HLTEN515B Implement and monitor nursing care for older clients · Section 17 Analyse a nursing care plan for the older person ... HLTEN515B Implement and monitor nursing care for

HLT07 Health Training Package

Learner resource

Version 2

Training and Education Support

Industry Skills Unit

Meadowbank

Product Code: 5573

HLTEN515B

Implement and monitor nursing care

for older clients

SAMPLE

HLTEN515B Implement and monitor nursing care for older clients

© TAFE NSW (Training & Education Support, Industry Skills Unit Meadowbank) 2012

Acknowledgments

The TAFE NSW Training and Education Support Industry Skills Unit, Meadowbank

would like to acknowledge the support and assistance of the following people in the

production of this learner resource guide:

Writers:

Glenys Wensor

Kylie Brennan

TAFE NSW

Reviewers:

Beth Rutherford

Chaya(Margaret)Bowring

Amanda Culver

Sherryl Dismorr

TAFE NSW

Project Manager:

Di Dawbin

Education Programs Manager

Training and Education Support, Industry Skills Unit, Meadowbank

TAFE NSW

Enquiries

Enquiries about this and other publications can be made to:

Training and Education Support Industry Skills Unit, Meadowbank

Meadowbank TAFE

Level 3, Building J,

See Street,

MEADOWBANK NSW 2114

Tel: 02-9942 3200 Fax: 02-9942 3257

ISBN 978-1-74236-310-3

© TAFE NSW (Training and Education Support, Industry Skills Unit

Meadowbank) 2012

Copyright of this material is reserved to TAFE NSW Training and Education

Support, Industry Skills Unit Meadowbank. Reproduction or transmittal in

whole or in part, other than subject to the provisions of the Copyright Act, is

prohibited without the written authority of TAFE NSW Training and Education

Support, Industry Skills Unit Meadowbank.

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Table of contents

Introduction ........................................................................................ 7

1. General introduction .............................................................................. 7

2. Using this learner guide ......................................................................... 8

3. Prior knowledge and experience ............................................................ 10

4. Unit of competency overview ................................................................ 10

Section 1 Theories of ageing/changing demographics .................. 13

Section 2 Age related changes ....................................................... 17

Section 3 Stereotypes and ageism ................................................. 25

Section 4 Mental health issues/behaviours of concern .................. 29

Section 5 Elder abuse .................................................................... 47

Section 6 Preventative health assessment tools ............................ 53

Section 7 Communication strategies ............................................. 59

Section 8 Prioritise and address needs of clients with complex/special needs .................................................. 63

Section 9 Community services ....................................................... 67

Section 10 Documentation ............................................................... 75

Section 11 Care of the dying ............................................................ 77

Section 12 Medication administration principles ............................. 83

Section 13 Funding mechanisms that impact on aged care provision ........................................................................ 85

Section 14 Current legal and ethical issues in aged care ................. 89

Section 15 Health promotion in the older person ............................ 91

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Section 16 Impact of complex issues on the carer(s) ..................... 93

Section 17 Analyse a nursing care plan for the older person with complex needs and evaluate .................................. 99

Reference list .................................................................................. 101

Resource Evaluation Form ............................................................... 107

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© TAFE NSW (Training & Education Support, Industry Skills Unit Meadowbank) 2012 Page 13 of 110

Section 1 Theories of ageing/changing

demographics

Growing older is not just an accumulation of years. The ageing process affects us all

in different ways. Some people seem to age faster than others and for others time

seems to leave few traces. The various aspects of ageing, whether physical or

psychosocial, don‟t occur at the same rate for all. Factors which may contribute to the

ageing process include heredity, congenital conditions, nutrition, environment and

lifestyle to name a few. It is important to acknowledge that the ageing process is one

which is natural, part of the human lifespan and should be considered a time of

growth and new challenges and not inevitable decline.

In contemporary Western society getting older is often regarded as a negative

experience. How and why we age is not often considered. The process of ageing is

difficult to explain and thus there are numerous theories as to why ageing occurs.

Ageing is unavoidable and an understanding of why we age will assist us to age more

gracefully or even retard the ageing process. Various theories have been developed

e.g. biological, psychosocial, disengagement and wear and tear. You will be

researching some of these theories and providing your understanding of them in

Activities 2 and 3.

