nursingaging week 8

Chapter_016.ppt

Chapter 16

Promoting Safety

Must be multifaceted and individualized to the areas of identified risks
Particularly important for older adults who are at risk for falls and is recommended in evidence-based protocols for fall risk reduction

Home Safety Assessment

Exposed to temperature extremes in dwellings can impose a serious risk to older persons with declining physical health
Older individuals are vulnerable to environmental temperatures
Thermoregulation
Hyperthermia
Hypothermia

Environmental Temperatures

Influenced by
Neurosensory changes
Medications
Economic, behavioral, and environmental factors
Diminished thermoregulatory responses and abnormalities in production and response to pyrogens contribute to differences in fever responses between older and younger patients

Thermoregulation

Body temperature increases above normal ranges because of environmental or metabolic heat loads
Risk factors
Administration of diuretics
Low fluid intake
Those with cardiovascular disease, diabetes, or peripheral vascular disease
Certain medications

Hyperthermia

Hypothermia

Recognize clinical signs and severity of hypothermia and hyperthermia
Keep frail elders in environments with appropriate temperatures for comfort and prevention of problems
Monitor body temperature and pay particular attention to lower or higher than normal readings
Advocate for community resources

Implications for Gerontological Nursing and Healthy Aging

Which patient assessment data does the nurse recognize could contribute to an older adult’s risk of hyperthermia?

Has a history of osteoarthritis

Takes furosemide 40 mg daily

Bathes daily with a hot shower

Keeps room temperature at 72°F

Question

Answer

Older adults are at great risk during and after disasters and have the highest casualty rate during disaster events
Older adults are vulnerable to natural disasters because of
Limited mobility
Social isolation
Cognitive impairment
Institutionalization

Natural Disasters

Critical link in the ability to remain independent and functional
Lack of accessible transportation may contribute to social withdrawal, poor nutrition, depressive symptoms, and health decline
With age, the risk for impairments that affect driving skills increases because of disease-related and normal aging changes

Transportation Safety

Assessment should include evaluation of whether an individual can drive, feels safe driving, and has a driver’s license
There is no gold standard for determining driving competency
Driving evaluations are offered by various community agencies

Implications for Gerontological Nursing and Healthy Aging

Hold promise for improving quality of life, decreasing the need for personal care, and enhancing independence
Assistive technology is any device or system that allows a person to perform a task independently, easier, and safer
Gerotechnology describes assistive technologies for older people

Emerging Safety Technologies

Use of electronic information and telecommunication technologies to support long-distance clinical health care, patient and professional health-related education, public health, and health administration
Includes
Remote monitoring devices
Smart medical homes

Telehealth

Advancements improve the quality of life, decrease need for personal care, and enhance the ability to live independently
Telemedicine allows for managing medical problems in the home or other settings, thereby reducing health care costs
Devices are available to monitor gait and to detect balance problems

Emerging Technologies

Elder-Friendly Communities

A nurse counseling an 85-year-old person regarding modifying driving habits would include

playing music will help keep you alert.

limit driving to familiar places close to home.

driving in heavy traffic is fine as long as it is not raining.

if you have a passenger, you may drive at any time of the day.

Question

B—Encourage older adults to modify their driving habits, such as not driving on unfamiliar roads, during rush hour, at dusk or at night, in inclement weather, or in heavy traffic. Distractions should be minimized.

Answer