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Nursing Care for Elderly Patients

In fact, every nurse has to look for elderly patients in their professional practice. However, only geriatric advanced practice nurses have the special preparation for elderly care; the other nursing specialists often lack it (Melillo & Houde, 2011, p. 31; Touhy & Jett, 2014, p. 11-13). Therefore, for a nurse it is important to understand the specifics of such patients in order to provide adequate care. In this paper, we will consider some prevalent age-related changes that affect the lifestyle of the elderly, and how a nurse can help such patients to adjust to them. We will also look into the issue of communication with the elderly and consider some modes of communication which may be useful or harmful while contacting with the aged patients.

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Among the prevalent age-related changes that have a major influence on the lifestyle of the elderly is mental and physical weakness. Delirium is rather widespread; from 14% to 56% of the elderly population suffer from it; severe physical frailty affects approximately every fourth older person (Fulmer, Foreman, & Walker, 2001, p. 30-31, 41). It means that the older people are not able to care for themselves properly and, depending on the severity of their condition, require the care of their family, as well as of healthcare specialists. In order to help them adjust to the new lifestyle, nurses ought to help them maintain their autonomy (which means the ability to make their own decisions and choices (Reed, Clarke, & Macfarlane, 2012, p. 9-10). The notion of independence (i.e., the state of being not dependent upon other people) is different from autonomy; it is hard for the elderly to remain completely independent from others, whereas they may still be autonomous (Reed et al., 2012, p. 12). Therefore, a nurse should help their patient to get used to the new situation when they have to rely on other people much, but should also attempt to build relationships in their family that would allow for maximally autonomous space. For instance, if the patient is incapable of doing something, the nurse might arrange the necessary assistance which would allow the elderly person to be able to do what they wish to do. Assisting to create the proper environment and working with the patient’s family are useful tools for helping the patient to adjust to their new condition (Reed et al., 2012).

There exist several modes of communication; it is stated that communication works best in “shared reality”, which means that a nurse should be able to understand the expectations of their elderly patient and adjust the communication to that patient’s needs and expectations (Mezey, 2001, p. 145). A good way of communicating with the elderly might be active listening. It works well with such patients, for they might often be bad listeners due to poor hearing, and they often would not like to argue about something they believe because of their habits or convictions. On the other hand, such communication works well for the professional, for it allows the nurse to notice nuances which might otherwise go unnoticed. The healthcare specialist is also able to receive the information they need in this mode by asking questions (Mezey, 2001, p. 145). On the other hand, unadjusted mode of communication, one a nurse uses with their relatives or colleagues, does not work well with the elderly patients, for the latter are often unable to focus on what the specialist says due to the pace of speech that requires quick information processing; poor hearing; cultural and generation differences, etc. It is important to take that into account in the nursing practice (Gartmeier, Bauer, Gruber, & Heid, 2010).

To sum up, it should be noted that the mental and physical frailty is the most widespread problem that changes the lifestyle of the elderly. To help the aged patients to adjust to these changes, a nurse should create conditions for the patient’s autonomy. While communicating with the elderly, it is a good idea to use active listening, whereas employing the “usual” mode of communication is likely to yield little positive result.

References

Fulmer, T. T., Foreman, M. D., & Walker, M. (Eds.). (2001). Critical care nursing of older adults: Best practices (3rd ed.). New York, NY: Springer.

Gartmeier, M., Bauer, J., Gruber, H., & Heid, H. (2010). Workplace errors and negative knowledge in elder care nursing. Human Resource Development International, 13(1), 5-25. Web.

Melillo, K.D., & Houde, S. C. (2011). Geropsychiatric and mental health nursing (2nd ed.). Sudbury, MA: Jones & Bartlett Learning.

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Mezey, M. (Ed.). (2001). The encyclopedia of elder care: The comprehensive resource on geriatric and social care. New York, NY: Springer.

Reed, J., Clarke, C. L., & Macfarlane, A. (Eds.). (2012). Nursing older adults. Maidenhead, UK: Open University Press.

Touhy, T. A., & Jett, K. F. (2014). Ebersole and Hess’ gerontological nursing & healthy aging (4th ed.). St. Louis, MO: Elsevier Mosby.

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