1. Caring for Older Adults Holistically, 4th Edition Chapter Ten Environments of Care

2. Caring for Older Adults Holistically, 4th Edition Environmental Management  Assess all aspects of the older adult’s living situation that can be seen, heard, touched, or smelled  Assess how well the older person functions in the living areas

3. Caring for Older Adults Holistically, 4th Edition Environmental Management  Climate of caring  People in the environment  Family members, neighbors, friends, paid caregivers  Environmental tone and atmosphere  Safety  Assess for environmental hazards  Keep environment free of fall risks

4. Caring for Older Adults Holistically, 4th Edition Environmental Management  Stimulation and personalization  Personalized items maintain a sense of identity  A caring climate facilitates optimal independence and autonomy  Personal space territoriality  Personal space is important to everyone  Personal space varies from person to person  Territory space is used by a person and seen as owned by the person

5. Caring for Older Adults Holistically, 4th Edition Environmental Management  Privacy  Provide opportunities for privacy  Respect right to privacy  Activity and involvement  Provide multiple and diverse opportunities for activity and involvement

6. Caring for Older Adults Holistically, 4th Edition Relocation Trauma  Moving from one environment to another can be stressful to older adults  Orient to new surroundings slowly  Incorporate personal furniture and objects into environment

7. Caring for Older Adults Holistically, 4th Edition Environments of Care  Variety of settings where older adults may receive health-care services  Day care  Day-care centers available to provide supervised activities for older adults  Provide specific services to meet their physical, psychiatric, and social needs  Ongoing assessments of the day-care participants are important

8. Caring for Older Adults Holistically, 4th Edition Environments of Care  Home care  Provide services for older adults in their homes  Provide nursing services, therapy services, medical supplies, and equipment  Care provided on a daily basis or intermittently  Community-based care  Community clinic, dialysis center, or physician’s office

9. Caring for Older Adults Holistically, 4th Edition Environments of Care  Hospice  Provide care for the dying patient and the family  Care given by interdisciplinary team approach  Allows nurses to give direct patient care to patient and family members

10. Caring for Older Adults Holistically, 4th Edition Environments of Care  Assisted living  Provide services for older adults with physical care needs  Person must be ambulatory and fairly independent  Environment is homelike  Nursing homes  Area of practice that has been available to practical nurses for a number of years

11. Caring for Older Adults Holistically, 4th Edition Environments of Care  Nursing Home (cont.)  Two categories  Skilled and nursing facility  Licensed by state  LPNs supervise nursing assistants and give medications and treatments

12. Caring for Older Adults Holistically, 4th Edition Environments of Care  Acute care  40% to 65% of hospital admissions include older adults  Patients admitted for short period of time  Difficult to develop trusting relationships with patients  Requires all the basic skills the practical nurse possesses