Chronic Illness and Older Adults Chapter 5 Overview Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Chronic Illness Table 5-1. Characteristics of Acute and Chronic Illness. Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 2

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Chronic Illness Trajectory of Chronic Illness Fig. 5-1. The Chronic Illness Trajectory is a theoretical model of chronic illness. The trajectory model of chronic illness recognizes that chronic illness will have many phases (see Table 5-3). Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 3

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Chronic Illness Trajectory of Chronic Illness, continued Preventing and managing a crisis Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 4

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Chronic Illness Trajectory of Chronic Illness, continued Carrying out prescribed treatment regimen Table 5-5. Characteristics of Treatment Regimens. Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 5

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Chronic Illness Trajectory of Chronic Illness, continued Controlling symptoms Reordering time Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 6

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Chronic Illness Trajectory of Chronic Illness, continued Adjusting to changes in course of disease Preventing social isolation Attempting to normalize interactions with others Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 7

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Chronic Illness Prevention of Chronic Illness Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 8

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Nursing Management Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 9

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Older Adults Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 10

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Demographics of Aging Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 11

Attitudes Toward Aging Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 12

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Biologic Aging Fig. 5-2. The aging process can be viewed as a balance between negative and positive factors. Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 13

Age-Related Psychologic Changes Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 14

Special Older Adult Populations Chronically Ill Older Adults Older Adult Woman Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 15

Special Older Adult Populations Cognitively Impaired Older Adults Table 5-8. Gerontologic Differences in Assessment: Effects of Aging on Mental Functioning Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 16

Special Older Adult Populations Rural Older Adults Homeless Older Adults Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 17

Special Older Adult Populations Fig. 5-3. Older adults living in rural areas often enjoy outside activities, such as gardening. Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 18

Special Older Adult Populations Frail Older Adults Table 5-9. Nutritional Assessment of Older Adults. Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 19

Culturally Competent Care Fig. 5-4. Ethnic older adults need special consideration. Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 20

Social Support and Older Adult Family Caregivers Elder Mistreatment/Abuse Self-Neglect Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 21

Social Services for Older Adults Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 22

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Medicare and Medicaid Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 23

Care Alternatives for Older Adults Housing Community-Based Older Adults With Special Needs Adult day care programs Home health care Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 24

Care Alternatives for Older Adults Fig. 5-5. Senior centers offer places for older adults who live independently to meet and gather with friends. Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 25

Care Alternatives for Older Adults Long-term Care Facilities Case Management Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 26

Care Alternatives for Older Adults Fig. 5-6. Social interaction and acceptance are important for older adults. Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 27

Legal and Ethical Issues Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 28

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Nursing Management Nursing Assessment Nursing Diagnoses Planning Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 29

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Nursing Management Fig. 5-7. SPICES. Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 30

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Nursing Management Nursing Implementation Health promotion Fig. 5-8. Water aerobics is an example of a health promotion activity for older adults. Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 31

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Nursing Management Nursing Implementation, continued Acute care Table 5-13. Care of the Hospitalized Older Adult. Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 32

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Nursing Management Nursing Implementation Acute care, continued Hospital discharge Geriatric rehabilitation Assistive devices Safety Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 33

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Nursing Management Fig. 5-9. The nurse assists a patient in a geriatric rehabilitation facility. Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 34

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Nursing Management Nursing Implementation Acute care, continued Medication use Table 5-14. Drug Therapy. Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 35

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Nursing Management Nursing Implementation, continued Fig. 5-10. The effects of aging on drug metabolism. Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 36

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Nursing Management Nursing Implementation Acute care, continued Depression Sleep Use of restraints Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 37

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Evaluation Table 5-16. Evaluating Nursing Care for Older Adults. Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. 38