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Discuss about the Nursing Care of the Older Person For Aging Problem.

Critical Reflection

Aging is a continuous process in a man’s life. Old age is a contradicting phase of a man’s life where he is weak on the outside while he is forged of steel on the inside due to the knowledge gathered all throughout his life. This assignment contains a face-to-face discussion with some older people. Through this discussion, they will be sharing certain significant things about their life. They will be sharing important information about the aging process and the challenges faced by them within 1 hr. This discussion is quite relevant to the topic of the main research because knowing the hardships in the older patient’s life can be helpful for the geriatric nurse to serve them better.  Through this experiment, the geriatric nurses can be trained and they can be made aware of the situations faced by the older people (Carpenito-Moyet and Carpenito 2012, p.36).

The discussion revealed a number of important facts of the old age, which requires special nursing attention. From this discussion, a few things such as each patient have a separate chronic disease, which becomes the main reason behind the sufferings of the older people. In certain cases, the old person might not have any chronic disease but still, nursing can be very challenging for them too. Old people have low energy and are less mobile and they are more susceptible to falling. Geriatric nurses are supposed to be quite patient and empathetic with their patients because they require help in every step.

It has been noted that the older people have many expectations from their nurse. They want their nurse to listen to them and handle them with compassion. The nurse is responsible for the physical as well as the mental well being of the patient. As in most cases the older person lives in isolation from the rest of the family so they turn to be more agitated and angry; it is the nurse’s job to keep them cheerful and become a bridge between the patient and his family members.

The main problem faced by the older person, who impairs their normal lifestyle is falling and immobility. These two major factors are an outcome of several other reasons.

Falling seems to be like a natural phenomenon for these old people, as they are quite sloppy and feeble at this age but the truth is sloppiness is not the only reason behind this fall. Falling can be an outcome of many reasons such as polypharmacy, vision impairment, Parkinson's disease, Alzheimer's disease etc.

Polypharmacy: This condition is described as the use of multiple medications at the same time. Thus, the patient bores the risk of drug interaction and procuring several undesirable side effects from those drugs. The side effects include blood pressure fluctuations, lack of postural reflexes and the patient is exposed to a lot of muscle weakness. In most cases the patient suffers from a chronic disease and the prescribed medications can be very overwhelming for the patient’s body. The patient might also take some herbal medications along with the chronic disease medications, which might cause this drug interaction. The central nervous system of the older people gets affected when they are taking a continuous medication of nerve suppressants or sedatives. The side effects of these medicines are often sustained sedation and the patient gets confused about his doings; this increases the risk of falling (Holmes 2012, p.54).

Critical review and discussion

As a nurse the primary job would be to look into the medications of the patient and the nurse must ensure that the patient consults only one physician and one pharmacy, the nurse must also inquire if the patient is taking any herbal remedies as well. The nurse should also make sure that the medications are being taken in the right order, at the right dosage and at the right time (Ritsner 2013, p.76).  

Vision impairment: The most common reason for falling is vision impairment, which causes the patient to lose their balance and maintain their position of standing.  Cataracts, glaucoma, can cause vision impairment besides age-related degeneration. In some cases, the patient might fail to distinguish between objects or colors and they end up mis-footing (Cattaneo and Vecchi 2011, p.63). The nurse must ensure that the patient’s vision is at its best. The nurse should send the patient to visit the Ophthalmologist periodically.

Alzheimer’s disease: this disease is the advanced stage of dementia, which is found in elderly people. This disease causes confusion, amnesia, behavioral changes and even trouble swallowing, speaking and moving around. So, they are highly susceptible to falling. An Alzheimer’s patient requires special attention as the normal things around the patient comes as confusion.

Hemiparesis: This disease can be described as a weakness on one side of the body, this occurs in a patient who has experienced a stroke or whose cerebellum is injured and the ability to move gets compromised. These patients require exercising regularly otherwise their muscles might stiffen and end up in immobility (Buschmann 2015, p.56).

