Nursing Care Management of Older Adults

Objectives  Review course requirements and expectations  Identify demographic and cultural facts of the aging  Recognize current theories on aging  Discuss issues of therapeutic communication  Incorporate principles of strength based assessment and care management of the elderly

 Working with an elder - Assisted Living experience or self selection (determined by instructor)  Three additional hours a week with the elder during a mutually agreed upon time  Attending conferences related to aging and reporting back to the cohort may be used towards clinical hours

 Complete a Wellness Evaluation including a Body Mass Index assessment (found on blackboard) and any other assessment tool you may determine helpful in the assessment of your elder ( ADL’s, depression scale, nutritional assessment ect..)  A Strength Based Inventory for your elder will be completed based on assessment findings. ( The format for Strengths Based Inventory is on Blackboard )

 ELDER EDUCATION  CARE OF THE ELDERLY REFERENCE BOOK

 Elder Education  Identify an educational need for your elder from your assessment  Develop, implement and evaluate a teaching plan on this health need.  Each learner will give a 5 minute presentation week 8 on this plan (see week 8 for details )  Care of the Elderly Reference Book  Based on the required resources listed in the Competencies of Care of Elders (Institute of Geriatric Nursing )  This is a group exercise  The Reference Book will be donated to a hospital to be used by providers in caring for the aging.

 Learners will be randomly assigned to groups  The group members will select a topic of interest on aging to present to the class  The Nursing Department Rubric for Oral Presentations will be used to grade the presentation.  Each group will peer review all members of their group for the degree of participation and this will be reflected on the individual learners grade

 Week 1 ( Computer generated ) one page guided reflection on aging in another Country. Each learner will share their reflection on week 2.  Week 2 a one page reflection on your feelings during your first interview with your elder. This will be discussed week 3.  Week 5 each learner will reflect on a recent news worthy issue related to aging. The article should be found in a newspaper, news magazine or on internet news and a copy of the article will be attached to the reflection paper. To be shared week 6

 What does aging look like in our society today? Exercise:  WHEN I AM 80 …What will I look like?....Where will I live?…..Who will I live with?’…….How do I fill my days?......What are my joys?......What are my worries/fears?

Population- 5,600,388 (8% increase from 2004) Life expectancy for an infant born in 2005 is 78 years : Whites 79.1 years Blacks 74.3 years Hispanics 74 years

 Death rate increased in 2005 in the following age groups: due to violence and HIV/AIDS due to heart disease and strokes due to heart disease, malignant neoplasm's and strokes

POPULATION 65 Y.O.>POPULATION 80 Y.O. >  Projected to increase from 35 million in 2000 to 71 million in 2030  Projected to increase from 9.3 million in 2000 to 19.5 million in 2030

MEDIAN AGEGLOBAL TRENDS  Global median age is increasing due to: - decline in fertility in developed countries -twenty year increase in the average life span - baby boomers (resulted from elevated fertility in many countries for 2 decades after WWII)  Worldwide population aged > 65 projected to increase from 550 million to 973 million in  Worldwide population. 80 y.o. projected to increase from 9.3 million in 2000 to 19.5 million in 2030

  Name some characteristics of this age group  What health care expectations do they have?

 DNA-Genetic Theory- (Don Kleinsek PhD) – The encoded blue print of genetic aging we receive from our parents.  Neuro- Endocrine Theory ( Dr. Ward Dean, Professor Vladimar Dilman)- A complicated system of biochemical's that govern the release of hormones by the hypothalamus. As we age the hypothalamus does not function as well.  Free Radical Theory (Dr. Denham Harman ) believes free radicals attaching to healthy molecules causes aging. Diet, lifestyle and stress accelerates free radical production and aging.

 Chronological- years since birth  Psychological- do you feel younger or older than your chronological age?  Social- are you living and participating in a community that keeps you active and connected?

 PERCEPTION of one’s health may differ depending on age group. This perception of health shapes quality of life during the aging process and will vary widely from person to person.

 Principle 1- Assessment and building on strengths rather than problems will promote hope, wellness and independence  Principle 2- Older people can make choices and decisions  Principle 3- Elders have the power and ability to learn, grow and change.  Principle 4- Relationship building is essential to gain knowledge of the strengths and wellness beliefs

 Current Status- What do I have going for me?  Individual Desires- What do I want?  Personal/ Social Resources- What has worked in the past?

 Review Ann's Strength Based Inventory. (Found on Blackboard)  In your groups complete a strength based assessment on the case study Sam (found on Blackboard )

Communication with your elder Getting to know you phase (assessment) Planning, Active Phase Implementation Phase Termination Phase Evaluation

 Purpose: (Arnold E., 2000)  To provide a safe, confidential environment to allow client to discuss health information.  To provide education and emotional support and coaching to assist client to reach health goals.  To communicate about a specific concern or strength. Therapeutic communication is goal directed, time limited and has a focus.