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Do not directly address the student in the responses

DQ1

4 posts

Topic 5 DQ 1: Saji Devassykutty

Prior to diving into the aging adults’ characteristics through the aging process, one should recognize the magnitude of the population that is being accounted for. The population of adults in the United States who are ages 65 and older increased 30% in just 10 years (2005–2015) (Federal Interagency Forum on Aging-Related Statistics, 2016). Statistics such as these are only going to grow and hence, understanding such a situation is vital.

The aging process is a point where it can be labelled as one where ego integrity vs despair is how it would be constituted for most of the part. Strong characteristics such as limited range of motion not just in the channel of reach, but also in the case of some of their senses as well, such as hearing loss and others. The spiritual side of a person is more embraced in such an age group. Another significant characteristic is how their psychological strength is affected, while many elders may still be ever confident as they were, there is a good proportion of people who would not be. This wild mix of limits with senses and psychological difficulties could lead to be dangerous for the elder. Such situations could keep the elder in an open position to the different forms of abuse.

A nurse should be aware of some critical factors when treating old aged people compared against the middle-aged population. Primarily, the physical mobility of the elder, this is very important and hence the kind of motion that the elder is asked to do should be tailored accordingly. Secondly, a thorough historical understanding, an elder has lived for longer and hence have been more prone to different diseases and injuries, all of which should be comprehended thoroughly because a slight compromise with such an area could have a profound effect on an elders health and situation, than it would for a middle aged adult. Lastly, patience, a lot of time and concentration must be channeled when treating an elder because of the many complications that will be brought up as a result of their age. Nurses could also imply a lot of different things they have learned over time from their experience as well, this could then lead to evidence based data which could be very useful in the future.

References:

Federal Interagency Forum on Aging-Related Statistics. (2016). Older Americans 2016: Key Indicators of Well-Being. Retrieved from https://agingstats.gov/docs/LatestReport/Older-Americans-2016-Key-Indicators-of-WellBeing.pdf

DQ2

Re: Topic 5 DQ 1

According to Green, the head-to-toe physical assessment never changes; however, it is important to meticulously asses the changes of aging on the integumentary system; the head, neck, and face; and the musculoskeletal system and corresponding functional status (Green, 2018). As you age, the skin becomes thinner, more fragile, dry, bruises easily, and cuts or bruises take longer to heal. Skin tears are common due to loss of connective tissue. The bladder muscles tend to relax and incontinence is a common complaint especially among women. Incontinence and assessing the patient’s hygiene to determine whether they are at risk for skin breakdown is another example of changes in integumentary system. Bones lose calcium, minerals and density which makes them weaker and susceptible to fractures. Muscles lose strength and flexibility which makes transferring or ambulating difficult. The loss of peripheral vision and decreased ability to judge depth can affect daily activities such as reading, watching television, and especially driving. Loss of hearing is extremely common. The sense of smell and taste work together, so if one is decreased the other will naturally become compromised. The mouth also produces less saliva as you age which can alter taste and lead to dry mouth and poor oral hygiene. The metabolism slows down and the absorption rate of medications are a major concern. The brains conductivity of synapses is less- leading to more “senior moments.”

The aging process is inevitable as well as the deteriorates in physical, mental, environmental and social health. As we age our health changes and the strategies in dealing with the reality of these changes is imperative as well as the support received from family, friends and medical providers. An assessment and interview will let the nurse know about their physical and mental health, the environment in which they live and socialize, and any barriers in health. This aging population is at risk for many unintentional injuries as well as intentional such as neglect or abuse. If the individual prefers to remain in their home after a death of a spouse the risk of neglect is of concern. Living alone requires family or nurses to assess if the person is eating, maintaining hygiene and ADLs, and complying to medication regimen. Neglect can also be found if an individual resides in a retirement/community setting, at home with a companion or family member, an assisted living or nursing home. These living arrangements can lead to neglect due to caregiver stress. The demands of care from a caregiver are stressful and strenuous. The mental capacity due to dementia, Alzheimer’s, or natural aging process, can lead to disorientation and the geriatric individual not complying with care. This is difficult for the caregiver to feed, bathe or clean which leads to physical harm from the geriatric and caregiver. The geriatric population is vulnerable to physical, mental, sexual or financial abuse. According to the National Council on Aging, approximately 1 in 10 Americans aged 60+ have experienced some form of elder abuse; and as high as 5 million elders are abused each year (National Council on Aging, nd).

When performing a head to toe assessment it is always in best practice to ask for permission prior to assessing a patient. When you are interviewing a geriatric patient, be mindful that it may take longer for the patient to respond; give them a moment to gather their thoughts instead of answering for them or adding additional questions. The elder patient who is alert and oriented may become offended and think you are rude because you rushed them. I have witnessed many geriatric patients who are more alert and oriented than a middle-aged adult. Also, depending on the age of the nurse the geriatric patient may be modest with the assessment as the nurse happens to be the same age as their daughter or granddaughter. They may not feel comfortable unveiling for the nurse to assess their body. It is important to clarify information as their memory may not be as sharp and stories can get mixed up. Verifying dosages and indications to medications with the patient or family members can clarify if the medications are still medically necessary. For example, a patient prescribed Amolodopine for elevated blood pressure reported side effects. The physician discontinued the order and prescribed Hydrochlorothiazide but the patient is taking both blood pressure medications.

Green, S. (2018). Health Assessment Foundations for Effective Practice. Health Assessment of the Aging Adult. Retrieved from: https://lc.gcumedia.com/nrs434vn/health-assessment…

National Council on Aging. (nd). Elder Abuse Facts. Retrieved from: https://www.ncoa.org/public-policy-action/elder-ju…

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