 Osteoarthritis: this disease can be recognized as joint pain due to the motion. This is a much common disease among the older people but sometimes the symptoms are misunderstood for common joint pains which are typical to the process of aging. There is no cure for this disease although the patients are prescribed with certain pain relievers, which take away the pain for a short period of time. The patients are mostly prescribed with NSAIDs and acetaminophen. The side effects of these medications include nausea, dizziness, and confusion. It is important to understand the effectiveness of those drugs before taking them and understand if those drugs might make the patient fall (Jones and Doherty 2013, p.35).  The nurse must encourage the non-pharmacological methods for treating the symptoms of this disease. The non-pharmacological methods include regular exercising, joint preservation methods and sometimes use of certain mobility equipment. The nurse should advise the patient to rest when the pain increases a lot.

Usually, the mobility rate amongst the older people is quite less but immobility is an extreme condition of bed rest where the patient cannot get out of bed. Immobility is too serious and a permanent condition. The consequences of immobility can be stiffness of muscle, depression, malnutrition, osteoporosis, hyperthermia etc (Evenson 2013, p.78).

Malnutrition: This condition is defined as failing to meet the nutrient requirements of the body.  Malnutrition is quite common among the immobile patients and they run a risk for pressure ulcers, infection, dehydration etc (Houde 2007, p.37).

Immobility

Pressure ulcers: the greatest risk of immobility is bedsores. The immobilized patient cannot move on his own so some pressure is created on the same areas continuously. The attending nurse must check the risky areas such as the heels and sacrum and look for damaged tissues. The nurse should try to move the patient often and the relatives must be informed to do the same as well.

Depression: the mental condition during this stage is very weak as the person cannot move around on his own free will and has to remain on the same bed for a long period. The patient gets very embarrassed when he needs help to do the daily work. Depression is proven to give headaches to the patient and helps to sustain any kind of pain for a long time (George 2016, p.85).  The nurse can try to communicate with the patient and keep the patient engaged and cheerful through talking, reading to them etc.

Orthostatic hypertension: immobility decreases the heart rate, stroke volume and the cardiac activities of the patient which increases the rate of orthostatic hypotension. The nurse must ensure that the patient is taking enough liquid and wear compression stockings to enable blood flow and encourage the patient to do some isometric exercises (Ellor 2013, p.87).

Deep vein thrombosis: the immobile patients have a slow blood flow and are often seen that they face a blood clot in parts of their body. The clogs may sometimes dislodge themselves and form pulmonary embolism; so the thrombus seems to become clogged in one blood vessels inside the lungs. The nurses must try to make some movements with the patients so clear the thrombus and if it is cannot be done the physicians can be consulted for some anti-thrombotic medications (McGaugh 2013, p.96).

Conclusion

Working as a geriatric nurse has its own merits and is an overwhelming job. The person working in this field needs to be compassionate and keep patience with the patients. Although it comes with its challenges both mentally as well as physically; mental challenges include dealing with patients who are contented in their old age as well as dealing with patients who are upset for their degrading health.  The nurses, as well as the patient, seems to be bound in an emotional bond together, so the death of the patients can be quite depressing for the nurses, but they have to bounce back from it so that the nurses can help the other patients to do better (Ramont, Niedringhaus and Towle 2012, p.21).  The nurses must devote themselves to the welfare of the patient so that the elderly can continue with their daily activities and feel at peace and independent. 

References

Buschmann, L. (2015) Virtual modified constraint induced movement therapy for stroke survivors with hemiparesis. Oxford: Clinical Pub.

Carpenito-Moyet, L. and Carpenito, L. (2012) Nursing Care Plans & Documentation. Philadelphia: Wolters Kluwer Health.

Cattaneo, Z. and Vecchi, T. (2011) Blind vision. Cambridge, Mass.: MIT Press.

Ellor, J. (2013) Aging Spirituality and Pastoral Care. Hoboken: Taylor and Francis.

Evenson, B. (2013) Immobility. New York: Tor.

George, L. (2016) Handbook of aging and the social sciences. San Diego: Elsevier.

Holmes, H. (2012) Polypharmacy. Philadelphia, Pa: Saunders.

Houde, S. (2007) Vision loss in older adults. New York, NY: Springer Pub. Co.

Jones, A. and Doherty, M. (2013) Osteoarthritis. Oxford: Clinical Pub.

McGaugh, J. (2013) Aging. Elsevier Science.

Ramont, R., Niedringhaus, D. and Towle, M. (2012) Comprehensive nursing care. Upper Saddle River, N.J.: Pearson.

Ritsner, M. (2013) Polypharmacy in psychiatry practice. Dordrecht: Springer.

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