viernes, 24 de mayo de 2013

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:

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:

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, FJCarida, JMdel Molino Martín, J PérezOcerín, Oceríndel Molino Martín, J Perez;Valderrama Gama, ELópez Pérez, MRomero López, MPavón Aranguren, MVGuerrero 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


jueves, 23 de mayo de 2013

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:

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


lunes, 20 de mayo de 2013

SPECIFIC GERIATRIC SYNDROME : IMMOBILITY.



For older people enjoy the best quality of life possible. It’s essential that they retain physical mobility because 
it indicates that the patient has autonomy.
Mobility, indicates that the elderly enjoy health level and indicates that maintaining a certain degree of independence.
An immobilized patient has a high risk of being dependent on daily life activities and also has many risks that nurses have to avoid using the cares that is provided to the patient. For this, first we try to correct the problems that lead to the old man to immobilization.
It is important to make a detailed plan of care for these people because bed rest due to organs and systems are affected. To do this, we make a detailed study of the patient.
We will work for the elderly for don´t lose the mobility and functions and prevent deterioration of organs and systems, reduce skin lesions and sociological and social complications such as social isolation and prevent the patient become unable to look after themselves.
If the old man loses all or part of her mobility, it is necessary to take appropriate action in specific cases such as architectural barriers.
It is very important that from primary care nursing we bridle the immobility and we encourage the patient to regain mobility. We will make home visits for home adaptation studies and aid patient counseling techniques which support the patient to remain mobile.
For us to carry out the degree of patient mobility we have stand validated scales: scale Timed up and go test, and Barthel Tineti that values ​​basic activities of daily living.

Bibliograpy:

1. Morales Razo. D.P; Durán de la Fuente. I.E; Cabello Ponce de Leon.S.A .Inmovilidad en el anciano; Available in:
http://www.facmed.unam.mx/deptos/salud/censenanza/spivsa/antol%202%20anciano/2parte2013/VI_sindrome.pdf

PRESSURE ULCERS



Pressure ulcers, is a prominent issue in the elderly and very important in nursing care to a geriatric patient.
With the emergence of chronic diseases that lead to immobility and stay in bed, if there is prevention and identification of risk factors can hardly avoid the occurrence of pressure ulcers in patients in these conditions.
Most pressure ulcers are preventable so good practice nurse will be reflected in the good prevention thereof.
To evaluate these items have validated scales noted for its greater use the Braden scale and Norton scale.



In our role as nurses we must put the necessary means to prevent these injuries (bony protection, repositioning etc.)
In the event that a patient come to us with a pressure ulcer we study and plan a standardized care based on scientific evidence in order to resolve it.

From my point of view, this issue is very important and is an area in which nurses should be renewed because these injuries can trigger other complications in patients and is always vital to prevent complications due to lower incomes of patients and the economic cost that this would take place.

Bibliography:

1. Bermejo Caja CJ; Beamud Lagos, Mde la Puerta Calatayud M; Ayuso Gill Mª  ; Martín Iglesias. S; Martín - Cocinas Fernández. Mª C ; Fiabilidad interobservadores de dos escalas de detección del riesgo de formación de úlceras por presión en enfermos de 65 o más años. Enferm Clin. 1998;8:242-. - vol.8 núm 6. Available in:
http://www.elsevier.es/es/revistas/enfermeria-clinica-35/fiabilidad-interobservadores-dos-escalas-deteccion-riesgo-formacion-5900-originales-1998

2. García Fernández F.P; Pancorbo Hidalgo P.L; Soldevilla Ágreda J.J, Blasco García C; Pressure ulcer risk assessment scales.  Gorekomos v.19 n.3 Madrid sep.2008. Available in:



GERIATRIC SYNDROMES,



Humans have always wanted to live as long as possible, but with the best quality of life.
At this time, the aging population in developed countries leads to increasing number of elderly and the need to put your care resources needed service.
In this population group are three factors to note:
PAIN, WEAKNESS AND CHRONIC.
The sooner these symptoms are detected, the sooner you can act on them and avoid greater evils.
Performing a quick intervention we can provide better care for the elderly and to act at an early stage, the resources needed to carry out the treatment of pathologies of this group can decrease both on medical and economic aspects.








Bibliography:
1. Alonso Galbán. P; Sansó Soberats, FJ; Díaz- Canel Navarro, AM elt al. Envejecimiento poblacional y fragilidad en el adulto mayor. Rev Cubana Salud Pública v.33 n.1 Ciudad de La Habana ene.-mar. 2007. Revised in: 




domingo, 19 de mayo de 2013

BASIC NEEDS IN THE ELDERLY.



 
The elderly person just like the rest of the population, might need a series of cares provided by the nursing staff based on their health, as have a number of risks and needs to satisfy.
Nursing, through a standardized care plan must satisfy these needs, solve problems and prevent them.
This is very important to perform a comprehensive assessment of the elderly.
To provide this cares, and basic needs can make the elderly person be independent and therefore they are in an optimal state of health.




Bibliography
1. Quality of life meaning for the older adult and his family. Available on:

 http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1134-928X2006000100002

 2. Rojas Ocaña. Mª. J.  ; Toronjo Gómez A. ; Rodríguez Ponce. C ; Rodríguez Rodríguez. J.B. Autonomía y estado de salud percibidos en ancianos institucionalizados. Gerokomos (Madr., Ed. impr.) v.17 n.1 Madrid mar. 2006  Available on: 

jueves, 18 de abril de 2013

GLOBAL GERIATRIC ASSESSMENT.



