Table of Contents1. Introduction .22. Healthy Physical Aging .2 33. Mental Aging 3 44. Maslows Hierarchy Of Needs 55. Activities Of Daily Living .6 76. Global and Nations Trends In Aging .7 97. Cultural Influences On Aging 108. Social Impact On Aging 11 139. Current Care Provisions 1410. Future Care Provisions 1511. Needs Of The Older Person . 15 1712. Preparation for Retirement ..1713. The Multidisciplinary Team 1814. The Role Of The Healthcare Assistant 1815. The Needs Of The Dying Person .19 2116. Personal Recommendation ..2117. Personal Reflection ..2118. References 221. IntroductionThis assignment will show my understanding of the topic. I will discuss the following to support my knowledge of the topic.Healthy physical agingMental agingMaslows needsActivities of daily livingGlobal trends in agingCultural Influences on agingSocial impact of agingCurrent care provisionsFuture care provisionsNeeds of the older personPreparation for retirementMultidisciplinary teamRole of the carerNeeds of a dying personThe information for this assignment has been sourced from the internet, class notes and my experience working in healthcare. I will finish with a conclusion and a personal reflection.2. Healthy Physical AgingAs we get older these are some of the changes happening in the body.Outside the BodyHairChange colour, Fine thinning and balding.EarsAs hearing deteriorates a hearing aid may be needed.SkinFlaky and dry, may bruise easily.EyesAs eyesight deteriorates glasses or contact lenses may be needed.HeightStart growing down, may stoop over and or get a hump.WeightMay start to lose weight, supplements may be used.Inside the BodyJointsJoints may stiffen which leads to not being able to move as quickly and not being able to move easily up and down stairs.LungsThere may be shortness of breath especially if the person is a smoker.Muscularly / MusclesAll muscles weaken, loss of energyElasticityCollagen loss, dry skinCirculatoryBlood can thicken (warfarin may be needed)RespiratoryShortness of breath, asthma may get worseDigestive systemSmaller appetite, dehydration can cause problems urinating, urgency issues are common3. Mental AgingAs the body gets older the mind also deteriorates for example: we might forget where we put something or to switch off the heating.It might be more difficult to learn new things as our mind is slowing down for example difficulty learning new technology (smartphone, TV or computers). LonelinessIf you were married and your partner dies after being together for a long time you may find yourself alone in your home with no family, friends or neighbours to visit. If mobility is poor or deteriorating if may be difficult to get out and this could lead other issues such as depression.Dementia Dementia is a term which describes a number of conditions that cause damage to brain cells.Those with dementia are still people and they still have stories and they still have character and they are all individuals and they are all unique and they just need to be interacted with on a human level. (www.alzheimers.net)Dementia is an umbrella term for a family of mental illness these include the following;Alzheimers disease: A build-up of protein in the brain which forms a plaque and stops the brain functioning normally.Vascular Dementia: The brain is hit by lots of little strokes with no chance of recovering.Mixed Dementia: Parkinsons like problems.Huntingtons Picks: This is a hereditary condition that is passed from a parent. A parent with Huntingtons has a one in three chance of passing this on to a child. Huntingtons disease strikes at a young age. It affects memory; balance etc. and ultimately the person will lose all body control.Korsakoffs syndrome: This condition is mostly commonly caused my alcohol misuse and poor diet which create a vitamin B1 deficiency. People with this condition experience loss of short term memory.Creutzfeldt Jakob disease or CJD: This is a rare degenerative and fatal disease caused by consumption of infected brain or nervous tissue.(Class notes and http://www.alzheimers.org.uk )Dementia Statistics for Ireland There are currently more than 40,000 people over 65 and 38,000 under 65 years old diagnosed with some form of dementia. This is expected to rise to 104,000 by 2036. Dementia affects 1 in 12 people over 65 and 1 in 5 over 85. It is the fourth largest cause of death in Ireland over 65%.The longer a person lives the more likely they are of getting Dementia. It is said between the ages of 65 70 years 8% of all people will have dementia of some form. From 75 84 years this increases to 20%with the figures increasing further to 30 47% of people aged 85 and over.