LEVELS OF CARE

The best care that we can provide the elderly is prevention and education on healthy habits that must be carried out in primary care, either in the clinic or in the home of the old man when he can´t move to the clinic.

If the old man isn´t sick with a sore geriatric and need your income, this will take place in the General Hospital after his condition improved and back to his home, nursing care need to complete their recovery.

When income geriatric pathology is caused by the old man will pass to the Geriatric Unit.

If the disease persists and it becomes chronic and its severity can´t be treated at home, he will pass to Geriatric Day Hospital.

From my point of view is essential to pay a care level that the elderly requiring lending the elder care needs.

Elderly patients may need specialized care with specialists in their pathologies.

HEALTH EDUCATION IN THE GERIATRIC PATIENT.

If health professionals tries to instill healthy habits in time the elderly population is likely to decrease health problems, preserve and maintain the functional independence. QUALITY OF LIFE and therefore healthy aging.

So it is essential to prevent or control future diseases, monitor organic risk factors, environmental or social and which are common to the elderly conducting periodic reviews.

Bibiography:

1. “Envejecimiento exitoso” y “tercera edad”: Problemas y retos para la promoción de la salud. Available in:

http://www.mednet.cl/link.cgi/Medwave/Revisiones/Analisis/5574

PALLIATIVE CARES.

Many times, medical personnel, when communicate health bad news, psychological reactions are detected which make that we get away from the terminal patient.

These reactions have to be avoided and must overcome the barriers that stand in our way.

Nurses should use a deliberative model to communicate with the patient, focused look at the same level in health, disease and psychosocial.

In a terminal patient in my opinion the first activity to be undertaken is eliminate pain suffered by the patient and symptom control. We mustn´t forget that support for the patient to remain at his side, be available for any questions and empathizing are important so will foster communication.

Another important aspect is to try making the patient's autonomy and the implementation of activities of daily living is present as long as possible.

We mustn´t forget in this process the family of the patient receiving palliative care. We will support them emotionally from start to finish the process.

The terminally ill patient suffers the "stages of grief": Denial, anger, bargaining, depression and acceptance. Since nursing is essential to carry out a series of interventions that help the patient to go through this stage.

 Bibliography: 

1. Aspectos psicosociales asociados con la calidad de vida de personas con enfermedades crónicas. Diversitas vol.1 no.2. Bogotá July/Dec. 2005. Available in:

 http://www.scielo.org.co/scielo.php?pid=S1794-99982005000200002&script=sci_arttext

INCONTINENCE IN THE ELDERLY.

Urinary incontinence is defined as involuntary loss of urine objective, resulting in unsuitable places and times and in quantity or often enough to be a problem hygienic, social and psychic to the person suffering and possible limitation of their activity and relationship.

For all this, I think it is important that nurses help the elderly to avoid the above problems.

In the elderly population urinary incontinence that occurs most frequently is incontinence due to detrusor instability.

The nurse takes a very important role in my point of view, in the evaluation of urinary incontinence.

This requires making an assessment of the elderly that is individualized, we note whether the patient takes drugs and which will be of great help and use of bladder diaries or records so that we can assess frequency.

It will be important in addition to cure incontinence improve at all times the situation of the patient to enjoy life quality.

Advising the patient is of great importance: unbutton clothes easy, absolute accessibility to toilet or a potty near the bed, adjust medications, particularly absorbent devices perform Kegel exercises to strengthen the pelvic floor.

It will be important that you fully understand the performance of those years and if necessary we could show videos and be available for any questions that may arise.

I think from our role nurse must put ourselves in the situation of the patient and understand that somewhat uncomfortable, it can trigger many problems and that our advice and understanding will be very useful for the elderly patient.

