Elderly (1-5)

PROVIDING CARE AND SUPPORT TO ELDERLY

STEREOTYPES OF THE ELDERLY

  • Common Stereotypes:
    • Old people are sick and disabled.
    • The majority of the elderly reside in nursing homes.
    • Senility is associated with aging.
    • The elderly have lower intelligence and resist change.
    • Individuals either become very tranquil or very cranky as they age.

CATEGORIZATION OF THE ELDERLY (BASED ON AGE)

  • Age groups for classifying elderly individuals include:
    • 65-75 years old: Young old.
    • 75-84 years old: Middle old.
    • 85+ years old: Old-old.
    • More than 100 years old: Elite old.

PATIENT'S RIGHTS

  1. Civil and Religious Liberties: Right to freedom of expression in civil and religious matters.
  2. Voicing Complaints: Right to express grievances without fear of repercussions.
  3. Refusal of Care: Right to refuse any medical treatment or care.
  4. Participation in Care Plan: Right to be actively involved in creating a personalized care plan.
  5. Respectful Treatment: Right to be treated with dignity and respect.
  6. Freedom from Abuse: Right to live free from physical and mental abuse.
  7. Use of Restraints: Right to be free from physical and chemical restraints.
  8. Privacy: Right to personal privacy.
  9. Communication: Right to communicate with family, friends, and medical professionals.
  10. Competent Care: Right to have care administered by qualified personnel.

RESPONSIBILITIES OF A GOOD CAREGIVER

  • Caregivers should:
    • Respect patients' privacy and individuality.
    • Cultivate trust with the patient.
    • Remain objective; never show pity.
    • Approach patients with an open mind.
    • Avoid antagonizing the patient.
    • Be organized in the caregiving process.
    • Maintain good hygiene practices.
    • Adequately perform various caregiver skills.

TERMINOLOGIES

  • Geriatrics: Study focusing on the physiological and pathological issues in older adults.
  • Senility: The aging process characterized by severe mental deterioration.
  • Senescence: The normal, gradual aging process.
  • Aging: Physiological, behavioral, and social transformations associated with increasing chronological age.
  • Ageism: Stereotyping of older adults based exclusively on their age.

PHYSICAL CHANGES OF AGING

  • Skin: Decreased pain sensation.
  • Eyes: Clouding of the lenses.
  • Ears: Reduced ability to hear high-frequency sounds.
  • Sense of Smell: Decline in olfactory ability.
  • Mouth & Teeth: Loss of gum and bone structure leading to dental issues.
  • Brain: Memory impairments especially notable.
  • Lungs & Chest: Stiffening of respiratory muscles and decreased elasticity of the rib cage.

PSYCHOSOCIAL CHANGES RELATED TO AGING

  1. Retirement: Can lead to adaptation challenges, associated with pursuing deferred projects or difficult adjustments.
  2. Economic Changes: Varied financial needs; rising costs can create management difficulties, particularly for those with low retirement benefits or no pension.
  3. Relocation: May be initiated due to the impracticality of current living arrangements.
  4. Facing Death and Grieving: Survivors face loss, most often women due to longer life expectancy, leading to solitude; coping is aided by meaningful relationships and security.
  5. Cognitive Abilities: Slower retrieval from long-term memory, especially for infrequently used information; short-term memory is particularly affected.
  6. Moral Reasoning: Elders' values stem from different cultural, life experience, and socio-economic backgrounds compared to younger generations.

SAFETY RISKS TO THE ELDERLY AND CONTINGENCY MEASURES

  1. Falls: Mitigation through decluttering and securing areas free from tripping hazards.
  2. Fires: Ensure adequate walking space, lighting, routine checks on appliances, smoke detector maintenance, and safe use of heating equipment.
  3. Poisoning: Install carbon monoxide detectors, avoid misuse of cleaning products, and manage medications diligently.
  4. Abuse and Crime: Implement security measures for the home and encourage caution against strangers.
  5. Consumer Products: Stay informed on product recalls and remove potentially dangerous items from the living space.

