Unit 16-psychological Effects Of Aging

Unit 16

Psychological Effects of Aging Nurse Aide I Course

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Psychological Effects Of Aging This unit deals with the feelings, emotional stress and psychological adjustments that are part of the aging process. It explores the physical and psychosocial needs of residents, and teaches the skills that the nurse aide will need to develop to provide understanding and compassionate care. DHSR Approved Curriculum-Unit 16

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Psychological Effects Of Aging (continued)

Other topics covered include: age appropriate behavior, sexuality, reality orientation, dementia, Alzheimer’s disease, confusion and developmental disabilities.

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16.0 Discuss ways to meet the resident’s basic human needs for life and mental well-being.

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Physical Needs For Survival And Care To Be Given • Oxygen – elevate head of bed – assist to sit up in chair – report to supervisor if resident is cyanotic or short of breath – assist with breathing exercises DHSR Approved Curriculum-Unit 16

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Physical Needs For Survival And Care To Be Given (continued)

• Food – Feed residents unable to feed themselves

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Physical Needs For Survival And Care To Be Given (continued)

• Food – Serve food • with proper temperature • in friendly manner • in pleasant environment • in appropriate amounts – Make sure dentures are in place DHSR Approved Curriculum-Unit 16

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Physical Needs For Survival And Care To Be Given (continued)

• Water – make available within resident’s reach – provide fresh water at periodic intervals

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Physical Needs For Survival And Care To Be Given (continued)

• Shelter – provide for warmth with extra blankets – be sure residents are dressed properly – avoid drafts or drafty areas DHSR Approved Curriculum-Unit 16

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Physical Needs For Survival And Care To Be Given (continued)

• Sleep – Minimize noise and lights during hours of sleep – Give back rub to relax resident

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Physical Needs For Survival And Care To Be Given (continued)

• Sleep (continued) – Report complaints of pain to supervisor – Listen to concerns or worries the resident may wish to express – Leave night light on in the resident’s room, if requested DHSR Approved Curriculum-Unit 16

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Physical Needs For Survival And Care To Be Given (continued)

• Elimination – Assist to bathroom as needed – Provide bedpan and/or urinal – Provide for privacy DHSR Approved Curriculum-Unit 16

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Physical Needs For Survival And Care To Be Given (continued)

• Elimination (continued) – Change soiled linen immediately – Following routine for bowel and bladder retraining as directed DHSR Approved Curriculum-Unit 16

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Physical Needs For Survival And Care To Be Given (continued)

• Activity – ROM exercises as directed – Turn and reposition at least every two hours

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Physical Needs For Survival And Care To Be Given (continued)

• Activity – Assist with activity as directed – Encourage movement – Encourage interesting recreational activities DHSR Approved Curriculum-Unit 16

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Safety And Security Needs • Provide for warmth • Establish familiar surroundings – explain procedures – talk about “their” room – keep your promises – provide a safe environment – promote use of personal belongings DHSR Approved Curriculum-Unit 16

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Safety and Security Needs (continued)

• Maintain order and follow routines, assisting resident to participate in establishing routine as often as possible

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Safety and Security Needs (continued)

• Assist to reduce fear and anxiety – listen to resident’s worries and report to supervisor – ease concerns when possible – check on residents frequently • Avoid rushing and assist resident in gentle manner DHSR Approved Curriculum-Unit 16

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Love and Affection Needs • • • •

Friendship Social Acceptance Closeness Meaningful relationships with others • Love • Sexuality DHSR Approved Curriculum-Unit 16

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Love and Affection Needs (continued)

• Belonging – Need met by family/support system – Friends may meet this need

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Love and Affection Needs (continued)

The nursing staff as family: • take time to greet residents when you see them • sit and visit for a few minutes when time allows • show interest in residents DHSR Approved Curriculum-Unit 16

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Love and Affection Needs (continued)

The nursing staff as family (continued): • display human warmth with a gentle touch • show acceptance of an individual for his or her unique qualities • provide care in a kind, friendly, considerate manner DHSR Approved Curriculum-Unit 16

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Self-Esteem Needs • Value, worth or opinion of oneself • Seeing oneself as useful • Being well thought of by others

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Self-Esteem Needs (continued)

