Geriatric nursing  Encourage independence and encourage him to

take his choices and decisions

Aging is a continuous, complex, and dynamic process
 Assists elderly to achieve emotionally stability
that begin with birth and ends with death. It is a
 Stimulate mental acuity and sensory input and
continuous and non-repairable process of human life and
physical to uplift their self-esteem, self-concept,
body decays gradually and slowly with time; not only a
and confidence.
physical body but the mind too. The thought and
 Make elderly stay at home interesting and lively
adaptation also change as we grow older our
 Provide diversion/occupational therapy
haemostatic mechanism become less sensitive, slower,
 Maintain privacy
less accurate and less well sustainable. As a result of the
process to aging changes in human tissues cells occur  handle them gently
which bring about alterations in the appearance and  make them comfortable by providing comfortable
abilities of the individual. The risk death is also increases bed, bed linen etc.
in the age advances.  encourage them to maintain body hygiene thus
regulate body temperature
Definition  assist them to take care of visual, auditory, and
dental aid
Elder- all individuals over the age of 65-74 were
considered older or elder. It can be categorized in to 3 geriatric health team
types.
 geriatrics, nurses, physiotherapist, health worker,
 Young old: 65-75 years old social worker
 Middle old: 75-84 years old
 Old: 85-100 years old changes with the aging process