More and more young people are seeking to delay the effects of ageing and to

surgically enhance their looks, in an effort to boost their self esteem. Older people

choose to undergo plastic surgery in an effort to appear younger as there is a stigma

attached to growing old. Either way no-one wants to get older!

There are many new terms associated with ageing that you will learn as you study

this unit. Some useful terms for you to familiarise yourself when nursing the older

person include „gerontology‟ which means the study of ageing. It is also used to

describe a specialty area for health care workers and other professions.

The word „geriatrics‟ refers to the diagnosis and treatment of disorders which occur in

older people. SAMPLE


Page 14 of 110 © TAFE NSW (Training & Education Support, Industry Skills Unit Meadowbank) 2012

Research is being conducted to increase our understanding of the ageing process:

does the body „wear out‟ like a machine, do our changing roles in society cause us to

age or is ageing due to lack of an understanding of how ageing occurs or poor

lifestyle choices? There are many theories of ageing and all sound very plausible.

Activity 2

Access websites, or texts of your choice and create a mind-map of the theories

of ageing which you have found. Write a brief explanation next to each of the theories

to assist you with understanding what they mean. An example is given below.

Activity 1

To assist in your understanding of ageing and the ageing process,

define the following terms:

Life expectancy ____________________________________________________

__________________________________________________________

Life span ____________________________________________________

__________________________________________________________

Morbidity ___________________________________________________

__________________________________________________________

Co-morbidity ________________________________________________

__________________________________________________________

Mortality ____________________________________________________

__________________________________________________________

Senescence __________________________________________________

__________________________________________________________

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Section 2 Age related changes

Growing old is a new experience for the person who experiences it and for their

relatives and friends as well. Your nursing experiences may bring you into contact

with older clients in a variety of settings, from residential aged care to homecare,

from acute care to hospice/palliative care. Providing appropriate basic nursing care to

the older client requires an understanding of the normal progressive changes which

affect the physical, psychological and social aspects of the client.

Activity 1

Refer to related text about the age-related changes which affect each body

system. You will find it useful to document your findings briefly in the form of a

table for your easy reference. In the last column write down some of the disease

processes which may affect individual systems.

Body system Physical changes of ageing Disease processes /

Conditions

Cardiovascular

more prominent

arteries in head, neck and extremities

valves become thicker and more rigid

stroke volume

decreases by 1% per

year

heart pigmented with lipofuscin

less elasticity of vessels

less efficient oxygen utilisation

aorta becomes dilated and elongated

cardiac output

decreases

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Activity 1 (continued)


Conditions

Respiratory

loss of elasticity and

increased rigidity of costal cartilage

blunting of cough and laryngeal reflexes

alveoli fewer in number and larger in size

thoracic muscles more

rigid

lungs are smaller and

more rigid and have less recoil

forced expiratory volume reduced

lack of basilar inflation

decreased ciliary action

Musculoskeletal

muscle fibres reduced in size

muscle strength diminishes

tendons shrink and harden

reflexes lessened

muscle cramping occurs

bones more brittle

impaired flexion and extension movements

shortening of vertebrae

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Conditions

Integumentary

skin loses resilience and moisture

epithelial layer thins

elastic collagen fibres shrink

wrinkling of face and neck

spots and lesions present

angiomas may be found on the trunk

seborrhoeic lesions or keratoses

pressure ulcers

Thermoregulation

lower normal body

temperature

reduced ability to respond to cold/heat

cooler extremities

decreased perspiration

Gastrointestinal

decreased taste sensation

reduced saliva and salivary ptyalin

oesophagus more dilated

liver smaller in size

reduced intestinal blood flow

decreased oesophageal motility

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Conditions

Genitourinary

bladder muscle weakens

and bladder capacity decreases

micturition reflex delayed

decrease renal filtration and renal efficiency

increased incontinence

Female:

diminished breast tissue,

pendulous flabby condition

decreased oestrogen and

vaginal secretions

decreased uterine size

atrophy of epithelial lining of vagina

urgency and stress incontinence

Male:

decreased testosterone,

sperm count and testicular

size

increased prostatic size

urinary frequency and

retention

Neurological

neurons are steadily lost in the brain

synthesis and metabolism

of neurotransmitters are

diminished

brain mass is progressively lost

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Documents

HLTEN515B Implement and monitor nursing care for older clients · Section 17 Analyse a nursing care plan for the older person ... HLTEN515B Implement and monitor nursing care for