(Class notes)4. Maslows Original Hierarchy of NeedsMaslows hierarchy of needs is a theory in psychology first developed in 1943. Maslow believed that a person must satisfy a lower basic need before progressing on to meet a higher level of growth. At the time the hierarchy of needs model comprised Five Needs. (Class notes).1. Biological or Physiological Needs. These are the primary needs of a client e.g. air, food, water, shelter, warmth, sleep.2. Security and Safety needs. The need to feel safe and secure e.g. home security, legal rights, financial security, employment security, healthcare.3. Social Needs. The need for love, affection, relationships, a sense of belonging, socialising e.g. being with family, loved ones, social or religious groups.4. Esteem Needs. The need for things that impact personal self-esteem, sense of worth, social recognition e.g. independence, status, social achievement, responsibility in life.5. Self-Actualisation. This needs is less concerned with the opinions of others and addresses the need for personal growth e.g. personal account of achievement, strong moral code (I know I am a good person), realising their own potential, keeping positive.5. Activities of Daily LivingActivities of daily living (ADLs) are basic self-care tasks developed by three nurses Roper, Logan and Tierney. The model promotes maximum independence and uses 12 activities to assess a clients condition. From this assessment a clear view of the clients needs can be noted from which a care plan can be established. A care plan is a legal document written by a qualified person e.g. a nurse and it outlines the care a person will need. (Class notes)The 12 areas of assessments are as follows:1. A Safe Environment: Locks on doors, alarms installed (smoke alarm, carbon monoxide alarm etc.), gas boiler maintained.2. Communication: Listening/hearing aid, can they speak and understand, can they read and write, how is body language particularly non-verbal.3. Breathing: Is an inhaler, nebuliser or oxygen tank needed?4. Eating and Drinking: Can they shop for themselves, can they cook (would meals on wheels help), Do they have difficulty feeding themselves or using cutlery, is assistance needed to eat, Is a specialised diet needed reduced portions, pureed food etc.5. Elimination: Can they use the toilet by themselves, is there any incontinence (would a pad help or is it more serious?), is there bowel control is a bag needed (stomach bag, colostomy bag, catheter tube etc.).6. Personal Dress: Is there any difficulty bathing, showering, shaving, brushing teeth, washing hair? Can they dress themselves?7. Controlling Body Temperature: Can they tell if they are hot or cold? It is important to take care when assessing as nerve damage might cause a delayed reaction hot and cold which could result in injury. Ensure windows are closed and extra layers are worn during cold weather.8. Mobilising: Can they walk independently or is a walking aid needed, is support/assistance needed to sit or stand or get up or down stairs.9. Working and Playing: Some people are introverts and some are extroverts but it is important that there is some level of social interaction as this will maintain self-esteem and a sense of worth. The level of social interaction can vary depending on the person (and there physical abilities) from meeting up with friends to volunteering.10. Expressing sexuality: Is there a partner or friend? Are they sexually active/interested in being sexually active?11. Sleeping: Is assistance needed to sleep comfortably e.g. has a doctor prescribed medication or an inhaler?12. Death and dying: Is the person spiritual or religious? Have they made a will, Have they discussed palliative care? Have they discussed their preferences for end of life care (resuscitation orders and who their decision maker/next of kin is)?6. Global Trends In AgingThe following are some statistics in relation to the global trends of the older population:In 2013 the average life expectancy at birth of the global population was 71 yearsThe healthy life expectancy (HALE) was 62 yearsThe global population could expect to live another 20 years on average(www.who.int)National Trends In AgingThe following are some of the statistics in relation to the aging population of Ireland:In 1990 in Ireland the life expectancy at birth of both sexes was 75 yearsBy 2013 this had increased to 81 years. From this we can see that people were living, on average, an extra 6 years.In 2000 the healthy life expectancy at birth for females was 70 years and for males it was 66 years. In 2013 this had increased to 73 years for females and 69 years for males. From this we can see that women stay healthier for longer and in the last 13 years both genders have increased their HALE by 3 years.(http://apps.who.int)We can contribute a number of factors to these statistics. Some of these are the following.Environment FactorsThere are a variety of environmental factors which will impact the older person in Ireland.Medical On average Ireland has good medical care compared to other countries and provides free medical care to the elderly.Government The Irish government provides a certain level of support for the elderly such as a state pension and a fuel allowanceHousing Most of the elderly in Ireland are living in a house, but some of these buildings are old and suffer from problems such as damp or poor insulation.Food Older people in Ireland have access to good, nutritious food whoever the cost of this may be a factor for them.Socio-cultural FactorsSocial factors such as smoking and drinking have a huge impact on aging.Smoking and Drinking The older generation would have started smoking at a very young age and would have smoked most of their life. In their younger days cigarettes would have been a lot cheaper than they are today and as they get older the price of cigarettes goes up. The older generation