Unit 16Psychological Effects of Aging: Unit 16 Psychological Effects of Aging Nurse Aide I Course


Psychological Effects Of Aging: Psychological Effects Of Aging This unit deals with the feelings, emotional stress and psychological adjustments that are part of the aging process. It explores the physical and psychosocial needs of residents, and teaches the skills that the nurse aide will need to develop to provide understanding and compassionate care.


Psychological Effects Of Aging(continued): Psychological Effects Of Aging (continued) Other topics covered include: age appropriate behavior, sexuality, reality orientation, dementia, Alzheimer’s disease, confusion and developmental disabilities.


Slide5: 16.0 Discuss ways to meet the resident’s basic human needs for life and mental well-being.


Physical Needs For Survival And Care To Be Given: Physical Needs For Survival And Care To Be Given Oxygen elevate head of bed assist to sit up in chair report to supervisor if resident is cyanotic or short of breath assist with breathing exercises


Physical Needs For Survival And Care To Be Given(continued): Physical Needs For Survival And Care To Be Given (continued) Food Feed residents unable to feed themselves


Physical Needs For Survival And Care To Be Given(continued): Physical Needs For Survival And Care To Be Given (continued) Food Serve food with proper temperature in friendly manner in pleasant environment in appropriate amounts Make sure dentures are in place


Physical Needs For Survival And Care To Be Given(continued): Physical Needs For Survival And Care To Be Given (continued) Water make available within resident’s reach provide fresh water at periodic intervals


Physical Needs For Survival And Care To Be Given(continued): Physical Needs For Survival And Care To Be Given (continued) Shelter provide for warmth with extra blankets be sure residents are dressed properly avoid drafts or drafty areas


Physical Needs For Survival And Care To Be Given(continued): Physical Needs For Survival And Care To Be Given (continued) Sleep Minimize noise and lights during hours of sleep Give back rub to relax resident


Physical Needs For Survival And Care To Be Given(continued): Physical Needs For Survival And Care To Be Given (continued) Sleep (continued) Report complaints of pain to supervisor Listen to concerns or worries the resident may wish to express Leave night light on in the resident’s room, if requested


Physical Needs For Survival And Care To Be Given(continued): Physical Needs For Survival And Care To Be Given (continued) Elimination Assist to bathroom as needed Provide bedpan and/or urinal Provide for privacy


Physical Needs For Survival And Care To Be Given(continued): Physical Needs For Survival And Care To Be Given (continued) Elimination (continued) Change soiled linen immediately Following routine for bowel and bladder retraining as directed


Physical Needs For Survival And Care To Be Given(continued): Physical Needs For Survival And Care To Be Given (continued) Activity ROM exercises as directed Turn and reposition at least every two hours


Physical Needs For Survival And Care To Be Given(continued): Physical Needs For Survival And Care To Be Given (continued) Activity Assist with activity as directed Encourage movement Encourage interesting recreational activities


Safety And Security Needs: Safety And Security Needs Provide for warmth Establish familiar surroundings explain procedures talk about “their” room keep your promises provide a safe environment promote use of personal belongings


Safety and Security Needs(continued) : Safety and Security Needs (continued) Maintain order and follow routines, assisting resident to participate in establishing routine as often as possible


Safety and Security Needs(continued) : Safety and Security Needs (continued) Assist to reduce fear and anxiety listen to resident’s worries and report to supervisor ease concerns when possible check on residents frequently Avoid rushing and assist resident in gentle manner


Love and Affection Needs : Love and Affection Needs Friendship Social Acceptance Closeness Meaningful relationships with others Love Sexuality


Love and Affection Needs(continued) : Love and Affection Needs (continued) Belonging Need met by family/support system Friends may meet this need


Love and Affection Needs (continued): Love and Affection Needs (continued) The nursing staff as family: take time to greet residents when you see them sit and visit for a few minutes when time allows show interest in residents


Love and Affection Needs (continued): Love and Affection Needs (continued) The nursing staff as family (continued): display human warmth with a gentle touch show acceptance of an individual for his or her unique qualities provide care in a kind, friendly, considerate manner


Self-Esteem Needs : Self-Esteem Needs Value, worth or opinion of oneself Seeing oneself as useful Being well thought of by others


