350 likes | 1.11k Views
An encompassing view of the care of older adults (Mauk, pg. 5)Providing both physical and emotional support in addition to respectful care. Gerontological Nursing Defined. Trailblazers. Florence NightingaleThe first true geriatric nurse Nurse superintendent comparable to our current nursing homesDoreen Norton1956 speech at the annual conference of the SNA in London.
E N D
1. Chapter 1: Introduction to Gerontological Nursing
Bonnie M. Wivell, MS, RN, CNS
2. An encompassing view of the care of older adults (Mauk, pg. 5)
Providing both physical and emotional support in addition to respectful care Gerontological Nursing Defined
3. Trailblazers Florence Nightingale
The first true geriatric nurse
Nurse superintendent comparable to our current nursing homes
Doreen Norton
1956 speech at the annual conference of the SNA in London
4. Advantages of Learning Geriatric Care Learning patience, tolerance, understanding, and basic nursing skills
Witnessing the terminal stages of disease and the need for skilled nursing care
Preparing for the future because the aged will always be a part of the care you provide
Recognizing the importance of rehab
A need for research
5. Landmarks 1950 – First geriatric textbook published
1952 – First geriatric nursing study published
1961 – ANA recommends specialty group for geriatric nurses
1966 – Duke opens first Master’s CNS program
1970 – ANA Standards or Practice
1973 – First certification exam
1975 – Journal of Gero Nursing by Slack, Inc.
1979 – First national gero nursing conference
6. Landmarks Cont’d. 1981 – ANA scope of practice
1984 – NGNA established
1988 – First PhD program
1992 – NICHE established at NYU
1996 – John A. Harford Foundation Institute of Geriatric Nursing established at NYU
1998 – ANA certification available for APNs
7. Old Defined Young old: 65 – 74
Middle old: 75 – 84
Old old: 85 and up
Only a guide as there is a vast difference in biological and chronological aging
8. Roles of the Gero Nurse Provider of care
Teacher
Manager
Advocate
Research Consumer
9. Certification Nurse certification is a formal process by which a certifying agency validates a nurse’s knowledge, skills, and competencies through a written exam in a specialty area of practice
Why certify?
Professional accomplishment/Leadership
Commitment to profession
Provide higher quality of care
EBP and resource to others
10. SOP & Core Competencies Scope and standards of practice
Core Competencies – review pg. 15
11. Continuum of Care Multitude of settings for those > 65
48% in hospital requiring care
80% receiving home care
90% in nursing homes receiving care
Acute Care Hospital
Acute Rehab
Home Health Care
LTC vs. SNF
Alzheimer’s Care – preserve functional status
Hospice
12. Continuum of Care Cont’d. Respite Care
Continuing Care Retirement Community
Independent living to skilled care
Assisted Living
Foster Care or Group Homes
Green House Concept – alternative to LTC
Adult Daycare
13. Chapter 2: The Aging Population
Bonnie M. Wivell, MS, RN, CNS
14. The Numbers Steady increase in older population
Projected 40 million age 65 or over in 2010
Old old is projected to increase to 6.1 million in 2010
By mid-21st century, old people will outnumber young for the first time in history
15. Why The Increase? Improved sanitation
Advances in medical care
Implementation of preventive health services
In 1900s, deaths were due to infectious diseases and acute illnesses
Older population now faced with new challenge
Chronic disease
Health care funding
16. Why The Increase? The average 75 yo has 3 chronic diseases and uses 5 rx meds
95% of health care expenditures for older Americans are for chronic diseases
Changes in fertility rates
Baby boom after WWII (1946 – 1964)
3.5 children per household
Older population will explode between 2010 to 2030 when baby boomers reach age 65
17. Some Facts Female to male ratio increases with age
Higher education equates to more money, higher standards of living, and above-average health
Older people who live alone are more likely to live in poverty
Significant increase in proportion of minorities
More racially and ethnically diverse
18. Facts Continued African Americans
Hispanics
Asians and Pacific Islanders
American Indians and Alaskan Natives
Older foreign-born are more likely than native-born elders to
Live in family households
Have less education
Higher poverty rate
Less health coverage
19. Facts Continued The number of U.S. Vets 85 or older is expected to increase to 1.4 million in 2012 due to Vietnam era
Aging disabled population
Traumatic injuries
Developmentally disabled
Elderly inmates
Elderly begins at 50 due to stresses of prison life
20. Mortality and Morbidity Heart disease and cancer are two top causes of death, regardless of age, race, gender or ethnicity
Diabetes
5th leading cause of death among black men
4th leading cause among Hispanic men
4th leading cause of death for Hispanic and black women 65 or older
6th among white men and men of Asian or Pacific Islander origin
7th leading cause of death for white women 65 or older
21. Chronic Disease Increases with age
4 leading causes of death
Heart disease
Stroke
Cancer
DM
Sensory impairments and oral health problems more frequent
22. Aging Well 72% of seniors report having good to excellent health
Numbers living in nursing homes has declined
1 out of every 5,578 people was 100 yo or older
Older adults are active and healthy
23. History of Aging 1861 – Military pensions were initiated by Teddy Roosevelt
1935 – Franklin Roosevelt signed social security act that provided income assistance to elderly
1965 – Medicare and Medicaid law signed by President Johnson
24. Successful Aging Achievement of sense of autonomy, dignity, and absence of suffering
New England Centenarians study
Avoided chronic/acute diseases
Successfully navigated through obstacles and the physical/psychosocial challenges
Healthy People 2010 – to increase the quality and quantity of a healthy life
A positive view of aging as a normal process is needed
25. Chapter 3: Theories of Aging
Bonnie M. Wivell, MS, RN, CNS
26. Purpose Of Nursing Theory Defines our practice
In gerontological nursing they must be comprehensive yet consider individual differences
Tells how and why phenomena are related
Leads to prediction
Provides process and understanding
Must be holistic and take into account all that impacts on a person throughout a lifetime of aging
27. Aging Theories Cultural, spiritual, regional, socioeconomic, educational, environmental factors, and health status impact the older adults perceptions and choices about their health care needs
Limited work has been done to identify nursing-specific aging theories
Aging is a distinct discipline that requires aging theories that have an interdisciplinary perspective
28. Types of Theories Psychosocial: Attempt to explain aging in terms of behavior, personality, and attitude change
Encompass psychological and sociological theories
Psychological: How mental processes, emotions, attitudes, motivation, and personality influence adaptation to physical and social demands
29. Maslow’s Hierarchy of Human Needs Theory
30. Maslow Continued Although Maslow doesn’t specifically address old age, it is clear that physical, economic, social, and environmental constraints can impede need fulfillment of older adults.
31. Types of Theories Cont’d. Sociological: How changing roles, relationships, and status within a culture or society impact the older adult’s ability to adapt
Activity theory – central theme that remaining active in old age is desirable
Disengagement theory – characterized by gradual withdrawal from society and relationships
32. Types of Theories Cont’d. Biological: Explain the physiologic processes that change with aging
Free Radical Theory – aging caused by effects of free radicals
Wear and Tear Theory – cumulative changes occurring in cells age and damage cellular metabolism
33. Nursing Theories Need to take human aging into consideration
Need to develop a more situation-specific theory of aging to guide practice
34. Functional Consequences Theory A guiding framework that would address older adults with physical impairment and disability
Nursing’s role is to minimize age-associated disability in order to enhance safety and quality of living
35. Theory of Thriving Based on the concept of failure to thrive and application of thriving to the experience of well-being among frail elders living in nursing homes
Nurses identify and modify factors that contribute to disharmony among a person and his or her physical environment and personal relationships