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THREE PROACTIVE STEPS


AWARENESS grants permission to acknowledge that indeed a loss has occurred ACCEPTANCE provides a feeling of gratification, eliminating conflicting feelings that clash because the elder is unsure how to come to terms with the problem

FINALS TOPIC
FRANELEE A. ZULUETA RN,MN

ACTION- allows the elder to move beyond the loss and replace it by putting something back into his/her life.

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COPING ASSISTANCE FOR ELDERLY


COPING WITH LOSS:
As we age we become more frequently exposed to loss and grieving becomes more apparent Losses: spousal/conjugal, siblings, friends, children, physical and cognitive functions, selfesteem, roles, autonomy, home, job, finances, community status, intimacy, objects and pets.

COPING WITH A CHRONIC ILLNESS


Chronic illnesses can create stress in elders and the care providers, both physically and psychologically. Apart from impairing physical and mental health, chronic illnesses may also have negative impact on occupational and social functioning thus affecting the quality of life of the elders and the care providers.

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There is a strong correlation between attachment and loss.
The degree of attachment and the type of loss can affect how the elder people copes.

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The elders may become depressed, anxious and even suicidal.


There is a high incidence of suicide among elderly than the younger person.

1). ACQUIRE NECESSARY KNOWLEDGE AND SKILLS understand the illness actively by consulting health care professionals and reading relevant reference books. The care provider may acquire skills to meet the specific needs of the patient in order to provide appropriate support. 2). BE OPTIMISTIC AND THINK POSITIVE increase the elders compliance to treatment regime and can motivate them to adjust their lifestyle thus help to promote healthy living. The elders should continue to participate in activities of daily living to improve self care abilities

STRATEGIES FOR COPING WITH CHRONIC ILLNESS

Many elderly resort to substance abuse to cope with loss

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Consequently, experiencing a loss for the elderly can be very stressful. If the elder is unable to resolve the sadness around the loss, he/she may experience COMPLICATED PATTERNS OF GRIEVING. Complicated grief can lead to years of emotional suffering and turmoil.
It is important for the care provider to recognize the grief surrounding the elders experience with a loss.

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3).PRACTISE HEALTHY LIFESTYLE It is vital importance to maintain healthy lifestyle for good health. A) observe good sleep hygiene B) regular exercise C) balanced diet
4). BUILD UP A SUPPORT NETWORK regular social life helps to increase confidence, improve mood and promote a positive attitude. Keep an open mind and accept care and support from relatives and friends. Seek advice from health care professionals and share with other patients. Social Isolation is not a natural consequence of aging and chronic illness.

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5.) PICK YOUR OWN RELAXATION STRATEGIES like deep breathing relaxation, progressive muscular relaxation, Tai Chi or listening to music. These help to break the vicious cycle of excessive anxiety, deteriorating health, escalation of anxiety, fluctuating course of illness. 6.) ACT SMART AND SEEK HELP there are many different organizations that provide services and support to the chronically ill and elderly.

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FOR IMPAIRED VISION: A) Use adequate diffused light B) Avoid having older patient face a direct source of light C) If with prescription glasses- make sure they are being worn D) Use large print for labels and instructions. FOR HEARING LOSS: A) Use low-pitched voice B) Speak clearly and slowly and face the patient while talking C) If with hearing aid encourage to use it D) Ask the patient questions to verify whether he or she understood what you have said E) Give written information as backup to what youve presented orally

STRATEGIES TO COMPENSATE FOR IMPAIRMENTS

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PATIENT EDUCATION
It is important for as nurses to understand normal physiological changes that occur with age and to know how to adapt teaching strategies to accommodate the changes.
It is important to interact with each elderly patient as a unique individual, capable of learning and changing. Patient teaching for older people should be delivered with the same enthusiasm and conviction with which it is provided to younger patients.

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FOR LIMITED ENDURANCE: A) Keep teaching sessions short-no more than 10-15 minutes and schedule them to allow patient rest as needed. B) Never rush the older person C) Do not set limits on task performance FOR MEMORY: A) More likely older person remember information he or she hears than information he or she reads. B) Repeat the message frequently C) Ask question regularly D) Pay particular attention to the language you use. E) Select clear, simple terminology and talk on the patients level F) Keep interaction short and simple G) Return demonstration are important to ensure they are able to do psychomotor skills independently

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During the teaching-learning process (assessment, planning, implementation and evaluation), focus your attention not just on the existing medical problem, but also on the potentially numerous functional and psychosocial problems that are common to old age. Detailed history is a critical part of the assessment.