might not be able to afford them anymore. Alcohol would have been a lot cheaper also and not they find they cant afford to go out for a drink and socialise, or even to go to an off licence and they might have to give it up as their money wont stretch that far.Care In The Home Ireland as a nation would love to keep family members in their own homes. They might not be possible for a variety of reasons. If there is an upstairs they might not be able to climb the stairs. Their health might be deteriorating. Their other half might have passed on and they are afraid to stay on their own especially if they live in rural Ireland and are isolated. Their family might not be able to afford to keep them at home as they may need someone to stay with them at night or the house might be too big to keep warm for just one person.The following are three services which are unique in their own different ways, all providing different services for our elderly to give them resources or somewhere to go for advice on things such as health or money worries:Fit for LifeThey are specialists in helping older adults to live a full and independent life and to maintain the best possible quality of life. They provide extensive health based services to over 5,000 clients in nursing homes, day centres, hospitals, communities and to private individuals on a weekly basis. (http://fitforlife.ie/)Age ActionThey promote positive aging and better policies and services for older people. Every year Age Actions Care and Repair Programme helps thousands of older people by providing a visitation and DIY service. Their volunteers enable older people to continue living at home with dignity and independence. (http://www.ageaction.ie)AloneAlones befriending service provides companionship for isolated older people. Every older person who goes to them for help receives a direct service from them or are referred on to an organisation who can provide them with the support they require. (http://alone.ie/)Political and Financial FactorsIn my opinion the pension in Ireland for the elderly is not enough and once they have paid their groceries, bills etc. they do not have much left over for themselves.The following details some of the political and financial factors that affect the elderly.The state pension (contributory) is paid to people from the age of 66 years who have enough Irish social insurance contributions. It is not means tested and you may have other income. This pension is however taxable. As the social insurance conditions are very complex someone should apply for a contributory state pension if they have ever works and have any contributions/stamps paid at any time.Budget 2016: It was announced in the most recent budget that the weekly rate for people getting the state pension will increase by 3 per week. This change will take place from January 2016 and is subject to legislation.Aged 80 years increase: Anyone in receipt of an Irish social welfare pension will automatically get an increase in their pension when they reach 80 years of age.National Fuel Scheme: The elderly can avail of a fuel allowance. This is a means tested payment to help people who cannot afford their own heating costs. This increased by 2.50 per week in the most recent budget.Water Charges: This is a new tax with is being placed on the water usage in our homes.Household Benefits Package: this includes the electricity or natural gas allowance and a free TV licence. If you are aged 70 years or older you qualify for this regardless of your income or who you live with.Children Staying At Home: due to the recession along with high rental rates, there is an increasing number of adult children living with their parents. This often proves to be an additional cost or financial strain on older people.(www.citizensinformation.ie)7. Cultural Influencing on AgingAs a culture we in Ireland used to put our loved ones in a nursing home, provided we could find one we liked and it was not to far away and our loved ones were happy to be there (our loved ones used to make this decision for themselves).Also we put our loved ones in a nursing home if we could not look after them ourselves at home. Since the government brought in this new rule (fair deal scheme) if you loved ones goes into a home they have to sign over there house to them and when they pass everything goes to the government. Personally I think it is a disgrace as they have worked their whole lives to provide for their families and paid their own mortgage so they could pass there home on the a loved one. The circle of life (like a wheel) they looked after and cared for us now we must take our turn and look after them. Its like they are a burden to us and the government dont want that burden but they are forgetting that one day they will be old themselves. Our loved ones while they are still mentally fit are gifting these possessions to friends and family and insuring that it is legally documented. This is similar to a will but it is carried out while the person is still living. There is also a scheme called senior options, an older person that does not need a nursing home and would like to stay in their own home. The government will give them money and in return when they pass their home is sold and the government get back the