Geriatric care

SEMINAR
ON
GERIATRIC CARE
www.drjayeshpatidar.blogspot.com

GERIATRIC OR
GERONTOLOGICAL NURSING-
Childhood, youth, adulthood and old age are different
stages of life. With increasing age we become old. Birth,
development, decline and death are the laws of life. Whether
we want it or not, we have to pass through these stages. Old
age is also one part of this cycle.
What is ageing?
Old age or ageing expresses the continuous pressure
and effect of time on our body, senses and skin. Due to
continuous functioning, the cells, tissues and organs of our
body degenerate. In the later part of life, we have to face many
physical and mental problems. Hence old age is the result of
physical and psychological fatigue caused by continuous
functioning. Just like problems or defects occur in machines
due to continuous functioning, or workload, with increasing
age, problems also arise in human body. www.drjayeshpatidar.blogspot.i
n

Ageing and Demography
 Large number of aged people in the population is the
result of demographic change.
 The number of people above 60 years is assessed to
be over 49 crores in world. By 2040, their number
will be 140 crores. (According to the prediction of
(W.H.O).
 As compared to old men, there are more old women.
 Because of the increasing number of old people,
many socio-economic problems are arising. The main
problems are of housing, their livelihood and medical
treatment.
 French doctor Jean Martan Carcot was the first
person who had studied about old age diseases, in the
year 1881. www.drjayeshpatidar.blogspot.i
n

National Policy for Older Persons
The Government of India in January-1999
announced the National Policy for older persons. The
principle areas of intervention and action strategies
suggested in the policy sector include the following:
 Financial security for older persons working in the
formal sector as well as those working in the informal
sector.
 Health care and nutrition to enable older persons to cope
with the health, associated with ageing, with particular
emphasis on prevention.
 Shelter/housing keeping in view the life style of older
persons.
 Emphasis upon education, training and information needs
for older persons.
 Priority attention to vulnerable groups such as the
destitute, widows and disabled older persons.www.drjayeshpatidar.blogspot.i
n

 Establishment of welfare fund for older persons.
 Protection of life and property of older persons.
 Concessions, rebates and discounts to older persons.
 Participation of NGOs in the care of aged.
 Strengthening the family and reinforcing inter-
generational relationship between children and older
persons.
 Formation of self-support group of older persons.
 Development of the manpower for the caring of
aged.
 Creative use of media in the sector for care of old
persons.
 Establishment of a separate bureau for older persons
in the ministry
www.drjayeshpatidar.blogspot.i
n

Gerontology
This is a science dealing with ageing
process.
Geriatric Care
This is related to the disease process of
old age and it aims at keeping old persons at a
state of self-dependence as far as possible and to
provide facilities to improve their quality of life.
Gerontoiogical Nurse-
A nurse who has specialization in geriatrics
or in the care of old people is called geriatric
nurse or gerontoiogical nurse.
n

Functions of Gerontoiogical Nurse-
 G (Guiding): Giving guidance to people of all ages
regarding ageing process.
 E (Eliminating): Eliminating ageism or considering old
age as disease.
 R (Respecting): Respecting the rights of old people.
 O (Observing): Observing the facilities provided to old
people and improving them.
 N (Noticing): Noticing health hazards that may happen
in old age and try to reduce them.
 T (Teaching): Teaching how to take care of old people,
for those who are caring for them (family members,
friends, community health worker, voluntary
organization, etc.).
 O (Opening Channels): Opening the channels of
developmental activities for the care of the aged.
n

 L (Listening): Listening attentively to the problems of old people and
giving due importance to them.
 0 (Offering): Offering positivism – Presenting different possibilities
of life.
 G (Generating): Generating energy for the participation in the care of
aged and researches for new supporting techniques.
 I (Implementing): Implementing activities for rehabilitation and re-
adjustment.
 C (Co-coordinating): Co-coordinating different services related to the
care of the aged.
 A (Assessing): Assessing the needs and health of the old people.
 L (Linking): Linking, contacting services according to need.
 N (Nurturing): Preparing future nurses for the care of the aged
 U (Understanding): Understanding every old person as an invaluable
asset of the society.
 R (Recognizing): Recognizing the moral and religious aspects of old age
and giving them recognition.
 S (Supporting): Supporting the old people in accepting realities and
preparing them mentally for impending death.
 E (Education and Encouraging): Educating and encouraging old people
for self care.
n

