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Consequently, experiencing a loss for the elderly can be very
stressful.
If the elder is unable to resolve the sadness around the loss,
he/she may experience COMPLICATED PATTERNS OF GRIEVING.Complicated
grief can lead to years of emotional suffering and turmoil.
It is important for the care provider to recognize the grief
surrounding the elders experience with a loss.THREE PROACTIVE
STEPSAWARENESS grants permission to acknowledge that indeed a loss
has occurred
ACCEPTANCE provides a feeling of gratification, eliminating
conflicting feelings that clash because the elder is unsure how to
come to terms with the problem
ACTION- allows the elder to move beyond the loss and replace it
by putting something back into his/her life.
COPING WITH A CHRONIC ILLNESSChronic illnesses can create stress
in elders and the care providers, both physically and
psychologically.
Apart from impairing physical and mental health, chronic
illnesses may also have negative impact on occupational and social
functioning thus affecting the quality of life of the elders and
the care providers.STRATEGIES FOR COPING WITH CHRONIC ILLNESS1).
ACQUIRE NECESSARY KNOWLEDGE AND SKILLS understand the illness
actively by consulting health care professionals and reading
relevant reference books. The care provider may acquire skills to
meet the specific needs of the patient in order to provide
appropriate support.
2). BE OPTIMISTIC AND THINK POSITIVE increase the elders
compliance to treatment regime and can motivate them to adjust
their lifestyle thus help to promote healthy living. The elders
should continue to participate in activities of daily living to
improve self care abilities
3).PRACTISE HEALTHY LIFESTYLE It is vital importance to maintain
healthy lifestyle for good health. A) observe good sleep hygiene B)
regular exercise C) balanced diet
4). BUILD UP A SUPPORT NETWORK regular social life helps to
increase confidence, improve mood and promote a positive
attitude.Keep an open mind and accept care and support from
relatives and friends.Seek advice from health care professionals
and share with other patients.Social Isolation is not a natural
consequence of aging and chronic illness.
5.) PICK YOUR OWN RELAXATION STRATEGIES like deep breathing
relaxation, progressive muscular relaxation, Tai Chi or listening
to music.These help to break the vicious cycle of excessive
anxiety, deteriorating health, escalation of anxiety, fluctuating
course of illness.
6.) ACT SMART AND SEEK HELP there are many different
organizations that provide services and support to the chronically
ill and elderly.PATIENT EDUCATIONIt is important for as nurses to
understand normal physiological changes that occur with age and to
know how to adapt teaching strategies to accommodate the
changes.
It is important to interact with each elderly patient as a
unique individual, capable of learning and changing.
Patient teaching for older people should be delivered with the
same enthusiasm and conviction with which it is provided to younger
patients.During the teaching-learning process (assessment,
planning, implementation and evaluation), focus your attention not
just on the existing medical problem, but also on the potentially
numerous functional and psychosocial problems that are common to
old age.
Detailed history is a critical part of the assessment.
With advancing age, there is a corresponding normal decline in
sensory function including vision, hearing and touch.TEACHING
STRATEGIES 1) present new information at a slower rate than you do
for younger patients.2) speak in a low tone of voice 3) allow
enough time for the patient to assimilate and integrate conceptual
materials.4) emphasize concrete rather than abstract material.5)
reduce environmental distractions
STRATEGIES TO COMPENSATE FOR IMPAIRMENTSFOR IMPAIRED VISION: Use
adequate diffused lightAvoid having older patient face a direct
source of lightIf with prescription glasses- make sure they are
being wornUse large print for labels and instructions.FOR HEARING
LOSS:Use low-pitched voiceSpeak clearly and slowly and face the
patient while talkingIf with hearing aid encourage to use itAsk the
patient questions to verify whether he or she understood what you
have saidGive written information as backup to what youve presented
orally
FOR LIMITED ENDURANCE:Keep teaching sessions short-no more than
10-15 minutes and schedule them to allow patient rest as
needed.Never rush the older personDo not set limits on task
performance
FOR MEMORY:More likely older person remember information he or
she hears than information he or she reads.Repeat the message
frequentlyAsk question regularlyPay particular attention to the
language you use.Select clear, simple terminology and talk on the
patients levelKeep interaction short and simpleReturn demonstration
are important to ensure they are able to do psychomotor skills
independently
SPIRITUAL CAREReligion may provide psychological benefits :A
positive and hopeful attitude about life and illness, which
predicts improved health outcomes and lower mortality rates A sense
of meaning and purpose in life, which affects health behaviors and
social and family relationships
C) A greater ability to cope with illness and disabilityMany
elderly people report that religion is the most important factor
enabling them to cope with physical health and life stresses.
