject matters in one semester that is used for undergraduate nursing students, and nursing lecturers can also use this book to increase knowledge about one application of the nursing model in providing nursing care. In actual fact, not all nursing lecturers have linear qualifications then some need additional knowledge. Moreover, this book can also be used as reading material for nurses who are now working to increase discourse in dealing with problems in elderly at the nursing home or community. Gerontic nursing textbook is prepared based on the semester learning plan or is called RPS in the Gerontic nursing course, which is required for VII semester students in the nursing study program. Gerontic nursing is a compulsory subject that is taken with a load of 2 SKS. This course provides an understanding of the aging process, changes that occur in the elderly, national programs, communication in the elderly and nursing process in the elderly both in theory and practice. The explanation of gerontic nursing material in this bookexpects the students to gain learning experience in in-depth study, diagnosis, intervention, implementation and evaluation. In the first chapter of this book, we will explain the basic concepts of nursing, how the aging process occurs in humans and the common changes in the aging process. In the next chapter, this course will teach you about the national health program for the elderly, health promotion strategies, issues and trends in gerontic health problems, communication to the elderly, and the final chapter will discuss the gerontic nursing process which includes assessment, formulation of nursing diagnoses in the elderly, planning nursing actions in the elderly. and will discuss examples of nursing care cases in the elderly, as well as examples of special assessment formats for the elderly. The learning achievements are:

1). Students are able to explain the concepts, theories of aging and common changes in the aging process used in nursing appropriately;

2). Students are able to understand the national health program of the elderly as well as issues and trends in health issues in gerontic;

3). Students are able to explain health promotion strategies in the elderly;

4). Students are able to demonstrate therapeutic communication strategies according to the problems and conditions of elderly development;

5). Students are able to arrange assessment and data analysis if they are given a case data of elderly;

6). Students are able to formulate a diagnosis and plan nursing interventions in accordance with NANDA standards.

TABLE OF CONTENTS

FOREWORD ................................................................................................... iii

INTRODUCTION ........................................................................................ iv

TABLE OF CONTENTS ................................................................. vi

LIST OF FIGURES ................................................................................... ix

LIST OF TABLES ............................................................................................... xi

CHAPTER I THE CONCEPT OF GERONTIC NURSING

A. BriefDescription ......................................................................................... 1

B. Learning Objectives ..................................................................................... 1

C. Material Presentation ................................................................................ 2

1. Definition of Geriatric, Gerontology and Gerontic ...................... 2

2. Focus on Nursing Gerontic ............................................................... 3

3. Purpose of Nursing Gerontic .............................................................. 5

4. Roles, Duties and Responsibilities of Gerontic Nurses ............... 5

D. Summary ...................................................................................................17

E. Exercise ................................................................................................. 19

References.................................................................................................. 27

CHAPTER II THEORIES OF AGING PROCESS

A. Brief Description ...................................................................................... 29

B. Learning Objectives ................................................................................... 29

C. Material Presentation .............................................................................. 30

1. Biological Theory........................................................................... 31

2. Stochastic and Non-stochastic Theories ............................................ 34

3. Psychological Theory .................................................................... 41

4. Sociological Theory ....................................................................... 48

5. Spiritual Theory or Moral Theory ............................................... 50

D. Summary ................................................................................................... 51

E. Exercise ................................................................................................ 53

References ................................................................................................. 59 vi

CHAPTER IIINORMAL CHANGES OF AGING PROCESS


B. Learning Objectives................................................................................... 66

C. Material Presentation .............................................................................. 66

1. Changes to Biology .......................................................................... 66

2. Psychological changes ..................................................................... 76

3. Psychosocial Change ....................................................................... 82

D. Summary ................................................................................................... 84

E. Exercise ................................................................................................ 88

References ................................................................................................. 95

CHAPTER IV NATIONAL PROGRAM OF ELDERLY HEALTH


B. Learning Objectives................................................................................... 99

C. Material Presentation ............................................................................ 100

1. National Elderly Program............................................................. 100

2. Elderly Nursing Law ..................................................................... 102

3. Elder Nursing Principles and Ethics .......................................... 115

D. Summary ................................................................................................. 117

E. Exercise .............................................................................................. 118

References ............................................................................................... 124

CHAPTER V HEALTH PROMOTION STRATEGY

A. Brief Description .................................................................................... 125

B. Learning Objectives................................................................................. 125

C. Material Presentation ............................................................................ 126

1. Primary Prevention ........................................................................ 126

2. Secondary Prevention .................................................................... 149

3. Tertiary Prevention ................................................................................ 163

D. Summary ................................................................................................. 164

E. Exercise .............................................................................................. 165

References ............................................................................................... 171

CHAPTER VI ISSUES AND TRENDS OF GERONTIC HEALTH PROBLEMS


B. Learning Objectives ................................................................................. 175 vii

C. Material Presentation ........................................................................... 176

1. Definition of Trends and Issues ................................................... 176

2. Demographic Phenomenon ......................................................... 176

3. Gerontic Health Problems ............................................................ 176

D. Summary ................................................................................................ 179

E. Exercise ..............................................................................................180

References ...............................................................................................186

