Geriatric Resources. The levels of care

For proper health care to the elderly, it is essential to proper coordination of different stakeholders involved. This health care could be based on:

 

Primary Care. Also called health centers. One goal of these centers is to get the elderly to remain or be reinstated on the usual residence in adequate conditions of safety and security. Among the functions of the nurse in primary care include:

• Prevention activities.
• Detection frail elderly.
• Periodic examinations.
• Health education.
• Avoiding iatrogenic.
• Care of chronic diseases.
• Home care.
• Etc.

 

Acute Geriatric Unit. Intended level of geriatric hospitalization where a thorough assessment is performed, it is diagnosed and treated acute processes or flare of chronic conditions. In these units the nurse:

• Performs secondary and tertiary prevention.
• Nurse Care Process.
• Comprehensive care.
• Health education to patient and family or caregiver.
• Management indicated treatment.
• Hygiene.
• Prevention and care of pressure ulcers.
• Etc.

 

Median Unit Stay or convalescence. Level that hosts patients in subacute phase and whose pathologies are disabling but potentially reversible, they can not yet follow outpatient treatment. At this level the nurse:

• Secondary and tertiary preventive care.
• Continuing care: Patients come from the treble unit.
• Comprehensive care: Emphasis on functional care and social issues.
• Etc.

  

Long Stay Unit or residence. Hospital level for the attention of elderly patients with little or no chance of recovery and that require continuous care clinicians. Nursing in this case perfoms:

• All types of care.
• Food.
• Hygiene.
• Symptom control.
• Treatment delivery.
• Preventing falls.
• Preventing immobility.
• Quality control.
• Leisure activities.
• Etc.

 

Geriatric Day Hospital. Care Level daytime functioning without inpatient beds designed to complete clinical recovery, physical, mental and social elder, combining the advantages of hospitalization and stay at home. The nursing activities in these centers are:

• Healing of ulcers.
• Placement and probes changes.
• Metabolic controls.
• Group therapy.
• Control and monitoring of diseases.
• Etc.

 

 

 

Bibliography:

• Assists in Geriatrics Levels [Website *]. [Revised 15/05/2013, updated 10/05/2013]. Available at: www.segg.es/download.asp?file=/tratadogeriatria/PDF/S35-05%2006.

Health Education in the Geriatric Patient

The promotion of health are measures that promote an optimal state of physical, mental and social development in the population. These measures include actions in the field of health education, public health policy, disease treatment and preventive measures.

The goal of health promotion in the elderly population is to maintain the highest degree of autonomy and prevent the onset of disease. It sets a top priority to improve the quality of life by promoting behaviors that favor a style of living. However, in the elderly disease prevention has special features. In many cases the disease are already present and perhaps more important than the classic goals of reducing mortality and increasing life expectancy, are the goals of preventing and delaying functional decline, avoid dependency and maintain independence and quality of life .

 

Health education is a basic tool in promoting health and preventive action. Preventative measures are classified according to the disease stage where they develop:

• Primary Prevention. It occurs when we try to prevent the occurrence of disease through risk factors and promoting healthy lifestyles (promoting physical activity, changes in the home, abandoned toxic habits, etc.).
• Secondary Prevention. To try early detect and treat existing diseases but hitherto asymptomatic (controls blood glucose, blood pressure, lipids, etc.).
• Tertiary Prevention. To try to avoid sequels, exacerbations, relapses, and promote the rehabilitation and recovery of the same (drug treatment, rehabilitation, etc..).

 

 

In my opinion, in the elderly all types of prevention are important, although most measures will be included among the secondary prevention measures. This is due to meet existing injuries or diseases at an early stage and in an attempt to prevent its progression.

 

 

 

Bibliography:

• Wideman M.. Geriatric Care Management: Role, Need, and Benefits. Home Health Nurse; 2011.

