Care of the Elderly

• Definitions of: Aging: The process of growing old

• Ageism: prejudice and discrimination on the basis of age

Health needs of elderly:
The increasing number of seniors in the community increases the need for
health promoting and preventive services.
These services help maximize an older person’s:
1. Ability to remain an independent.
2. Contributing member of society
3. Accessibility to a better quality of life.
4. Eradication and control of many communicable diseases.
5. Use of antibiotics and other medicines.
6. Healthier dietary practices.
7. Safer global water supplies.
8. Regular exercise.
There are three levels of prevention of older adults
1. Primary prevention
Area of concern Primary Prevention Strategies
1.Diet and nutrition • Educate public regarding nutritional needs of older adults.
• Assure access to nutritional foods.
• Eliminate social and environmental barriers to good nutrition.

2.Safety • Educate public regarding safety issues for older adults.

• Promote exercise to strengthen muscles, bones, and joints.
• Eliminate environmental safety hazards.
• Educate older drivers regarding the hazards of driving.
• Promote alternative forms of transportation for older adults.
• Initiate or promote programs to alert fire and police personnel to older clients in specific residences.
• Promote family coping abilities and relieve stress to prevent abuse of older persons.

3.Immunization • Educate older populations regarding the need for immunizations.

• Provide immunization services and assure their accessibility to all segments of the older population
• Develop immunization programs in places where older clients are frequently found.
4.Rest and exercise • Educate the older population on the need for exercise.
• Participate in the development of physical activity programs that address the
most common barriers to exercise among older clients.
• Develop programs to deal with insomnia in the elderly.

5.Smoking cessation • Assist in the development of programs to assist older clients with smoking cessation.
• Educate the older population on the need for and benefits of smoking cessation.

6.Life resolution Encourage reminiscence.

2.Secondary prevention focuses on early detection of disease and prompt intervention Early
Detection or Diagnosis:
Clint Problems Secondary Prevention Strategies

1. Skin breakdown • Inspect extremities regularly for lesions.

• Keep lesions clean and dry.
• Eliminate pressure by frequent changes of position.
• Refer for treatment as needed.

2. Constipation • Encourage fluid and fiber intake.

• Discourage ignoring urge to defecate.
• Encourage regular exercise.
• Encourage regular bowel habits.
• Use mild laxatives as needed, but discourage overuse.
• Administer enemas as needed; discourage overuse.
• Administer bulk products or stool softeners as indicated.
3. Urinary • Refer for urological consult or treatment of underlying physical causes.
incontinence • Refer for modification of medication regimen as needed.
• Encourage frequent voiding.
• Teach Kegel exercises
• Decrease fluids after the evening meal.
• Assist with bladder training.
• Encourage use of sanitary pads, panty liners, etc., with frequent changes of such
aids.
• Keep skin clean and dry; change clothing and bed linen as needed.
• Offer bedpan or urinal frequently or assist to bedside commode at frequent
intervals.
4.Fecal incontinence • Refer for medical treatment of underlying causes as needed.
. • Educate for dietary changes to address contributing factors.
• Encourage avoidance of caffeinated beverages and chocolate.
• Suggest smaller, more frequent meals.
• Suggest eating and drinking at different times.
• Encourage consumption of soluble fiber.
• Encourage sufficient fluid intake.
• Teach Kegel exercises or bowel training
• Suggest strategies to decrease embarrassment.
5. Sensory loss • Provide adequate lighting.
• Keep eyeglasses clean and hearing aids functional.
• Eliminate safety hazards.
• Use large-print books or materials.
• Use multisensory approaches to communication and teaching.
• Avoid using colors that make discrimination difficult.
• Speak clearly and slowly, at a lower pitch.
• Eliminate background noise.
• Assist clients to obtain voice enhancers for phone.
• Use additional herbs and spices, but use with discretion.
• Purchase small amounts of perishable foods.
• Check pilot lights on gas appliances frequently.
• Encourage the use of smoke detectors.
6. Mobility • Provide assistance with ambulation, transfer, etc.
limitation • Assist clients to obtain equipment such as walkers and wheelchairs.
• Install ramps, tub rails, etc., as needed.
• Promote access to public facilities for older persons.
• Assist clients to Find alternative sources of transportation.
• Make referrals for assistance with personal care or instrumental activities as needed.
7. pain • pain activities for times when pain is controlled.
• Encourage warm soaks.
• Encourage adequate rest and exercise to prevent mobility limitations.
• Encourage effective use of analgesics.
• Refer for assistance with alternative pain control measures.

