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Health Care of Older Adults

Health Care of Older Adults. Some facts about the elderly – Currently about 13% of the population 50% to 80% of hospitalized individuals (med/surg) are > 65 years of age 75% of malignancies are diagnosed in individuals who are > 75 years of age

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Health Care of Older Adults

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  1. Health Care of Older Adults • Some facts about the elderly – • Currently about 13% of the population • 50% to 80% of hospitalized individuals (med/surg) are > 65 years of age • 75% of malignancies are diagnosed in individuals who are > 75 years of age • The fastest growing group of elderly individuals are those between 85 and 95 years of age (the “old-old”) (Ignatavisius & Workman, 2010)

  2. Health Care of Older Adults • Why is it important for healthcare providers to be aware of the specific health needs of elderly adults? • What are some of the common health issues faced by elderly adults? (metabolism slower, polypharmacy, brain cells atrophy, risk for falls, bleeds that go unnoticed) • What is the role of the nurse in providing care to older adults? (book does a good job of talking about that)

  3. Health Care of Older Adults • Late adulthood is divided into four distinct groups. Of these, the “old, old” is the fastest growing • 65 to 74 years of age: the young old • 75 to 84 years of age: the middle old • 85 to 99 years of age: the old-old (a/k/a “the frail elderly”) • 100 years of age or more: the elite old (Ignatavicius & Workman, 2010)

  4. Health Care of Older Adults • Health issues faced by elderly individuals include: • Health promotion - Elderly neglect/abuse • Self-management - Mobility • Nutritional awareness • Accidents - Stress management • Drug use and misuse • Mental health/behavioral health issues (Ignatavicius & Workman, 2010)

  5. Health Care of Older Adults : Health Promotion • Health promotion: • Needed to ensure optimal level of health • Risk factors that negate “successful” aging • alcohol abuse • smoking • depression • lack of exercise and obesity. • Individuals at greater risk for health problems: • minorities (Ignatavicius & Workman, 2010) • uneducated

  6. Health Care of Older Adults • Chronic conditions are a significant contributor to ill-health in the elderly population (stroke, heart disease, diabetes, COPD) • What are some of the chronic illnesses? • How might these conditions have a different and/or greater impact on elderly individuals as compared to other people? (think of how the different systems of the body are slowed down… actual anatomy changes/slows)

  7. Health Care of Older Adults: Health Promotion • Education • Flu shot • Pneumococcal vaccination • Tetanus immunization (booster at 10 years) • Seat belts • Alcohol in moderation / Smoking – No • Hazard-free environment • Meds only as prescribed / Avoid OTC meds • One aspirin daily (between 81 & 325 mg) Why?

  8. Health Care of Older Adults: Health Promotion • Yearly physical examination (more often if needed) • Reduce intake of fat to 30% of calories; saturated fat less should be < 10% of total calories (Examples of saturated fats?) • Increase fiber-containing foods (Examples?) (Ignatavicius & Workman, 2010)

  9. Health Care of Older Adults: Health Promotion • Increase calcium intake (Why?) • Exercise 3-5 times a week for 30 minutes each time (weight bearing, walking, doing weights) • Coping • Socialization • Talk about your life… (a lot of them are lonely… just want to talk) (Ignatavicius & Workman, 2010)

  10. Health Care of Older Adults: Health Promotion

  11. Health Care of Older Adults: Self Management • Elderly individuals experience losses that may include • Death of a spouse and significant others • Loss of social networks (homebound, friends dye) • Decrease in mobility • Reduced sense of control • Sense of increasing years • What is the role of the nurse assess cog. Ability, coping mechanisms, abililty to do ADLs, what is their normal social network?(Ignatavicius & Workman, 2010)

  12. Health Care of Older Adults: Nutrition • Elderly individuals are at risk for under-nutrition • Older individuals require increased intake of calcium, vitamins A, C and D (Why?) • Because… • Aging interrupts the body’s capacity for storing, using, and absorbing these nutrients • What else? (Ignatavicius & Workman, 2010)

  13. Health Care of Older Adults: Physical Mobility • Exercise has been shown to aid in • Decreasing falls • Increasing strength • Reducing arthritis pain • Reducing depression • Improving longevity • Reducing risks for diabetes and coronary artery disease (Ignatavicius & Workman, 2010)

  14. Health Care of Older Adults: Stress Management • Maintaining and establishing relationships • Close, stable relationships (having someone to confide in) helps to increase ability to response more positively to stress Less favorable response to stress!

