1. Nursing Care Management of Older Adults

2. Objectives  Review course requirements and expectations  Identify demographic and cultural facts of the aging  Recognize current theories on aging  Discuss issues of therapeutic communication  Incorporate principles of strength based assessment and care management of the elderly

3.  Working with an elder - Assisted Living experience or self selection (determined by instructor)  Three additional hours a week with the elder during a mutually agreed upon time  Attending conferences related to aging and reporting back to the cohort may be used towards clinical hours

4.  Complete a Wellness Evaluation including a Body Mass Index assessment (found on blackboard) and any other assessment tool you may determine helpful in the assessment of your elder ( ADL’s, depression scale, nutritional assessment ect..)  A Strength Based Inventory for your elder will be completed based on assessment findings. ( The format for Strengths Based Inventory is on Blackboard )

5.  ELDER EDUCATION  CARE OF THE ELDERLY REFERENCE BOOK

6.  Elder Education  Identify an educational need for your elder from your assessment  Develop, implement and evaluate a teaching plan on this health need.  Each learner will give a 5 minute presentation week 8 on this plan (see week 8 for details )  Care of the Elderly Reference Book  Based on the required resources listed in the Competencies of Care of Elders (Institute of Geriatric Nursing )  This is a group exercise  The Reference Book will be donated to a hospital to be used by providers in caring for the aging.

7.  Learners will be randomly assigned to groups  The group members will select a topic of interest on aging to present to the class  The Nursing Department Rubric for Oral Presentations will be used to grade the presentation.  Each group will peer review all members of their group for the degree of participation and this will be reflected on the individual learners grade

8.  Week 1 ( Computer generated ) one page guided reflection on aging in another Country. Each learner will share their reflection on week 2.  Week 2 a one page reflection on your feelings during your first interview with your elder. This will be discussed week 3.  Week 5 each learner will reflect on a recent news worthy issue related to aging. The article should be found in a newspaper, news magazine or on internet news and a copy of the article will be attached to the reflection paper. To be shared week 6

9.  What does aging look like in our society today? Exercise:  WHEN I AM 80 …What will I look like?....Where will I live?…..Who will I live with?’…….How do I fill my days?......What are my joys?......What are my worries/fears?

10. Population- 5,600,388 (8% increase from 2004) Life expectancy for an infant born in 2005 is 78 years : Whites 79.1 years Blacks 74.3 years Hispanics 74 years

11.  Death rate increased in 2005 in the following age groups: 25-34 due to violence and HIV/AIDS 55-64 due to heart disease and strokes 75-84 due to heart disease, malignant neoplasm's and strokes

12. POPULATION 65 Y.O.>POPULATION 80 Y.O. >  Projected to increase from 35 million in 2000 to 71 million in 2030  Projected to increase from 9.3 million in 2000 to 19.5 million in 2030

13. MEDIAN AGEGLOBAL TRENDS  Global median age is increasing due to: - decline in fertility in developed countries -twenty year increase in the average life span - baby boomers (resulted from elevated fertility in many countries for 2 decades after WWII)  Worldwide population aged > 65 projected to increase from 550 million to 973 million in 2030.  Worldwide population. 80 y.o. projected to increase from 9.3 million in 2000 to 19.5 million in 2030

14.  1946- 1964  Name some characteristics of this age group  What health care expectations do they have?

15.  DNA-Genetic Theory- (Don Kleinsek PhD) – The encoded blue print of genetic aging we receive from our parents.  Neuro- Endocrine Theory ( Dr. Ward Dean, Professor Vladimar Dilman)- A complicated system of biochemical's that govern the release of hormones by the hypothalamus. As we age the hypothalamus does not function as well.  Free Radical Theory (Dr. Denham Harman ) believes free radicals attaching to healthy molecules causes aging. Diet, lifestyle and stress accelerates free radical production and aging.

16.  Chronological- years since birth  Psychological- do you feel younger or older than your chronological age?  Social- are you living and participating in a community that keeps you active and connected?

17.  PERCEPTION of one’s health may differ depending on age group. This perception of health shapes quality of life during the aging process and will vary widely from person to person.

18.  Principle 1- Assessment and building on strengths rather than problems will promote hope, wellness and independence  Principle 2- Older people can make choices and decisions  Principle 3- Elders have the power and ability to learn, grow and change.  Principle 4- Relationship building is essential to gain knowledge of the strengths and wellness beliefs

19.  Current Status- What do I have going for me?  Individual Desires- What do I want?  Personal/ Social Resources- What has worked in the past?

20.  Review Ann's Strength Based Inventory. (Found on Blackboard)  In your groups complete a strength based assessment on the case study Sam (found on Blackboard )

21. Communication with your elder Getting to know you phase (assessment) Planning, Active Phase Implementation Phase Termination Phase Evaluation

22.  Purpose: (Arnold E., 2000)  To provide a safe, confidential environment to allow client to discuss health information.  To provide education and emotional support and coaching to assist client to reach health goals.  To communicate about a specific concern or strength. Therapeutic communication is goal directed, time limited and has a focus.