BASIC NEEDS IN THE ELDERLY

The nursing valuation can be made according to the classification of Marjory Gordon and Virginia Henderson.

We can not fail to mention either, geraquizada Maslow's pyramid, which gives priority to basic needs.

Virginia Henderson defined nursing as: 

"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 given the strength, the will and the necessary knowledge. and do this in a way that will help you become independent as soon as possible "

The valuation of Virginia Henderson, consists of fourteen needs, which are:

1. Breathe normally.
2. Drink and eat properly.
3. Eliminate all body passageways.
4. Move and maintain good body alignment.
5. Sleep and rest.
6. Wear appropriate clothing, dressing and undressing.
7. Maintain a body temp within normal limits.
8. Maintain personal hygiene and skin integrity.
9. Avoid environmental hazards.
10. Communicate, express their sexuality and emotions.
11. Live with their own beliefs and values.
12. Be busy.
13. Participate in recreational activities to take place.
14. Learn, discover and satisfy the curiosity.

Within these fourteen needs we can say that the elderly are dependent or independent.

We speak of independence, when: the elder performed a series of actions to maximize health status, making their skills and potential.

We speak of dependence when: inability to perform skills and potential, and to meet their basic needs.

According to an article by Vallejo Sanchéz, which consisted of "developing a nursing assessment tool, based on the conceptual model of Virginia Henderson and complemented with validated questionnaires and scales, allowing us to identify the needs of the elderly, weigh the risk of geriatric syndromes and plan appropriate care. "

It was found that the time spent in carrying out the assessment, it was an investment in improving healthcare quality. And he reinforced the importance of valuation for a proper management plan and care, providing health in recent years.

I totally agree with the item, since a good plan of care is based on an exhaustive and appropriate valuation. With the assessment is not only detect problems, but also to see that we must prevent factors.

In the valuation must not only assess the patient, but also the environment and the primary caregiver, as many times these too require our private help.

Finally, I leave this video made by the Government of Aragon, which shows a very general way how to help a patient dependent.

    

                                    

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Bibliography:

1. Vallejo Sáchez JM, Rodríguez Palma M, Valverde Sánchez MM. Valoración enfermera geriátrica. Un modelo de registro en residencias de ancianos. Gerokomos v.18 n.2. Madrid. Junio. 2007. Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1134-928X2007000200003

2. Modelo de Virginia Henderson. Enfermería. Universidad Mayor Temuco. Chile. 2009. Disponible en: http://enfermeriatravesdeltiempo.blogspot.com.es/2009/09/virginia-henderson.html

3. Vernet Aguiló F. Conceptos básicos de enfermería en la atención gerontológica según el Modelo V.Henderson. Gerokomos. 2007; v.18 (nº2). Disponible en: http://scielo.isciii.es/scielo.php?pid=S1134-928X2007000200004&script=sci_arttext

COMPREHENSIVE GERIATRIC ASSESSMENT

The nursing process is divided into: assessment, diagnosis, planning, implementation and evaluation.

Geriatric assessment is the essential tool of Geriatrics.

Is the technique that is responsible for detecting and quantifying the problems affecting four areas: clinical, functional, mental and social ability, and emotional capacity.

Within these areas I will talk about the functional, which is the most important I think. since at this value the independence to perform activities of daily living.



FUNCTIONAL AREA

Classification:

Basic activities of daily living	Instrumental activities of daily living
Feeding Dress Cleanliness Bath Arrangement Wandering (bed, couch, shower, bath ...) Transfer Continence Communication	Writing Reading Kitchen Cleaning Shopping Wash Climbing stairs Use phone Medication Management Money Management Transport

To assess this we used a series of scales in Spain. Depending on whether they are basic or instrumental activities scales are different.


Basic activities of daily living scales:  

1. Katz Index.

2. Barthel Index.

3. Physical Disability Scale of Red Cross.

4. Plutchik Scale.

Instrumental activities of daily living: 

1. Lawton y Brody Scale.

According to the Acosta study: Activities of daily living in older adults: The experience of two focus groups.



The study aims to obtain a sample of examples of physical and mental recreation, social, independence and health protection, as initially proposed an inventory of life activities
seniors daily.
Taking it just with two focus groups, one eight and fifteen other formed by elderly.



