CARACTERISTICS OF DISEASES IN ELDERLY

First of all, I want to talk about geriatrization of medicine, something that anyone who has visited a hospital can see. Hospitals are becoming more full of elderly patients with chronics diseases and they could not stay at hospital. For look after chronic situations of aging there are home nursing...

 

It is very important to know common aspects of geriatric syndromes that determine the specificity of care:

1. Heterogeneity of the population over age 65 : healthy elderly, sick old man, frail elderly and geriatric patient.
2. Peculiarities of disease: atypical presentations of disease.
3. Fragility and signs of vulnerability in older people.
4. Comorbidity and polypharmacy: differents diseases can affect different organs or systems related to each other.
5. There are many factors in aging: impaired ability to maintain a constant internal environment, interaction  between internal organs, long latency diseases periods become asymptomatic, immunological and iatrogenic. Increased drugs consumption is often resulting in prevalent iatrogeny. 
6. Tendency to chronicity and frequent disorders: promote independence. High prevalence chronic and degenerative diseases cause dependence.
7. Less favorable prognosis of disease: due to changes of old age, such as flu
8. Diagnostic and therapeutic difficulties: both diagnostic and therapeutic activities in geriatrics should be guided by the risk / benefit always keeping in mind benefit, and after dogin an integral geriatric valuation that justify the medical actions to perform.   
9. Most useful health resources: hospitalization rate twice of the general population.
10. Increased need for rehabilitation: our outcome, maintain autonomy  
11. Frequent need to use social resources: in the elderly ofte diseases aggravate social and family problems. 
12. Frequent ethical problems: taking diagnostic and therapeutic decisions in the final stages of life, longer life artificially .... 

I want to highlight and summarize one of the symptom of geriatric syndromes, the pain. Pain is a experience that have a three-dimensional character. Chronicity is usually.Often the healthy personal do not give the necessary importance to pain. Response to pain differs between persons. There are factors such as culture, sex, spiritual and age that can change the response to pain.

 

Older adults have increased pain risk as a result of  higher incidence of disease conditions joined with aging. Some older adults have decreased their ability to sense pain, whereas others are highly sensitive to painful stimulus.

 

Many older adults deny pain because they fear they will be avoided or lose their independence. They live with pain because they think that it is a normal part of aging and sometimes nurses thinks that pain is normal too.

I attach an example of VAS (visual analog scale), this the scale to meassure pain.

 

 

I would like explain some nurse´s interventions to controll the patient and help our patients. Well, as I have explained in other post to do our job like nurses we have to considerer 14 basic needs accordin to Virginia Henderson and we have to suggest nursing goals and a nursing interventions to meet the outcomes with our patients.

 

For this reason I want to explain some nursing outcomes and their nursing intervention.

The nursing outcomes for acute or chronic pain are to resport an improved comfort level or decrease in pain, verbaliza the ability to cope with pain and demonstrate techniques that provide relief from pain.

Some possible nursing interventions are:

• Evaluate kind of pain. Not all pain is the same, for this reason is important assess the pain with differents types of scales like VAS. I change the mnemonic PQRST (provocation or palliation, quality, region, severity, timing) I think that it is very interesting to do an accurate measurement.
• Provides comfort measures such as repositioning, giving a backrub, providing a noiseless environment...Listening patients could decrease  them fear and anxiety and could decrease  pain.
• Administer medications as erdered
• We could recomended non pharmacologic approaches like a meditation
• If movement increase pain, we try to reduce that.
• Teach our patients to breath when they are in pain, long, slow and focused breathing helps relaxation and takes attention away from pain.

I think that the most important thing to understand pain is try to put yourself in someone else's place. The chronic pain results in a reduction of quality of life. We have to become more empathy.