Elderly (6-10)

BASIC BODY POSITIONS

  • Supine Position

    • Definition: The patient lays on their back with legs straight and arms at their sides or folded across their chest.

    • Uses: Commonly used in various medical examinations and procedures.

  • Dorsal Recumbent Position

    • Definition: Similar to the supine position, but the legs are bent at the knees with knees pointed upwards.

    • Uses: Utilized during childbirth, genital examinations, procedures, for heart issues, and for running IVs and catheters.

  • Prone Position

    • Also known as: Ventral recumbent position.

    • Definition: The patient is lying on their stomach with legs straight and arms resting at their sides or bent at the elbows facing forward.

  • Fowler's Position

    • Definition: The patient is in a semi-sitting position with varying degrees of torso elevation, typically ranging from 15 to 45 degrees.

    • Types: Low Fowler's (15-30 degrees) and High Fowler's (30-45 degrees).

  • Lateral Recumbent Position

    • Definition: The patient lies on their side (left or right lateral) with the top leg bent at the knee.

    • Support: A stable triangle-shaped support base is formed, with pillows or supports placed beneath the top leg for additional support.

  • Trendelenburg Position

    • Definition: The patient lies on their back with their legs elevated, creating a descending angle where the head is lower than the feet.

    • Note: The patient must be secured to prevent slips or falls.

    • Variation: Reverse Trendelenburg position, where the head is elevated higher than the feet.

BODY MECHANICS

  • Definition

    • Body mechanics refers to the proper use of the human body to perform tasks while minimizing injury and strain.

  • Key Components

    • Balance: Achieving a steady position with weight evenly distributed.

    • Center of Gravity: The point at which the mass of an object is centered.

    • Base of Support: The area on which an object rests, crucial for stability.

    • Body Alignment: Arranging the body in a straight line to keep all body parts in proper anatomical position.

  • Guidelines for Good Body Mechanics

    • Use as many muscles as possible for physical tasks (e.g., use both hands).

    • Maintain good posture: keep the body aligned and back straight.

    • Keep knees bent and weight evenly balanced on both feet.

    • Feet should be at least 12 inches apart to provide a broad base of support.

    • Lift smoothly and in coordination, counting "one, two, three" with helpers.

    • Prefer pushing, pulling, or rolling objects instead of lifting.

    • Always bend knees, keeping the back straight when lifting to avoid strain.

  • Directional Movement

    • Pivot with your feet when changing direction of movement.

    • Turn your body using short steps and avoid twisting the neck and back.

    • When dealing with a patient in a hospital bed, elevate the bed to a comfortable lifting height and move the patient closer to your work side for ease.

POSITIONING RULES

  • General Rules

    • When an arm or leg is swollen, elevate it above the heart to promote fluid drainage via gravity.

    • Reduce pressure on open skin to enhance healing and allow circulation.

    • Support only non-functional parts of the body while allowing movement in other areas to facilitate blood flow.

    • Proper positioning aids clients in maintaining or recovering optimal health status.

ACTIVITIES OF DAILY LIVING (ADL)

  • Definition:

    • Activities of Daily Living (ADLs) refer to basic self-care tasks that measure an individual's independence, particularly for the elderly.

  • Common ADLs Include:

    • Washing:

    • Ability to wash face/body independently, including getting in and out of the shower.

    • Safety concerns: Older adults may require assistance to prevent falls due to balance loss or cold sensitivity.

    • Dressing:

    • Refers to selecting clothing and putting it on independently, including using medical or surgical appliances such as braces.

    • Loss of ability to dress independently can occur due to health conditions (e.g., arthritis, stroke) or cognitive impairments (e.g., dementia).

    • Toileting:

    • Involves getting to/from the toilet and using it correctly; also includes cleaning oneself afterward.

    • Functional disabilities may necessitate using adult diapers due to loss of bladder or bowel control, which increases fall risk for elderly individuals.

    • Feeding:

    • Refers to the ability to feed oneself after meal preparation.

    • Cognitive or physical declines can impact independence, leading to difficulties in feeding oneself due to reduced motor skills or appetite.

    • Mobility:

    • Functional mobility encompasses activities such as sitting, standing, walking, and moving across level surfaces independently.

    • Involves getting on/off the toilet, rising from furniture, and navigating stairs.

    • Transferring:

    • Similar to mobility but focuses on moving from one location to another, such as from a bed to a wheelchair.

  • Instrumental Activities of Daily Living (IADLs):

    • Require higher cognitive functions and organizational skills, including:

    • Managing finances: Paying bills and managing financial assets.

    • Transportation management: Driving or arranging for transport.

    • Shopping and meal preparation: Obtaining groceries and preparing meals.

    • Housecleaning and maintenance: Keeping living spaces tidy and functional.

    • Managing communication: Handling mail and phone calls.

    • Medication management: Acquiring and taking medications as prescribed.