Aging process a. changes in posture and appearance-at aging

process lean body mass in muscle tissue is lost,
 Heredity whereas the proportion of fats increase. Change
 Nutrition in body composition is due to the result of ther
 Health status diet and lifestyle, the skin becomes wrinkled,
 Life experiences dried and tougher skin surface due to the
 Environment ultraviolet from the sun which damage the elastic
 Activity fiber and this is known as photo aging
b. changes in Musculo-skeletal system – older
 Stress produce unique
people suffer from arthritis, paralytic, stroke in
Geriatrics – this word Is taken greek word “gears” (old addition to osteoporosis problems. This produces
age) and iarik (medicine) is the branch of medicine stiffness of joint making them difficult for easy
concerned with medical problems and care of older movement such as getting up from a chair, to
people. turn their neck and to keep an erect posture.
c. Changes in CNS- because of changes in CNS
Gerontology – this is the scientific study of the process older people develop decrease ability to orient
and problem of aging and focuses on the biological their bodies in space to detect externally induced
aspects of normal aging. changes in body portion. Atrophy of the brain
decrease blood flow and affection of peripheral
Geriatric nursing – it defined as the specialized nursing
nerves like deep tendon reflexes
care of the older adults that occur in any setting in which
d. Changes in respiratory system- w/ aging the
nurses use knowledge, expertise and caring abilities to
respiratory muscle strength is reduced, the lungs
perform optimal functioning.
loose elasticity so that efficiency in breathing is
General principles of geriatric reduced.
e. Changes in immune system- this aging affect
 Consider individually, consult his preferences immune system of the body making it defective
 Be patient, kind and sympathetic, communicate and attacking not just foreign proteins, bacteria,
effectively demonstrate respect
 viruses, but also producing antibodies against - Changes in hearing, an older person who is
itself (i.e. diabetes and rheumatoid arthritis having a hearing loss learns to adapt and make
f. Changes in cardiovascular system – a loss of changes in behaviour and social interaction, so
elastic tissue and increase in collagen and the as to reduce the bad social impact of hearing
muscle fibres are deposited with an age, pigment loss.
of fats and proteins called LIPOFUSICIN which is - Changes in taste and smell, in older people
the cause of loss of elasticity in the arteries their taste also changes due to the loss in taste
g. Changes in urinary system- the kidney also buds as the age or their ability to appreciate
lose their capacity to absorb glucose as well as taste. So they may require more salt, more spicy
their concentrating and diluting ability food so in order to avoid giving more salty and
contributing to increased problems w/ spicy food.
dehydration and loss of salts in the blood
h. Changes in gastrointestinal system- the main The common old age health problems
changes are the decrease in contraction of the
Cardiovascular disease – hypertension,
muscle and more time for the cardiac sphincter
atherosclerosis, congestive heart failure, cardiomyopathy
to open, thus taking more time for the transmitted
strokes
to the stomach before having a full meal. This will
produce loss of appetite and cause deficiency in Locomotor disorder- osteoarthritis, rheumatoid arthritis,
nutrients, this is the reason older people eat gout, fibrositis, myositis
small amount of salt.
i. Changes in endocrine system - this estrogen Cancer- prostrate and breast cancer
protects women from hard disease and bone
demineralizing. The other hormone are Diabetes and urinary incontinence
testerone, thyroid, growth hormone and insulin
Role of nurse in elderly care
production are decreased. Changes in insulin
level causes high blood sugar level and diabetic.  Promotion of self respect and dignity- the aim
j. Changes in reproductive system- in men the in the geriatric ward should be to reduced to a
sperm count decrease erection process minimum amount of control, restriction and
decrease urge for sexual intercourse gradually supervision imposed upon patients and to
decrease. In women the production of the eggs encourage the maximum of personal choice,
in the ovary decrease and menopause sets in decision making and emotions should be shown
along with less estrogen. Vaginal secretion  Approach towards the elderly- elderly may
decrease causing dry vagina. Laxity in pelvic have difficulty in understanding what is said to
floor causes prolapsed of the uterus and bladder. them because of loss of sensory function and
Incontinence of urine, cancer breast ovary and reduced comprehension. They should be spoken
cervix are common in old age. to clearly and face to face.
k. Changes in sensory function- sensation is the  Promotion of comfort- physical and mental
process of taking information through sense comfort and relaxation has to be achieved. Care
organs. of the skin, care of the body structure, maintain
- Changes in touch, deteriorate w/ age especially nutritional status, maintain fluid balance, maintain
in finger-tips and palms and in the lower body temp.
extremities, this is my also cause less level of  Safety- correct height of bed and chairs, extra
painful stimuli, but they may complain of pain due comforts w/ cushion, the provision of walking
to thedepression. aids like walker or sticks or wheel chairs, grab
- Changes in vision, loss of vision in older people nails to hold and walk and also hand rails, which
prevents the form their daily activities. The are environment features that contribute to the
important problems is the changes in the visual safety of the pt.
pathways of the brain and in the visual cortex  Promotion of independence- Pt. is encouraged
which block the transmission stimuli from the to be out of bed as much as possible according
sensory organ. to the capabilities and needs. Movement and
mobility should continue throughout the pt. care.
  Promotion of mental activity and interest- the confined themselves. Spend time with them, chat
disease and disabilities and social problems of w/ them, and make them feel wanted, cared for
the elderly are such that the time spent in and loved. Pay special attention to their room.
hospital may be an extended one. Your could consider installing a few senior citizen
 Use of medications in elderly- drug interaction firneldy appliances which they would be use.
increases with age and the number of the drugs  Psychological need of the elderly- elderly can
taken. Many elderly report adverse reaction to be easoly overwhelmed by a disaster and may
the medication therefore the nurses should know experience difficulty in coping w/ the situation
the various drugs, their actions, side effects, and and their feelings. We can help them by talking
must cautiously for the elderly. openly about what has happened and how they
 Rehabilitation- rehabilitation for elderly includes feel about it. Encourage them to also speak
all those activities which aim at restoring the pt. freely about whatever is on their minds. Be
to the highest possible degree of independent careful not to argue with them or to tell them how
living of which he is capable which also include they should feel. There feeling are real to them
physiotherapy and speech therapy and nurse need to validate those feeling, express
 Role of community and family- the ultimate confidence in your ability to help them
aim of treatment and rehabilitation is to achieve  Emotional needs - elderly not only physical
for the person a normal social setting obstacles as their bodies age but they
 Assess elderly for elderly abuse- many of the experience emotional challenges as well. Seniors
elderly are abused in their own home in relatives are faced w/ stress that may include living on a
homes and even facilities responsible for their reduced retirement income or being unable to
care. Elderly person can be harmed physically or care for theselves independently. Caretakers
emotionally neglectful or overwhelmed caregiver need to know what to expect regarding the
or being preyed upon financially emotional of seniors and be prepared to help w/
 Teach the self care- the aim of the geriatric them
nursing is along with to provide the  Spiritual needs- many elders take their faith and
preventive,promotive and curative care the religious practice very seriously and display a
rehabilative care is also provided by the nurse. high level of spirituality. Involvement in religion
often helps the adult to resolve issue related to
Needs of elderly the meaning of life, to adversity or to good
fortune. Religion may also be an important
 Physical needs – it is important part of total coping resource, leading to enhanced well being.
health programme the elderly. It is vital to keep
moving and exercise; maintain circulation, Abuse of early
muscle tone and general health and to prevent
disuse deformity. The need for the physical - Abuse involves physical emotional or sexual
safety is upmost important. abuse and also can neglect or economic
 Mental needs- disease associated w/ aging- exploration
such as Alzheimer and Parkinson become more - Mistreatment of older people referred to as elder
commonplace as well. All of this takes a toll on abuse- was first described in british scientific
their mental health, too. Knowing their health is journal in1975 under the term granny battering
declining can be disappointment hard to cope - Old people may have to undergo a lot of neglect
with. Losing loved ones as the age brings on - The abuse may be a physical nature may it be
seemingly never ending parade of grief. And the psychological (involving emotional or verbal
isolation of being place in an assisted living aggression) or it may involve financial or other
facilities or nursing home can make some people material maltreatment and the neglect may be
feel like there’s little left to live. intentional or unintentional
 Social needs- one thing that should keep on - Elder abuse refers to ill treatment of an elderly
mind is to shwer all your love and care on your person.
elderly relative or family member. Just because - It is a very sensitive issue and require a high
they have become old and slow, doest not mean index of suspicion
that you should ignore them or let them be
Victims guarantee aging in place that is the resident can move
from one level of care to the next as needs change. For
- A female of very advanced age residents the transition to a nursing home is easier,
- Role less family because they are able to remain in familiar surroundings.
- Functionally impaired They may require buy in or an up front annuity purchase
- Lonely followed by monthly payments which cover services,
- Some are men amenities, and needed medical care