More than 90% of elderly patients relied on religion.
Elderly people who use religious coping mechanisms are less
likely to develop depression and anxiety than those who do not.
Some religious groups (mormon, seventh-day adventists) advocate
behaviors that enhance health.ROLE OF HEALTH CARE
PRACTITIONERTalking to elderly patients about their religious
beliefs and practices helps health care practitioners provide care
because these beliefs can affect the patients mental and physical
health.Inquiring about religious issues during a medical visit is
appropriate under certain circumstances, including the following:A)
when patients are severely ill, under substantial stress or near
death.B) when patients tell a practitioner that they are religious
and that religion helps them cope with illnessC) when religious
needs are evident and may be affecting patients health or health
behaviors Health care practitioners should support the patients
religious involvement as long as it doe not interfere with
necessary medical care because such involvement may contribute to
good health.
Some practitioners pray with patients, read religious scriptures
to them or make sure patients have the religious materials they
want. However, practitioners should not feel obliged to do anything
that violates their own beliefs.RISK REDUCTION ACTIVITIES FOR
ELDERLYPROBLEMS IN THE KITCHEN:Open flames and burners- use a
microwave, hot plate, electric stoves, toaster and coffeemaker.Hard
to open refrigerator have one with a foot leverReaching items -
place everyday items within easy reach, adjust the height of
counters, cupboards and drawers.Carrying items - use a cart or
walker basket or slide items across a counter.Difficulty seeing use
contrasting colors for china, place mats and napkinsPROBLEM WITH
THE TELEPHONE:
Difficult to reach - use a cordless phone and tell friends to
give you 10 rings to answer. Also, call can be answered by an
answering machine you just return the call.Difficulty hearing the
ring use volume control, blinking lights or vibrationDifficulty
holding the receiver use a headset, speakerphone or adapted
handles.Difficulty dialing numbers program preset number, use a
phone with large buttons and numbers PROBLEMS WITH STAIRS:
cant climb or go down - use a permanent, portable or removable
ramp.No handrails - install on at least one side; make sure the
installation is stableCannot use a walker on the stairs have a
second walker or wheelchair at the top or bottom of the
stairs.PROBLEMS WITH MEDICATIONS:Difficulty reading labels ask the
pharmacist for large print on prescription labels, use a magnifying
glass and have adequate lighting.Memory loss user automatic pills
dispensers, organise medications in envelopes with the time and
date.
PROBLEMS WITH LEISURE ACTIVITIES:Cannot hear the television use
a personal listening device with an amplifier. Select programs with
closed captions.Remote is complicated use a remote with large
buttonsCannot read small print use a magnifying glassGlare on
reading materials place the light source to the left or right of
the material, avoid glossy paper in reading materials and read
black ink rather than blue ink or pencil
ETHICAL ISSUESADVANCE CARE PLANNING involves advance preparation
for lifes unexpected emergencies. Provides greater control over
decisions that affect a persons future and takes into consideration
the persons beliefs and preferences in the event they are unable to
make decisions on their own.
HEALTH CARE often referred to as medical ethics, relate to
issues of privacy, confidentiality and informed consent as well as
the courses of action involved in makinng medical decisions.FINALS
TOPICFRANELEE A. ZULUETA RN,MNRIGHT TO PRIVACY medical treatment
often involves sensitive subjects that we would rather not share
with other people- even those who are very close to us.
RELIGION AND HEALTH CARE it is crucial to know your religions
true beliefs about certain medical procedures.COPING ASSISTANCE FOR
ELDERLYCOPING WITH LOSS:
As we age we become more frequently exposed to loss and grieving
becomes more apparent
Losses: spousal/conjugal, siblings, friends, children, physical
and cognitive functions, self-esteem, roles, autonomy, home, job,
finances, community status, intimacy, objects and pets.There is a
strong correlation between attachment and loss.
The degree of attachment and the type of loss can affect how the
elder people copes.
The elders may become depressed, anxious and even suicidal.
There is a high incidence of suicide among elderly than the
younger person.
Many elderly resort to substance abuse to cope with loss