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SPIRITUAL CARE
Religion may provide psychological benefits : A) A positive and hopeful attitude about life and illness, which predicts improved health outcomes and lower mortality rates B) A sense of meaning and purpose in life, which affects health behaviors and social and family relationships
C) A greater ability to cope with illness and disability

With advancing age, there is a corresponding normal decline in sensory function including vision, hearing and touch.

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TEACHING STRATEGIES
1) present new information at a slower rate than you do for younger patients. 2) speak in a low tone of voice 3) allow enough time for the patient to assimilate and integrate conceptual materials. 4) emphasize concrete rather than abstract material. 5) reduce environmental distractions

Many elderly people report that religion is the most important factor enabling them to cope with physical health and life stresses.

More than 90% of elderly patients relied on religion. Elderly people who use religious coping mechanisms are less likely to develop depression and anxiety than those who do not.
Some religious groups (mormon, seventh-day adventists) advocate behaviors that enhance health.

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ROLE OF HEALTH CARE PRACTITIONER


Talking to elderly patients about their religious beliefs and practices helps health care practitioners provide care because these beliefs can affect the patients mental and physical health. Inquiring about religious issues during a medical visit is appropriate under certain circumstances, including the following: A) when patients are severely ill, under substantial stress or near death. B) when patients tell a practitioner that they are religious and that religion helps them cope with illness C) when religious needs are evident and may be affecting patients health or health behaviors

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PROBLEMS WITH STAIRS:

a) cant climb or go down - use a permanent, portable or removable ramp. b) No handrails - install on at least one side; make sure the installation is stable c) Cannot use a walker on the stairs have a second walker or wheelchair at the top or bottom of the stairs.

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Health care practitioners should support the patients religious involvement as long as it doe not interfere with necessary medical care because such involvement may contribute to good health. Some practitioners pray with patients, read religious scriptures to them or make sure patients have the religious materials they want. However, practitioners should not feel obliged to do anything that violates their own beliefs.

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PROBLEMS WITH MEDICATIONS: a) Difficulty reading labels ask the pharmacist for large print on prescription labels, use a magnifying glass and have adequate lighting. b) Memory loss user automatic pills dispensers, organise medications in envelopes with the time and date.

PROBLEMS WITH LEISURE ACTIVITIES: a) Cannot hear the television use a personal listening device with an amplifier. Select programs with closed captions. b) Remote is complicated use a remote with large buttons c) Cannot read small print use a magnifying glass d) Glare on reading materials place the light source to the left or right of the material, avoid glossy paper in reading materials and read black ink rather than blue ink or pencil

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PROBLEMS IN THE KITCHEN: a) Open flames and burners- use a microwave, hot plate, electric stoves, toaster and coffeemaker. b) Hard to open refrigerator have one with a foot lever c) Reaching items - place everyday items within easy reach, adjust the height of counters, cupboards and drawers. d) Carrying items - use a cart or walker basket or slide items across a counter. e) Difficulty seeing use contrasting colors for china, place mats and napkins

RISK REDUCTION ACTIVITIES FOR ELDERLY

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ETHICAL ISSUES
ADVANCE CARE PLANNING involves advance preparation for lifes unexpected emergencies. Provides greater control over decisions that affect a persons future and takes into consideration the persons beliefs and preferences in the event they are unable to make decisions on their own. HEALTH CARE often referred to as medical ethics, relate to issues of privacy, confidentiality and informed consent as well as the courses of action involved in makinng medical decisions.

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PROBLEM WITH THE TELEPHONE:

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a) Difficult to reach - use a cordless phone and tell friends to give you 10 rings to answer. Also, call can be answered by an answering machine you just return the call. b) Difficulty hearing the ring use volume control, blinking lights or vibration c) Difficulty holding the receiver use a headset, speakerphone or adapted handles. d) Difficulty dialing numbers program preset number, use a phone with large buttons and numbers

RIGHT TO PRIVACY medical treatment often involves sensitive subjects that we would rather not share with other people- even those who are very close to us.

RELIGION AND HEALTH CARE it is crucial to know your religions true beliefs about certain medical procedures.

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