money they gave that person while alive and a percentage from the house, the loved ones get the balance.It is also worth looking at other cultures views on how they treat their older people for exampleNative American nations each have their own traditions and attitudes towards aging and elderly care. But in many tribal communities elders are respected for their wisdom ad life experiences. Within Native American families it is common for elders to be expected to pass down there learnings to younger members of the family (source: university of Missouri, Kansas City, USA).Korean elders are highly respected. Young members of the family have a duty of care for the aging members of the family ad even outside the family unit Koreans are socialised to respect and show deference to older individuals as well as authority figures.Chinese children care for their parents in old age placing your parents in a retirement home will see you labelled as uncaring or a bad son. To abandon ones family is seen as dishonourable. However this tradition is starting to break down in China due to the countrys one child policy rising life expectancy and aging population nursing homes are beginning to become more socially acceptable option for elderly care.In India the elderly are often the most religious and charitable members of the family. Disrespecting the elders of the family or sending them to an old age home has a social stigma in India.(www.huffingtonpost.com)8. The Social Impact of AgingYou may look at the lives of your elderly loved ones and think that they havent a care in the world. Their education is complete. Their children are raised and they no longer must slave away at a job every week. At first glance it seems that the average senior citizen is free to pursue leisure interests and generally enjoy life unencumbered by former responsibilities and aggravations. While these things are true to a degree, it is important not to overlook or discount the many stresses a person faces when he or she begins to age.Major Life ChangesAs your loved one grows older the familiarity that he or she has come to rely upon in life will gradually or sometimes very abruptly transition. Major changes can be scary and may lead to feelings of insecurity and or loss of self-worth, for example while you may think your retired mother is the luckiest person in the world because she has not longer to get up early to drive to work much of Mums identity may have been wrapped up in her work and she may no longer feel needed or valuable.Likewise your may envy the fact that your father gets to play with his grandchildren all day and relaxes with a book in the evening while you are at home organise bedtime and set up for the next day, but he might miss being a person that his children rely upon for his care and support.Elderly individuals must accept that their role in life will change as there former lifestyles are replaced by new routines and relationships.Fear of the FutureAs a person ages they inevitability of death becomes more real and can often be a source of uncertainty and dread. But many seniors also struggle with anxieties linked to pre-mortality concerns such as;Will my life lose its meaning if I am no longer useful?How will I be able to care for myself?Will I lose my mental faculties?If my physical health deteriorates will I have to give up the activities I enjoy?Can I cope with losing my loved ones?These are questions with no definite answers and wondering what the future may hold can be can be a great source of anxiety for your senior loved one.Memory and LearningIt is a widespread belief that as the brain grows older a persons capacity for reasoning begins to decline; there is very little truth in this. A senior citizens intellectual capacity remains the same will into old age and as little as 1% of the population will live long enough to be affected by senility. (http://www.seniorhomes.com)While the elderly are just as intelligent as younger people the sometimes process information more slowly or must repeat a new skill several times before the step becomes second nature. Anybody who has received emails from an elderly relative is well aware that the saying cant teach an old dog new tricks is completely untrue!If you feel that your loved ones forgetfulness is interfering significantly with his or her ability to function you should research the signs of early onset dementia. Also be aware that certain reversible conditions affect the memories of people who are both young and old, some of these may be;Lack of sleepside effects of medicationdepression or apathy for lifeHigh stressTreatable conditions such as thyroid problems, a vitamin B12 deficiency, a UTI.Loss of IndependenceAs elderly people become less physically able to engage in favourite hobbies, drive themselves to appointments or take care of things around the house they often mourn the loss of their independence. At times it is difficult to rely on others for essential care or even to ask for small favours particularly if it is from people that once relied on them for daily assistance (e.g. a now adult child or spouse). Some seniors find themselves losing their freedom as they become caregivers for spouses, siblings or other elderly friends whose health has declined more