Palliative Care

Palliative care is the attention, care and treatment, nurses and drug treatments given to patients in advanced and terminal illness in order to improve their quality of life and ensure that the patient is without pain. Palliative care doesn't anticipate or delay death but it is a real support system and integrated support for the patient and family.

 

The above paragraph I have just described is the theory, but in this blog I want off a bit of the protocol, theory and nursing procedures. I believe that if a subject has yet to be theoretical is more human than this.

 

As we have seen in the video, which for us are palliative care for the person is the last stage in this life. Therefore, if in all areas we must listen and treat them as humanely as possible, in this situation I think we should be even more so and we skip some protocol. In these final moments of the life of the person I think nothing better than to appeal to common sense and all naturally arises. With this, I mean to create a climate of trust, exchange of views, listen to the person and make him as comfortable as possible the last stage in this life. For this, we take care of all the details, both the patient and the family remaining in this life. At this stage nurses play a very important role because, as the video says, "the patient invites us to be your partner in this last stage of his life".

 

 

As reflected in the bibliography's article, I believe that whatever procedures are maintained and quality are good for the patient, but I think that, even if it means cutting corners and perform nursing procedures, what he really matter to the person is the humane treatment by the nurse at this stage of his life.

 

 

 

Bibliography:

• Scientific Electronic Library Online - SciELO. [Website *]. [Revised 14/05/2013, updated 09/05/2013]. Available at: http://scielo.isciii.es/scielo.php?pid=S1132-12962011000100015&script=sci_arttext

Geriatric Syndromes. Urinary Incontinence

Urinary incontinence is a geriatric syndrome that occurs when urine is lost involuntarily and objective, resulting in a time and place unsuitable and quantity or often enough to be a problem hygienic, social and psychic to the person suffering, as well as a possible limitation of their daily activities. There are several types of urinary incontinence: stress, functional, overflow, emergency, etc.

 

In this post, I will focus on stress urinary incontinence and, more specifically, I will give some tips to improve the quality of life of these people. This urinary incontinence occurs during physical activity like coughing, sneezing, laughing, or exercise. Then, I'm going to name a number of changes in behavior that a person with stress urinary incontinence should take to improve their quality of life:

 

• Drink less liquid (if you take more liquid than normal).
• Urinating more often to reduce the amount of urine escapes.
• Avoid jumping or running, which can cause greater leakage of urine.
• Ensure that more regular bowel movements taking dietary fiber or laxatives to prevent constipation (which can worsen incontinence).
• Quit smoking to reduce coughing and bladder irritation (and the risk of bladder cancer).
• Avoid alcohol and caffeine can stimulate the bladder.
• Lose weight if you are overweight.
• Avoid foods and drinks that irritate the bladder, like spicy foods, carbonated drinks and citrus.
• Keep blood sugar under control if you have diabetes.

 

I have chosen this disease because it is one of the most common in the geriatric spectrum, due to partial or total loss of systems such as neurological and musculoskeletal.

 

 

 

Bibliography:

• National Library of Medicine U.S. - MedlinePlus. [Website *]. [Revised 14/05/2013, updated 13/05/2013]. Available at: http://www.nlm.nih.gov/medlineplus/spanish/ency/article/000891.htm

Geriatric Syndromes. Constipation

Constipation is defined as excessively dry stool output, low (less than 50g/día) or infrequent (less than two bowel movements per week). This is most often caused by:

• .Low fiber diet
• Lack of physical activity.
• Not drinking enough water.
• Delay to go to the bathroom when you have the urge to defecate.
• Stress and travel can also contribute to constipation or other changes in bowel habits.

 

In this case, nursing through health education plays an important role. Then, I will show methods of prevention and treatment for constipation:

• Drink plenty of fluids each day (at least 8 glasses of water per day).
• Eating foods high in fiber (fruits, vegetables, legumes, etc..).
• Exercise regularly.
• Go to the bathroom when you have the urge and not wait.
• Administration of laxatives or enemas.