8.COPD(shortness of • Refer for medical therapy (e.g., bronchodilators, steroids, oxygen), as needed.
breath) • Educate regarding safety precautions with oxygen therapy.
• Encourage smoking cessation, as needed.
• Advocate for coverage of smoking cessation under health insurance plans.
• Encourage and refer for pneumonia and influenza immunization.
• Promote adequate nutrition.
• Encourage small, easily prepared and eaten meals or ask for assistance in meal preparation from family
members.
• Discourage use of cough suppressants.
• Suggest taking fluids at the end of the meal rather than before or with foods.
• Refer to Meals-on-Wheels, if appropriate.
• Suggest sitting upright to eat.
• Educate client for pursed-lip breathing, diaphragmatic breathing, and controlled coughing.
• Promote physical activity as tolerated.
• Advocate for access to necessary diagnostic and treatment services.
9.Cognitive • Apply principles of validation therapy, if helpful.
Impairment • Refer for Alzheimer's drug therapy as indicated.
• Refer for antidepressant, mood-stabilizing, or antipsychotic medications as
needed.
• Promote exercise (register wanderers with national registry if appropriate).
• Promote activities to enhance memory (e.g., discussion of current events, games,
puzzles, etc.).
• Educate families and caregivers regarding the progression of disease.
• Provide hand massage or therapeutic touch services or teach these interventions
to caregivers.
• Establish consistent daily routines.
• Reduce environmental stimulation and triggers for aberrant behavior.
• Provide adequate rest.
10.Depression • Accept feelings and reflect on their normality; encourage client to ventilate feelings.
• Refer for counseling or medications as needed.
11.Social • Compensate for sensory loss; enhance communication abilities.
Isolation • Improve mobility; provide access to transportation.
• Assist client to obtain adequate financial resources.
• Refer client to new support systems.
• Assist client to deal with grief over loss of loved ones.

12.Abuse or • Assist caretakers to develop positive coping strategies.

neglect • Assist families to obtain respite care or day care for older members.
• Refer families for counseling as needed.
• Arrange placement in temporary shelter.
• Assist families in making other arrangements for safe care of older clients.
• Advocate for laws and protective services systems that protect older clients from abuse.
13.Substance Identify problem drinking by older clients.
Abuse Refer for therapy, Alcoholics Anonymous, or Al-Anon as appropriate.
3.Tertiary prevention:
Involves follow-up and rehabilitation after a disease or condition
has occurred: Maintain health while assessing increasing
dependency needs, including alternative housing, modifications
transportation, and changing health care needs
Focus Tertiary Prevention Strategies

1. Monitoring health • Monitor health status and treatment effects for individual older clients.
status • Design and implement programs to monitor health status in older client.

2. palliative care • Provide palliative care or refer individual clients for palliative care services.
• Advocate for accessible palliative care services for population groups.

3.End-of-life care • Assist individual clients and families with advance care planning.
• Advocate for adherence to advance directives within health care systems.
• Advocate for effective state and national policies related to advance directives.
• Provide culturally sensitive and appropriate end-of-life care to individual clients.
• Advocate for access to hospice and other end-of-life services.
• Advocate for changes in reimbursement for end-of-life services.
4.Caregiver support • Provide support to individual caregivers, including referral to available support services.
• Educate the public and caregivers regarding their own needs.
• Promote caregiver empowerment.
• Advocate for support services for caregivers.
• Advocate for insurance coverage of supportive services needed by caregivers
THANKS