• Nurse aide’s responsibilities – call resident by proper name – praise accomplishments – discuss current issues – request resident’s opinion – show respect and approval DHSR Approved Curriculum-Unit 16

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Need for Self-Actualization (experiencing one’s potential) • Cannot occur until all other needs are met • A feeling that a person is what one wants to be • Rarely is this need totally met DHSR Approved Curriculum-Unit 16

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Need for Self-Actualization (experiencing one’s potential) (continued)

• Ways to help residents to meet this need: – assist to participate in meaningful activities – assist to dress and help with grooming – encourage independence – encourage socialization DHSR Approved Curriculum-Unit 16

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Need for Self-Actualization (experiencing one’s potential) (continued)

• Ways to help residents to meet this need (continued): – share goals with residents and praise their success or accomplishments – know what resident has accomplished in his/her lifetime and talk about these things DHSR Approved Curriculum-Unit 16

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Spiritual Needs • Residents have the right to worship and express their faith freely.

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Spiritual Needs (continued)

• Guidelines for the nurse aide: – respect resident’s beliefs – respect resident’s religious objects – inform residents of the time and place for religious services DHSR Approved Curriculum-Unit 16

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Spiritual Needs (continued)

• Guidelines for the nurse aide (continued): – assist resident to attend religious services – provide privacy for members of the clergy and residents – welcome members of the clergy DHSR Approved Curriculum-Unit 16

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16.1 Identify eight defense mechanisms that could be used by a resident in response to stress.

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Coping Mechanisms • Established early in life as part of personality • List of defense mechanisms (unconscious behaviors) – Projection - blaming others – Rationalization - false reason for situation DHSR Approved Curriculum-Unit 16

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Coping Mechanisms (continued) • List of defense mechanisms (unconscious behaviors) (continued) – Denial - pretending a problem doesn’t exist – Compensation - making up for a situation in some other way

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Coping Mechanisms (continued)

• List of defense mechanisms (unconscious behaviors) (continued) – Displacement - transferring feelings about one person to another person – Daydreaming - escape from reality DHSR Approved Curriculum-Unit 16

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Coping Mechanisms (continued)

• List of defense mechanisms (unconscious behaviors) (continued) – Identification - idolizing another and trying to copy him/her – Sublimation - redirecting feelings to constructive activity

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16.2 Recognize how age, illness and disability affect sexuality.

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Sexuality • Expressed by individuals of all ages • A way to show feminine or masculine qualities – Clothing styles and colors – Hairstyles – Hobbies and interests – Sexual habits (continue into old age) – Gestures DHSR Approved Curriculum-Unit 16

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Sexuality (continued)

• May be expressed by: – Sexual intercourse – Caressing, touching, holding hands – Masturbation • Is a right of all residents to experience DHSR Approved Curriculum-Unit 16

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Guidelines For The Nurse Aide In Dealing With Resident Sexuality • Assist to maintain sexual identity by dressing residents in clothing appropriate for men or women • Assist with personal hygiene DHSR Approved Curriculum-Unit 16

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Guidelines For The Nurse Aide In Dealing With Resident Sexuality (continued)

• Assist to prepare for special activities by “dressing up” – selecting attractive clothing – fixing hair in a special way – applying cosmetics – wearing a special perfume or aftershave DHSR Approved Curriculum-Unit 16

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Guidelines For The Nurse Aide In Dealing With Resident Sexuality (continued)

• Help to develop a positive self-image • Show acceptance and understanding for resident’s expression of love or sexuality – provide privacy – always knock prior to entering a room at any time – assure privacy when requested DHSR Approved Curriculum-Unit 16

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Guidelines For The Nurse Aide In Dealing With Resident Sexuality (continued)

• Never expose the resident • Accept the resident’s sexual relationships

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Guidelines For The Nurse Aide In Dealing With Resident Sexuality (continued)

• Provide protection for the nonconsenting resident • Be firm but gentle in your rejection of a resident’s sexual advances

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Possible Effects Of Injury Or Illness On Sexuality • Disfiguring surgery may cause a person to feel: – unattractive and ugly to others – mutilated and deformed – unworthy of love or affection DHSR Approved Curriculum-Unit 16

