Meeting the Health Needs of Older Clients Copyright ©2008 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Community.

Meeting the Health Needsof Older Clients

Copyright ©2008 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458

All rights reserved.Community Health Nursing, 5/eMary Jo Clark

Community Health Nursing, 5/eMary Jo Clark

Copyright ©2008 by Pearson Education, Inc.

Gerontological Nursing Con

• Gerontological Nursing: contributes to and often leads the interdisciplinary and multi-agency care of older people.



Myths related to aging

• Most of the myths surround the concept of aging affect the psychological status of the aged person– Older persons cannot learn, change or

grow emotionally– They are negative– Stooped posture



Myths related to aging

– Forgetfulness– Rigid helpless dependent and others

that younger individuals try to joke about

– Poor health– Unproductive and unattractive.



Factors that influence the elderly health status

1. Human biology• Maturation and aging that affect all

body systems (eg. cardiovascular changes)

2. Environment Considerations• Physical • Psychological• social



Factors that influence the elderly health status

3. Behavioral Considerations4. Health system Considerations



Psychological environment Considerations

• To evaluate the cognitive status the nurse:– Evaluate long and short term memory– Power of concentration and judgment– Ability to engage in mathematical

calculations

• To evaluate affective status the nurse:– Presence of depression– Presence of dementia– Saddened mood status



Physical Environmental Considerations

• Safety hazards in the home or the community

• Adequate housing• Availability of necessary goods and

services• Neighborhood shopping facilities



Socio-cultural Environmental Considerations

• Changes in family roles and responsibilities

• Social support • Economic and employment factors• Abuse and violence

– Increased incidence of financial and physical abuse



Socio-cultural Considerations

• Social net work– Include number and frequency of

contacts, the durability of network, geographical proximity and reciprocity( mutual help)



Behavioral Considerations

• Diet and consumption patterns• Physical activity• Sexuality• Medication use



Behavioral Considerations

• Client independence– Personal activities

• Bathing• Dressing• Ambulation

– Instrumental activities• House keeping• Taking medication• Use of transportation



Health System Considerations

• Demand on health care services• Health care access• Costs of health care for uninsured• Lack of appropriate medical services• Societal response to high costs of

medications• Client-provider interaction



Health System Considerations

• Are health services sought to promote health as well as to cure illness?

• Are health services used effectively?, the CHN will explore the distance to health facilities used and the means of transportation



Changing Dynamics in Families

• More older people are raising grandchildren

• Increased incidence of health problems for caregivers

• Impact of economic factors– Diminished access to care– Less utilization of health services– Employment and workforce retention of

older population



Nurse’s Role in Meeting the Health Needs of the Older Client

• Identify community resources• Identify financial assistance

resources• Identify support networks



Changes With Aging

• Heart conditions (hypertension, vascular disease, congestive heart failure, high blood pressure and coronary artery disease)

• Dementia, including Alzheimer's disease• Depression• Incontinence (urine and stool)• Arthritis • Osteoporosis• Diabetes• Breathing problems• Frequent falls, which can lead to fractures



• Parkinson's disease • Cancer • Eye problems (cataracts, glaucoma, Macular

Degeneration)• As the body changes, other things to be aware

of are:• A slowed reaction time, which is especially important

when judging if a person can drive.• Thinner skin, which can lead to breakdowns and

wounds that don't heal quickly• A weakened immune system, which can make fighting

off viruses, bacteria and diseases difficult• Diminished sense of taste or smell, especially for

smokers, which can lead to diminished appetite and dehydration



How to Teach the Elderly



Educational Considerations

• Multi-sensorial presentations• Multiple repetitions• Reinforce verbal materials with

written• Memory aids• Endurance or time considerations



Thus You Have To:

• Screen for changes that may impair learning

• Adapt to alterations in cognitive processes– Before planning a teaching session, find

out what the patient already knows about the topic Encourage her to provide examples of how she can make appropriate behavior changes.



• Mental capacity generally declines with aging due to a loss of neurons and decreased cerebral blood flow. This affects what's known as "fluid intelligence"— the ability to think abstractly and to see relationships across topics. Thus, watch for these behaviors: prolonged processing time, after-imaging (fixating on a word or idea after the other person has moved on to another topic), limited short-term memory, and "test anxiety."



• Start by giving an overview of what you will cover prior to each teaching session.

• let the patient control the time the teaching session is held

• Allow sufficient time for processing • Take after-imaging into account • Promote the formation of short-term

memory • Avoid creating "test anxiety.



• Use short, simple words and sentences. • Speak slowly, clearly and loudly.• Avoid visual or auditory distractions. • Stick to one topic at a time • Simplify and write down your instructions • Use charts, models and pictures • Frequently summarize the most

important points • Sit face to face with the patient.• Listen without interrupting the patient.• Give the patient a chance to ask

questions.

Meeting the Health Needs of Older Clients Copyright ©2008 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Community.

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