NURS 115 ELDER MODULE STUDENT PACKET Objective Completion of the Elder Module will increase the learner s knowledge base and effect positive attitudes toward aging STUDENT OBJECTIVES 1 2 3 4 5 6 7 Evaluate and state own feelings toward aging Demonstrate therapeutic communication and interpersonal skills when interacting with the aged State the availability of community resources and health care resources for the aged Recognize commonly occurring physiological changes that occur with aging and differentiate them from those due to illness or injury Utilize the nursing process to assist the aging patient with adaptation rehabilitation safety and restoration needs related to aging Demonstrate humanistic and caring services for aged patients Identify with rationale the developmental level of the patient ACTIVITIES 1 2 3 4 5 Practice psychomotor skills in caring for the aged patient Practice therapeutic communication skills Complete a nursing assessment of an aged patient Complete a nursing care plan for an aged patient Contribute to the general health assessment and care planning by utilization of these activities a Home Safety Assessment b Evaluation of Physical Changes c Evaluation of Sensory Loss d Environmental Barriers e Enhance Your Communication with the Elderly f The Value of Reminiscence for the Giver and the Recipient g Normal Physical Assessment Findings in the Elderly Review before Clinical Day 1 ENHANCE YOUR COMMUNICATION WITH THE ELDERLY 1 The elderly person has decreasing energies to cope with the tasks of everyday living invest proportionately more energy into the visit 2 Pace your visit according to the elderly person s fluctuating energy levels and physical conditions 3 Maximize communication by sitting 1 to 2 feet from the person and face them directly Bright lights from the window or a lamp can put additional strain on weakened eyes of the elderly 4 The use of touch can be a meaningful communication bridge 5 Avoid information overload by speaking slowly using short sentences deal with one thought at a time and ask for feedback to be certain meaningful communication has taken place When asking questions or in dialogue with the elderly know that the elderly person needs 15 more time to respond 7 Allow choices Express confidence in the person s ability to make choices and follow through with their choices 8 Motivation to participate in an activity will be increased if 1 the person is intrigued by a task rather than perceiving it as just busy work 2 the activity conveys the message that you are important 3 there is a possibility of forming meaningful relationships 9 The use of reminiscence is an effective tool in linking relevant past events to present situations 10 Some elderly do not have the strength to cope with the confusion of bureaucracies Be an advocate for the elderly Connect the person with appropriate resources in the community attentiveness sincerity respect CARING COMMUNICATION climate of trust individuality nurturance vitality self knowledge introspection empathy timing involvement CARING NURSE BEHAVIORS address the patient by name respectfully give honest and accurate information accept the patient s feelings stay with the patient support important relationships support patient s right to choose seek to understand the patient s perspective provide feedback Student Name Patient Initials Date DUE CLINICAL DAY 1 To be done outside the clinical facility HOME SAFETY ASSESSMENT Throughout the interior of the home there are several common features which should be carefully checked for safety Indicate yes or no by each of the following 1 Are scatter rugs firmly anchored with rubber backing 2 Are electrical cords in good repair especially a heating pad 3 Is there adequate night lighting 4 Are stairways continually lighted 5 Is the temperature within a comfortable range 6 Is the heater adequately ventilated 7 Is there adequate cross ventilation 8 Is furniture sturdy enough to give support 9 Is there a minimum of clutter allowing room for easy mobility 10 Are smoke detectors present in at least one room on each level of the home 11 Are emergency phone numbers posted by the phone fire 911 ambulance doctor 12 If you spend time alone at home does someone check on you at intervals 13 If you have impaired hearing does the phone have amplified receiver 14 If you have limited vision does the phone have enlarged numbers 15 If you have small pets do they ever get in your way causing tripping or falling 16 Is the stove free of grease and flammable objects 17 Is baking soda available in case of a grease fire 18 Are matches safely stored if there is not a pilot light on the stove 19 Is the refrigerator working properly 20 Is the sink draining well 21 Is food being stored properly 22 Is trash taken out daily 23 Is there a sturdy step stool available 24 Are there handrails beside the bathtub 25 Are skidproof mats in the tub and or shower Student Name Patient Initials Date HOME SAFETY ASSESSMENT continued 26 Are electrical outlets and appliances a safe distance from the tub 27 Are there raised or uneven places on the sidewalks 28 Are handrails fastened on the stairways or outside steps 29 Are screens on doors and windows in good repair 30 Are there adequate locks on the outside doors Other problem areas identified Suggestions made as a result of home safety assessment Review before Clinical Day 2 NORMAL PHYSICAL ASSESSMENT FINDINGS IN THE ELDERLY CARDIOVASCULAR CHANGES Cardiac output Heart loses elasticity therefore heart contractility decreases in response to increased demands Arterial circulation Decreased vessel compliance with increased peripheral resistance to blood flow occurs with general or localized arteriosclerosis Venous circulation Does not exhibit change with aging in the absence of disease Blood pressure Significant increase in the systolic slight increase in the diastolic increase in peripheral resistance and pulse pressure Heart Dislocation of the apex is due to kyphoscoliosis therefore diagnostic significance of location is lost Premature beats increase but are rarely clinically important Murmurs Over half the aged have diastolic murmurs the most common are heard at the base of the heart due to sclerotic changes on the aortic valves Peripheral pulses Easily palpated because of increased arterial wall narrowing and loss of connective tissue vessels feel more tortuous and rigid Pedal pulse may be weaker due to arteriosclerotic changes lower extremities are colder