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Possible Effects Of Injury Or Illness On Sexuality (continued)

• Chronic illness and certain medications can affect sexual functioning

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Possible Effects Of Injury Or Illness On Sexuality (continued)

• Disorders that cause impotence – diabetes mellitus – spinal cord injuries – multiple sclerosis – alcoholism

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Possible Effects Of Injury Or Illness On Sexuality (continued)

• Surgery can have both physical and/or psychological effects – removal of prostate or testes – amputation of a limb – removal of uterus – removal of ovaries – removal of a breast – colostomy – ileostomy DHSR Approved Curriculum-Unit 16

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Possible Effects Of Injury Or Illness On Sexuality (continued)

• Disorders affecting the ability to have sex: – stroke – nervous system disorders – heart disease

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Possible Effects Of Injury Or Illness On Sexuality (continued)

• Disorders affecting the ability to have sex: – chronic obstructive pulmonary disease – circulatory disorders – arthritis or conditions affecting mobility/ flexibility DHSR Approved Curriculum-Unit 16

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16.3 Identify developmental tasks associated with aging.

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Developmental Tasks Of Aging • Adjustment to: – retirement – reduced income – death of friends – death of spouse – physical changes – loss of independence DHSR Approved Curriculum-Unit 16

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Developmental Tasks Of Aging (continued)

• Creating new friendships and relationships • Loss of vitality • Integrating life experiences • Preparation for death DHSR Approved Curriculum-Unit 16

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16.4 Identify symptoms of depression and define the nurse aide’s role in caring for a depressed resident.

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Depression • Reasons for depression – Loss of independence – Death of spouse or friend – Loss of job or home – Decreased memory – Terminal illness

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Common Signs And Symptoms Of Depression • Change in sleep pattern • Loss of appetite and weight loss • Crying, withdrawal from activities, appearing sad DHSR Approved Curriculum-Unit 16

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Nurse Aide’s Role In Caring For The Depressed Resident • • • • •

Listen to feelings Encourage to reminisce Involve in activities Encourage friends and family to visit Report changes in eating, elimination or sleeping patterns DHSR Approved Curriculum-Unit 16

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Nurse Aide’s Role In Caring For The Depressed Resident (continued)

• Avoid pitying the resident • Help to focus on reality • Monitor eating and drinking • Promote self-esteem • Report observations to supervisor DHSR Approved Curriculum-Unit 16

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16.5 Identify the issues to be considered when elderly are unable to provide for their own needs in their own homes.

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Issues Involving Care Of The Elderly • • • •

Amount of care needed Cost Nutritional needs Relationship with family/support system • Location of family/support system • Medical care needs DHSR Approved Curriculum-Unit 16

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Issues Involving Care Of The Elderly (continued)

• The elderly person may experience: – Living with a group of people – Less independence – Structured lifestyle – Less privacy – Difficulty adapting to change DHSR Approved Curriculum-Unit 16

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Issues Involving Care Of The Elderly (continued)

• Decision made by individual or family for long-term care may cause stress

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16.6 Utilize the resident’s family or established support system as a source of emotional support.

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Emotional Support for Residents • Family/support system meets needs for: – Safety – Security – Love – Belonging – Esteem DHSR Approved Curriculum-Unit 16

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Emotional Support for Residents (continued)

• Family/support system provides: – Comfort – Support – Relief from loneliness – Contact with familiar people and things – Mental stimulation – Reasons to live DHSR Approved Curriculum-Unit 16

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Ways To Promote Family Involvement • Include in care conferences • Encourage to do some or all of personal grooming • Provide outside picnic areas, playground equipment, gardens DHSR Approved Curriculum-Unit 16

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Ways To Promote Family Involvement (continued)

• Provide area for family/support system parties • Invite families to scheduled activities • Encourage to assist with feeding if appropriate

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Ways To Promote Family Involvement (continued)

• Encourage to bring special foods or beverages for resident if allowed • Encourage time together DHSR Approved Curriculum-Unit 16

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Responsibilities of the Nurse Aide when Dealing with Family/Support System Members • Greet the family/support system • Address family members by name • Make family and friends feel welcome • Provide for privacy • Keep lines of communication open DHSR Approved Curriculum-Unit 16