rapidly than their own.Grief and LossSome seniors must face the fact that the longer he/she lives the more friends and family members will pass away ahead of them. Losing the people they care about can leave seniors feeling abandoned, vulnerable and scared.Ageism and Discrimination Ageism is defined as discrimination based on an individuals age. Although there were more people above 65 years counted in the 2010 census that in any previous census ever conducted our seniors still struggle with stigmas placed on them by a youth orientated society. (www.seniorhomes.com/) Sadly, older people are commonly perceived as unsuitable employees, part of a demographic that is not worth advertising too because they are already set in there ways. This neglect by the workplace and the media leads to widespread misconceptions about the lifestyles and usefulness of our elderly citizens.Helping your Loved Ones CopeThe best thing you can do to help your senior loved one live a worry free life is to listen to them and to be vigilant about detecting any problems that he or she may not feel comfortable sharing. Be sensitive to your loved ones feelings and fears, initiate conversations about the concerns of later life. Socialising and relationships are very important to a humans wellbeing. If you notice your elderly loved one withdrawing from social activities encourage them to join a senior centre, attend church or participate in any event that may be of interest. Transportation is often a problem for seniors who no longer drive their own vehicle but you can help your loved one by arranging for public or private transport assistance. You can help your loved one cope with memory loss by using these helpful tipsStay mentally activeSocialise regularlyGet organisedFocusEat a healthy dietDo physical activities dailyManage chronic illnessesRemind your loved one that the aging brain is as capable as anybody elses when it comes to creativity and learning new skills. The alliance for aging research suggests these 10 ways to keep the brain young:Playing games that challenge your mind.Explore new hobbies or craft possibilitiesTake a class or courseWrite your autobiography or create a family history scrapbookWork as a volunteer in a non-profit organisationConsider starting a new part time careerVisit a new placeOrganise an activity for a group of friends or family membersWrite letters to your loved onesKeep a dream journal(http://www.agingresearch.org)Combat the negative effects of ageism by researching and discussing this troubling social problem with your loved one. Make sure that he or she does not buy into the stereotypical images. Be prepared to act as an advocate for your loved one if his or her life if ever directly influenced by ageism with the benefit of your concern, live and dedication your elderly friend or relative will be better able to face the challenge of growing older and to enjoy a healthy thriving late adulthood.(www.seniorhomes.com)9. Current Care ProvisionsThere are 3 different types of care in Ireland.1. Primary Care GP, Family Planning, chiropodist, dentist2. Secondary Care X-ray department, haematology, accident and emergency3. Tertiary Care Diagnostic care services provided by hospitals eg. Coronary care dept.The Health Service Executive (HSE) is Irelands state healthcare service provider. The HSE provide public health and social care services to everyone living in Ireland.The current minister in charge of the Department of Health is Leo Varadkar. The goal of the department of Health is to assist the people of Ireland live better for longer by providing the care and treatment they need with the compassion, respect and dignity they deserve.The Health Information Quality Authority (HIQA) is an independent authority established in May 2007 to drive continuous improvement in Ireland health and social care services. (www.hiqa.ie). HIQA is an independent body who govern themselves. They set standards and policies for residential healthcare ie. Nursing homes, hospitals, days centres etc. They then communicate those standards, and give recommendations or a list of requirements. Their first inspection of a premises will be announces, however after that they do not have to tell you when they will be coming.Reporting directly to the Minister for Health and the Minister for Children and Youth Affairs their role is to promote quality and safety in the provision of health and personal social services for the benefit of the health and welfare of the public The Authority has four core activities or functions aimed at achieving these outcomesRegulationSupporting ImprovementAssessing Health Technologies (HTA)Improving outcome through information(www.hiqa.ie)10. Future Care ProvisionsIn the future we will need more nurses and carers so that we will be able to give the care that is needed to our elderly and sick. At the moment we only treat the physical needs of a person and then move on to the next patient. But we need to care for the whole person and to see them as a whole person not just a patient or a diagnosis. Holistic nursing care involves healing the mind, body and soul of our patients. It involves thinking about and assisting patients with the effects of illness of the body, mind, emotions, spiritually, religion and