Factors Affecting Ageing
 Hereditary Factors
Hereditary diseases, the capacity for longevity
and physical capacities influence the ageing process.
 Environmental Factors
Three types of environmental factors affect ageing:
a) Abiotic Factors
Factors affecting ageing process like climate, radiation, chemical and
physical elements of pollution, etc. are included in this.
b) Biotic Factors
In this, living organisms present in the environment like pathogens,
parasites, the availability and quality of food etc. are included. They
all influence the ageing of the person.
C) Socio-economic Factors
Several socio-economic factors responsible for creating adverse living
or working conditions increase "the wear and tear" of life. Such
tensions make people grow old early.
n

Common Ageing Changes
Physical Changes-
Changes, which may occur in different systems, are as follows:
1. Integumentary System
 Decrease in elasticity of skin and dryness appears
 Wrinkles appear
 Age spots appear
 Hair of head, axilla or pubic region become scanty grey/white
 Hair growth on women's face
 Thickening of nasal hair and hair on ears
2. Cardiovascular System
 Less blood circulation in heart
 Increased blood pressure
 Flexibility of heart valve diminishes
 Blood vessels of head, neck, hands and legs become prominent.
3. Respiratory System
 The capacity of lungs becomes less.
 Ineffective gas exchange
 The chances of cough increases
 More chances of respiratory infections
n

4. Genito-Urinary System
 The kidney function may be impaired
 Fluid and electrolyte imbalance
 Capacity of urinary bladder decreases
 Incontinence
 Enlargement of prostate in males
 Atrophy of reproductive organs in females
 Vaginal secretion decreases
5. Gastro-intestinal System
 Falling of teeth
 Less secretion of saliva and gastric juice
 Complaints of constipation
 Digestion becomes weak
6. Musculo-Skeletal System
 Height reduces (In most of persons above 70 years height decreases
unto two inches)
 Kyphosis, swelling in joints
 Bones become weak
 Mobility decreases, if proper exercise is not donewww.drjayeshpatidar.blogspot.i
n

7. Endocrine System
 Thyroid gland becomes less active
 Alertness decreases
 More susceptible to cold
 Secretion of testosterone, oestrogen, progesterone decreases.
 Less secretion of insulin by pancreas
8. Neurological System
 Sensitivity becomes less/reaction is delayed
 Change in sleeping habits
 Frequent awakening
9. Sensory System
 Eyes become weak
 Hearing capacity decreases
 Complaint of presbyopia
 Ability to smell is reduced
 Ability to taste is reduced
 Tactile sensations are affected
10. Immune System
 Ability to prevent diseases or resistance power decreases
 Probability of infections increases www.drjayeshpatidar.blogspot.i
n

2. Psychosocial Changes
The psychosocial changes occurring in old age cannot be
separated from physical changes. Because of decreased
activity of sensory organs, person is not able to work with full
efficiency in his environment. Due to this, psychosocial state
is affected. Person feels the sense of 'uselessness'. Social and
psychological changes of old age are as follows
a) Personality
Because of the experiences and happenings of life, person's
personality is affected. But in old age, no remarkable changes
occur in the basic personality structure. Changes may occur in
the personality due to death of life partner, decreased or end of
self-dependence, loss of source of income, incapacity, etc.
b) Memory
Memory power may decrease with increasing age.
Recalling of less frequently used information is difficult. In
some old people, the tendency to repeat facts and information
increases. Confused memory also may be found.
n

Some Forms of Old Age Abuse
Old people may have to undergo a lot of neglect. Some main
forms of neglect or abuse are following:
Physical Abuse
 Beating and physical punishment
 Sexual abuse
 Restraining or locking them in the house
 Teasing them for physical conditions or diseases
Psychological Abuse
 Giving mental torture
 Abusive language
 Calling by names (disrespectful words like old man etc.), making
fun of them, threaten them.
 Forced isolation
 Treat them as children
Material Abuse
 Snatching their property illegally
 Economic exploitation
 Misuse or wasting their property for personal pleasureswww.drjayeshpatidar.blogspot.i
n

Active Neglect
 Not providing food purposely or giving less food
 Neglecting their likes and dislikes
 Spoiling or removing their dentures, glasses, hearing aid
etc.
 Forbid them to play with grand children
 Encouraging grand children to insult grand parents
Passive Neglect
 Become lazy or neglecting the care of old people.
Neglect may be due to ignorance also.
Social Abuse
 Neglecting their advice
 Overlooking their experiences
 Not providing them proper place or
honour on social occasions. www.drjayeshpatidar.blogspot.i
n

