CURRENT ISSUES &

TRENDS IN OLDER
PERSONS CHRONIC
CARE
• Health trends in the fastest growing sector of the
population, the oldest old, have received much
attentionduring the past decade because of the rising
costs of medical and long-term care. Many studies have
suggested a compression of morbidity in this sector,
implying that the future care needs of elderly people will
not follow the demographic prognoses. Most of these
studies have used health indicators based on disability, a
concept that is contextually embedded.
• Chronic illness is now the dominant feature of health care,
and its impact will grow with the aging of the population.
Managed care could provide an environment conducive to
better care for chronically ill patients. A precondition for
these activities is a shift in Medicare payment approaches
to managed care organizations to recognize differences in
risk.
COMPONENTS OF ASSESSMENT
• Physical
• Functional
• Psychological
 Cognitive
 Affective
• Socio-Economical
• Environmental
• To improve care for the chronically ill, changes need to
occur in two major areas:
1. The approach to chronic care needs to become more
aggressive, with higher expectations about the benefits
from care (even if measured by slowing the rate of
decline)
2. an information infrastructure is needed to help focus
clinicians' attention on changes in patients' status.
• There are four new programs available from the American
Journal of Nursing Company that are designed to inform
and update all nurses on current trends and research in
caring for the elderly. Three of these programs include
study guides to help reinforce the material and are
approved for continuing education credit by the American
Nurses' Association.
1. "Alzheimer's Disease: Coping with Confusion,"
describes specific nursing interventions for such
common problems as personal hygiene, nutrition,
exercise, incontinence, wandering, communication, and
agitation. It is especially recommended for nursing staff
in acute care and long-term facilities.
2. "Alzheimer's Disease: Discharge Planning," focuses on
the nurse's role in preparing the family for the the
patient's return home. Nurses will learn practical tips they
can share with the family on patient care and safety.
3. "Medicating the Elderly," presents essential current
information about administering medication to elderly
persons. The program highlights medication concerns
that are specific to aging patients from both
psychological and physiological perspectives.
4. "Gerontological Nurse Practitioners: The New
Professionals," explores the broad role of these
extremely able, cost-effective specialists, and
demonstrates their competence in assessing, monitoring,
and managing the common acute and chronic health
problems of the elderly in collaboration with physicians.
PRIMARY PREVENTION
• Health Habits
 Inadequate Nutrition
 Addiction to Smoking & Alcohol
 Lack of Exercise
 Inadequate Sleep
• Immunization
 Influenza
Pneumoccocal
Tetanus
• Injury Prevention
 Removal of Obstacles
 Keep the floor dry
 Bright Lighting
 Flat Shoes
 Railing/ Holding bars in bathrooms
 Low Level Switch
 Easy and Safe access to water
SECONDARY PREVENTION
• Screening helps in early detection of modifiable risk
factors and their adequate management
• Hyper/Hypotension, DM
• Dental Problems
• Drug adverse effects
• Cancers
• Infections
• Nutriotional Deficiency states
• Eyes/Ears
TERTIARY PREVENTION
• It deals with rehabilitation and caregiver support
• Rehabilitation is a problem solving process focused on
the patients functional abilities
• Rehabilitation team includes; a physician, physiotherapist,
occupational therapist, speech and language therapist,
psychiatrist, dietitian, nurse and a social worker.