The results show a wide variety of activities  of daily activities as a consequence of heterogeneity in aging process, and set bases for further studies on adaptation mechanisms of aged people facing aging changes, to attend needs that this population sector demands.

The differences in the previous study are given mainly by the degree of cognitive impairment with patients. Cognitive impairment is considered one of the factors that affects the dependency in old age.

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Bibliography:

1. Sanjoaquín AC, Fernández E, Mesa MP, García-Arilla E. Valoración geriátrica integral. En: Tratado de geriatría para residentes. Madrid: Sociedad Española de Geriatría y Gerontología (SEGG); p.59-68. Disponible en: http://www.imsersomayores.csic.es/documentos/documentos/segg-tratado-01.pdf

2. MªTeresa Alarcón Alarcón. Valoracíon geriátrica: Utilidad Predictiva en el estudio y seguimiento del paciente geriátrico hospitalizado. Tesis Doctoral. Dirigida por: Prof. JM RIBERA CASADO, Dr. JI GONZÁLEZ. Madrid. 1996. Disponible en: http://biblioteca.ucm.es/tesis/19911996/D/0/AD0042701.pdf 

3. Acosta Quiroz CO, González-Celis Rangel ALM. Activities of daily living in older adults: 

The experience of two focus groups.Instituto Tecnológico de Sonora. Universidad Nacional Autónoma de México. VOL. 15, NUM. 2: 393-401 JULIO-DICIEMBRE, 2010. Disponible en: http://www.cneip.org/documentos/revista/CNEIP_15_2/Christian-Oswaldo-Acosta-Quiroz.pdf

THEORIES OF AGING

There are many theories of aging. We can divide them into:

• Biologic theories.
• Psychosocial theories.

Biologic theories	Psychosocial theories
- The Programmed Theory. - The Rut-out-program Theory. - The Living Theory. - The Gen Theory. - The Molecular Theories. - The Error Theory. - The Somatic Mutations Theory. - The Free Radical Theory. - The Cross Line. - The Clinker Theory.  - The Neuroendocrine Theory. - The Immunologic Theory.	- The Disengagement Theory. - The Actitvity Theory. - Life Course Theories:      Erikson's Theory.      Havighurt's Theory.      Jung's Theory.

There are so many different theories and is a subject so vast, that I think the most important thing is to know the essential functioning.

So I'm putting this video, which is very interesting. Speaking in general of all these theories, very explanatory and easy to understand.

It is in Spanish, a program of the  Tve, called "Networks".

Bibliography:

1. Pérez V, Sierra F. Biología del envejecimiento (Biology of aging). Rev. Méd.Chile. 2009; 137: 296-302.

DISPONIBLE EN: http://www.scielo.cl/scielo.php?pid=S0034-98872009000200017&script=sci_arttext

AGING

According to WHO, health is a "state of complete physical, mental and social".

Aging is a "process normally associated with impaired progressive responses the adaptive homeostatic body, leading to changes in the structure and function of the different systems. Also increases the vulnerability of individual to environmental stress and the disease".

Aging can be seen from three points: biological, social and psychological.

Within the biological standpoint, there are changes in: cells, skin and appendages, bones, muscles, cardiovascular system, respiratory system, digestive system, genito-urinary system, endocrine system, immune system, in the sense organs and nervous system.

In this case I decided to focus on the integumentary system and explain the changes it undergoes.

CHANGES IN THE INTEGUMENTARY SYSTEM

The skin due to its large size, is the organ most susceptible to environmental damage, especially by exposure to sunlight. Due to this exposure to the sun, appears the liver spots.

Over time, skin gets thinner, drier, more transparent. Loses elasticity, wrinkles and has a yellowish color.

In the epidermis: keratinocytes lose their polarity. There is also a decrease in the number of melanocytes and no increased risk of dysplasia.

In the dermis: there is a loss of collagen that leads to wrinkles. There is also a loss of elastin, which produces an increase of glycosaminoglycans which lead to the formation of a pseudo elastin that is what gives yellowish color to the skin.

In the hypodermis: the amount of fatty tissue so it loses dense.

Hair follicles, eventually lose density and atrophy. Also pigment production lost due to the decreased number of melanocytes. Some women experience the growth of facial hair, particularly after menopause.

