Presentation on theme: "Prepared by: Dr. Soad Hassan Lecturer of Gerontological Nursing"— Presentation transcript:
1Prepared by: Dr. Soad Hassan Lecturer of Gerontological Nursing Health promotionPrepared by: Dr. Soad Hassan Lecturer of Gerontological Nursing
2Health promotion of the elderly Health promotion is the process of enabling people to increase control over & improve their health by developing their resources to maintain or enhance well being.Health promoting is an action for health using knowledge, communication & understanding
3Objectives of health promotion Increase quality and years of healthy lifeMaintain functionEliminate health disparities and independencyImprove (enhance) quality of lifeExtend life expectancy → ↓ premature mortality caused by chronic& acute diseases
4Component of health promotion ExerciseNutritionRest & sleepPeriodic medical check upHigh risk behaviorSpiritual well-beingPsychosocial well-being
6Physical benefits of exercise Consumption of body fatImprove cardio-vascular capacity( by↑ blood flow----- keep tissue healthyControl hypertension& blood sugarImprove respiratory functionImprove joint flexibilityImprove pattern of sleep & rest↑ independencyImprove sense of well –being & relaxationMaintain mind’s functionPromote sense of normalityPeristaltic movement
7Psychological benefits of exercise Improve mood stateImprove self-imageReduce stressEnhance sleepImprove depressive state of elderly
8Social benefits of exercise Improve social interaction & relation with other
10Role of the nurse during exercise I- Assessment done at the beginning of exercise program include:History & physical examination (CVS, resp, musculoskeletal & neurological system)Renal & liver function testsECG,& exercise stress testAssess range of motion & use of assistive devices.Assess environmental hazardsII-Set a regular time to exercise each day
11III- Before starting exercise the nurse should advice the elderly about: Document baseline resting function status (ht &resp rate, bl.sugar)10 minutes warms up stretching exerciseDrink water before and after exercise is important as water will be lost during exerciseClothes worn during exercise should allow for easy movement and perspiration.Athletic shoes provide both support and protectionOutdoor exercise should be avoided in extremely hot or cold weather.
12Enclosed shopping malls are sheltered places for walking during the extreme weather or when there are concerns about neighborhood safety.Exercising with a partner provides both encouragement to continue exercising and safety.Nurse should advice the older adults to stop exercising and seek help if they experiences chest pain or tightness, shortness of breath, dizziness, or palpitation during exercise.
13During exerciseMonitor heart & resp. rateStop exercise if elderly has fatigue , chest pain or ↑heart & resp. rateAfter exercise:10 minutes cooling up at end of exerciseMonitor pulse rate during cooling for returning to resting ht. rate
142- NutritionIt is neglected especially those living alone or with low income.Factors affecting nutritional status:Age related changesPsychosocial factorsEconomic factorsCultural factors
15Age related changes ↓ Taste & smell ↓ Visual acuity Loss of teeth & poor fitting denture↓ Gastric secretion→ influence in absorption of B12, folic acid& iron.Food remain longer time in stomach + ↓ gastric secretion will lead to indigestion &feeling of fullness.
16Psychosocial factorsDepression is common ( losses, death, retirement, change of body appearance, impaired vision &poor physical fitness) this will lead to lack of interest in eating& anorexia and ↓ food intake.Living alone also will lead to lack of incentive to cook &eat.
17Economic Factors Low income Limited access to food and food choices Inadequate facilities to food storage and preparation
18Cultural factorsEating habits may miss certain food group as vegetarians.
19Nutritional requirement of elderly 1- CaloriesCaloric requirement diminished by 10% in age years and by 20-25% in age more than 75 years.N.B: Fat yield 9 cal/gram, CHO and protein yield 4 cal/gram, mineral and water yield no calories
202- Protein requirement 0.8 g/kg body wt A balanced diet of a healthy elderly should contain 12-14% of total caloric intake.During infection, stress, trauma protein ↑ to 1.6 or 1.5 g/kg body wt
213-Fat requirement Fat either saturated or unsaturated Total fat intake limited to 30 % or less of total energy intakeSaturated fat limited to 10-15% of total energy intakeDietary cholesterol intake limited to 300mg/ day or less
224- Carbohydrates requirement CHO is essential for maintaining normal bl. glucose level & preventing protein break down.50% of total calories CHOSimple CHO as sugar, honey ( avoided)Complex CHO as vegetables, grains, fruitsComplex CHO has vit, minerals, fibers which help in bowel elimination& ↓ bl. cholesterol level.