Self-Esteem Needs (continued): Self-Esteem Needs (continued) Nurse aide’s responsibilities call resident by proper name praise accomplishments discuss current issues request resident’s opinion show respect and approval


Need for Self-Actualization (experiencing one’s potential) : Need for Self-Actualization (experiencing one’s potential) Cannot occur until all other needs are met A feeling that a person is what one wants to be Rarely is this need totally met


Need for Self-Actualization (experiencing one’s potential) (continued): Need for Self-Actualization (experiencing one’s potential) (continued) Ways to help residents to meet this need: assist to participate in meaningful activities assist to dress and help with grooming encourage independence encourage socialization


Need for Self-Actualization (experiencing one’s potential) (continued): Need for Self-Actualization (experiencing one’s potential) (continued) Ways to help residents to meet this need (continued): share goals with residents and praise their success or accomplishments know what resident has accomplished in his/her lifetime and talk about these things


Spiritual Needs: Spiritual Needs Residents have the right to worship and express their faith freely.


Spiritual Needs(continued): Spiritual Needs (continued) Guidelines for the nurse aide: respect resident’s beliefs respect resident’s religious objects inform residents of the time and place for religious services


Spiritual Needs(continued): Spiritual Needs (continued) Guidelines for the nurse aide (continued): assist resident to attend religious services provide privacy for members of the clergy and residents welcome members of the clergy


Slide33: 16.1 Identify eight defense mechanisms that could be used by a resident in response to stress.


Coping Mechanisms : Coping Mechanisms Established early in life as part of personality List of defense mechanisms (unconscious behaviors) Projection - blaming others Rationalization - false reason for situation


Coping Mechanisms (continued): Coping Mechanisms (continued) List of defense mechanisms (unconscious behaviors) (continued) Denial - pretending a problem doesn’t exist Compensation - making up for a situation in some other way


Coping Mechanisms(continued): Coping Mechanisms (continued) List of defense mechanisms (unconscious behaviors) (continued) Displacement - transferring feelings about one person to another person Daydreaming - escape from reality


Coping Mechanisms(continued): Coping Mechanisms (continued) List of defense mechanisms (unconscious behaviors) (continued) Identification - idolizing another and trying to copy him/her Sublimation - redirecting feelings to constructive activity


Slide39: 16.2 Recognize how age, illness and disability affect sexuality.


Sexuality: Sexuality Expressed by individuals of all ages A way to show feminine or masculine qualities Clothing styles and colors Hairstyles Hobbies and interests Sexual habits (continue into old age) Gestures


Sexuality(continued): Sexuality (continued) May be expressed by: Sexual intercourse Caressing, touching, holding hands Masturbation Is a right of all residents to experience


Guidelines For The Nurse Aide In Dealing With Resident Sexuality: Guidelines For The Nurse Aide In Dealing With Resident Sexuality Assist to maintain sexual identity by dressing residents in clothing appropriate for men or women Assist with personal hygiene


Guidelines For The Nurse Aide In Dealing With Resident Sexuality(continued): Guidelines For The Nurse Aide In Dealing With Resident Sexuality (continued) Assist to prepare for special activities by “dressing up” selecting attractive clothing fixing hair in a special way applying cosmetics wearing a special perfume or aftershave


Guidelines For The Nurse Aide In Dealing With Resident Sexuality(continued) : Guidelines For The Nurse Aide In Dealing With Resident Sexuality (continued) Help to develop a positive self-image Show acceptance and understanding for resident’s expression of love or sexuality provide privacy always knock prior to entering a room at any time assure privacy when requested


Guidelines For The Nurse Aide In Dealing With Resident Sexuality(continued) : Guidelines For The Nurse Aide In Dealing With Resident Sexuality (continued) Never expose the resident Accept the resident’s sexual relationships


Guidelines For The Nurse Aide In Dealing With Resident Sexuality(continued) : Guidelines For The Nurse Aide In Dealing With Resident Sexuality (continued) Provide protection for the non-consenting resident Be firm but gentle in your rejection of a resident’s sexual advances


Possible Effects Of Injury Or Illness On Sexuality: Possible Effects Of Injury Or Illness On Sexuality Disfiguring surgery may cause a person to feel: unattractive and ugly to others mutilated and deformed unworthy of love or affection