Legal and Ethical issue Nursing home (skilled nursing facility)- offer 24 hrs a
day car for those who can no longer live independent. In
- Informed consent nursing homes trained medical professionals provide
- Autonomy specialized care to seniors with severe illness or injuries.
- Euthanasia Specially in short term or acute nursing
- Assisted suicide care ,intermediate care
- Pallation

Types of facilities – the range of housing options and

varying levels of care offered within senior communities
helps ensure that every senior will find a perfact match
for their housing needs and for their lifestyle

Independent living facilities- are ideal for senior who

does not need personal or medical care but who like live
with other seniors who share similar interest. Im ILF
seniors can take advanatage of planned comm. Events,
field trips, shopping, excursions and co-premise project.
The apartment are not licensed and regulated.

Adult homes- are licensed and regulated for temporary

or longterm residence by adults unable to live
independently. They usually include supervision,
personal care, housekeeping, and 3x meals a day

Family types home- offer a long term residential care,

house keeping and supervision for four or fewer adults
unrelated to operator. The department of social service
overseas their operation

Enriched house- is similar to adult homes with the

exception that seniors live in independent living units.
They offer a minimum of one meal per day and are
licensed by state department of health

Assisted living facilities- an excellent alternative to

nursing homes for senior who need help with their ability
but who do not need 24 hrs care. Room board, case
management and skilled nursing service come from
outside agency. This program accept medical,
supplemental security income (SSI) and home relief
recipients

Contuining care retirement communities (lifecare

comm.)- offer a variety of facilities from assisted living
facilities to nursing home all on one campus. They