Cuidados del anciano

 " Elderly Cares for Nursing"

Nursing subjet -

San Jorge University

Saragossa, Spain

CRISTINA RUIZ ESTERAS

Bibliography

This blog has been created by Cristina Ruiz mats, but the information has been consulted on many pages and books such as those given below

• HOFFMAN, Gloria. Basic Geriatric Nursing 5th Edition. Elsevier.2012.
• BURKE, Mary M./WALSH, Mary B. Enfermería Gerontológica: Cuidados Integrales del Adulto.Harcourt-Brace. Madrid 1998
• CARNEVALI,Doris L.PATARICK,Maxine.Enfermeria Geriátrica. Ed. Interamericana/Mc Graw-Hill. Nueva York/Madrid 1996
• GARCÍA Hernández, M./TORRES Egea, M.P./BALLESTEROS Pérez, E. Enfermería GeriatricaEditorial: Masson Barcelona 2003.
• GUILLÉN Llera, F. PÉREZ del Molino, J. Sindromes y cuidados en el paciente geriátrico. Ed. Elsevier. 2007.
• MILLÁN,J.C.Gerontología y Geriatría.Valoración e intervención. Ed.Panamericana. 2011.
• RODRIGUEZ, R. Práctica de la geriatría. Ed Mcgraw-Hill.2007.
• WACHTEL,T.J. ; FRETWELL, M.F. Guía práctica para la asistencia del paciente geriátrico. Ed. Elsevier.2008; 3a ed. 2008

PALIATIVE CARES

The World Health Organization’s (WHO) definition is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other physical, psychosocial and spiritual problems (WHO, 2005).

The goal of the geriatric palliative cares is care to the chronical and fragile elderly to relieve pain and suffering, giving them the best possible quality of life.

The palliatives cares are given to people in situation where there is no cure.

Needs of the Geriatric Palliative Care Patient:

• Continuity and coordination of care that responds to episodic and long-term chronic diseases and the management of multiple chronic illnesses
• Maintaining functional independence as possible
• Decision regarding care and the risk versus benefit of treatment
• Pain and symptom control
• Home support for family caregivers
• Community resource information

Nursing have an important role in palliative cares because a nurse spend a lot of time near patients, more than the doctor and they are the indicate persons to help to patients to express their feelings and be they feel safe in their last moments

Its very important the psychological area in this kind of patients, not only the physical condition.

GERIATRIC SYNDROME: URINARY INCONTINENCE

URINARY INCONTINENCE is a unwanted leakage of urine, it has a several impact in the quality of life and leads to the shame and social isolation: it cause anxiety and depression in a big percentage of people who suffers it.

The Uninary incontienence imposes a several burden on caregivers and it is one of the mains causes for admission into a nursing home.

There are differents kinds of uninary incontinence:

1. Stress UI: defined as an involuntary loss of urine associated with activities that increase intra-abdominal pressure. 

2. Urge UI: characterized by an involuntary urine loss associated with a strong desire to void (urgency).  An individual with an overactive bladder may complain of urinary urgency, with or without UI. 

3. Mixed UI: usually defined as a combination of Stress UI and Urge UI

4. Overflow UI: an involuntary loss of urine associated with over-distention of the bladder and may be caused by an under-active detrusor muscle or outlet obstruction leading to over-distention of the bladder and overflow of urine.

5. Functional UI: caused by nongenitourinary factors, such as cognitive or physical impairments that result in an inability for the individual to be independent in voiding .

Treatment Treatment of UI in elderly:

 Medications

 Anti-incontinence rings incontinence rings

 Mi i ll I i S Minimally Invasive Surgery

 Behavioral Treatment

-          Bladder Diary

-          Pelvic Floor exercice – Kegel’s execice

-          Bladder training: frequent voluntary voiding

Nursing Care Strategies

A. General principles that apply to prevention and management of all forms of UI:

-          Identify and treat causes of transient UI

-          Develop an individualized plan of care using data obtained from the history and physical . Implement toileting programs as needed

-          Avoid medications that may contribute to UI

-          Avoid indwelling urinary catheters whenever possible to avoid risk for UTI

-          Monitor fluid intake and maintain an appropriate hydration schedule.