Possible Effects Of Injury Or Illness On Sexuality(continued): Possible Effects Of Injury Or Illness On Sexuality (continued) Chronic illness and certain medications can affect sexual functioning


Possible Effects Of Injury Or Illness On Sexuality(continued): Possible Effects Of Injury Or Illness On Sexuality (continued) Disorders that cause impotence diabetes mellitus spinal cord injuries multiple sclerosis alcoholism


Possible Effects Of Injury Or Illness On Sexuality(continued): Possible Effects Of Injury Or Illness On Sexuality (continued) Surgery can have both physical and/or psychological effects removal of prostate or testes amputation of a limb removal of uterus removal of ovaries removal of a breast colostomy ileostomy


Possible Effects Of Injury Or Illness On Sexuality(continued): Possible Effects Of Injury Or Illness On Sexuality (continued) Disorders affecting the ability to have sex: stroke nervous system disorders heart disease


Possible Effects Of Injury Or Illness On Sexuality(continued): Possible Effects Of Injury Or Illness On Sexuality (continued) Disorders affecting the ability to have sex: chronic obstructive pulmonary disease circulatory disorders arthritis or conditions affecting mobility/ flexibility


Slide54: 16.3 Identify developmental tasks associated with aging.


Developmental Tasks Of Aging: Developmental Tasks Of Aging Adjustment to: retirement reduced income death of friends death of spouse physical changes loss of independence


Developmental Tasks Of Aging(continued): Developmental Tasks Of Aging (continued) Creating new friendships and relationships Loss of vitality Integrating life experiences Preparation for death


Slide58: 16.4 Identify symptoms of depression and define the nurse aide’s role in caring for a depressed resident.


Depression: Depression Reasons for depression Loss of independence Death of spouse or friend Loss of job or home Decreased memory Terminal illness


Common Signs And Symptoms Of Depression: Common Signs And Symptoms Of Depression Change in sleep pattern Loss of appetite and weight loss Crying, withdrawal from activities, appearing sad


Nurse Aide’s Role In Caring For The Depressed Resident: Nurse Aide’s Role In Caring For The Depressed Resident Listen to feelings Encourage to reminisce Involve in activities Encourage friends and family to visit Report changes in eating, elimination or sleeping patterns


Nurse Aide’s Role In Caring For The Depressed Resident(continued): Nurse Aide’s Role In Caring For The Depressed Resident (continued) Avoid pitying the resident Help to focus on reality Monitor eating and drinking Promote self-esteem Report observations to supervisor


Slide64: 16.5 Identify the issues to be considered when elderly are unable to provide for their own needs in their own homes.


Issues Involving Care Of The Elderly: Issues Involving Care Of The Elderly Amount of care needed Cost Nutritional needs Relationship with family/support system Location of family/support system Medical care needs


Issues Involving Care Of The Elderly(continued): Issues Involving Care Of The Elderly (continued) The elderly person may experience: Living with a group of people Less independence Structured lifestyle Less privacy Difficulty adapting to change


Issues Involving Care Of The Elderly(continued): Issues Involving Care Of The Elderly (continued) Decision made by individual or family for long-term care may cause stress


Slide69: 16.6 Utilize the resident’s family or established support system as a source of emotional support.


Emotional Support for Residents: Emotional Support for Residents Family/support system meets needs for: Safety Security Love Belonging Esteem


Emotional Support for Residents(continued): Emotional Support for Residents (continued) Family/support system provides: Comfort Support Relief from loneliness Contact with familiar people and things Mental stimulation Reasons to live


Ways To Promote Family Involvement: Ways To Promote Family Involvement Include in care conferences Encourage to do some or all of personal grooming Provide outside picnic areas, playground equipment, gardens


Ways To Promote Family Involvement(continued): Ways To Promote Family Involvement (continued) Provide area for family/support system parties Invite families to scheduled activities Encourage to assist with feeding if appropriate


Ways To Promote Family Involvement(continued): Ways To Promote Family Involvement (continued) Encourage to bring special foods or beverages for resident if allowed Encourage time together


Responsibilities of the Nurse Aide when Dealing with Family/Support System Members: Responsibilities of the Nurse Aide when Dealing with Family/Support System Members Greet the family/support system Address family members by name Make family and friends feel welcome Provide for privacy Keep lines of communication open


