course materials

1. Assignment: nursing actions that address the needs of older adults.
Assignment: nursing actions that address the needs of older adults. ON Assignment:
nursing actions that address the needs of older adults.Read chapter 19 of the class textbook
and review the attached PowerPoint presentation. Once done, answer the following
questions.Mention and discuss the Healthy People 2020 wellness goals and objectives for
older adults.Define and discuss the aging process and the demographic characteristics of
the elderly population in your community.Identify and discuss nursing actions that address
the needs of older adults.Mention and discuss health/illness concerns common to the
elderly population.INSTRUCTIONS:As stated in the syllabus present your assignment in
an APA format word document. A minimum of 2 evidence-based references (besides the
class textbook) no older than five years must be used. A minimum of 800 words are
required and not exceeding 1,000 words (excluding the first and reference page). Please
make sure to follow the instructions as given and use either spell-check or Grammarly
before you post your assignment.Assignment: nursing actions that address the needs of
older adults.attachment_1Unformatted Attachment PreviewChapter 19 Senior Health
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
Aging is a natural process that affects all living organisms. ? Chronological age ? The young-
old (ages 65-74) ? The middle-old (ages 75-84) ? The old-old (ages 85 and older) ? The elite-
old (more than 100 years old) ? Functional age ? Functional ability and the ability to
perform activities of daily living (ADLs) ? A better measure of age than chronological age
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 2
Why Do People Age? ? Biological theories ? ? ? Events that occur randomly and accumulate
over time (stochastic theories) Predetermined aging (nonstochastic theories) Psychosocial
theories: how one experiences late life (behavioristic) ? Disengagement theory—
withdrawal, decreased interaction ? Activity theory—remaining active and involved is
necessary to maintain life satisfaction ? Continuity theory—continue through life as in
previous years Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of
Elsevier Inc. 3 Demographic Characteristics ? ? ? ? ? ? Americans are living longer than ever
before and the older population will continue to grow. Older population is becoming more
diverse. Number of seniors differs by geographic location. Older women outnumber older
men. Older men are more likely than older women to be married. Educational attainment
has increased among older adults. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by
Saunders, an imprint of Elsevier Inc. 4 Demographic Characteristics (Cont.) ? ? ? ? ? Older
women are more than twice as likely as older men to live alone. Older adults want to live in

2. their own home for as long as possible—“age in place.” Alternative housing options are
available with services to help seniors. With aging, a good percentage of income is spent on
health care. The proportion of the older population living in poverty has decreased but is
affected by gender, marital status, race, and ethnicity. Copyright © 2015, 2011, 2007, 2001,
1997, 1993 by Saunders, an imprint of Elsevier Inc. 5 Psychosocial Issues and Role Changes
Affecting Seniors ? ? ? ? ? Retirement Relocation Widowhood Loss of family and friends
Possibly raising their grandchildren Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by
Saunders, an imprint of Elsevier Inc. 6 Physiological Changes of Aging ? ? Occur in all body
systems Rate and degree of changes are highly individualized ? Influenced by: ? Assignment:
nursing actions that address the needs of older adults.Genetic factors ? Diet ? Exercise ? The
environment ? Health status ? Stress ? Lifestyle choices ? And many other elements
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 7
Wellness is different than “good health.” Wellness exists at one end of a continuum with
illness at the other end. Health promotion programs focus on helping individuals to
maintain their wellness, prevent illness, and manage any chronic illnesses that the
individual may have. Preventive health services are valuable in improving the individual’s
health status to maximum wellness potential. – Nies & McEwen (2015) Copyright © 2015,
2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 8 Recommended
Health Practices ? ? ? ? ? ? Encourage recommended health care screenings and
examinations. Encourage physical activity and fitness. Evaluate the nutritional status and
needs of older adults. Monitor chronic illnesses. Monitor medication use. Monitor and
accommodate sensory impairments. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by
Saunders, an imprint of Elsevier Inc. 9 Recommended Screenings and Exams for Health
Promotion and Disease Prevention For All Older Adults ? Complete physical: Annually ?
Blood pressure: Annually ? ? Blood glucose: Annually ? ? More often if diabetic or at risk
Serum cholesterol: Every 5 years ? ? More often if hypertensive or at risk More often if at
risk Fecal occult blood test: Annually Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by
Saunders, an imprint of Elsevier Inc. 10 Recommended Screenings and Exams for Health
Promotion and Disease Prevention (Cont.) For All Older Adults ? Sigmoidoscopy: Every 3 to
5 years OR ? Colonoscopy: Every 10 years ? ? ? ? More often if high risk Visual acuity and
glaucoma screening: Annually Dental exam: Annually for those with teeth; cleaning every 6
months (every 2 years for denture wearers) Hearing test: Every 2 to 5 years Copyright ©
2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 11
Recommended Screenings and Exams for Health Promotion and Disease Prevention (Cont.)
For All Older Women ? Breast self-exam: Monthly ? Clinical breast exam: Annually ?
Mammogram: Every 1 to 2 years if age 40 or older ? ? Pelvic exam and Pap smear: Annually
? ? ? Check with HCP if 74 years+ Check with HCP about discontinuation at 65 or older with
three consecutive negatives exams and no abnormal in previous 10 years and not otherwise
at risk Digital rectal exam: Annually with pelvic exam Bone density: Once after menopause ?
More often if at risk Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an
imprint of Elsevier Inc. 12 Recommended Screenings and Exams for Health Promotion and
Disease Prevention (Cont.) For All Older Men ? Digital rectal exam and prostate exam:
Annually ? Prostate-specific antigen (PSA) blood test: Annually Copyright © 2015, 2011,

