CARE OF THE GERONOLOGIC PATIENT IN VARIOUS SETTINGS Home Assisted Living Hospital Long Term Care

HOME CARE Encourage independence Support from family Coordinated health care plan -yearly physical with health care provider -appropriate med administration -community/government resources as needed

ASSISTED LIVING Promote as much independence as possible Monitored health care Support services provided

Health Care Issues in Hospitals Sleep disorders Problems with eating and feeding Incontinence Confusion Evidence of Falls Skin breakdown

SLEEP DISORDERS Keep patients awake during the day Manage patient’s pain especially before bedtime Provide a conducive environment for sleep

Problems with Eating or Feeding Collaborate with nutritionist regarding patient’s diet: -preferences of patient -cultural preferences Manage GI symptoms (nausea/vomiting) Appropriate dentures Appropriate diet(pureed)

INCONTINENCE Bladder and bowel training Identify potential UTI and treat Pharmacological measures -detrol -ditropan

CONFUSION Reorient the patient as much as needed -clocks -calendar Avoid multiple drugs if possible Promote adequate sleep

SKIN BREAKDOWN Assess for risk of pressure ulcers (Braden Scale) Nutritional support Avoid skin injury from friction/shearing forces Repositioning and support surface When appropriate: mobility & activity level Skin care: cleansing and use of moisture barriers

FALLS Assess risk for falls -recent fall history -advanced age -general weakness/decreased mobility -disorientation -incontinency -visual problems

FALL PREVENTION Monitor activities Frequent toileting Provide/remind patient of assistive devices -Walker, cane, glasses, hearing aids Provide a safe environment - good lighting -clutter free environment

Restraints Reduction of use in nursing homes and hospitals Chemical restraints Physical restraints used when chemical restraints and warnings fail

LONG TERM CARE Acute nursing care not required Individuals in need of skilled nursing care Similar health care issues as in the hospital