Responsibilities of the Nurse Aide when Dealing with Family/Support System Members(continued): Responsibilities of the Nurse Aide when Dealing with Family/Support System Members (continued) Understand that family and friends will do or say things to try and please the resident Use tact in dealing with family complaints and requests that you cannot honor


Responsibilities of the Nurse Aide when Dealing with Family/Support System Members(continued): Responsibilities of the Nurse Aide when Dealing with Family/Support System Members (continued) Assist families to understand the facility and how it works Provide explanations for family questions or report to supervisor to assist the family with questions


Responsibilities of the Nurse Aide when Dealing with Family/Support System Members(continued): Responsibilities of the Nurse Aide when Dealing with Family/Support System Members (continued) Reassure family as they cope with resident’s actions, problems and concerns


Slide80: 16.7 Identify the symptoms displayed by residents with dementia.


Dementia (Group Of Symptoms): Dementia (Group Of Symptoms) Defined as a progressive loss of mental functioning


Dementia (Group Of Symptoms)(continued): Dementia (Group Of Symptoms) (continued) Two categories of dementia 1st Category: Primary No known cause Irreversible May be treated but not completely cured


Dementia (Group Of Symptoms)(continued): Dementia (Group Of Symptoms) (continued) Two categories of dementia 1st Category: Primary Examples of diseases causing dementia Alzheimer’s disease Parkinson’s disease Huntington’s Chorea (genetic)


Dementia (Group Of Symptoms)(continued): Dementia (Group Of Symptoms) (continued) Two categories of dementia 2nd Category: Secondary Usually has known cause Treatable Reversible to some degree


Dementia (Group Of Symptoms)(continued): Dementia (Group Of Symptoms) (continued) Two categories of dementia 2nd Category: Secondary Examples of secondary causes of dementia depression minor stroke thyroid dysfunction medication induced


Symptoms Of Dementia: Symptoms Of Dementia Confusion Inability to reason accurately Recent memory loss Detailed long-term memory Repetitious speech Self-centered behavior Agitation Disorientation Confabulation


Slide88: 16.8 Review the psychosocial characteristics and care needs of a person with Alzheimer’s disease.


Alzheimer’s Disease: Alzheimer’s Disease Defined as a progressive, 3-stage, incurable disease that involves changes in brain tissue Responsible for about half of the dementia seen Symptoms usually occur in people 50-69 years of age


Alzheimer’s Disease(continued): Alzheimer’s Disease (continued) Affects more women than men Always ends in death 3-15 years after symptoms begin


Alzheimer’s Disease: Signs And Symptoms: Alzheimer’s Disease: Signs And Symptoms Irreversible loss of memory Speech and writing difficulties Disorientation Difficulty walking loss of balance short steps spatial disorientation


Alzheimer’s Disease: Signs And Symptoms(continued): Alzheimer’s Disease: Signs And Symptoms (continued) Deterioration of mental functions Unable to make decisions Loss of ability to make judgments Changes in behavior restless angry depressed irritable


Alzheimer’s Disease: Signs And Symptoms(continued): Alzheimer’s Disease: Signs And Symptoms (continued) Possible seizures Coma and death


Alzheimer’s Disease: Considerations For Care: Alzheimer’s Disease: Considerations For Care Assist to be as active as possible Encourage in activities of daily living Orient to reality Protect from injury


Alzheimer’s Disease: Considerations For Care(continued): Alzheimer’s Disease: Considerations For Care (continued) Maintain calm, consistent environment Complete ADL at the same time each day Use reality orientation


Alzheimer’s Disease: Considerations For Care(continued): Alzheimer’s Disease: Considerations For Care (continued) Same caregivers assigned to resident Involve in simple, limited activities Follow routines Treat with patience and compassion


Alzheimer’s Disease: Considerations For Care(continued): Alzheimer’s Disease: Considerations For Care (continued) Support family Communicate with simple phrases Don’t pose questions or ask to make choices


Slide99: 16.9 Discuss disorders that cause confusion for residents.