 

 

Bibliography:

• National Library of Medicine U.S. - MedlinePlus. [Website *]. [Revised 14/05/2013, updated 13/05/2013]. Available at: http://www.nlm.nih.gov/medlineplus/spanish/ency/article/003125.htm
• Scientific Electronic Library Online - SciELO. [Website *]. [Revised 14/05/2013, updated 09/05/2013]. Available at: http://scielo.isciii.es/scielo.php?pid=S1130-01082006000400010&script=sci_arttext

Geriatric Syndromes. Instability and falls

The fall is another important geriatric syndromes, if carried out, often leads to physical consequences (fractures), psychological (postcaída syndrome) and social (isolation and dependence in activities of daily living).

 

In my opinion, for to avoid this geriatric syndrome is very important the prevention. Therefore, the work of nurses and social workers is of great importance in this matter. Among the preventive measures can include:

 

• Primary Prevention. To detect and to correct predisposing factors, removing carpets, doing exercise programs, avoiding harmful habits, avoiding uneven floors, good lighting, orderly, bed railings, etc.. At this stage we can assess using scales such as the Tinetti scale or scale Downton risk.
• Secondary Prevention. In a fall discard loss of consciousness, syncope diseases, ask when and where it fell, what was at the time, how he got up, ask if there have been previous falls, identify gait disturbance, mental confusion, etc.. At this stage we can apply the comprehensive geriatric assessment.
• Tertiary Prevention. To reduce the consequences of the fall, both physically and psychologically. We need to teach the old man up, to restore stability, first sitting and then standing up, to reeducate the orthotics and supportive psychotherapy.

 

 

Bibliography:

• Ruddick S, Scollen C. Fracture prevention in the frail elderly. Practice Nurse; 2003.
• Scientific Electronic Library Online - SciELO. [Website *]. [Revised 13/05/2013, updated 9/05/2013]. Available at: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-21251999000100011

Geriatric Syndromes. Dementia and Delirium

Dementia and delirium are geriatric syndromes caused by neurological problems. In the table below I show the most significant differences:

	DELIRIUM	DEMENTIA
Beginning	Sudden	Gradual
Course	Floating with nocturnal exacerbations	Progressive
Awareness	Decreased	Normal
Atenttion	Affected globally	Normal, except in several crises
Cognition	Altered globally	Altered globally
Perception	Hallucination common, especially visual	Hallucinations rare
Delusions	Little systematic and fluctuating	Missing
Orientation	Decreased	Gradual decreased
Psychomotor Activity	Delayed, agitated or mixed	Normal

 

 

In patients with these conditions is important that health professionals follow communication guidelines:

• Approaching with a smile.
• Look to the eyes.
• Catch up with the patient.
• Use to short words and simple sentences.
• Repeat your statements.
• Avoid unusual expressions.
• Give to directions using fewer words.
• Ask questions so that patients have to answer "yes or no" when patients have difficulty answering.
• Make distracting noises disappear.

Today, families often blamed dementia "things of old age" and not caring. Furthermore, these diseases are often hidden under a depressive process. In my opinion and as a future nurse, I would make a good assessment of the patient. Then, together with other health professionals, we explain to the patient and her family her process and treatment to improve her quality of life.

 

Bibliography:

•  National Library of Medicine U.S. - MedlinePlus. [Website *]. [Revised 12/05/2013, updated 7/05/2013]. Available at: http://www.nlm.nih.gov/medlineplus/spanish/delirium.HTML
• National Library of Medicine U.S. - MedlinePlus. [Website *]. [Revised 12/05/2013, updated 7/05/2013]. Available at: http://www.nlm.nih.gov/medlineplus/spanish/dementia.HTML
• National Library of Medicine U.S. - MedlinePlus. [Website *]. [Revised 12/05/2013, updated 7/05/2013]. Available at: http://vsearch.nlm.nih.gov/vivisimo/cgi-bin/query-meta?v%3Aproject=medlineplus-spanish&query=diferencias+entre+demencia+y+delirio&x=0&y=0