personal relationships. Holistic care also involves taking into consideration social and cultural differences and preferences. As every person is their own individual the care of each patient should be individualised. We need to be on a one to one with our patients or clients and give them the care and attention they need. 11. Needs Of The Older PersonWe have already discussed the ADLs and how these are used to identify the needs of the older person e.g.:Eating Adaptive cutleryMobility handrails, walkersElimination catheter, padsWorking and Playing coffee mornings, community events.However, as people age more specific needs may occur as the result of a particular illness. One of the most common illness for an older person to develop is Alzheimers.What Is Alzheimers?Alzheimers is a type of dementia that causes problems with memory, thinking and behaviour. Symptoms usually develop slowly and progress over time, becoming severe enough to interfere with daily tasks.Alzheimers is the most common form of dementia and accounts for 60 to 80% of all dementia cases.Alzheimers is not a normal part of aging, although the greatest known risk factor is age and the majority of people with it are aged 65 and older. However up to 5% of people with the disease have early on-set Alzheimers and develop it in their 40s or 50s.Alzheimers is a progressive disease and the symptoms gradually worsen over a number of years. In its early stages the memory loss is mild but during late stage individuals lose their ability for carry on a conversation or to respond to their environment.It is the sixth leading cause of death in the USAThose affects by it live on average 8 years after their symptoms become noticeable to others, but survival can range from 4 to 30 years depending on their age and health conditions.There is no current cure but treatments for symptoms are available and research is ongoing. Current treatments do not stop the disease from progressing but they can temporarily slow the progression of symptoms and improve quality of life. 90% of what we know about this disease has been discovered in the last 15 years.(Class notes and www.alz.org)What Are the Symptoms of Alzheimers?The most common early symptoms of Alzheimers is difficulty remembering newly learned information. Memory loss and confusion are signs that the brain cells may be failing.DisorientationMood and behavioural changesDeepening confusion about events, time, and place.Unfounded suspicions about family, friends and caregivers.Later stage symptoms include difficulty speaking, swallowing and walking.People with memory loss or other possible signs may find it hard to recognise that they have a problem. It may be more apparent to family members of friends. Anyone experiencing dementia-like symptoms should see a doctor as soon as possible.(http://www.alz.org)Care Requirements of Someone with AlzheimersThe care needs for a client who has Alzheimers, in relation to their ADLs, are as follows:Mobility they may need a walker, stick or wheelchair. They need to be familiar with the route they are taking or else they may get lost.Eating they may need adapted cutlery, a cup with handles, or may need to be shown how to eat. Pictures can be put on press doors and cutlery drawer to show contents so they can find them. Unfortunately in the late stages a sufferer can forget how to eat and swallow and may pass away from this.Working and playing they need stimulation. Tasks that exercise the muscles and bones. Tap into previously developed and learnt skills. Ensure they had a sense of identity and that games etc. are age appropriate (for the age they feel they are).A person who has Alzheimers may have great muscle memory, for example, they could sit down at a piano and play a whole song, knit, crotchet, sewing/dress making, shuffling cards, gardening etc.Emotional Needs these can include the need for love and affection, a sense of security, freedom from fear or loneliness. Often the client will remember their long term partners name but not that of their grandchildren and they may not even recognise them.Carers Duties a carers role is to try and help their client to the best of their ability in any way they can. They can put the memory pictures in place, accompanying them to the shops and also keep them stimulated in both body and mind.12. Preparation for RetirementIdeally there should be a plan for retirement. This will assist with the transition from full time work to a meaningful retirement. Everyone has some idea of how they would like to spend their retirement it may help to write out your plan this should help to explore options and see what is affordable and possible.Some possible thing to include on a retirement planCourses: Lifelong learning is the process of keeping your mind and body engaged at any age by actively pursuing knowledge and experience through hobbies, evening courses.Joining a dating website.Passport for leisure for the over 65s: This offers a wide range of activities including, cultural events, sports, gyms, shopping, arts and crafts, music, theatre and cinema, travel, golf, swimming, dining out and many more. (http://www.passportforleisure.ie/)Travel: using the free seniors travels pass local day trips and traveling around Ireland a
Recent Comments