Foundations of healthy aging

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  1. Aging Cohort
    • Aging is determined by society and culture
    • in 1985 w/establishment of social security old was set at 65
    • in the 2000's was set closer to 70
    • centenarian a person who has lived at least 100 yrs
    • traditional categories:
    • - young old- 65-74
    • - middle old- 75-85
    • - old old 85 or older
  2. Aging depends on
    • decade one was born in or his/her history
    • gender: women tend to live longer
    • ethnic group- certain ethnic live longer
    • Definitions of health:
    • - health is influence by culture and age
    • - wellness is ones whole being; physical, emotional, mental, and spiritual
    • - functional ability are the person's ability to live independently to enjoy family and life. (able to make own choices)
  3. Global Aging
    • 2050, the number of person 60 are older worldwide is likely to exceed those younger than 15 yrs (huge disparity between young and old)
    • occurred in europe in 1995 estimated not occur in North America until 2015
    • people older than 60 yrs of age will not surpass children until 2040 in Asia, latin american, and the caribbean
    • in 2007, japan alread had the highest percentage of person 60 yrs of age and older at 27.9%
    • only africa, major region, when population is relatively young (60 wont exceed)
  4. Identified need for Certification in Gerontology
    • less than 1% RN are certified in gerontolgy
    • only 3% of APRN's are certified gerontology
    • you have to be skilled in this
  5. Healthy people 2020 part 1
    • to attain high quality, longer live and free of preventable diseases, disability injury and premature death
    • to achieve health equity, eliminate disparities, and improve the health of all groups
    • to create social and physical environments that promote good health for all
    • to promote quality of life, healthy development, and healthy behaviors across all life stages
  6. Healthy people 2020 part 2
    • emerging issues in the health of older adults- identifies needs
    • coordinates care- collab with family and care team
    • help older adults manage their own care
    • establish quality measures
    • identify minium levels of training for people who care for older adults- nurse/cna/people who bring the food tray
    • research and analyze appropriate training to equip providers with tools they need to meet basic needs of the older adults
  7. Interventions to promote wellness
    • Preventive service: Screening screening services and preventing illness thru vaccinations (pneumococal and hep b), hearing balance exams, vision, smoking cessation, senses intact. encourage annual wellness exams
    • Wellness and person-oriented intervention: largest barrier to pt's participanting related to lack of knowledge and resources to promote wellness related to coverage by insurance and co payment
  8. select clinical preventive services by race and ethnicity
    • American Indian/Alaskan native adults: 40% need influenza vaccination, 35% need pneumococcal
    • Asian/pacific islander adult: 49% colorectal cancer screening; 47% dm screening
    • black americans: 47% need pneumococcal vaccination 46% influenza
    • hispanic: 51% pneu, 47% colorectal
    • white: 34% need colorectal, 31% dm screening
  9. examples of interventions to promote wellness
    • Preventive services: influenza, pneu, mammogram, colorectal
    • wellness and person-oriented intervention: community outreach- such as home visits, neighbor to neighbor campaign. develop effective reminder systems
    • reminder systems, one to one education and counseling, transportation issues
    • coverage depends of type of test used. develop effective reminder system, reduce structural barriers such as transportation
  10. Maslow heirachary of human needs
    • is an organized framework for understanding individuals and their concerns during a particular time or situation
    • to reach the higher levels, lower levels must be met first
    • the gerontological nurse ensure that the needs of older adults are met and that they can function at a high level of wellness
  11. Level of needs
    • Basic needs: air, food, water, sleep, homeostasis
    • safe and secure: family, health, morality, employment
    • needs to belong: family, friendship, sexual intimacy
    • develop self-esteem and self efficacy: confidence, achievement, respect of others
    • Self actualization: morality, creativity, acceptance, lack of prejudice
    • (healthy lifestyle, quality life, stimulate interest/ engage them, no isolation convo
  12. Orem's universal self-care requirements
    (1, 2) similar to maslow- a nurse theorist 1990
    • 1. maintaining sufficient intake of air, water, food
    • a. taking in the quantity required for normal functioning
    • b. preserving the intergrity of associated anatomic structures and physiologic processes
    • 2. Maintaining satisfactory elimination
    • a. same as b above
    • b. providing hygenic care to the body or surfaces to prevent injury or/and infection
    • c. maintaining adequate and sanitary disposal systems
  13. Orem's universal self care requirements
    • 3 maintaining a balance between activities and rest:
    • a. selecting activities that stimulate, engage and keep in balance physical movement and rest adequate for health
    • b. know when they need activity and when they need to rest
    • c. know cultural norms
    • 4. maintaining a balance between solitude and social interaction
    • a. need personal automy and social interaction
    • b. fostering bonds of affection, love and friendship
    • c. participating in situations of social warmth and closeness
    • d. pursuing opportunities for satisfying group interactions
    • (helps in eliminating depression)
  14. Role of Gerontological Nurse
    • Assist the older person to achieve their highest level of functioning (adapt their level of functioning to meet their needs)
    • fosters empowerment to enhance, and support the client for achievement of wellness (empower them)
    • uses available resources (some don't know what is out there)
    • collaborate with older adult to implement interventions (team care approach)
    • care and comfort always, cure sometimes, prevent what can be prevented (can't heal everything but teach them how to live with it)
  15. We are Aging
    • by 2050 1 in 5 americans will be older than the age of 65
    • the number of those living beyond 100 yrs old is increasing
    • older people are healthier, better educated and expect a higher quality of life as they age than in the past
  16. Eldercare
    • eldercare is the fastest growing employment sector
    • older adults are the core consumers of health care
    • older adults have the highest rates of outpatients visits
    • the interest of nurses to care for older adults is low
  17. Patient protection and affordable care act
    • Provide quality affordable healthcare for all Americans
    • identify the role of public programs
    • improving the quality and efficacy of healthcare
    • Prevention of chronic disease improving public health (biggest focus, need for healthcare will be less)
  18. Current Initiatives
    • Hartford institute for Geriatric nursing- most significant influence (only nurse led org) (great resource)
    • To improve care provided to older adults by:
    • - Promoting geriatric nursing education, nursing practice, nursing research and nursing policy
    • - Providing nurses a web based gerontology resource center to obtain evidence-based information on topics related to the care of older adults
    • - building nursing leadership skills through the geriatric nursing leadership academy (GNLA)
  19. gerontolgy nursing education
    • 2010, the american association of critical care nurses (AACN) addressed the geriatrics nursing educational content for the bachelor's of science in nursing (BSN) degree
    • clinical practice sites are not limited to acute care or nursing home setting but also those elders in the community
    • Identified need for educators: faculty members with geriatrics expertise are scarce
  20. Roles in Gerontological nursing
    • Gero nurses may be:
    • - Generalist: work in hospitals, homes, or sub acute and long term facilities or in the community providing care to individuals and their families
    • - Specialist: work in acute care settings, nursing homes, retirement homes, assisted living facilities, adult daycare centers, and seniorĀ  citizen housing
  21. Gerontological Nursing research
    • research has investigated:
    • 1. interventions for improving care of those with dementia
    • 2. reducing falls
    • 3. use of restraints: dont really use now use of alarms
    • 4. pain management
    • 5. delirium- differ from dementia
    • 6. care transitions- is it safe for them to go home?
    • 7/ end of life care
  22. Other gerontological caregivers
    • CNA and nurses aides provide the majority of care in the nursing home
    • older adults in the nursing home will develop relationships with the CNAs, they are often described as family
    • CNA's must have the respect that is developed in the culture of the care facility
    • CNA's high job turnover as high as 100% a need to promote job satisfaction and quality care across the healthcare continuum
  23. Early history of the Gerontological nurse
    • 1906: Lavina Docl address the needs of older adults in almshouses
    • 1912: The american nurses association (ANA) appointed a almshouse committee to oversee nursing for older adults
    • 1935: passing of social security act- monies were set aside for insurance and assistance
    • 1940: centers of geriatrics excellence were established
    • 1950: the first text book of geri
    • 1968: ANA published geriatrics standards of practice and a geriatrics certificate was offered
    • 1984: the speciality of geriatrics nursing was form
    • **2010: the first edition of scope and standards of gerontology nursing practice is published
    • 2013:Gerontology acute and primary care certified nurse practioner
  24. Community based homes care
    • care of elders living in the community (people checking in on them)
    • independent in home care
    • senior housing
    • adult day health
    • high healthcare cost people are being d/c home earlier with home care team
    • assessment, wound care, medication compliance, IV therapy, rehab, palliative care
  25. Focus of Acute and long term care
    Acute care orientation: illness, high technology, short term, episodic, one dimentional, professional, medical model, cure