The nail growth decreases, turning these more opaque, hard and thick. This is due to an increase of keratin.



            ROSACEA                                                                          LIVER SPOTS

   

As the skin is more sensitive, is more exposed to the appearance of ulcers, inflammation and infection.

Finally, a video of the WHO, which I found very interesting because I totally agree with the message of healthy aging.

I think that aging is natural, that at one time or another will affect us, because time passes for everyone. We must also think that from birth we're older, that's what life. Born, grow and die.

There should be no rejection or stereotypes, and that aging does not make us different.

We will all grow old, but we will decide as. if we live a life saluble from the beginning ,our life expectancy should be greater.

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Bibliography:

1. Introducción al concepto de envejecimiento. Disponible en: http://www.ujaen.es

2.Algunos cambios asociados al envejecimiento. Disponible en:

 http://escuela.med.puc.cl/publ/manualgeriatria/PDF/CambioEnvejec.pdf

GERIATRIC NURSING

According to WHO,"nursing encompasses autonomous and collaborative care dispensed to people of all ages, families, groups and communities, sick or not, and in all circumstances. Includes health promotion, disease prevention and HIV care for sick, disabled and terminally ill people".

It is important to know the difference between geriatrics and gerontology.


Geriatrics: "The science that studies the aging process in general as well as biological changes, psychological and social changes that occur in old age."

Gerontology: "The branch of medicine that studies the acute and chronic diseases in older patients in its clinical, therapeutic, preventive and social".

Gerontological Nursing is a specialty that encompasses the assessment of the needs of the elderly, planning and management of care to meet their needs as well as the evaluation of the effectiveness of such care in achieving and maintaining a level wellness consistent with the constraints imposed by the aging process.

For some time, there has been an increase in life expectancy due to the reduction of mortality and birth rates.

All this leads to increased social problems, economic and health.

If this continues, the results could prove to be the following:

• Not all older people have the same degree of health, can be classified into:

	Healthy older person	Sick older person	Frail elderly	Geriatric patient
Concept	Advanced age and absence of disease.	Healthy elderly with an acute illness.	Old age and with several underlying conditions that are compensated. It is independent but has a high risk of being dependent.	Elderly with chronic diseases who become dependent. They often have mental and social problems.
Instrumental activities of daily living.	All independent	All independent	Dependent to some	Dependent to some
Basic activities of daily living.	All independent	All independent	All independent	Dependent to some
Illness behavior.	Low tendency to dependence	Low tendency to dependence	High tendency to dependence	Tendency to increased dependence
Probability of geriatric syndromes.	Low	Low	High	Very high

Bibliography:

1. Robles Raya MJ, Miralles Basseda R, Llorach Gaspar I, Cervera Alemany AM. Definición y objetivos de la especialidad de Geriatría. Tipología de anciano y población diana. En: Tratado de geriatría para residentes. Madrid: Sociedad Española de Geriatría y Gerontología (SEGG); p.21-32.http://www.imsersomayores.csic.es/documentos/documentos/segg-tratado-01.pdf

2. Organización mundial de la salud: Temas de salud: El envejecimiento:http://www.who.int 

3. Cortés Rubio JA, Méndez-Bonito gonzález E, Koutsourais Movilla R, Utrilla Moro J, Macias Rodríguez J, Casado Aguado MA, Rozas Barrera Z. ¿Cuál es la prevalencia de ancianos de alto riesgo en atención primaria?. Aten Primaria. 1996; vol.18 núm 6: 18:327-31. Disponible: http://www.elsevier.es/es/revistas/atencion-primaria-27/cual-es-prevalencia-ancianos-alto-riesgo-atencion-14365-originales-breves-1996

4. US National Library of Medicine National Institutes of Health: Pubmed: Factors associated with functional status in a population aged ≥75 years without total dependence: http://www.ncbi.nlm.nih.gov/pubmed/22342046

WELCOME! =)

Welcome to my blog!

This is a blog in which I will deal with issues related to elder care by nurses, this course having scientific evidence.

This is a blog focused on health personnel, but I think many things can also be of interest to anyone wanting to expand their knowledge.

I hope you will find interesting and serve.

Thanks in advance for reading.