Bibliography:

1.  Gavira Iglesias, FJ; Carida, JM; del Molino Martín, J Pérez; Ocerín, Ocerín; del Molino Martín, J Perez;Valderrama Gama, E; López Pérez, M; Romero López, M; Pavón Aranguren, MV; Guerrero Muñoz, JB. Uso de accesorios para incontinencia urinaria en los ancianos de la zona básica de salud de Cábra (Córdoba). Publicado en Aten Primaria. 2000;25:88-95. - vol.25 núm 8. ; Available in: 

http://www.elsevier.es/es/revistas/atencion-primaria-27/uso-accesorios-incontinencia-urinaria-los-ancianos-zona-11190-originales-2000?eop=1#4fa8812a92bbda9822d9736064d39daa

2. Mañá Gonzalez. M; Mesas Sáez. A.; Incontinencia urinaria en la mujer: plan de cuidados de enfermería. Available in: http://www.elsevier.es/sites/default/files/elsevier/pdf/35/35v12n05a13038478pdf001.pdf

DIGESTIVE-ENDOCRINE PATHOLOGY: CONSTIPATION AND FECAL INCONTINENCE. OSTOMY AND DYSPHAGIA

Focusing on constipation as major geriatric syndromes, can highlight multiple reasons of which we highlight in this post nutrition, physical activity and patient education.

We must teach the patient to maintain adequate food rich in fiber insoluble fiber recommending produce less flatulence in the elderly.

We must also educate the patient to maintain a regular bowel habit. Try it every day.

I will discuss the possibility of aid to encourage emptying the rectum when sitting on the toilet like a drawer to keep feet high and can successfully perform abdominal press.

On the other hand we will encourage physical activity in the patient, that favor the press exercises abdominal and pelvic floor.

We must educate the patient on this issue as it is a common complication in the elderly population and this can improve quality of life for patients suffering from constipation.

GERIATRIC SYNDROME FALL

WHO defines the fall as a result of any event which tumbles down the person against their will.

The elderly patient is at high risk of falls. There are many risk factors that make the elderly susceptible to falls.

We must bear in mind that a patient suffering from a fall are at risk for a fracture, the most common being the hip suffering a post-fall syndrome or suffer social isolation.

Since my point of view is very important that the patient has autonomy, which can perform basic activities of daily living and instrumental daily life.

A drop will cause the patient to reduce or eliminate their mobility therefore not be autonomous.

A result of a fall is encouraged bedridden patient which would lead to the emergence of multiple complications, highlighting the possibility of having a pressure ulcer.

I think it will be an important role of nursing to educate the patient, teaching him to rise, deriving to carry out rehabilitation aid, assistive devices and encourage him to walk again, reducing anxiety and fear of falling as we must to avoid in the elderly mobility impaired, leading to the institutionalization of the elderly and death.

Bibliography:

1. Risk factors for falls in the elderly: sistematyc review. Rev. Saúde Pública vol.42 no.5 São Paulo Oct. 2008. Available in:

http://www.scielo.br/scielo.php?pid=S0034-89102008000500022&script=sci_arttext

NEUROLOGICAL DISEASES: COGNITIVE IMPAIRMENT AND DEMENTIA.

The topic of cognitive impairment and dementia is a problem of major public health in developed countries. This is because the population is becoming more longevity.

The detection of dementia in the elderly is very low.

This topic has great relevance because early detection is crucial and in primary care we have a important role in this regard.

These problems are often blamed on "things blamed on the age" which must stop nursing staff.

We should also encourage all elderly patients pass regularly screening to detect cognitive impairment.

Nursing reached a very important role because it is responsible for once detected cognitive impairment performs a number of changes, such as changes in the patient's home. This will require making a home view to advise the family of changes at home that could be favorable for the elderly.

We must take into account a variety of patterns present for communication with the patient is optimal.

On the other hand we show our support for the family as it is a complicated process for them and can lead to an "overload".

Bibliography:

1. M.V. Zunzunegui Pastora, T. del Ser, A. Rodríguez Lasoc, M.J. García Yébenesc, J.Domingo
y A. Otero Puimec. Demencia no detectada y utilización de los servicios sanitarios: implicaciones para la atención primaria. Available in.
http://www.elsevier.es/sites/default/files/elsevier/pdf/27/27v31n09a13048142pdf001.pdf