meeting the health needs of older clients

1. See discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/356207571
Meeting The Health Needs of Older Clients
Presentation · November 2021
CITATIONS
0
READS
28
1 author:
Some of the authors of this publication are also working on these related projects:
Guar gum & Iron deficiency anemia among the patients with inflammatory bowel disease View project
Fatma Ibrahim Abdel-Latif Megahed
Suez Canal University
30 PUBLICATIONS 7 CITATIONS
SEE PROFILE
All content following this page was uploaded by Fatma Ibrahim Abdel-Latif Megahed on 15 November 2021.
The user has requested enhancement of the downloaded file.

3. Meeting The Health
Needs of Older Clients
Supervised by:
Prof. Nawal Soliman
Presented by:
Fatma Ibrahim Abdel-latif Megahed

5. Objectives:
At the end of this lecture the students will be able
to:
1. Define Older Adult and Relevant Terms.
2. Discuss Theories of Aging.
3. Enumerate Health Needs of Older Population.
4. Identify The Epidemiology of Health for Older
Clients.
5. Assess The Health of The Older Population.

6. Cont.
6. Identify Diagnostic Reasoning and Care of
Older Population.
7. Implement Care for Older Population.
8. Evaluate Health Care for Older Population.

7. Introduction:
 In fact the first quarter of the twenty-
first century has often been called the
“age of ageing”.
The world’s elderly population is
increasing monthly by about 1 million
persons.
Older adult make up a group whose
health needs are not understood.

8. Cont.
For community health nursing, this
population group possesses a special
challenge which increases the need for
health-promoting and preventive services.
This services help maximize an older
person’s ability to remain an independent,
contributing members of society and to
maintain a high quality of life.

9. Definitions:
Older Adult:
He or She is one who is 60 years of age or
more.
There are many approaches to defining
people as being old:
The most common of these approaches are
the chronological approach & the functional
approach.

10. Cont.
A. Chronological Approach:
• It is the number of years you have been alive.
1) Age 60 to less than 75 years ……………. The
young- old.
2) Age 75 to less than 85 years ……………... The
middle- old.
3) Age 85 years or more ………………………
The old-old.

11. Cont.
B. Functional Approach:
• Based on how people look and what they can do.
To better classify people by their functional
capacities, there are three categories:
1) Well elderly……… Who are healthy and active&
involved in social activities.
2) Impaired elderly ……. Are those in a transitional
stage & need some assistance from their family
and they are being to experience chronic illness.

12. Cont.
3) Frail elderly ……. This group shows some
mental &physical deterioration and depends on
others for carrying out their daily activities.

13. Cont.
Aging is:
• A biological process.
• Naturalnot Pathological.
• Being at conception.
• Throughout whole life cycle till death.
• Decline in the functional status.
Aging Process:
• It is gradual accumulation of irreversible
functional losses which involve not only
physiological changes but also social &
psychological ones.

14. Cont.
Life Expectancy:
• It is the average number of years that a person can be
expected to live.
Ageism:
• It is negative & unfavorable attitude directed from
community population against old aged people, just
because of their age.

15. Cont.
 Gerontology:
• It is the science that studies the aging process
from all aspect, including economic, social,
clinical, and psychological factors and their
effects on the older adults & on society.
 Geriatrics:
• It is the medical specialty that deals with the
physiology of aging and with diagnosis &
treatment of diseases affecting the elderly.

16. Common Theories of Aging:
A.Biological Theories:
1. Genetic Theories.
2. Wear & Tear Theory.
3. Immunity Theories.
4. Free Radical Theories.
5. Cross- Linking Theories.
B. Psychosocial Theories:
1. Disengagement Theory.
2. Activity Theory.
3. Continuity Theory.

17. Cont.
A.Biological Theories:
1.Genetic Theories:
propose a “biologic clock” that starts ticking at the
time of conception.
 Each person has a genetic code that determines how
long he or she will live which include (*
Programmed aging theories……”genes” & * the
error theory….”errors in protein synthesis”).

