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Online Companion: Fundamentals of Nursing Standards and Practice 2E
The subject of Chapter 18 is the aging process in humans and how the nurse can assist people to maintain independence and maximum functional level in their older years. There are several definitions of "old" as well as numerous theories about the process of aging in humans. There are also many misconceptions and myths about aging and older persons, many of which have a negative view. While there is a trend for people to live longer and healthier lives, there remains a challenge to older adults to maintain a high quality of life. The older adult needs to adapt to changes resulting from aging: developmental changes such as becoming a grandparent, physiological changes such as decreased visual acuity and psychosocial changes such as loss of a lifetime partner through death. Chapter 18 details the physical changes of aging by body system and lists ways in which nurses can assist elderly to adjust to these alterations in body structure and function. Elderly people who take prescribed drugs are prone to adverse drug reactions (ADRs). The symptoms of many of these ADRs are subtle, such as constipation, fatigue and dizziness; these may be confused with other conditions or attributed to the aging process. The cost of drugs, polypharmacy and impaired memory are factors that negatively affect accurate medication compliance in older people. Mistreatment of the elderly is a serious problem. It may take the form of physical abuse and injury, neglect, psychological abuse or exploitation of elders. The nurses assesses older adults in all settings carefully for evidence of mistreatment, documents findings and uses interventions at the primary, secondary and tertiary levels. The application of the nursing process for elderly clients has some unique features. Fluid balance assessment is critical since elderly can become dehydrated quickly. The mental status of elderly clients needs to be assessed frequently so that underlying causes of confusion and impaired memory can be identified and treated. The integumentary system is vulnerable to pressure and friction in older adults so that the skin condition should be checked frequently. Results of a thorough assessment are analyzed to determine nursing diagnoses. There may be many problem areas so there is a need to prioritize the problem list. Outcome identification will focus on three areas: maintaining physical health, supporting psychosocial well-being and promoting safety. The nurse gives special attention to using strategies to promote communication and education about self-care for older adults. Using reminiscence is a therapeutic modality to enhance problem-solving and maintaining self-esteem for older clients. For elders who have chronic illness or injury, restorative nursing care seeks to increase independence and self-care ability. The goal of care is to help the elder function at a maximal level. Chapter 18 concludes with a sample care plan for an older adult who is confused.
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