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Responsibilities of the Nurse Aide when Dealing with Family/Support System Members (continued)

• Understand that family and friends will do or say things to try and please the resident • Use tact in dealing with family complaints and requests that you cannot honor DHSR Approved Curriculum-Unit 16

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Responsibilities of the Nurse Aide when Dealing with Family/Support System Members (continued)

• Assist families to understand the facility and how it works • Provide explanations for family questions or report to supervisor to assist the family with questions DHSR Approved Curriculum-Unit 16

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Responsibilities of the Nurse Aide when Dealing with Family/Support System Members (continued)

• Reassure family as they cope with resident’s actions, problems and concerns

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16.7 Identify the symptoms displayed by residents with dementia.

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Dementia (Group Of Symptoms) • Defined as a progressive loss of mental functioning

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Dementia (Group Of Symptoms) (continued)

• Two categories of dementia – 1st Category: Primary • No known cause • Irreversible • May be treated but not completely cured DHSR Approved Curriculum-Unit 16

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Dementia (Group Of Symptoms) (continued)

• Two categories of dementia – 1st Category: Primary • Examples of diseases causing dementia –Alzheimer’s disease –Parkinson’s disease –Huntington’s Chorea (genetic) DHSR Approved Curriculum-Unit 16

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Dementia (Group Of Symptoms) (continued)

• Two categories of dementia – 2nd Category: Secondary • Usually has known cause • Treatable • Reversible to some degree

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Dementia (Group Of Symptoms) (continued)

• Two categories of dementia – 2nd Category: Secondary • Examples of secondary causes of dementia – depression – minor stroke – thyroid dysfunction – medication induced DHSR Approved Curriculum-Unit 16

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Symptoms Of Dementia • • • • • • • • •

Confusion Inability to reason accurately Recent memory loss Detailed long-term memory Repetitious speech Self-centered behavior Agitation Disorientation Confabulation DHSR Approved Curriculum-Unit 16

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16.8 Review the psychosocial characteristics and care needs of a person with Alzheimer’s disease.

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Alzheimer’s Disease • Defined as a progressive, 3-stage, incurable disease that involves changes in brain tissue • Responsible for about half of the dementia seen • Symptoms usually occur in people 50-69 years of age DHSR Approved Curriculum-Unit 16

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Alzheimer’s Disease (continued)

• Affects more women than men • Always ends in death 3-15 years after symptoms begin

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Alzheimer’s Disease: Signs And Symptoms • • • •

Irreversible loss of memory Speech and writing difficulties Disorientation Difficulty walking – loss of balance – short steps – spatial disorientation DHSR Approved Curriculum-Unit 16

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Alzheimer’s Disease: Signs And Symptoms (continued)

• Deterioration of mental functions – Unable to make decisions – Loss of ability to make judgments – Changes in behavior • restless • angry • depressed • irritable DHSR Approved Curriculum-Unit 16

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Alzheimer’s Disease: Signs And Symptoms (continued)

• Possible seizures • Coma and death

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Alzheimer’s Disease: Considerations For Care • Assist to be as active as possible • Encourage in activities of daily living • Orient to reality • Protect from injury

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Alzheimer’s Disease: Considerations For Care (continued)

• Maintain calm, consistent environment • Complete ADL at the same time each day • Use reality orientation

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Alzheimer’s Disease: Considerations For Care (continued)

• Same caregivers assigned to resident • Involve in simple, limited activities • Follow routines • Treat with patience and compassion DHSR Approved Curriculum-Unit 16

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Alzheimer’s Disease: Considerations For Care (continued)

• Support family • Communicate with simple phrases • Don’t pose questions or ask to make choices DHSR Approved Curriculum-Unit 16

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16.9 Discuss disorders that cause confusion for residents.

