Care for the

Elderly
 Emotional Changes
• Integrity vs. Despair
– Elderly who come to accept their
lives and have the sense of
fulfillment (Ego Integrity)
– Or others who contemplate their life
as unproductive and unfulfilling
(Despair)
Cognitive Changes
Short term memory loss
Long term memory loss
 Dementia - Alzheimer’s,
Parkinson’s
Hearing and vision impairment
Depression
Other common problems
 Goal of Care for Elderly
 Risk for Injury
• Explain to client about the
causes of rheumatic aches and pain
• Massage or relaxation techniques
• Avoid doing heavy activities
• Avoid foods contain nuts and beans
• Observe proper skin management
• Practice safety at all times
 Acute Pain
• Cold compress on the forehead,
back and neck massage
• Quiet, dim lights during sleep
• Medicines as prescribed
 Activity Intolerance due to weakness
• Leg exercises / ROM
• Massage
• Introduce one activity at a time
 Risk for infection
• Teach to minimize contact and pathogens
• Maintain hygiene at all times
• Increase fluid intake
• Nutrition and proper diet
• Vitamins and minerals
• Services provided to elderly
– Nutrition
– Socialization
– Personal care: for skin, oral,
genitalia, body
– Housekeeping in the home
observing safety and cleanliness
– Transport and mobility
COMMON ILLNESS AND DISEASE
 ALZHEIMER’S DISEASE
 Degenerative cerebral disease with
insidious onset, which is characterized by
a slow progressive decline in cognition
and ability to function.
 “women’s disease”
 Symptoms of AD
 Problems in performing familiar tasks
 Difficulty writing and speaking
 Loss of orientation to time and place
 Losing or misplacing items in the house
 Mood or behavioral changes
 Loss of interest in daily activities
 Poor judgement
 Struggle to find the right word or name
 Recent forgetfulness
 Management for AD
• Supportive and preventive
management
• 3 “R’s” (Repeat, Reassure, Redirect)
in a calm and friendly manner
• Medicines as prescribed
(ex: Aricept, Exelon, etc..)
 increase fluid intake to prevent dry
mouth
When communicating with them…
 Never argue, instead agree
 Never reason, instead divert
 Never shame, instead distract
 Never lecture, instead reassure
 Never say “remember”, instead reminisce
 Never say “I told you”, instead repeat
 Never say “You can’t”,
instead do what they can do
 Never command or demand, instead ask or model
 Never condensed, instead encourage/praise
 Never force, instead reinforce
 PARKINSON’S DISEASE
 affects the nerve cells in the brain that
produce dopamine. Parkinson’s disease
symptoms include muscle rigidity, tremors,
and changes in speech and gait.
 Parkinson’s disease affects the nerve cells
in the brain that produce dopamine
 treatment help relieve
s/sx but there is no cure
 Symptoms of PD
 Tremor or shaking
 Stiff muscles (rigidity) and aching
muscles. 
 Slow, limited movement
 Weakness of face and throat
muscles.
 Difficulty with walking and balance. 
 Freezing or stupor
 Changes in speech and gait
 Management for PD
• Supportive Management:
• Medicines: such as Levodopa and
dopamine agonists. It should be given on
full stomach and increase water intake to
prevent dry mouth. This is the most
common treatment for Parkinson's disease.
• Home treatment. Such as getting regular
exercise and eating a healthy diet.
• Speech Therapy
• Physical and Occupational Therapy
 Home Treatment for PD
• Modify your activities and your home. For example, simplify
your daily activities, and change the location of furniture so that
you can hold on to something as you move around the house.
• Eat healthy foods, including plenty of fruits, vegetables, grains,
cereals, legumes, poultry, fish, lean meats, and low-fat dairy
products.
• Exercise and do physical therapy
• Deal with tremor. This may include putting a little weight on
your hand to help reduce tremor and restore control.
• Improve speech quality by working with a speech therapist
(also called a speech-language pathologist).
• Reduce problems with eating and drooling by changing how
and what you eat.
• Deal with "freezing" by various means, such as stepping toward
a specific target on the ground.
 HYPERTENSION
• An increase in blood pressure (110/70)
• Increases the risk of any CVA diseases or
myocardial infarction (stroke)
• Predisposing factors
 smoking, drinking too much alcohol, drug use
 obesity or too much fats or sweets
 high sodium and high sugar in diet
sometimes hereditary
 Symptoms of HTN
• Severe headache (nape)
• Fatigue or confusion
• Blurred vision
• Chest pain
• Difficulty breathing
• Hot, red flushes in face
• Nose bleeding
• Irregular heartbeat, pulse
• Pounding beats in neck, chest
 Management of HTN
• Losing weight if you’re obese
• Quit smoking, limit alcohol
• Reducing the amount of sodium in your diet.
• Getting regular aerobic
• Eating a healthy diet, including the DASH diet
• Eat more fruits, vegetables, low-fat dairy foods
• Cut back on foods that are high in saturated fat,
cholesterol, and trans fats
• Eat more whole-grain foods, fish, poultry, nuts
• Limit sodium, sweets, sugary drinks, red meats
 DIABETES MELLITUS
• An increase in blood sugar over a
prolonged period of time
• Either may be hereditary or acquired
through lifestyle, sometimes gestational
• If left untreated, it may cause many
complications
Symptoms of DM
Management of DM
 Management of DM
Low Sugar diet
Monitor the blood sugar with the
GLUCOMETER
Proper exercise and diet
Quit smoking and drinking alocohol
Medication: need to take oral
medicines or insulin injections as per
doctor’s prescription.
Wound care if (+) for DM
 CEREBROVASCULAR
ACCIDENT (CVA)
• caused by a blocked blood vessel or
bleeding in the brain. (STROKE)
• Narrowing or ulceration in the major arteries
• