Page 66 nursing.elitecme.com Complete Your CE Test Online - Click Here Activity director June D. Thompson, DrPH, MSN, RN, FAEN, Lead Nurse Planner Disclosures Resolution of Conflict of Interest In accordance with the ANCC Standards for Commercial Support for continuing education, Elite implemented mechanisms prior to the planning and implementation of the continuing education activity, to identify and resolve conflicts of interest for all individuals in a position to control content of the course activity. Sponsorship/Commercial Support and Non-Endorsment It is the policy of Elite not to accept commercial support. Furthermore, commercial interests are prohibited from distributing or providing access to this activity to learners. Disclaimer The information provided in this activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition. ©2018: All Rights Reserved. Materials may not be reproduced without the expressed written permission or consent of Elite Professional Education, LLC. The materials presented in this course are meant to provide the consumer with general information on the topics covered. The information provided was prepared by professionals with practical knowledge of the areas covered. It is not meant to provide medical, legal, or professional advice. Elite Professional Education, LLC recommends that you consult a medical, legal, or professional services expert licensed in your state. Elite Professional Education, LLC has made all reasonable efforts to ensure that all content provided in this course is accurate and up to date at the time of printing, but does not represent or warrant that it will apply to your situation nor circumstances and assumes no liability from reliance on these materials. Quotes are collected from customer feedback surveys. The models are intended to be representative and not actual customers. Demographics related to the aging population The needs of persons over the age of 65 will continue to place significant demands on the healthcare system for the foreseeable future. The enlargement of the older adult population has been, and will continue to be, dramatic. For example, in 2014 the United States (U.S.) Census Bureau reported that 14.5% of the population was 65 years of age or older [1]. Data supplied by the World Health Organization (WHO) shows that the pace of the growth of the aging population is noteworthy worldwide [2]: ● ● The proportion of the world’s population over 60 years of age will nearly double from 12% to 22% between 2015 and 2050. ● ● The number of persons 60 years of age and older will outnumber children younger than five years by the year 2020. ● ● In 2015, 80% of the aging population was living in low and middle income countries. ● ● By 2050, the number of people aged 60 and older throughout the world is estimated to total two billion, up from 900 million in 2015. This means that there will be 434 million people in this age group worldwide. ● ● The growth pace of the aging population is much faster than in the past. ● ● All countries are facing major challenges in making sure that their health and social systems can deal with this demographic shift. Nursing consideration: The rapid pace of growth in the older adult population makes it essential that more nurses seek education to increase their knowledge in or even specialize in the field of gerontological nursing. Older adults often have one or more chronic illnesses or conditions, such as urinary incontinence, dementia, cardiovascular disease and diabetes mellitus. In fact, “about 92% of older adults have at least one chronic health problems and 77% have at least two [3]. However, chronic health problems are not limited to older adults. As of 2012, about half of all adults, i.e. 117 million people, had one or more chronic health conditions, and one in four adults had two or more chronic health conditions [4]. Nurses must consider the usual physiological changes that accompany aging. Although older adults make up the majority of those who use healthcare services, most are able to live independently in the community. This indicates that nurses must be quite knowledgeable in the delivery of geriatric services in both inpatient and outpatient settings, including such services as preventive care, risk identification, patient education and the promotion of maximum health and wellness. The health care demands of a dramatically aging population require a workforce of nurses skilled in caring for a population with complex health care conditions. As a result, there has been a significant increase in the amount and depth of gerontological nursing content in baccalaureate schools of nursing during the past two decades [5]. There is a corresponding need for continuing education in gerontological nursing for licensed professionals and nursing assistants. Nurses play a critical role in helping older adults to effectively manage health problems, create and maintain safe and healthy living environments, and live lives of dignity and quality [6]. One of the most important ways nurses can accomplish this is to perform a thorough assessment of their older adult patients. Such assessments require that nurses be astute observers and excellent communicators. A good assessment begins with the nurse’s first glimpse of the patient. Jillian is a graduate nursing student at a large Midwestern university. She is specializing in gerontological nursing. As part of a senior project she must prepare to teach her fellow-students how to perform an assessment of an older adult patient. She begins with what she calls “assessment at first glance.” Jillian’s goal for this part of her presentation is to explain just how important the first impression of a patient is and how much information can (and should) be obtained from the first few minutes of interaction. She will include critical thinking exercises to help her peers perform a more in-depth assessment. Assessment at first glance Assessment begins with your first glimpse of the patient. So many things can be observed in these first few moments. Start with the patient’s appearance. How is the patient dressed? Is the clothing appropriate for the time of year and the weather? Are clothes neat and clean? Do they fit properly? Is the patient clean? Do you smell any unusual odors such as urine, which may indicate incontinence problems, or sweat, which may indicate lack of hygiene? Are the patient’s hands and fingernails clean? Is there any evidence of unusual bruising or injuries such as lacerations, scars, or burn marks? At first glance, what is the patient’s mobility status? Is he or she (s/he) ambulating independently or is assistance required? Does the patient use any assistive devices such as a cane or a walker? Observe the quality of his or her gait. Is balance maintained without difficulty? Is the patient able to move all extremities without difficulty? Do you notice any tremors of any extremities? How does the patient respond to your initial greeting? Is the response appropriate? Does the patient speak clearly and distinctly? Are his or her facial features symmetrical? If not, what abnormalities are present? For example, is one side of the face drooping or is one eyelid drooping? Is the patient oriented to person, place, and time? Is eye contact maintained (if culturally appropriate)? Is s/he able to respond to simple questions such as, “How are you feeling today?” Does the patient wear glasses? Does s/he seem able to see his surroundings without difficulty? Can the patient hear what you are saying, assuming you are speaking clearly and distinctly and in a normal tone of voice? Does the patient use hearing aids and/or are they wearing them?