Nursing Elderly, Elderly Care, Old Age Homes, Nursing and Rehabilitation of elderly, Nursing Services related to old age, Nursing Interventions for elderly

1. NURSING AND REHABILITATION OF
RESIDENTS OF OLD AGE HOMES

2. • Between 2015 to 2050 the
proportion of the world’s
population over 60 years will
nearby double from 12% to
22%
• In 2050 the world’s population
aged 60 years and older is
expected to total 2 billion up
from 900 million in 2015 .
• Today 125 million people are
aged 80 years are older
- WORLD HEALTH ORGANISATION

3. INTRODUCTION
• More than 142 million people are currently unable to
meet all their basic daily needs – baseline report of for
the decade of healthy ageing, WHO (17th December 2020)
• The increasing median age and total number of older
adults in our society present numerous challenges for
the health care system.
• In addition to this old age people requires high quality
nursing services.
• Nursing is the unique discipline in its ability to address
the physical, psychological, and social elements of care
and to provide comprehensive, coordinated services that
not only treat illness but also to promote healthy aging
and restore optimum function.

4. INDIAN SCENARIO
• Many senior citizens of our society are able to live a very
meaningful and independent life, but at the same time
the fact remains that there are some who are unable to
do so.
• Elderly individuals, who develop dementia, or such
considerable impairment need a rehabilitation program
may help them to overcome this disability and to live
life meaningfully and as independently as possible.
• Some of the senior citizens, who are unable to lead an
independent life in their own homes, may require old age
home or residential care facility.

5. Demographic Profile
of the Indian Population
• Many senior citizens o our society are able to live a very
meaningful and independent life, but at the same time
the fact remains that there are some who are unable to
do so.
• Elderly individuals, who develop dementia, or such
considerable impairment need a rehabilitation program
may help them to overcome this disability and to live
life meaningfully and as independently as possible.
• Some of the senior citizens, who are unable to lead an
independent life in their own homes, may require old age
home or residential care facility.

6. HOW OLD IS OLD?
OLD –
OLD
85 -100
YEARS
ELITE OLD
ABOVE
100
YEARS
It is necessary to define the differences for each
age group because their health needs medication
dosages and frailty relate specifically to their age
category.

7. THE NORMAL AGING PROCESS
THE CARDIOVASCULAR SYSTEM:
HEART:
• Cardiac muscle strength is diminished
• Heart valves become thickened and more rigid

8. Blood Vessels and Blood
• Arteries become less
elastic
• The greater rigidity
of the vascular walls
increase both
systolic and diastolic
pressures
• Blood volume is
decreased
• Bone marrow activity
is reduced

9. Respiratory System
• Lung elastic recoil is
progressively lost
with advancing age
• Oxygen saturation is
diminished because
of shallow
respiration

10. Musculoskeletal System
• The vertebral column may compress leading to
reduction in height
• Muscle wasting occurs
• Range of motion may be limited
• Cartilage thins so that joint may be painful,
inflamed or stiff

11. Genitourinary System
• Loss of bladder muscle tone
• Increased frequency of
urination

12. Nervous System
• Slower reaction time in
maintaining balance
leading to falls
• Insomnia and increased
night walking

13. Special Sense Organs
• Vision –ability to focus closed objects is
diminished ,increased density of lens occurs
• Hearing-ability to hear high frequency tone
decreases
• Taste: ability to perceive bitter ,salt ,and sour
taste diminishes
• Touch –ability to feel light touch ,pain or
different temperature may diminishes

14. PSYCHOLOGICAL ASPECTS OF AGING
SPECIAL CONCERNS OF THE ELDERLY:
• Retirement – Feelings of being unproductive and
economic hardship
• Economical implications – Reduction in personal
income

15. COMMON HEALTH CONDITIONS
ASSOCIATED WITH AGING
Cardiovascular Conditions
• Coronary heart disease
• Congestive heart failure
• Hypertension
• Peripheral vascular diseases
Neurological Conditions
• Cerebrovascular accident
• Parkinson’s disease
• Sensory losses
Pulmonary Diseases
• Chronic pulmonary disease
Musculo Skeletal
System
• Osteoarthritis and
degenerative joint
disease
• osteoporosis
Metabolic and
Endocrine Diseases
• Diabetes mellitus
• Hypothyroidism
Geriatric
Syndromes
consequence of
multiple underlying
factors:
• frailty
• Urinary
• Incontinence
• Falls
• delirium
• pressure ulcers

17. FACILITIES IN OLD HOME
• Professional geriatric team
• Balanced need-based nutrition
• Safe engaging environment
• Person centered elderly care
• Medication, feeding and bathing
• Regular doctor check
• Specialized services – palliative care

