Definition:
Is concerned with the assessment of nursing needs of older people, planning and implementing nursing care to meet these needs and evaluating the effectiveness of such care to achieve and maintain a level of wellness consistent with the limitation imposed by the aging process.
Community services available for the elderly:
1- Home health services:
Many elderly persons require both daily care from a home health care professional and supportive assistance from health aids. This care is provided by a professional nurse and a home health aid.
2- Alternatives to institutions:
· Day care centers:
Serve the elderly who has some physical or mental limitation that interferes with totally independent living and who needs social, nutritional or recreational services.
· Day hospitals:
Providing day health services to a person who can live at the home during the evening.
· Respite care program:
Provides care for the dependent elderly for several days to a week.
· tered housing:
It is an alternative- living arrangement that ter and support services to the elderly who is independent or semi-independent and has some functional impairment or social deprivation but is otherwise healthy.
3- Nursing homes:
Provides along term residential, intermediate or skilled nursing care, medical care , personal and psychological services.
4- Hospice:
Available for the care of terminally ill. A hospice program has a family orientation and is concerned with medical, nursing, spiritual and social care of the terminally ill.
Role of the community health nurse in geriatric care:
I-Assessment:
1- Health assessment of the client
a- Health history (past, family, sexual, occupational history- present health complaints)
b- Physical examination ( vital signs , height, weight, inspection of feet and nails )
c- Check of all medication
d- Nutritional assessment ( diet history, avoided food, likes and dislikes, adequacy, fluid intake and number of meals)
e- Daily living activities ( self care ability , mobility , housekeeping ability and exercise)
f- Clients ability to relax or reduce stress
2- Examination of the home for environmental hazards, needs of repairs and safety measures
3- Determination of significance family members or neighbors in case of emergency
4- Assessment of client knowledge about available community resources ( transportation, recreational facilities, volunteers , mobile library, home health services and educational facilities)
5- Assessment of client’s lifestyle ( friends , socialization with others)
II-Nursing diagnosis:
The nurse analyze information and describes the client’s problems , recorded on the care plan and sets goals and plans care.
III- Planning care :
It can be short or long term plan according the time available to care with the client and the home setting
IV- Implementation:
1- Daily observation( physical condition, needs ,problems and takes necessary action)
2- Provide rehabilitation procedures ( skin care , bowel and bladder training )
3- Prepare and administer medication
4- Coordinate the care of the client ( personal care, therapy and recreation)
5- Promote accident prevention
6- Educate the client about (Nutrition, self care , foot care , stop smoking , side effect of drugs and exercise )
a- Self care:
Helps the elder person to adapt to the environment , to modify habits ,activities and to learn new things.
b- Exercise:
1- When get up in the morning stand and stretch arms straight up and count to five , repeat several times
2- Breathing exercise three times
3- When bathing ( wash arms from fingertips toward shoulder and legs from feet up to thigh )
4- When doing something that doesn’t require watching move head from side to side , back and forth and around in circle
5- When sitting down to rest , stretch legs and feet straight out in front.
6- While watching T.V stretch arms straight out to the sides and make circle with hands
C- Special body care:
1-Regular eye, ears, teeth, breasts, skin examination .
2-Avoid varicosities by walking every day for 30 minutes , get off socks
before sleeping , avoid tight socks
3- Feet care:
It should be washed , dried and inspected daily, wearing proper fitting
Shoes and lowed heeled rubber soled are best
D- Immunization: ( influenza)
7-Use comprehensive services available for the elderly
V- Evaluation:
The nurse reviews the goals and checks the client progress . the plan is updated with new nursing orders as necessary.