1. Effects - Social & Cultural Independence is an important! Teaching self- management skills helps Culturally appropriate care is important Social acceptance IMAGE: HOPENETWORK.ORG

2. Discuss barriers to and review strategies for teaching the older adult

3. Vision Changes Glaucoma, cataracts, macular degeneration (legal blindness) Squinting Relying on touch Being withdrawn Being reluctant to communicate

4. Vision Changes - What do you do for this patient?

5. Vision Changes - Teaching Implications Always speak to the patient and identify yourself when entering the room. Use touch more frequently. Position yourself close to the patient. Face the patient directly when speaking, speak clearly, and avoid speaking too rapidly.

6. Vision Changes - Teaching Implications Ensure that there is good lighting with no glare. Give verbal explanations since the patient may have few, if any, visual cues as reference. Use other forms of sensory stimulation, such as touch, sound, and smell. Substitute or reduce reading demands by using tapes, CD’s, models, etc.

7. Vision Changes - Teaching Implications Make materials easier to see! Lettering size (14 point font) Thickness Style (simple) Spacing (double spacing) Contrast (black on white or yellow) Upper and lower case

8. Hearing Changes Atrophy of the inner ear structures and hearing loss for higher frequencies. Cup their ear Position their head (good ear) Ask for things to be repeated Answer questions inappropriately Blank looks, inattentive, or short attention span

9. Hearing Changes - What do you do for this patient?

10. Hearing Changes - Teaching Implications Touch the patient so he or she is aware of your presence before you attempt to speak. Keep your face visible to the patient and do not cover your mouth with your hands. Have the patient look at you while you are talking. Keep yourself positioned on the same level as the patient.

11. Hearing Changes - Teaching Implications Be certain that the windows or lights are behind the patient so a glare will not occur when he or she looks at you. Do not shout. Enunciate clearly and slowly in a low pitched voice. Speak towards the ear which seems to have the most hearing. Use shorter sentences and repeat or rephrase important areas of instruction. If necessary, write or draw the information.

12. Hearing Changes - Teaching Implications Use gestures or objects to clarify what you are saying. Eliminate distractions or extraneous noise before teaching. Do not change the topic abruptly. Ask the patient to restate instructions or other information in their own words. If the patient is fatigued or in pain, he or she will understand less.

13. Intellectual Ability Does not necessarily decline but changes Capacity to perceive relationships or think abstractly decreases. May be still thinking of information previously discussed while health provider has moved on. Established habits interfere with learning. Short term memory loss

14. Intellectual Ability - What do you do for this patient?

15. Intellectual Ability - Teaching Implications Allow patients to set their own pace of learning. Supply written materials to read or make equipment available for the patient to practice at his or her convenience. Make whatever is to be learned as meaningful and relevant to the patient as possible. Use audiovisual materials to strengthen associations.

16. Intellectual Ability - Teaching Implications Reduce the number of alternative responses and complexity of the cues given to the patient. Before introducing new material, find out what material previously learned can be recalled. Proceed from teaching simple or familiar tasks to more complex or unfamiliar tasks. Emphasize desired actions, not actions that the patient should avoid. Do not mix positive and negative information.

17. Discuss communicating treatment plans and self care goals

18. Self Care Instructions Exercise regularly Monitor your blood pressure Eat a healthful diet

19. Cup exercise

20. Can you make the cup?

21. Make the cup Easy as 1-2-3

22. Instructions 1. Fold the square in half along a diagonal to form a triangle. Hold the paper with the tip of the triangle facing up. 2. Fold the left point of the triangle to the middle of the opposite side. 3. Fold down a single layer from the top. 4. Fold the right point of the triangle to the middle of the opposite side. 5. Fold back the other single layer from the top.

23. Paper Cup Illustrated Fold the square in half along a diagonal to form a triangle. Hold the paper with the tip of the triangle facing up.

24. Paper Cup Illustrated Fold the right point of the triangle to the middle of the opposite side. Fold down a single layer from the top.

25. Paper Cup Illustrated Flip the piece over. Fold the right point of the triangle to the middle of the opposite side. Fold down a single layer from the top.

26. Paper Cup Illustrated Hurray! You’ve got some skills!