  15. Health Care of Older Adults: Environmental • Changes in vision, touch and mobility contribute to problems in adjusting to a new environment • At home, safeguards should be in place (Describe) • “Fallophobia” • “Polypharmacy” (Ignatavicius & Workman, 2006)

  16. Health Care of Older Adults: Drug Use • Physiologic changes in elderly individuals equate to changes in the ability to absorb, distribute, metabolize and excrete the drug • Drug metabolism most often occurs in the liver • Age related changes: decrease in liver size; decrease in liver blood flow; decrease in liver enzyme activity = increased plasma concentration of a drug (Ignatavicius & Workman, 2010)

  17. Health Care of Older Adults: Drug use • Excretion of drugs most often involves the renal system • Age related changes include decrease in renal blood flow and reduced glomerular filtration rate – result in decreased creatinine clearance and slower excretion time for drugs – thus, serum drug levels can be toxic, and the individual may become ill or die (Ignatavicius & Workman, 2010)

  18. Health Care of Older Adults: Common Adverse Drug Reactions • Edema * Dizziness • Nausea and vomiting * Diarrhea • Dry mouth * Constipation • Anorexia * Urinary retention • Fatigue * Confusion • Weakness (Ignatavicius & Workman, 2010)

  19. Health Care of the Older Adult: Depression • Most common mental health/behavioral disorder affecting elderly individuals • Thought to be the result of a lack of the neurotransmitters norepinephrine and serotonin in the brain • Often under-diagnosed (Ignatavicius & Workman, 2010)

  20. Health Care and the Older Adult:Depression • Depression (untreated) may result in • Worsening of a medical condition • Risk of physical illness • Alcoholism • Increased pain and disability • Delayed recovery from illness • Suicide (esp. elderly men) (Older adults have the highest suicide rate among any age-group) (Ignatavicius & Workman, 2010)

  21. Health Care of the Older Adult:Dementia • Dementia is a broad term used to describe encompassing impairment of intellectual function • Chronic and progressive • Most common type: Alzheimer’s disease • Multi-infarct dementia – 2nd most common (Ignatavicius & Workman, 2010)

  22. Health Care of the Older Adult:Delirium • “Acute stage of confusion” • Often seen in older adults who are in unfamiliar surroundings • Two types: hyperactivity (most common) and hypoactivity (less common) • Differs from dementia • Is short term • Is reversible (usually within 3 weeks) (Ignatavicius & Workman, 2010)

  23. Health Care of the Older Adult:Delirium (Causes) • Medications • Metabolic disturbances • Infections • Surgical operations • Circulatory, renal, and pulmonary disorders • Nutritional deficiencies • Major loss (Ignatavicius & Workman, 2010)

  24. Health Care of the Older Adult: Neglect and Abuse • Verbal and physical • Abuser most often a family member • Caregiver role strain • Four most common types of abuse • Neglect • Physical abuse • Financial abuse • Emotional abuse (Ignatavicius & Workman, 2010)

  25. Health of the Older Adult:Neglect and Abuse • Neglect • Caregiver does not provide for the elderly person’s basic needs or ADLs • Intentional or non-intentional • Neglect occurs in half of all cases of elder abuse • Physical abuse • Results in bodily injury, esp. the “bathing suit” area (Ignatavicius & Workman, 2010)

  26. Health Care of the Older Adult:Neglect and Abuse • Financial abuse • Property or other resources is mismanaged or misused • More common than physical abuse • Emotional abuse • Intentional use of threats, humiliation, intimidation and isolation toward elderly individuals • Accounts for one-third of all elder abuse

  27. Health Care of the Older Adult: Neglect and Abuse Every state requires (by law) that healthcare providers report suspected elder abuse

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