Unit 5 Geriatric Giants

Unit Overview

  • Course: Gerontology and Palliative Nursing (HDNC 4340224)

  • Institution: AIMST University

  • Unit 5: Geriatric Giants

Learning Outcomes

By the end of this session, students will be able to:

  • Define geriatric giants.

  • Explain the four geriatric giants identified by Bernard Isaacs in 1965.

  • Identify common geriatric health needs of older persons.

  • Describe the causes of common geriatric health needs.

  • Explain nursing interventions for these health needs.

Differences in Older Persons

  • Multiple Pathology: Older adults may have multiple health issues simultaneously.

  • Non-specific Presentation: Diseases may not present typical symptoms.

  • Rapid Decline: Conditions can worsen quickly if untreated.

  • High Incidence of Complications: Increased risk of secondary complications from diseases and treatments.

  • Need for Rehabilitation: Rehabilitation is crucial for recovery.

  • Social and Environmental Factors: These influence health outcomes significantly.

Geriatric Giants

  • Origin: Coined by Prof. Bernard Isaacs, addressing significant illnesses related to aging.

  • Key Characteristics:

    • Major disabilities impacting quality of life.

    • Chronic, multiple causes with no straightforward cures.

    • Often leads to reduced independence.

The Four Geriatric Giants

  1. Immobility

    • Definition: Inability to move independently, limiting life space.

    • Causes include:

      • Physical Symptoms: Heart failure, lung disease, arthritis, neurological disorders.

      • Psychological Factors: Depression, fear of falling.

      • Environmental Factors: Poor footwear, flooring defects, low furniture.

    • Nursing Interventions:

      • Use aids to assist mobility.

      • Regular review of mobility status by professionals.

  2. Instability

    • Definition: Poor balance leading to falls.

    • Causes include:

      • Visual Impairment

      • Vestibular Defects

      • CNS Disorders

      • Proprioceptive Issues

    • Nursing Interventions: Focus on improving balance and providing safety measures.

  3. Incontinence

    • Definition: Involuntary leakage of urine occurring at least twice a month.

    • Types of incontinence:

      • Stress incontinence

      • Urgency incontinence

      • Overflow incontinence

    • Causes:

      • Neurogenic issues, functional disabilities.

    • Nursing Interventions: Assess and address toileting needs, provide dignity in care.

  4. Intellectual Impairment

    • Definition: Cognitive decline affecting daily function.

    • Manifestations include:

      • Memory loss, perceptual errors, coordination impairments.

    • Nursing Interventions: Tailored cognitive support and stimulation activities.

The Fifth Geriatric Giant: Frailty

  • Definition: Increased vulnerability to stressors, leading to negative health outcomes.

  • Indicators: Weakness, slowness, weight loss, exhaustion, low physical activity.

  • Nursing Approach: Comprehensive assessments and personalized intervention plans.

Major Health Problems of the Elderly

  • Musculoskeletal: Osteoarthritis, fractures, osteoporosis.

  • Integument: Decubitus ulcers, skin conditions.

  • Urinary: Incontinence, urinary tract infections.

  • Nervous System: Dementia, Parkinson's disease, depression.

  • Respiratory: COPD, pneumonia, lung cancer.

  • Cardiovascular: Hypertension, heart diseases.

Care Approaches for Elderly Clients

  • Multidisciplinary Care Team includes: Geriatricians, nurses, psychologists, physiotherapists, and social workers.

  • Goals of Treatment:

    • Maximize functional ability in Activities of Daily Living (ADLs).

    • Promote health and prevent disabilities.

    • Maintain dignity and comfort until end of life.

  • Activity of Daily Living (ADLs):

    • Eating, bathing, dressing, toileting, mobility, grooming.

  • Instrumental Activities of Daily Living (IADLs):

    • Managing medication, transportation, financial management.

Safety Considerations

  • Skin Care: Use moisturizers, trim nails, and prevent pressure sores.

  • Nutrition: Balanced diet, manage fluid intake, and oral care.

  • Environmental Safety: Proper lighting, prevent tripping hazards, encourage use of walking aids.

  • Emotional Support: Provide a safe space for expression and connection.