CHAPTER VII COMMUNICATION WITH THE ELDERLY


B. Learning Objectives ................................................................................ 187


1. Communication Process Stage ....................................................... 188

2. Application of Communication in the Elderly ......................... 189

3. Changes That Affect Communication withthe Elderly ................ 196

D. Summary ................................................................................................ 206

E. Exercise .............................................................................................. 207

References............................................................................................... 214

CHAPTER VIII NURSING PROCESS FOR THE ELDERLY


B. Learning Objectives ................................................................................ 217


1. Study on Gerontic Nursing .......................................................... 218

2. Formulation of Gerontic Nursing Diagnosis ............................ 225

3. Gerontic Nursing Planning .......................................................... 227

4. Implementation Strategy .............................................................. 239

5. Evaluation of Gerontic Nursing .................................................. 243

D. Summary ................................................................................................ 245

E. Exercise ..............................................................................................246

References ...............................................................................................253

APPENDIX ............................................................................................ 254

GLOSARRY .......................................................................................... 281

INDEX ............................................................................................ 284

viii

LIST OF FIGURES

Figure1.1The focus of gerontic nursing....................................................... 4

Figure1.2Nurse as a care giver ...................................................................... 6

Figure 1.4Nurse as an educator .................................................................... 8

Figure 1.5Nurse as a manager ....................................................................... 9

Figure 1.7Nurse as a rehabilitator .............................................................. 10

Figure 1.8Nurses as clinical decision makers (collaborators)11

Figure 1.9Nurse as an independent practitioner ..................................... 14

Figure 1.10Nurse as a counselor ................................................................. 14

Figure 1.11 Nurse as a researcher ............................................................... 13

Figure 1.12The role of the nurse ............................................................. 13

Figure 2.1Stochastic theory ...................................................................... 37

Figure 2.2Non-stochastic theory .............................................................. 41

Figure 2.3Psychological theory ................................................................ 48

Figure 3.1Biological Change ........................................................................ 76

Figure 3.2Psychological Change ................................................................. 81

Figure 3.2Psychosocial Change................................................................... 84

Figure 5.1Alcohol ................................................................................... 128

Figure 5.2Smoking ................................................................................. 129

Figure 5.3Nutrition and Hydration .................................................... 130

Figure 5.4Sports ...................................................................................... 136

Figure 5.5Sleep ............................................................................... 137

Figure 5.6Fall Risk .................................................................................. 140

Figure 5.7Use of Restrain ........................................................................... 141

Figure 5.8Immunization ....................................................................... 142

Figure 5.8Medicine ................................................................................ 144

Figure 5.9Mental Health Examination .................................................... 145

Figure 5.10Alternative Health Care ......................................................... 149

Figure 5.11Cardiovascular Disease .......................................................... 150

Figure 5.12Examination of Blood Sugar Levels ..................................... 151

Figure 5.16Obesity ................................................................................. 152

ix

Figure 5.17Cancer .......................................................................... 153

Figure 5.18Hypertension .............................................................. 158

Figure 5.19Cerebrovascular Disease .................................................. 159

Figure 5.20Osteoporosis ................................................................ 161

Figure 5.21 Vision and hearing ............................................................ 163

Figure 5.22 Primary prevention, secondary prevention,

tertiary prevention

...................................................................................................................... 164

Figure 7.1 Communication process stage ..................................... 189

Figure 7.2Communication Techniques in the elderly .................. 196

Figure 7.3 Common Visual Diseases and Types of Disorders

Hearing …………………………………………………………... 206

x

LIST OF TABLES

1. Table5.1American Cancer Society Recommendations

for Early Detection of Cancer on Average-Risk

Asymptomatic People

..................................................................................................... 154

2. Table7.1 Normal and Pathological Changes and their Impact on Communication

............................................................................................................... 200

CHAPTER I [THE CONCEPT OF GERONTIC NURSING]

A. BRIEF DESCRIPTION

The increasing age of life expectancy in Indonesia is one indicator of the success of development in Indonesia. The projection results of the population in 2010 to 2035, Indonesia will enter the aging period (aging), of which 7.8% or around 36 million people in Indonesia are elderly. Elderly will add some health problems because of the deterioration of bodily functions if there is no effort towards good health services. Considering the purpose of this book as guidelines for gerontic nursing care, the following will describe several theories related to the concept of gerontic nursing, which include; a) Definition of Geriatrics, Gerontology, and Gerontic; b) Focus on Gerontic Nursing; c) Purpose of Gerontic Nursing; d) Roles, Duties and Responsibilities of Gerontic Nurses; e) Issues and Trends in Gerontic Health Problems.

B. LEARNING OBJECTIVES

After studying this book, the students in general are expected to be able to understand and explain the concept of nursing correctly. Specifically, students are expected to be able to:

1).Re-explain the definition of geriatrics, gerontology and gerontic.

2). Explain the focus of gerontic nursing

3). Explain the purpose of gerontic nursing

4). Explain the roles, duties and responsibilities of gerontic nursing.

C. MATERIAL PRESENTATION

GERONTIC NURSING TEXTBOOK

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