Elderly Care: Nursing perspective

Elderly Care: Nursing perspective

– Mr. Sudip Rudra Paul, Pune

Geriatric Palliative Care (GPC) is a field of inter-specialty collaboration unifying competences from geriatric medicine and palliative care to respond to the socio-demographic changes and challenges of older adults with severe and life-limiting conditions.

Geriatric Palliative Care can be provided when there are indications for the need for palliative care in older adults due to complexities in ageing, and when elements of geriatric palliative care can help improve the quality of life of older persons. Adopting an interdisciplinary care model along with a ‘person-centered’ approach will help provision quality geriatric palliative care. Community based setting along with home care based models seem to be the most effective models of care delivery for these vulnerable older persons.

Let’s now look at some of the most common Myths Vs Facts surrounding Ageing.

Myth	Fact
All older persons are quite similar	They are a very diverse age group
They are generally alone and lonely	They most oftenly try and maintain close contact with the family
They are sick, frail and dependent on others	Actually, most older persons live independently
They are often cognitively impaired	For most older persons, if there is decline in some intellectual abilities, it is not severe enough to cause problems in daily living
They are depressed	Community dwelling older persons have lower rates of diagnosable depression than younger adults
They become more difficult and rigid as they advance in age	One’s personality remains relatively consistent throughout one’s lifespan
Older persons barely cope with the inevitable declines associated with aging	Most older persons successfully adjust to the challenges of aging, gracefully

It is noticed that approx. 50% of older persons have 3 or more chronic conditions which may be due to changes in their Physiological (cardiovascular, nervous, genitourinary etc.), Psychosocial (Retirement and social isolation, elder abuse, housing and environment etc.) or Cognitive conditions (delirium, depression, dementia etc.).

The most common factors that influence ageing are Heredity, Nutrition, Health status, Life experiences, Environment, Activity, and Stress.

The most common age related problems are Osteoarthritis, Osteoporosis, Cardiovascular disease, Alzheimer‘s, Cancer in the Older Adult, Diabetes, Heart failure and Chronic Obstructive Pulmonary Diseases (COPD).

Listed below are a few ways in which nursing care can help improve the quality of life of these older persons.

• Older persons get easily confused and find it very difficult to understand technical terms. This will eventually lead to them to getting anxious and depressed. It is therefore absolutely essential for the palliative nurse to encourage family members’ to get the older persons in their families actively engaged during various decision making processes and acknowledge and prioritise their inputs. Families should make these older persons feel secure and not threatened.
• It is the primary responsibility of the palliative care nurse to educate, explain and provide support to the family on the various aspects of care that needs to be provided for the older persons to help them function to the extent possible, normally in their day-to-day life.
• It is equally important to recognise that families often don’t like to be dependent on others or seek out help actively. It is therefore the responsibility of the prepare them to look out for the constantly changing needs of the older persons along with ways to tend to them.
• The palliative nurses must sensitise and educate the families to not impose the usage of hi tech or complicated accessories by older persons.
• The palliative care must closely monitor the older person’s medication and explain dosages using simple and easy to understand communication styles.
• The palliative nurse must provide quality symptom management so that the older persons don’t get anxious or lethargic.
• It is critical for the palliative nurses to provide psychological support to these older persons as needed so that they are happy and at peace.