CEREMONIAL PERSPECTIVE OF THE ELDERLY

  • Religious, Cultural, and Spiritual Factors: The majority of older adults (over 90%) identify as religious or spiritual, impacting their quality of life and cognitive health positively.
  • Spiritual Needs: Include the need for meaningful relationships, coping ability, and a positive outlook.
  • Cultural Practices: Diverse influences on elderly life involve dietary, medical, artistic, and childcare practices.

PHYSICAL PERSPECTIVE OF THE ELDERLY

  • Signs of Aging:
    • Fine lines and wrinkles.
    • Dullness of skin.
    • Uneven skin tone and texture.
    • Dryness and age spots.
    • Visible pores.

DEMENTIA

  • Dementia Explained: Progressive loss of cognitive functions characterized by memory impairment and chronic cognitive disturbances.
  • Interventions:
    • Engage clients in social interaction.
    • Utilize comforting touch to convey empathy.
    • Use environmental cues like clocks and calendars.
    • Maintain structured routines to minimize stress.

DEATH AND GRIEVING

  • Concept Definitions:
    • Death: The final stage of the life cycle; individual transition.
    • Grief: The emotional process of dealing with loss.
    • Bereavement: The state of mourning after a significant loss.
    • Mourning: Social expression of bereavement.

STAGES OF DYING

  1. Denial: Protecting oneself through avoidance of reality; signs include noncompliance or ignoring symptoms.
  2. Anger: Frequently directed at healthcare personnel or family.
  3. Bargaining: Seeking to extend life through deals with a higher power.
  4. Depression: Resulting from perceived losses associated with health status.
  5. Acceptance: Coming to terms with the inevitable outcome.

SPECIAL NEEDS OF THE DYING

  • Core Needs:
    • Normalcy and meaningful relationships.
    • Emotional support and recreation.
    • Safety and security measures.

GUIDELINES FOR COMMUNICATION WITH DYING CLIENTS

  • Prioritize honesty and refrain from offering false hope.
  • Engage minimally without dominating the conversation; allow the client to lead.

HOSPICE AND PALLIATIVE CARE

  • Hospice Care: A program for patients with a diagnosis of terminal illness, focusing on improving quality of life rather than curative treatment.
  • Palliative Care: A comprehensive approach addressing physical, emotional, and spiritual needs through pain and symptom management.

ADVANCED DIRECTIVES FOR HEALTH CARE/LIVING WILLS

  • Definition: A legal document detailing a person's health care preferences when they are unable to make such decisions.
  • Implementation Steps:
    1. Assessment of patient’s decision-making capacity by a physician.
    2. Physician diagnoses and outlines treatment options.
    3. Evaluation of previously expressed wishes in the directive.

HEALTH CARE PROXY & DNR

  • Health Care Proxy: Individual designated to make healthcare decisions on behalf of a patient when they cannot do so.
  • DNR (Do Not Resuscitate): Legal preference guideline stating that no resuscitation should occur in the event of cardiac arrest; requires a physician’s signature and proper documentation.

PHYSICAL CARE OF THE DYING

  • Care Elements Include:
    • Skin integrity and hygiene.
    • Proper positioning to maintain comfort.
    • Oral and bowel care.
    • Assessing and managing circulation.
    • Nutritional needs and hydration.

POSTMORTEM CARE

  • Procedures Following Death:
    1. Remove excess pillows, leaving one under the head.
    2. Clean the body, removing secretions.
    3. Place dentures as able.
    4. Close the eyes gently.
    5. Straighten the body and limbs for dignity.
    6. Handle gently to prevent bruising.
    7. Consult family regarding jewelry removal.
    8. Position arms over abdomen appropriately.
    9. Review agency policies for any additional requirements regarding care post-mortem.