    Long term care orientation: function, high touch, extended, interdisciplinery model, ongoing, mulitdimentional, paraprofessional and family, care
  26. Skilled nursing homes and facilities
    • mixed patients some with skilled nursing, rehab units, dementia units
    • 2 types:
    • - skilled nursing care
    • - sub acute: patients with complex needs length of stay usually 1 month (higher levels of professional staffing
  27. Long term care or custodial care
    • 24 hour personal care
    • pts with strokes, dementia, hospice and more than 50% have some cognitive dysfunction
    • american healthcare association (2010) identifies there is a need of 41% of RN's in long term facilities
  28. Levels of Staffing
    • only 1 RN is required for staffing in a nursing home for 8 hours day the rest can be LPN's and CNA's
    • need for more direct care. RN's have shown benefits of decreasing hospitalizations, pressure ulcers, UTI (which cause confusion) and weight loss
  29. goal of LTC
    • provide safe & supportive environment for chronically ill and functionally dependent people
    • restore and maintain highest level of functional ability
    • preserve individual autonomy
    • maximize quality of life, satisfaction w/care
    • provide comfort and dignity at end of life for residents and families
    • provide coordinated care to subacute ill residents who plan to return to homeless restrictive level of care
    • stabilize and delay progression when possible of chronic medical conditions
    • prevent acute medical/atrogenic illnesses. identify and treat rapidly
    • create a homelike environment that respects dignity of each resident
  30. SPICES
    • Sleep pattern
    • Eating
    • Incontenience
    • confusion
    • evidence of falls
    • skin
  31. Gerontology Organizations
    • demostrates the need for interdisciplinary collaboration in research and practice
    • improve the understanding of direct care among disciplines
    • provide nurses the opportunity to occupy positions as officers and committee chairs
    • include national and international concerns
    • are associations for nursing assistants
  32. implication for gerontological nursing
    • nursing is a vital aspect of health care for older people
    • gerontogical nursing specialization provides experts in caring for older people
    • Gero nursing have made an impact in research
    • Gero nursing is the most needed specialty
Card Set:
Foundations of healthy aging
2015-05-28 02:26:08

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