235-Fluid intake Elderly at high risk for dehydration due to: ↓ Thirst sensationInadequate fluid intake ( cc/day) requiredSome medications, such as for high blood pressure or anti-depressants, and diureticSome medications may cause patients to sweat moreFrail seniors have a harder time getting up to get a drink when they’re thirsty, or they rely on caregivers who can’t sense that they need fluidsAs we age our bodies lose kidney function and are less able to conserve fluid (this is progressive from around the age of 50, but becomes more acute and noticeable over the age of 70)Illness, especially one that causes vomiting and/or diarrhea, also can cause elderly dehydration
246- Vitamins & mineral requirements Calcium:---for mineralization of bone &has a role in blood & cardiac function.Daily requirement 1200 mg./day if there is no contraindicationsVitamin D : needed for calcium absorption& metabolism.Exposure 15 minutes/day to sun is enough
25Nurse RoleAssessment involves: nutritional history, physical examination, anthropometric measurements, biochemical evaluation, cognitive & mood evaluationHealth history related to nutritionAnthropometric measurementClient and family education
26Dietary guideline for old persons Eat a variety of foodMaintain a healthy wtChoose a diet low in fat,saturated & cholesterolChoose a diet plenty ofvegetables, fruits & grain productsUse sugar & salts in moderateDrink cc/daily
273- Rest& sleep Person spend 1/3 of his life in sleep Sleep is time for cell growth& repairElderly need 5-7 hrs at nightImportance of Rest& sleep:Conserve energyProvide organ respite (rest)Restore the mental alertness& neurological efficiencyRelieve tensionEmerge feeling of well being
28Factors affecting sleeping patterns Age related changes in sleep patternsInternal factorsExternal factors
29Nursing measures adopted to promote sleep Engage in exercise programAvoid exercise within 3-4 hr. of bedtime.Spend time out door in the sunlight each day but avoid period between 12 Md to 3 PM sunshine exposure.Engage in relaxing activities near bedtime.Avoid tobacco at bedtimeAvoid drink any caffeinated beverages before mid afternoon.Limit fluid intake after the dinner hour if nocturia is a problem.Limit daytime naps to 30 minutes or less.Avoid using the bed for watching TV, writing bills, and reading.
304- Periodic medical examination Importance of Periodic medical examination:Assess elderly level of well-beingDetect early signs of diseaseEducate client how to promote his healthReinforce + ve promoting & protecting behaviorsIf examination done at home, it permit evaluation of environment ( hazards care giver…)
31Types of health screening PeriodBl. pEach Dr. visit or 3-6 monthsHt & wtPeriodically as part of comprehensive physical examinationDental check upOnce / year( annually)Fecal occult blood& sigmoidoscopy( annually)Vision including glaucoma testEvery 2 years
32Evaluate periodically Health screeningPeriodHearingEvaluate periodicallyCholesterol levelEvery 5 yearsCancer screeningAnnuallyMammography for women under 70 y1-2 yearsDigital rectal examination
33Immunizations Vaccination Period Influenza (over 65y) Annually (mid October to mid November)Tetanus & diphtheriaEvery 10 yearsPneumococcal vaccinationOnce at age 65y, revaccination for high risk fatal pneumonia/6 y
345- High Risk Behavior It is behavior that damage physical health. It includes:Over the counter medication (multiple medications )SmokingCaffeine
35SmokingNicotine & toxic substances in cigarette has impact on detoxication process in the body cell damage& variety of diseases as cancer, respiratory, CVD, ↑ risk of osteoporosisCessation of smoking improves cerebral blood flow& ↑ pulmonary function
36Multiple medicationOlder people consume many medication ↑adverse drug reactionThe most common over the counter medication: Analgesics, laxatives& antacids followed by cough products, eye wash& vitamins.
37Caffeine Found in coffee, tea, soft drinks, chocolate It is mood elevatorIt stimulates sympathetic nervous system↑motor activity↑ muscle capacity & alertness↑ Rapid pulse↑ calcium excretion
386- Spiritual Well- being Spiritual well-being is the practice and philosophy of the integral aspects of mental, emotional and overall wellbeing.Spiritual well-being is a state in which the positive aspects of spirituality are experienced, incorporated and lived by the individual and reflected into ones environment.
39Signs of spiritual distress: DoubtDespairGuiltBoredomExpression of anger toward god
40BenefitsThe practice and incorporation of Spiritual Wellbeing into one’s life influences and includes benefits for ones; Emotional Wellbeing, Physical Wellbeing, and Mental Wellbeing.
41Some of the measurable benefits that people experience from spiritual wellbeing counseling and groups include:A feeling of being more contented with their life’s situationGreater enjoyment of self time, finding an inner peaceGreater ability to take control of and resolve their life’s issuesA greater sense of satisfaction in their activities and life situationsAbility to take a more active part in life rather than standing still and watching it pass byAbility to build more intimate, loving and lasting relationshipsA greater feeling of purpose and meaning in their life
42Measures to increase Spiritual well being Identify ways that believes give meaning to lifeUse problem solving to solve any conflict related to spiritualityMeeting with religious man at regular intervalsPresence of religious literatures in the immediate environment such as Quran on beside tableReading in religious books & prayingDiscuss role of spirituality in one’s life
437- Psychosocial Well- being Psychosocial changes may alter an individual relationship with others.Physical wellbeing depend on:Psychosocial wellbeingSocial structurePersonal relationshipsIn Later years many adjustment are necessary
44Role of the nurse in health promotion Assessment to his physical health, Psychosocial Well- being, lifestyle pattern, hobbies, high risk behaviors, knowledge, believes& attitudes that affect health & wellbeing.Assess health needsAssess social , environmental & cultural influences on health behaviorsLifestyle modifications is a comprehensive approach for effective change in heath promotion behaviors
45Nurse role should directed toward helping elderly to cope with his function level delay disabilities & impairments.Nurse identify environmental hazards & make necessary modificationsIdentify social needs & encourage participation & social support groups.Nurse should inform elderly & caregivers about aging process, common disorders & disabilities , different services available
46Encourage elderly to take better care to them, avoid high risk behaviors,& hazards affecting their health.Regular and continuous evaluation is important aspect of nurse’s role.