18. Cont.
2.Wear & Tear theory:
 Proposes that ageing occurs as a result of the normal
use of the body and the body systems.
 The cumulative damage from the continuous use and
the abuse leading to the damage of tissue, cells,
organs and the organism.

19. Cont.
3. Immunity Theories:
States that aging occurs as a result of the disease in the
activity of the immune system.
According to these theories the defense mechanisms of
the body weaken over the time, which increases the
aging susceptibility to disease.

20. 4. Free Radical Theories:
 The basis of this theory is the accumulation of products
called free radicals as a result of oxygen use within the cells.
 It may be caused by the radiation, environmental pollutants,
chemicals, sunlight, stress and smoking. Avoiding these
factors and taking the antioxidants supplements are two of
the many ways to slow the aging process and degenerative
diseases.

21. Cont.
5.Cross- Linking Theories:
Propose that aging is result of a decrease in cellular
division caused by a cross linking- agent attaching
itself to DNA stand.
When that occurs, the changes take place in the
collagen tissue within the body so that, it decreases
the mobility and causes a loss of elasticity in heart,
lungs, vessels, and muscles resulting in degenerative
changes.

22. Cont.
B. Psychosocial theories:
1.Disengagement theory:
views aging as a process of withdrawal from life.
 Society withdraws from the elderly and the elderly person
withdraws from the society.
This withdraws acceptable to the individual to the individuals and
to the society because it prohibits the frustration in the elderly
when faced with the changes that occur with aging.

23. Cont.
2. Activity theory:
Proposes that activity is necessary for successful
aging.
Active participation in both physical & mental
activities helps the maintain functioning into old
age.
Purposeful activities and interactions, those
promote self- esteem, improve overall satisfaction
with life.

24. Cont.
3. Continuity Theory:
 According to this theory, the successful aging depends on the
individual’s ability to maintain and continue previous
behavior patterns.
 Coping mechanisms & Behavior patterns allow the person to
adjust & adapt to aging successfully.
 For example, nursing intervention that encourages greater
social interaction is not therapeutic for an individual who
spends the greater part of life somewhat socially isolated.

25. Health Needs of Older Adult:
1. Nutrition Needs.
2. Exercise Needs.
3. Rest, and Sleep Needs.
4. Economic Security Needs.
5. Psychological Needs.
6. Safety Needs.
7. Spirituality , Advance Directives, and Preparing for
Death.

26.  The Epidemiology of Health for
Older Clients.
1. Biophysical factors:
2. Psychological factors:
3. Physical Environmental factors:
4. Sociocultural factors:
5. Behavioral factors:
6. Health system factors:

27. Cont.
1. Biophysical factors:
a) Maturation and Aging.
b) Physiologic function.

28. Cont.
2. Psychological factors:
a) Cognitive impairment.
b) Stress and Depression.

29. Cont.
3. Physical environmental factors:
a) Living in neighborhoods with problems of traffic, noise, crime,
and trash.
b) Poor lightening and Inadequate public transportation.
c) Safety hazards for example housing condition.

30. Cont.
4. Sociocultural factors:
a) Family roles and Responsibilities.
b) Social support.
c) Economic and Employment.
d) Abuse and Violence.

31. Cont.
5. Behavioral factors:
a) Diet.
b) Other consumption patterns.
c) Physical activity.
d) Sexuality.
e) Medication use.

32. Cont.
6. Health system factors:
a) Health care access.
b) Prescription drugs.
c) Client – provider interaction.

33.  Assessing The Health of The
Older Population:
1. Assessing biophysical factors:
• What is the age composition of the elderlypopulation?
• What are the primary causes of death in the elderly population?
• What is the incidence and prevalence of acute and chronicdisease in the
elderlypopulation?
• What is the extent of disability in the elderly population?
• What types of disability are prevalent?
• What is the immune status of the elderlypopulation?

34. Cont.
2. Assessing psychological factors:
• What sources of stress in the elderlypopulationexposed?
• What is the extent of coping abilities in the elderlypopulation?
• What is the prevalence of cognitive impairment in the elderlypopulation?
• What levels of cognitive impairment are representedin the population(e.g., mild
confusion, vegetative states)?
• What is the extent of mental illness in the elderlypopulation?
• What mental illness are prevalent in the elderly population?
• What are the rates of suicide and attempted suicide in the elderly population?