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Confusion • Symptom or side effect of many disorders • Disorders causing confusion – Stroke – Arteriosclerosis – Dementia – Alzheimer’s Disease – Huntington’s Chorea DHSR Approved Curriculum-Unit 16

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Confusion (continued)

• Other Causes – Drug reactions – Depression – Environmental changes – Vision and/or hearing loss – Dehydration – Poor nutrition – Decreased oxygen levels in blood – Head injury DHSR Approved Curriculum-Unit 16

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Confusion (continued)

• Condition can be permanent or temporary

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Reality Orientation Used For Confusion • Includes: – Facing resident and speaking clearly and slowly – Greeting the resident by name with each interaction – Identifying yourself with each interaction DHSR Approved Curriculum-Unit 16

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Reality Orientation Used For Confusion (continued)

• Includes: – Explaining care in simple terms prior to giving care – Frequently orienting the resident to the day, month, date, and time – Giving short, simple instructions DHSR Approved Curriculum-Unit 16

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Reality Orientation Used For Confusion (continued)

• Includes: – Encouraging residents to wear glasses or hearing aides – Communicating with touch and clear and simple comments and questions DHSR Approved Curriculum-Unit 16

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Reality Orientation Used For Confusion (continued)

• Includes: – Encouraging use of radio, television, newspapers, and magazines – Maintaining resident’s routine DHSR Approved Curriculum-Unit 16

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Reality Orientation Used For Confusion (continued)

• Includes: – Giving only one direction at a time – Keeping the environment calm and relaxed

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Reality Orientation Used For Confusion (continued)

• Includes: – Providing clocks, calendars and bulletin boards to remind residents of time and activities – Discussing current topics DHSR Approved Curriculum-Unit 16

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Reality Orientation Used For Confusion (continued)

• Includes: – Reminiscing – Showing resident self-image in mirror – Providing recreational activities which reinforce reality orientation DHSR Approved Curriculum-Unit 16

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Reality Orientation Used For Confusion (continued)

• Includes: – Dressing residents during the day and assisting them to stay on a day-night schedule

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16.10 Identify basic skills the nurse aide will need to use when caring for residents with developmental disabilities.

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Developmental Disabilities • Diagnoses – Mental retardation – Cerebral palsy

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Developmental Disabilities (continued)

• Guidelines for Care – Treat the individual with respect and dignity – Encourage residents to: • make personal choices • do as much as possible for themselves DHSR Approved Curriculum-Unit 16

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Developmental Disabilities (continued)

• Guidelines for Care (continued) – Encourage residents to: • use age appropriate personal skills • achieve their potential • interact with others

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Developmental Disabilities • Guidelines for Care – Do not: • act as resident’s parent • create dependency • label or categorize residents – Do provide privacy – Do build resident’s self-esteem DHSR Approved Curriculum-Unit 16

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16.11 Identify ways to assist residents with cognitive impairments.

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Ways To Assist Stressed Residents • Listen to concerns • Observe and report nonverbal messages • Treat with dignity and respect • Attempt to understand behavior DHSR Approved Curriculum-Unit 16

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Ways To Assist Stressed Residents (continued)

• Be honest and trustworthy • Never argue with residents • Attempt to locate source of stress • Support efforts to deal with stress DHSR Approved Curriculum-Unit 16

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Ways To Assist Demanding Residents • Attempt to discover factors responsible for behavior • Display a caring attitude • Listen to verbal and nonverbal messages • Give consistent care DHSR Approved Curriculum-Unit 16

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Ways To Assist Demanding Residents (continued)

• Spend some time with the resident • Agree to return to see the resident at a specific time and keep your promise

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Ways To Assist Agitated Residents • Encourage to talk about fears • Remind resident of past ability to cope with change • Encourage to ask questions about concerns DHSR Approved Curriculum-Unit 16

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Ways To Assist Agitated Residents (continued)

• Involve in activities that promote self-esteem • Observe for safety and to prevent wandering away • Assign small tasks • Use reality orientation DHSR Approved Curriculum-Unit 16

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Ways To Assist Residents Displaying Paranoid Thinking • Reassure the resident that you will provide for his or her safety • Realize behavior is based on fear • Avoid agreeing or disagreeing with comments • Provide calm environment • Involve in reality activities DHSR Approved Curriculum-Unit 16

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Ways To Assist Combative Residents • Display a calm manner • Avoid touching the resident • Provide privacy for out-of-control residents • Secure help if necessary DHSR Approved Curriculum-Unit 16

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Ways To Assist Combative Residents (continued)

• Do not ignore threats • Protect yourself from harm • Listen to verbal aggression without argument DHSR Approved Curriculum-Unit 16

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