3. 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 13 Immunizations for Older
Adults Assignment: nursing actions that address the needs of older
adults.http://www.cdc.gov/vaccines/schedules/downloads/adult/mmwradult-
schedule.pdf. Immunizations for All Older Adults ? Tetanus, diphtheria, pertussis: Every 10
years ? Influenza (flu) vaccine: Annually ? Pneumonia vaccine: Once after age 65 ? ? ? ? Ask
physician about booster every 5 years Hepatitis A and B: For those at risk Herpes zoster
(shingles): One-time dose Varicella: If evidence of lack of immunity and significant risk for
exposure Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of
Elsevier Inc. 14 Encourage Physical Activity and Fitness ? Physical activity … ? ? ? ? ? ? ? ?
Improves functional status Reduces blood pressure and cholesterol Decreases insulin
resistance Prevents obesity Strengthens bones Reduces falls Walking is one of best forms of
exercise. Barriers: Pain, fatigue, lack of access to safe areas, impairment in sensory function
and mobility Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of
Elsevier Inc. 15 Assess Nutritional Status ? Poor nutrition in older adults is common. ? ? ? ?
Obesity in adults over 70 years and older has been increasing. Normal physiological changes
related to aging affect nutritional status. Income, functional status, medications, social
isolation, transportation, and dependence on others affect nutrition as well. Recommend
myplate.gov for assessment of eating patterns. Copyright © 2015, 2011, 2007, 2001, 1997,
1993 by Saunders, an imprint of Elsevier Inc. 16 Nutrition Checklist for Seniors: Warning
Signs of Poor Nutritional Health D isease E ating poorly T ooth loss/mouth pain E conomic
hardship R educed social contact M ultiple medications I nvoluntary weight loss/gain N eed
assistance in self-care E lder years (>80 years old) Copyright © 2015, 2011, 2007, 2001,
1997, 1993 by Saunders, an imprint of Elsevier Inc. 17 Monitor Chronic Illnesses ? ? ? ?
Chronic disease is the leading cause of death among persons 65 years and older. The
prevalence of chronic disease increases with aging; many older adults have at least two
chronic conditions. The most common conditions are arthritis, hypertension, and diabetes.
Chronic illness is a major cause of disability and may cause limitations with activities of
daily living (ADLs and IADLs). Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by
Saunders, an imprint of Elsevier Inc. 18 Monitor Medication Use ? ? ? ? ? ? Older adults
consume more than one third of all Rx drugs, as well as many OTC drugs and “folk”
remedies. Age-related changes influence the effects of drugs. Polypharmacy may lead to
drug interactions and dangerous adverse reactions. Most emergency hospitalizations for
adverse drug events are caused by a few commonly used medications. Closely monitor
medication use in homes to ensure safety. Older adults should be educated about potential
adverse reactions, including drug-drug and drug-food interactions. Copyright © 2015, 2011,
2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 19 Monitor and
Accommodate Sensory Impairment ? Visual impairment impacts social abilities, depression,
falls, and communication. ? ? Hearing loss one of most common conditions affecting older
adults. ? Assignment: nursing actions that address the needs of older adults.? ? Cataracts,
macular degeneration, diabetic retinopathy, and glaucoma Presbycusis and tinnitus Dental
problems are neglected because of inadequate dental care, limited mobility and
transportation, poor nutrition, myths, lack of finances and reimbursement. Incontinence
affects quality of life and is a symptom of underlying problems. Copyright © 2015, 2011,

4. 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 20 Elder Safety and Security
Needs ? ? ? ? ? Falls Traumatic brain injury (TBI) Driver safety Residential fire-related
injuries Cold and heat stress disorders ? ? ? Elder abuse Crime Psychosocial disorders ?
Anxiety disorders ? Depression ? Substance abuse ? Suicide ? Alzheimer’s disease Copyright
© 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 21
Alzheimer’s Disease ? ? ? Slowly progressive brain disorder: begins with mild memory loss;
progresses through stages to total incapacitation and eventually death. Diagnosing is
difficult; often reached after all other conditions ruled out. Assessment tools include: ? Mini-
Cog, MIS, and GPCOG ? Clock drawing ? No cure and limited treatment options are available.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 22
Alzheimer’s Disease (Cont.) ? ? Behavioral and physical changes create many challenges for
caregivers. Management strategies include: ? Appropriate use of available treatment
options ? Assignment: nursing actions that address the needs of older adults.Management of
coexisting conditions ? Coordination of care among professionals and caregivers ?
Participation in activities and adult day care programs ? Support groups and support
services Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of
Elsevier Inc. 23 Spirituality ? ? ? Involves “finding core meaning in life, responding to
meaning, and being in relationship with God/Other” (Manning, 2013) Spirituality has health
benefits—resilience Nurses should address spiritual needs and concerns as part of holistic
care. ? Interventions include nurses’ presence, active listening, caring touch, reminiscence,
prayer, hope, nonjudgmental attitude, facilitation of religious practices, referral to spiritual
care experts. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of
Elsevier Inc. 24 End-of-Life Issues ? Patient Self-Determination Act (PSDA) ? ? Federal law
enacted in 1990 Requires health care facilities that receive Medicare and Medicaid funds to
ask patients on admission if they possess advance directives. • Living wills • Durable power
of attorney • DNR (do-not-resuscitate) order Copyright © 2015, 2011, 2007, 2001, 1997,
1993 by Saunders, an imprint of Elsevier Inc. 25 Nurse’s Role in End-of-Life Issues ? ? ? ? ?
Discuss and educate patients about end-oflife issues. Inform other members of the health
care team about advance directives. Make sure that the document is visible and accessible
in the patient’s chart. Encourage patients to discuss their wishes with their family.
Encourage patients to discuss with physician so it becomes part of medical record.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 26
…Assignment: nursing actions that address the needs of older adults.