Adjustment in Ageing
a. Family Changes :
Family is such a unit through which maximum satisfaction
may be obtained. But in old age the person's family status is
changed. A father, who was the chief of the family till now,
may have to become dependent on his children. A mother
may have to subject herself to the rule of daughters-in-law. If
one of the partners is dead, the other has to face loneliness.
The decision making process in the family changes and the
control is transferred.
b. Retirement
In Indian context, retirement is a symbol of old age. In the
retirement process, the person may pass through the following
phase:
1. Remote Phase
Even when retirement is near or approaching, person does not
get ready for it.
2. Near Phase
When retirement is very near, making imaginary plan for it
(day dreaming)
n

3. Honeymoon Phase
Just after retirement person wants to do all those
things, which he could not do so far or was always
desirous of doing. But health and financial resources may
cause problems (not in all people) in fulfilling his dreams
or imaginations.
4. Disenchantment Phase
The problems/realities of retired life may dispirit the
person. His excessive dream regarding retired life may
result in more disappointments. At this stage, person may
begin to come out of false imaginations.
5. Stability Phase
Person understands the realities of retired life. He
makes adjustments to his new roles.
6. Termination Phase
This happens either by taking up some work again or
due to illness or incapacity. www.drjayeshpatidar.blogspot.i
n

Responsibilities of Nurse in Ageing
 Care giver
 Health educator
 Coordinator of health services
 Counselor and guardian (Those people who
protect the old person or take responsibilities
as his guardian, spokesman or responsible
person).
n

Health Assessment
 Daily activities of living (bathing, excretion,
clothing, urinary control, ability to eat etc.).
 Activities related to use of equipment (Telephone,
bank account, food preparation, etc., his ability in
these activities).
 Health Screening: Ability to see and hear, dental
problems, blood pressure, examination of breasts and
uterus, cancer testing, examination of skin, etc.
should be done.
 In laboratory tests; blood examination, urine
analysis, cholesterol, blood sugar, thyroid, etc. tests
should be conducted www.drjayeshpatidar.blogspot.i
n

2.Arranging / Promoting Good Nutrition
3.Promoting Activity and Exercise
4.Preventive Care of Elderly
5.Providing Psychological Support
n

Ageing: New Nursing Challenges
 Gerontological psychiatric nurse specialist in old age
home and nursing homes.
 Care manager and family counselor of chronic old
patients in the community.
 Pre admission assessor of nursing homes hospitals.
 Nurse Director of old age care giving training centre,
old age day care centre.
 Counselor of old patients in surgical wards.
 Pre-retirement counselor / educator.
n

Theories of Aging:
 Biological Theories:
 Intrinsic Factors: Several theories assume that individuals inherit a
genetic program that determines their specific life expectancy. In fact,
various studies have shown a positive relationship between parental
age and filial life span. Genetic mutations are also thought to be
responsible for aging, a pattern depicted below, laboratory experiments
which have accelerated mutation rates have not produced proportionate
increases in the rate of aging, thus reducing support of this theory.
Some theorists believe that a growth substance fails to be produced
causing the cessation of cell growth and reproduction.
 Extrinsic Factors: Disease producing organisms are often associated
with biological aging. Bacteria, fungi, viruses, and other organisms are
thought to be responsible for certain physiological changes during the
aging process. Although no conclusive evidence presently exists to link
these pathogens with the aging process, interest in this theory has been
stimulated by the fact that humans and animals have been shown to
live longer with the control or elimination of certain pathogens via
immunization and the use of antimicrobial drugs.
n

 Psychological Theories:
Psychological and social changes during the aging
process are closely united, and they have a significant impact
on each other. It is difficult to explain mental processes,
behavior and feelings without the perspective of social roles,
positions and norms. A theory of aging that is purely social or
psychological would be most unusual, and it is more
appropriate to approach these aging factors as psychosocial
theories. Probably the most controversial and widely
discussed is the disengagement theory, developed by Elaine
cumming and William Henry. This theory views aging as a
process whereby society and individual gradually withdraw or
disengage, from each other, to the mutal satisfaction and
benefit for both. The benefit to individual is that they can
reflect and be centered on themselves, having been freed from
societal roles. The value of disengagement for society is that
some orderly means is established for the transfer of power
from old to young, making it possible to society to continue
functioning after its individual members have died.www.drjayeshpatidar.blogspot.i
n

Bibliography:
 Springhouse, mastering geriatric care, USA.1997.1-
447.
 Charlotte Eliopoulos, Geriatric nursing, UK.1-335.
 Park.k, Preventive and social medicine, 19th edition,
India (Jabalpur).2007; 475.
 Gulani k, Community health nursing principles and
practices. Delhi; 469-472.
 www.google.com
Search-Geriatric care.
n

Geriatric care

More Related Content

What's hot (20)

Similar to Geriatric care (20)

More from Nursing Path (20)

Recently uploaded (20)

Geriatric care