Role Of Elderly In Nursing

Elderly in Acute Care Setting
Dominick A. Major
Gerontological Nursing
University of Toledo College of Nursing
July 15th, 2015

Special Needs for Elderly
As we age our bodies change, our abilities to care for our selves lessen and we start to rely more on our caregivers for the proper care. According to the Centers for Disease Control and Prevention by 2015 there will nearly 89 million people by 2015 who are 65 years of age of older. This will be almost double the elders there were in 2010. This means that as a nurse we will see an increase in elders in the hospital needing care. A study done in 2009 stated that “64% of caregivers of persons 50 years of age or older with a chronic or disabling condition” (Earlea & Heymann, 2012, p. 359).

With 64% of the population having a chronic or disabling condition nurses will have to be ready to provide the best quality of care for them. The leading cause of chronic conditions resulting in death include heart disease, cancer, chronic lower respiratory conditions, stroke, Alzheimer’s disease, diabetes, influenza and pneumonia (Centers for Disease Control and Prevention, 2013). As we age mobility becomes an issue; it is said that one of three elders 65 years and older fall. Falls can be mild or severe. Severe falls can result in hip fractures, long bone fractures, wrist fractures, and head trauma which can increase their risk of premature death. Falls or fears of falls can lead to a loss of physical activity, which in return can result in loss of mobility, and put the elders at an ever more increased risk for fall then just their age.
Elders need special care when they are in a hospital setting. Theses needs include taking the time to listen to the elder as they discuss what is going on with the, getting the whole history for the patient, a list of current medications which should be checked for interactions or multiple drugs of the same type of medication, assistance with mobility, and hygiene. Many elders will need education on the type of disease process they have going on. They will also need education on medications added or removed and what they are used to treat. In elderly patients it is important to take the time developed trust and listen to what they have to say. Many elders will have multiple needs related to their chronic conditions.
Way’s to Care for The Elderly
As an individual who is about to graduate as a nurse, it is important to know about the fastest growing part of the population.

Elderly patients require special needs when they come into the hospital, weather they are ill, have fallen, end of life care, or are going to undergo surgery. As a nurse the most important and beneficial thing you can do is a full head to toe assessment, and ask the patient if they have an advance directive. If the elder has an advance directive, it will help you as the nurse as well as the multidisciplinary team provide the best care for the client if something was to happen if they were unable to make the decisions on what they want. An assessment is an important part of the nursing practice because as a nurse who is with the patient most at the bed side it is important to have a base line of your patient. A base line is important so you can provide the best care for your patient and be able to determine if they are improving or declining. This is important because as a nurse taking care of an elderly you will most likely be working with a multidisciplinary care team, along with residents and families of the elder you are taking care of. According to the Hartford Geriatric Nursing Institute developed the Nurses Improving Care for Health Systems Elders (NICHE) program, “the nurse plays a pivotal role in influencing the older adult’s hospital experience and outcomes, through direct nursing care, as well as coordination of interdisciplinary

activities” (Touhy & Jett, 2012, p. 309).
When looking at the number one chronic health condition (heart disease) that the elderly most often have, you must be able to identify and address complaints that could be either life or death (Centers for Disease Control and Prevention, 2013). Heart disease can leaded to coronary artery disease, congestive heart failure, and many other things. When a patient has congestive heart failure, assessments are key to be able to identify if the patients condition is improving or getting worse, and if the patient is getting worse feel comfortable enough to talk with the doctors to address the findings.
When working with the patients and families you need to treat them as unique individuals and take the appropriate measures to accommodate the patient and family with the needs they may need. When addressing the patient and family it is important to remember that they will have questions, no question is a “dumb” question. The family is just trying to understand what is going on with the patient and to make sure they are getting the best possible care. The patient will ask questions because they want to know what is going on with them and if they are going to be okay. It is important to make sure you answer the patient and family’s questions using therapeutic technique to ensure that you are providing the answer to the question they asked. It is important to provide patience and provide your presences to the elder to make sure they know you are there and to build a trusting relationship.
For elderly patients it is important that the environment that you assign to your patients meets their needs for themselves, as well as the staff and family who is helping provide the care for the patient. For an elder friendly environment, it is important to ensure they have a safe, well lit environment for them to stay in. You should also ensure that the floor is free of any obstacles that they could trip over. It is important to work with your patient and ensure they have the proper mobility equipment, so they can get up and walk around if able to. Physical activity is important to work on with your elderly patient’s to keep them mobile and maintain their strength.
If a patient is immobile it is important to ensure that they patient is getting the proper assistance with activities of daily living that they are unable to perform.

It is important to ensure that the patient is getting a bath daily, oral care, as well as brief changes so they are not setting in their excretions.
For elderly patients it is important for the you as the nurse to be up on the most recent evidence based practice for the geriatric population. Evidence based practice is important to follow as a nurse because it is set from the research that is proven to be beneficial. There are This is important because the elderly population is treated differently then the regular adult population. This is due to them being on multiple medications at once, multiple chronic health conditions, and the body inability to process and excrete drug

efficiently.
One of the most critical things you as a nurse may come encounter with when taken care of an elderly patient is end of life care. When dealing with a patient who is at this stage in their life, it is important to access if they have an advance directive, DNR-CC, or DNR-CCA. Taking care of an elder who needs end of life care for a nurse maybe a very hard and ethical decision to partake in. I say this because when you take care of an elder on end of life care, you maybe asked to give the elder pain medications, anxiety medications, or both and the elder maybe so weak and sick that if you give them this last dose, their breathing may stop. This is can be very hard on a nurse because you want them to be comfortable, but at the same time you don’t want to be the reason that they quit breathing.