-          Limit dietary bladder irritants.

-           Modify the environment to facilitate continence.

-           Prevent skin breakdown by providing immediate cleansing after an incontinent episode and utilizing barrier ointments.

GERIATRIC SYMDROME: CONSTIPATION

Constipation is a common disease of older people.

 The reason why older people prone to constipation, mainly causes is follow:

there are a mainly causes to produce the constipation in elderly and it can coexist at the same time:

1. They do less activity and their phsysiological functions.

2. The suffer diseases like anemia, diabetes, depression, central nervous system diseases...all of this have a influence in the costipation

3. They take a lot of drugs. The opiate for exaple dicrease the peristaltisms

4. They could suffer a obstructive process.

ASSESSMENT TO PREVENT THE CONSTIPATION

1, schedules to develop regular bowel habits

2, Good diet: Usually the elderly should eat more food with cellulose and fruits to increase  fiber intake for stimulate and promote intestinal peristalsis.

3, a good water intake : to increase the intestinal peristalsis, and promote defecation.

4, increase the activity:

5, the mood of optimism: anxiety and other bad mood can lead to or aggravate constipation. Despiste of this, elderly people should always keep a good mood.

6, medication: In the elderly can use drugs to help defecation. Paraffin oil can be oral or enema. be noted that the elderly  should not be long-term use of drugs in order to avoid the formation of dependency so that the function of peristalsis degradation, increase constipation.

GERIATRIC SYNDROME: FALLS AND INESTABILITY

Falls are a common and serious problem among older people, causing a tremendous amount of morbidity, mortality and use of health care services including premature nursing home admissions.

Most of these falls are associated with one or more identifiable risk factors ( weakness, unsteady gait, confusion and certain medications etc ), and research has shown that attention to these risk factors can significantly reduce rates of falling.

Older adults can remain independent and reduce their chances of falling.  They can:

·             Exercise regularly. It is important that the exercises focus on increasing leg strength and improving balance, and that they get more challenging over time. Tai Chi programs are especially good.

·             Ask their doctor or pharmacist to review their medicines—both prescription and over-the counter—to identify medicines that may cause side effects or interactions such as dizziness or drowsiness.

·             Have their eyes checked by an eye doctor at least once a year and update their eyeglasses to maximize their vision. Consider getting a pair with single vision distance lenses for some activities such as walking outside.

·             Make their homes safer by reducing tripping hazards, adding grab bars inside and outside the tub or shower and next to the toilet, adding railings on both sides of stairways and improving the lighting in their homes.

GERIATRIC SYNDROMES. NEUROLOGIC DISEASE: Alzheimer's disease

Alzheimer's is the most common form of dementia, a general term for memory loss and other intellectual abilities serious enough to interfere with daily life

Alzheimer's is not a normal part of aging, although the greatest known risk factor is increasing age, and the majority of people with Alzheimer's are 65 and older.

Alzheimer's is a progressive disease, where dementia symptoms gradually worsen over a number of years.

SYMTOMS:

People in the early stages of Alzheimer's disease may experience lapses of memory and have problems finding the right words. As the disease progresses, they may: become confused and frequently forget the names of people, places, appointments and recent events xperience mood swings, feel sad or angry, or scared and frustrated by their increasing memory loss become more withdrawn, due either to a loss of confidence or to communication problems and they have difficulty carrying out everyday activities

As the disease progresses, people with Alzheimer's will need more support from those who care for them. Eventually, they will need help with all their daily activities.

While there are some common symptoms of Alzheimer's disease, it is important to remember that everyone is unique. No two people are likely to experience Alzheimer's disease in the same way.

Alzheimer's has no current cure, they can temporarily slow the worsening of dementia symptoms and improve quality of life for those with Alzheimer's and their caregivers.