NURSING CARE IN ELDERLY

 "The only function of a nurse is to assist the individual in health and disease, in the performance of those activities contributing to health, recovery or a peaceful death, that he realized without help if I had the strength, will and knowledge necessary . and do this in a way that will help you become independent as soon as possible ". Virginia Henderson

I want to start this post with this sentence of Virginia Henderson, I think that summarize the work that we can develop as nurses. In addition I find particularly interesting this sentence in the care of the elderly, and we should always try to promote elder's independent soon as possible. 
Virginia Henderson developed her care system  according to 14 needs, satisfying each need is influenced by biological, psychological, cultural and spiritual needs of each of us, this needs are interrelated so that should not be considered a need without taking into account the other. From these 14 needs will derive our basic cares that include all therapeutic interventions that we will make on each patient. This needs are designed to reach outcomes that we establishes to complete the patient's needs.
It is very important in the elders care to valuate the 14 basic needs and valuate if them present any manifestations of dependence or independence, that are specific characteristics of the elderly cares. The manifestations of dependence or independence has not taken into account in other age.
Then to summarize this topic,I want to highlight some possible interventions that we could carry out in some situations.

These are: 
1. Breathe normally : a patient that suffers chronic obstructive pulmonary disease, some interventions that we could make are: 

• Teach to use inhalers to our patient, if he needs it.
• Help this patient to eliminate toxics habits, such as cigarrets.
• Teach patient how to make respiratory rehabilitation exercises.

2.  Eat and drink adequately,  dehydrate elderly patient:

• We have to provide liquids to treat the dehydrate, if the patient is in a severe stage the liquids administration will be intravenous.
• Managing a balanced diet
• Inform patient of the importance of drinking two liters of water a day

  




 3. Eliminate body wastes, a constipation patient:

• Advise the patient benefits of a rich fiber diet
• Avoid irritant foods such as spices, spicy foods, alcohol ... 
• Adequate fluid intake (2 liters a day)

4.Move and maintain desirable postures, patients with impaired physical mobility:

• Encourage exercise
• Correct the cause of physical deterioration
• Awareness of the limitations of aging.

5.Sleep and rest. Patient with insomnia:

• Control proper sleep hygiene (schedules, food ...)
• Control fluid intake at night
• Encourage moderate physical activity

6.Select suitable clothes-dress and undress, unkempt patient:

• Provide recommendations on suitable clothing and footwear
• Promote hygiene
• Valuate periodically dressing ability 

 7. Maintain body temperature within normal range by adjusting clothing and modifying environment, hypothermic patient.

• Controll body temperature
• Treat the fever with antipyretics and other interventions
• Control fluid intake    

              

8. Keep the body clean and well groomed and protect the integument, immobile patient with impaired cutaneous integrity:

• Daily skin revision
• Bathe with neutral soap and water 
• Protein-Rich diet. 

9. Avoid dangers in the environment and avoid injuring others. , patients with cognitive impairment: 

• Periodically assess functional areas
• Control of  enviroment risks
• Teach patient using care devices
  

10.Communicate with others in expressing emotions, needs, fears, or opinions. , express their sexuality and emotions, social isolation patient

• Listen to patient to find why is he isolated.
• Encourage participation in social groups as neighborhood associations, daily centers ..
• Study the family environment and foster communication with him.    

11. Worship according to one’s faith. , patient death anxiety:

• Reassure the patient
• Help the patient to talk about their fears, anxieties ...
• Encourage communication with his social environment.

12. Work in such a way that there is a sense of accomplishment, patient worthlessness:

•  Study the family environment of the patient and his support enviroment.
• Encourage the patient to attend group therapy
• Encourage the patient to participate in voluntary activities, asocicaciones of neighbors ...  

13.Play or participate in various forms of recreation, patient expresses feeling bored.:

• Encourage the patient to read, write, and stay informed about daily news.
• Encourage the patient to do things that he coludn't do in other ages.
• Perform cultural activities.

14. Learn, discover, or satisfy the curiosity that leads to normal development and health and use the available health facilities. Patient with early Alzheimer's. :

• Teach patient about his disease.
• Promote mental exercises      
• Evaluate mental functions periodically by doing tests.

I want describe with these small examples the valuation process in nursing care as clearly and "graphic" as possible, in this case, focused on elderly patients.

Rodrigo. M.T; Fernández. C; Navarro. M.V. De la teoria a la práctica. El pensamiento de Virginia Henderson en el siglo XXI. 3º edición.Elsevier masson.2005. Barcelona