Confusion: Confusion Symptom or side effect of many disorders Disorders causing confusion Stroke Arteriosclerosis Dementia Alzheimer’s Disease Huntington’s Chorea


Confusion(continued): Confusion (continued) Other Causes Drug reactions Depression Environmental changes Vision and/or hearing loss Dehydration Poor nutrition Decreased oxygen levels in blood Head injury


Confusion(continued): Confusion (continued) Condition can be permanent or temporary


Reality Orientation Used For Confusion: Reality Orientation Used For Confusion Includes: Facing resident and speaking clearly and slowly Greeting the resident by name with each interaction Identifying yourself with each interaction


Reality Orientation Used For Confusion(continued): Reality Orientation Used For Confusion (continued) Includes: Explaining care in simple terms prior to giving care Frequently orienting the resident to the day, month, date, and time Giving short, simple instructions


Reality Orientation Used For Confusion(continued): Reality Orientation Used For Confusion (continued) Includes: Encouraging residents to wear glasses or hearing aides Communicating with touch and clear and simple comments and questions


Reality Orientation Used For Confusion(continued): Reality Orientation Used For Confusion (continued) Includes: Encouraging use of radio, television, newspapers, and magazines Maintaining resident’s routine


Reality Orientation Used For Confusion(continued): Reality Orientation Used For Confusion (continued) Includes: Giving only one direction at a time Keeping the environment calm and relaxed


Reality Orientation Used For Confusion(continued): Reality Orientation Used For Confusion (continued) Includes: Providing clocks, calendars and bulletin boards to remind residents of time and activities Discussing current topics


Reality Orientation Used For Confusion(continued): Reality Orientation Used For Confusion (continued) Includes: Reminiscing Showing resident self-image in mirror Providing recreational activities which reinforce reality orientation


Reality Orientation Used For Confusion(continued): Reality Orientation Used For Confusion (continued) Includes: Dressing residents during the day and assisting them to stay on a day-night schedule


Slide112: 16.10 Identify basic skills the nurse aide will need to use when caring for residents with developmental disabilities.


Developmental Disabilities: Developmental Disabilities Diagnoses Mental retardation Cerebral palsy


Developmental Disabilities(continued): Developmental Disabilities (continued) Guidelines for Care Treat the individual with respect and dignity Encourage residents to: make personal choices do as much as possible for themselves


Developmental Disabilities(continued): Developmental Disabilities (continued) Guidelines for Care (continued) Encourage residents to: use age appropriate personal skills achieve their potential interact with others


Developmental Disabilities: Developmental Disabilities Guidelines for Care Do not: act as resident’s parent create dependency label or categorize residents Do provide privacy Do build resident’s self-esteem


Slide118: 16.11 Identify ways to assist residents with cognitive impairments.


Ways To Assist Stressed Residents: Ways To Assist Stressed Residents Listen to concerns Observe and report nonverbal messages Treat with dignity and respect Attempt to understand behavior


Ways To Assist Stressed Residents(continued): Ways To Assist Stressed Residents (continued) Be honest and trustworthy Never argue with residents Attempt to locate source of stress Support efforts to deal with stress


Ways To Assist Demanding Residents: Ways To Assist Demanding Residents Attempt to discover factors responsible for behavior Display a caring attitude Listen to verbal and nonverbal messages Give consistent care


Ways To Assist Demanding Residents(continued): Ways To Assist Demanding Residents (continued) Spend some time with the resident Agree to return to see the resident at a specific time and keep your promise


Ways To Assist Agitated Residents: Ways To Assist Agitated Residents Encourage to talk about fears Remind resident of past ability to cope with change Encourage to ask questions about concerns


Ways To Assist Agitated Residents(continued): Ways To Assist Agitated Residents (continued) Involve in activities that promote self-esteem Observe for safety and to prevent wandering away Assign small tasks Use reality orientation


Ways To Assist Residents Displaying Paranoid Thinking: Ways To Assist Residents Displaying Paranoid Thinking Reassure the resident that you will provide for his or her safety Realize behavior is based on fear Avoid agreeing or disagreeing with comments Provide calm environment Involve in reality activities


Ways To Assist Combative Residents: Ways To Assist Combative Residents Display a calm manner Avoid touching the resident Provide privacy for out-of-control residents Secure help if necessary


Ways To Assist Combative Residents(continued): Ways To Assist Combative Residents (continued) Do not ignore threats Protect yourself from harm Listen to verbal aggression without argument