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

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, M; de 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:

http://scielo.isciii.es/scielo.php?pid=S1134 928X2008000300005&script=sci_arttext&tlng=en

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: 

http://scielo.sld.cu/scielo.php?pid=S0864-34662007000100010&script=sci_arttext 

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: 

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