Global geriatric assessment is a very important goal of nursing.
The elderly population which attends nursing visits can suffer many problems to be detected early.
It is important that this assessment is a process diagnostic dynamic and structured. We assess all the individual systems orderly and all areas: functional, social, mental...
                                                                                              
At this point we have to give great importance to the need to use scales and instrumental evaluation validated. Each scale is for the evaluation of a particular problem.
To carry out the comprehensive geriatric assessment, it is very important that when we do the clinical interview, this is the best possible way in spite of the difficulty whit some patients. 
From my point of view, it is very important to communication with the patient. Speak clearly with appropriate voice tone and establish good communication in addition to giving confidence to our patient is the most important.
Another important and alarming to consider, is attributed to the age old problems that present such as memory loss. I think it is a worrying issue and it is necessary that people are aware that any problem detected early can be resolved or do not get worse. Therefore it is important to conduct separate interviews with family and patient, so that we can compare information.


For all this, we have a very important role in promoting patient autonomy. We detect problems at an early stage, making prevention and preventing the elderly lose functionality and becomes a dependent of your family or institutionalized.





Bibliograhy:

1. Baztan, JJ; Gil, L; Andrés, E. Actividad comunitaria de un servicio de geriatría hospitalario: un ejemplo practico de coordinación entre atención primaria y especializada. Aten primaria. 2000;26 : 374-82. -vol. 26 núm 06. Disponible en:

2. Redín, J.M. Valoración geriátrica integral ( I ). Evaluación del paciente geriátrico y concepto de fragilidad. Disponible en:  





domingo, 14 de abril de 2013

THEORIES OF AGING.






Theories of aging, want expose an explanation of why aging occurs.
In this process there are a number of changes on the person which these theories try to explain, each from their point of view.
There are a number of theories emphasizing among them two large groups: the biological and psychosocial.
Based on these theories, we can make prevention and advice to the person on possible changes that will be appearing.
Each theory attempts to give an explanation for this process differently.
We have achieved the main objective, the independence of the person and involve them to live in a healthy environment.
The theory used in nursing is the LIFE COURSE THEORIES.
From my point of view during our life happens a series of changes and causes on the person, that deteriorate functions previously had and appearance changes.
I believe that the best way to combat the aging process, is coping with the changes happening in the person. Addressing this in a positive way I think is very important.
Life involves a series of stages that we all go. Since nursing is important to support the person in the changes and answer any questions that may arise to the person.
We understand it can be difficult for the person because it carries a deterioration and decay of health, a possible departure from the company, retirement and other. One of our roles is to encourage the person to maintain an active lifestyle and non-stop activities previously undertaken within their means.


lunes, 8 de abril de 2013

PHYSIOLOGIC CHANGES



The ageing process begins with the birth of the person and continues throughout of their life cycle. It is a physiological process.
People, suffers from a series of biological changes in organs and systems characteristic of this process called aging.
In the aging process the person suffer from various physical and physiological changes which affect the appearance and the functioning of organs and systems.
This means that could appear malfunctions of the body of the person.
Is very important in our profession as nurses, understand the person about their feelings and experiences of the changes that occur in them in addition to providing the best nursing care related to diseases that may be suffering in process of ageing and prevent complications.
During the last years of our lives, we suffer from more illness and find more limitations to adapt to the environment.
The aging process is individual, occurs in all people and is different between individuals and species.
One very important thing to consider is that our country has decreased the birth rate, but have increased life expectancy, which creates a challenge to society: to optimize health and functional capacity of the elderly patients, participation and security of them.


Bibliography
1.      Noriega Borge MJ, Garcia Hernandez M, Torres Egea MªP. Proceso de envejecer: cambios físicos, cambios físicos, cambios psíquicos, cambios sociales. Disponible en: http://www.arrakis.es/~seegg/documentos/libros/pdflibro/Cap2.pdf
2.      OMS. Envejecimiento. Disponible en: http://www.who.int/topics/ageing/es/index.html


domingo, 24 de febrero de 2013

GERIATRIC NUSRSING

Geriatric Nursing is responsible for specialized care for sick or the institutionalized elderly.

Nurses have a very important role in this stage of life of the people because they are responsible among other things for the process of care, disease prevention and aid in the process of dying.

The nurse is responsible for the following functions:
Care, management, teaching and research.

It is very important to know the different types of elderly people in relation to guiding clinical profiles.
- Healthy elderly: age and absence of disease, they are independent in their activities of daily living and basic activities. They have a low tendency for dependence.
- Frail Elderly: elderly patients that have some disease or other condition that remains balanced and with a high risk of becoming dependent. They are dependent for some of the instrumental activities of daily living, and dependent for basic activities of daily living. They are high tendency to dependence.
- Geriatric patient: elderly patient with one or more chronic diseases that need a lot of help.
Normally they are connected with a mental disorder or a social problem.
This patient is dependent one or more basic activities of daily living and for one or more instrumental activities of daily living.

National and International statistics show that health teams will have to respond to the needs of caring for older people, considering the implication of the functional capacity as a variable of evaluation of their health condition.(1)
In my opinion, geriatric nursing is very important in our work because ageing is a process which all the people support.
We should prevent problems that could occur, so that elderly  people get the best possible quality of life.

"The glory of young men is their strength, the beauty of the elderly is their old age."
Proverbs of Solomon


BIBLIOGRAFIA

1.  Lara Jaque, R. A., López Espinoza, M. Á., Espinoza Lavoz, E. D. C., & Pinto Santuber, C. (2012). Actividades Instrumentales de la Vida Diaria en Personas Mayores atendidas en la red de Atención Primaria de Salud en la comuna de Chillán Viejo-Chile. Index de Enfermería21(1-2), 23-27.  Disponible en http://scielo.isciii.es/scielo.php?pid=S1132-12962012000100006&script=sci_arttext&tlng=en%5D