18. NURSING SERVICES AND
REHABLITATION
ASSESSMENT:
• Health history-Biographical data
• Current health status
• Past health history
• Family history
• Personal and Psychosocial profile

19. NURSING SERVICES AND
REHABLITATION
FUNCTIONAL ASSESSMENT:
The KATZ index of activities of daily living:
Assess the activities of bathing, dressing,
toileting, transfer, continence and feeding
in the continuum of Independent,
Assistance and Dependent
BARTHAL Index
Instrumental activities of daily living tool
are the instruments used in assessing
client’s ability to perform ADLs

20. NURSING SERVICES AND
REHABLITATION
COMPLETE HEAD TO TOE PHYSICAL
ASSESSMENT :
• When examining older client make sure
the environment is safe and appropriate
as possible

21. SENIOR FRIENDLY ENVIRONMENT:
• Keep examination room warm
• Use bright and non glaring lights
• Keep background noise to a minimum
• Arm rest on all chairs
• Privacy
• Minimize position changes
• Provide reading materials with large print
• Take time to explain the procedures

22. ASSESSMENT OF COGNITIVE
FUNCTION(MEMORY)
Mini mental status examination
FALLS ASSESSMENT
FOR PREDICTING PRESSURE SORE
RISK
Braden scale

23. BED SIDE CARE
Vital signs monitoring: (pulse, respiration,
temperature, blood pressure and pain
assessment)
Dressing
Collecting samples for investigation (e.g.,
blood, urine)
Foot care diabetic patients
Urinary catheterization and catheter care
Insertion of suppositories
NURSING SERVICES

24. EDUCATION
Providing information related to disability its
treatment and management

25. ACTIVE EXERCISE
Transferring from bed to
chair
Walking and ambulating
with assisted devices
Assisting with crutch
walking
Range of motion
exercises

26. BLADDER TRAINING PROGRAMS
Every 2 hours emptying the bladder
Limiting fluids after 6 pm
Initiating bladder training programs reduces
the chance of urinary tract infection and
avoids the use of catheters.

27. BOWEL TRAINING PROGRAMS
 Establishment of a routine for emptying bowel daily
 Diet consisting of whole grains, cereals , fresh fruits,
fluids,
 If constipation occurs providing medication to soften
the stool.

28. PASSIVE RANGE OF MOTION
EXERCISE (nurse moves the joints)
Flexing and stretching the joints
Can be done 2-3 times a day

29. PALLIATIVE CARE-END OF LIFE CARE
 Symptomatic care
 Pain management
 Support and Advice
 Relaxation techniques
 Healing touch
 Arranging for spiritual meeting

30. FEEDING & SELF FEEDING PROGRAM
 Feeding through Nasogastric tube
 Assistance during self feeding

31. MEDICATION ADMINISTRATION
 Administration of prescribed medications
 Administering IV fluids
 Documenting in medication chart

32. ASSISTANCE WITH ACTIVITIES OF
DAILY LIVING

33. PROMOTING SLEEP
(Sleep disturbances increases during age)
 Warm milk at bedtime
 Providing socks or
extra blanket increase
body temperature
 Alleviating pain
 Dim lights at night
 Increased motor
activities and outdoor
activities at daytime

34. COUNSELING
 Helping them to ventilate their problems
 Offering counseling to the family members
 Identifying the old age person’s psychological
problems and coping strategies

35. RECORDS
COMPREHENSIVE ADMISSION ASSESSMENT
Minimum data set: case history
Ongoing nursing assessment
Medication chart
Intake out put chart
Fall assessment chart
Bedsore risk assessment chart
Informed consent (for using restraints)

36. RECORDS
Investigation
reports
Physician’s
progress report
and prescription
chart
Diet plan
Nurses Notes

37. “The process of developing and
maintaining the functional ability
that enables well being in older age”
Optimizing functional ability is the
goal of WHO in 2021

38. FUNCTIONAL ABILITY
The ability to
meet basic
needs
to continue
to learn and
make
decisions
To be mobile
To build and
maintain
relationships
To contribute
to the
society

39. CONCLUSION
Nurses are the foundation of a country’s primary
health care; they act as health gatekeepers.
Nurses provide a variety of care like
health promotion advice, lifestyle
counseling, educational programs and the
provision of early interventions to prevent
exacerbation or complications for elderly
persons living with diseases.
Nurses help in healthy aging improved,
functional ability and quality of life
of the elderly.

40. “A nurse is one who opens the
eyes of a newborn and gently
closes the eyes of a dying man”