💰Call Girl In Bangalore☎️63788-78445💰 Call Girl service in Bangalore☎️Bangalo...
2015: Safety Issues in the Geriatric Environment of Care-Hysten
1. Safety Issues in the Geriatric Environment of Care
Michaela Hysten, RN
2. Objectives
Recognize patients and environments at risk
Identify sources of safety issues to prevent and/or report
Discover ways of altering the environment to prevent
unsafe events and situations
Outline the advantages of modifications in practice to
accommodate geriatric changes
3. Definitions
Geriatrics – a branch of medicine that deals with the problems and
diseases of aging people
Environment – the conditions that surround someone; the conditions
and influences that affect the growth, health, progress, etc., of someone
Empathy – the action of understanding, being aware of, being sensitive
to and vicariously experiencing the feelings, thoughts and experience of
another
Dignity – the quality or state of being worthy, honored or esteemed
Merriam-Webster Online, 2015
4. Effects of Aging
Physical effects
Visual problems
Diminshed Hearing
Decreased Sensation
Stiffness and decrease in
dexterity
Cognitive decline
Psychological effects
Embarrassment
Fear
Depression
Pride
Social effects
Lonliness
Vulnerability
5. Environment of older patients
Home alone - 27% of surveyed elderly in San Diego
Lives with family or CG
Assisted Living or SNF
Homeless - 8,506 in San Diego County
26% of the unsheltered homeless in San Diego are over 54
years of age
4% of the unsheltered homeless in San Diego are over 65
years of age
(San Diego County, 2014, p. 13-14); (SANDAG, 2012, p.C-7)
6. Home Safety Issues
Infestation/Sanitation
Insects
Rodents
Primary CG issues/neglect
Ambivalance
Physical, emotional, clinical neglect
Abuse
Physical, emotional, sexual
Neglect (including self-neglect), abandonment, isolation
Financial
Transitional care
Discharged with no primary caregiver
Polypharmacy with little understanding of medications
Unable to fully perform ADLs and IADLs
(Health and Human Services, n.d.)
7. Role of the provider
Accommodations
Visual problems
Hearing problems
Decreased dexterity and sensation
Decrease flexibility
Recommendations and ideas
Practical
Preserve dignity
Express empathy
8. Case Studies
Patient #1
76 year old male arrives at his Primary Care visit disheveled,
malodorous. He has a history of HTN, prostate cancer and
chronic pain. The patient is being seen today for a worsening
rash on his extremities. He uses hearing aids bilaterally, wears
glasses and walks with a cane. While updating his face sheet,
he does not provide an emergency contact, states that he is not
married and estranged from his children.
9. Case Studies
Patient #2
65 year old male arrives at the community clinic via his own
vehicle. He is being seen today for a follow-up appointment
due to chronic health conditions which include CHF, HTN, DM
and COPD. He presents with a productive cough, VS 187/90,
91, 20, 95%, 5/10 pain, and a blood sugar of 236. He was able
to drive himself to the appointment and he has a cell phone.
When updating his face sheet, he states his address as a PO
Box.
10. Case Studies
Patient #3
91 year old female arrives in the ED via ambulance from her
home. She has multiple bruises of varying ages. VS are 100/50,
99, 24, 95%, and complains of pain 8/10 in her left arm and
shoulder. She is alert and oriented, but cannot give you a
medical history and seems anxious and worried. Shortly after
her arrival, her “grandson” arrives at bedside and answers all
questions even though they are directed toward the patient.
11. Case Studies
Patient #4
89 year old female discharged from Telemetry after a 2 day stay for a
change in level of consciousness (day one was in the step-down unit).
She is discharged AMA because she wants to go home. She is alert
and oriented, VS are 110/75, 85, 16, 99%, 0/10 pain. She has a
history of CVA, DM, and syncopal episodes due to hypoglycemia.
She walks with a cane and wears glasses. During her stay, she adjusts
the TV so that it is directly in front of her. Upon discharge she states
that although she normally drives herself around, she will have to
take the bus home because she was brought to the hospital via
ambulance.
12. References
Health and Human Services (n.d.). Adult Protective Services. Retrieved from
http://www.sandiegocounty.gov/hhsa/programs/ais/adult_protective_services/
Merriam-Webster (2015). Retrieved from http://www.merriam-webster.com
SANDAG (2012). Survey of Older Americans Living in San Diego. Retrieved from
http://www.sandiegocounty.gov/content/dam/sdc/hhsa/programs/ais/documents/surveyofolderamer
icans2003report.pdf
San Diego County (2014). 2014 San Diego Regional Homeless Profile. Retrieved from
http://www.rtfhsd.org/wp/wp-content/uploads/2014/10/RHP-2014_FINAL_9-25-141.pdf