Downloaded 19 times
Uploaded bygrace lindsay
Nursing and challenges for geriatric care in acute hospitals
The document discusses the increasing complexities of geriatric care due to rising life expectancy and the growing population of older adults, emphasizing the essential role of nursing in meeting their diverse health needs. Key challenges include the medical model focus, multi-agency involvement limitations, and the necessity for individualized care approaches that promote independence and quality of life. It highlights the importance of addressing social, emotional, and psychological well-being alongside physical health for effective geriatric care.
More Related Content
Similar to Nursing and challenges for geriatric care in acute hospitals
Nursing and challenges for geriatric care in acute hospitals
- 1. Role of nursingin geriatric care: barriers in practice Grace Lindsay BSc, RN, RM, MN, PhD Faculty of Nursing Umm Al Qura University Makkah
- 2. Overview • Reflection oncomplexity of older population health issues • Nature of the client population health needs/goals and potential challenges • Considerations for nurses in provision of care of older patient in acute care
- 3. World Health Organizationsurvey results…. …of those 13% are over 80 years old. . 804 million people (approx.) over the age 60 living in the world WHO 2011 …by 2050 ..estimated that this number will be almost 2 billion and number of elderly exceed number of children
- 4. Distribution of populationsize by age ranges for males and females KSA MoH 2014
- 5. Changing population size:a hundred year ‘snap shot’ KSA MoH 2014
- 6. Life expectancy increases duringlife course KSA MoH 2014
- 7. Demographics • Facing increasingnumbers of people • aged 60 year+….on a large scale – Pattern of exceeding predicted life expectancy as a person ages – Currently large numbers of population in 20-30 year old age bracket • In the ‘oldest old’ women and men have almost same mortality rates: but many more women
- 8. Definitions of ‘health’ •“a complete state of physical, mental and social well-being, and not merely the absence of disease or infirmity.” WHO (1). • “a dynamic state of well-being characterized by a physical and mental potential, which satisfies the demands of life commensurate with age, culture, and personal responsibility” (2) • “a condition of well being, free of disease or infirmity, and a basic and universal human right” (3) 1. WHO. Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19-22 June 1946, and entered into force on 7 April 1948. 2.Bircher J. Towards a dynamic definition of health and disease. Med. Health Care Philos 2005;8:335-41. 3.Saracci R. The World Health Organization needs to reconsider its definition of Health. BMJ 1997;314:1409-10
- 9. Challenges in careof older people: Population perspectives • Increased life expectancy • Increased numbers of older people potentially needing healthcare • Evolving models of multi-sector provision • Government funding level not guaranteed • Supporting healthy quality-living survivorship
- 10. Productive ageing • Strategiesto slow decline into frailty and dependence • Greater importance given to wider social, emotional, psychological well-being • Enhance self-management potential • Active ageing • Quality of life Concepts
- 11. Health factors • Physicalstatus • Mental health • Emotional wellbeing • Social Isolation • Economics • Family support networks Chronological age vs biological age ???
- 12. Functional decline • Hearing/Vision+ other senses • Agility • Strength • Eating & Digestion • Mental acuity • Continence • Dependency
- 13. Common medical conditionsin older age • Cancers • Respiratory disease • Cardiovascular disease and stroke • Mental health, behavioural problems, vascular dementia
- 14. Health Challenges....Co-morbidities more common •Cancer • Ischaemic disease- heart; brain +? • Diabetes • COPD • Osteo- arthritis • Parkinsonism • Mental health issues inc. Depression • End-of-life care • Life situation issues – Sedentary – Anxiety – Financial – Family roles – Reduced autonomy; increased dependency – Respect from others? – Sense of lack of dignity
- 15. Acute healthcare settings Someof the challenges for nursing….. • Focus on disease/injury treatment • Medical model of health • Outwith specialist facilities for older care infrastructure for multi-agency, multi-disciplinary involvement may be limited • Complexity, dependency • Length of hospital stay
- 16. All cause mortalityby age and sex (UK, 2013) 0 20000 40000 60000 80000 100000 120000 140000 Male Female • Numbers of males and females in mid-life similar • Cumulative earlier male deaths • More older women survivors
- 17. Nursing considerations • Conditions/treatments •Health Goals /targets • Individual focussed care • Activities of daily living • Promoting independence • Quality of life • Chronic disease....self- management focus Framework for care delivery
- 18. Applying the ‘Nursingprocess’ • Assessment – Multi-dimensional – Standardised tools – Risk of harm potential • Diagnosis – Individualised – Priority of needs – Multi-factorial • Planning and implementation – Careplans – Multi-disciplinary input – Family/carers engagement – Goal focussed • Evaluation – Sensitive meaningful outcome measures Standards set…clinical quality indicators across practice
- 19. Nursing care planning:Individual level • ADL support needs • Risk Assessment- falls, nutrition, cognition • Care/dependency levels • Pharmacy (poly) • Discharge planning (early in process) • Medical investigations, diagnosis and management • Vital signs • Monitoring routine/specialist tests Use of standardised and validated assessment tools Based on overall health status and presenting condition
- 20.
- 21. Common reported barriersin caring for older people • Time consuming • Repetitive tasks • Uncertain outcomes • Expectations achievable? • Influence of stereotype assumptions?
- 22. Stereotyping .... • Generalisationof characteristics of groups • Convey certain qualities that engender presumptions • Positive and negative perspectives • Could be seen as a form of equality within groupings • Groupings implies a ‘single entity’ not at an individual level • Fosters judgemental attitudes
- 23. Not all hemay seem...
- 24. Considerations • Do olderpeople need to be treated any differently? • If so why?....in what manner? • Perceptions mismatch...them and us?
- 25. Conclusions • Growing sectorof the population • Clarity on appropriate and achievable health outcomes • Targeting multi-dimensions of health improvement • Individualised approach has even greater importance • Multi-discipline/sector/individual and family involvement
- 26. Growing older isa privilege denied to many Thank you