35. Cont.
3. Assessing physical environmental factors:
• How adequateis housing available to the elderly population?
• What is the extent of home ownership in this population?
• What safety hazards are presented by housing for elderly?
• Does the physical environment of the community promoteor impede physical
activity in the elderlypopulation?
• What health effects does environmental pollution have for the elderly
population?

36. Cont.
4. Assessing sociocultural factors:
• What are societal attitudestoward the elderly?
• What languages are spoken among the elderly population?
• What religious affiliations are represented among the elderlypopulation?
• What health and social services are provided to the elderly populationby
religious organizationsin the community?
• What is the income distributionwithin the elderlypopulation?
• What is typical educationlevel in the elderlypopulation?
• What proportion of the elderly population is working?
• What retirement planningand assistance are available to oldermembers of the
population?
• What transportationresources are available to the elderly population?
• What is the extent of social isolation in the elderly population?

37. Cont.
5. Assessing behavioral factors:
• What are the typical dietary patternsamong the elderly in the population?
• What is the extent of obesity in the elderly population?
• What is the extent of smoking, alcohol,and drug use in the elderly population?
• What are treatment rates for alcoholand drug abuse?
• To what extent do members of the elderlypopulationengage in health related
behaviors such as mammography?
• What proportion of the elderly population drives?
• What is the incidenceof motor vehicle accidents among this population?
• What is the incidenceof events due to inappropriatemedication use in the
population?

38. Cont.
6. Assessing health system factors:
• What proportion of the elderly population has a regular source of health care?
• What is the level of insurance coverage among the elderlypopulation?
• To what extent are medication needs covered by insurance plans among the
elderlypopulation?
• What preventive and restorative health care services are available to members of
the elderly population?
• To what extent are these services used by the population?
• How adequateare these services in meeting the needs of the elderlypopulation?

39.  Diagnostic reasoning and care of
older population:
• Nursing diagnosis may be either positive or negative.
• Positive diagnosis usually indicate that no further
nursing intervention is needed, but that the health status
of the population in this area should continue to be
monitored.
• Negative diagnosis would indicate the need for
intervention by nurses and others in the community to
resolve the identified problem.

40.  Planning health care for older
populations:
It may be take place at the primary, secondary, and tertiary levels of
prevention.
A. Primary prevention focus on health promotion and illness
prevention which often depend on changes in health related
behaviors.
• The major considerations in primary prevention among older
adults are the following:
1. Adequate nutrition.
2. Safety.
3. Immunization.
4. Rest and exercise.
5. Smoking cessation.
6. Maintaining independence.

41. Cont.
B. Secondary prevention focuses on screening and treatment of
disease.
1. Screening.
2. Disease self management.
3. Dealing with common health problems such as
• Pain.
• Skin breakdown.
• Constipation.
• Urinary incontinence.
• Fecal incontinence.
• Mobility limitation.
• Sensory loss.
• Abuse and neglect.

42. Cont.
C. Tertiary prevention focus on preventing complications of existing
conditions and preventing their recurrence.
1. Monitoring health status.
2. Palliative care is a care that addresses pain and symptom relief
without attempting to cure the underlying disease process.
3. End of life care include formulation of advance directives,
personal preparation for death and actual care of dying client.
4. Caring for caregivers include information, referral to needed
assistance, counseling, and help with supplies, assistive device and
so on.

43.  Implementing care for older
population:
• Two major considerations in implementing
care for older populations are health education
directed at this group and political advocacy.

44.  Evaluating health care for older
population:
• Evaluating the effectiveness of health care for older members of
the population can occur at the individual or aggregate level.
1. At the individual level, the community health nurse would assess
the client's health status and the effects of primary, secondary and
tertiary intervention in improving health status.
2. At aggregate level, evaluation of the effects of care on health of
the elderly can be measured, in part, by level of accomplishment
of relevant national health objectives.

45. View publication stats