Question

1. Explain the roles of Gerontological Nurse as:

a. Provider of care

b. Teacher/Educator

c. Manager

d. Advocate

e. Research Consumer

2. What are different components of health promotion for the elderly?

3. Choose one competency guidelines for geriatric nursing care and explain.

Answer 1

1.a. Care provider:

• Providing need based care to the elderly clients
• Encouraging active participation of the client in planning and implentation of care aiding to functional independance
• Implementing innovative care techniques as per individual differences

1.b. Educator

• Nurse caring for a geriatric client must posses good communication skills
• Provide health education after identifying areas of health care where the client lacks knowledge and skills
• Nurse can teach the clients about normal physiological changes that occurs as a part of ageing process that helps to reduce unnecessary worries
• As an educator, the nurse must give importance to interactive conversations, patient listening, clarification of doubts in simple language that the client can undersatnd easily.

1.c.Manager

• Assessing and identifying the necessary environmental modifications at clients home
• Developing the plan of care after consulting with the client,his/her physician and family
• Supervising the visits by health care aides and during referral services
• Nurse manager can help to connect the client and their family members to the available community resources that can be helpful.

1.d. Advocate

• Nurse should posses good knowledge about the rights of the elderly
• Nurse can advocate for the rightful needs of the clent, and for providing the best available health care services
• Can seek for help and assistance from community support groups that can be beneficial to their client

1.e.Research consumer

• Practicing new care models based on evidences that promotes the outcome of care
• The nurse can also conduct researches based on her experiences and day to day practice, in order to develop innovative techniques in caring for geriatric clients. The results of which may be utilised for evidenced based practice.

2. The aim of health promotion in geriatric clients are to maintain maximum functional abilities, improving the self care abilities and to improve socialisation.

Physical wellbeing: It can be promoted by regular exercise, healthy diet, adequate rest and sleep, reducing stress and periodic medical check ups including screening.

Exercise: helps to maintain a healthy body, improves muscle strength,reduces the stress level and promotes sleep. It also helps to improve socialisation. Nurse can educate the client about importance of exrecise, types of exercises like isotonic,isometric exercises, importance of stretching and warm up exercises and also the precautions to be taken while exercising (like avoid exercising outdoors in extremely hot or cold weather, stop exercising immediately and seek medical help if chest pain occurs, drink adequate water)

Diet: Food intake may be reduced in elderly due to several factors like indigestion, loss of taste and smell senses, loss of teeth. Nurse can advice to take easily digestable, chewable and palatable food items. Teach about the food items to be avoided(high fat,spicey,carbohydrate rich) and those food items that must be included in daily diet(fruits, green leafy vegetables)

Rest and sleep: Old age people may suffer from inadequate sleep or disturbed sleep pattern, due to certain disease conditions or emotional disturbances. Educate about importance of rest and sleep, and techniques to get a better night sleep like avoiding exercising immediately before bed time, avoiding day time naps,avoiding stimulants like caffeine before bed time.

Periodic health checkups: It helps to assess the prognosis of existing problems and also to identify other health deviations at an early stage. Screening for vision,hearing, cancer screening techniques like mamography, digital rectal examination may help to identify potential problems at an earlier stage and initiates prompt treatment. Checking the immunisation status and administering booster doses if required may also promote the health status.

Identification of high risk behaviours: Alcoholism and smoking, inactive life style, may deteriorate health and well being. Identification and diversion from such habits may help in gradual cessation of such habits and promotes the health status by preventing risk factors.

3. Participation and empowerment of the patient and family: Along with adequate medical and nursing care the geriatric client as well as his family should posess adequate knowledge regarding the heath status, the prognosis and care needed in the home setting. Nurses can assess the level of knowledge and competencies and skills the client and family posses and can empower them with adequate knowledge. This includes ensuring the client and family participation in clinical decision making and care planning, assessing the resources available at home and community, supporting in availing community based services, proper education about the discharge plan, home care and follow up. Also the nurse can demonstrate and encourage the client or the family member who will be the primary care giver to re demonstrate skills like insulin administration, bed bath and tracheostomy care inorder to ensure skilled care delivery in home setting.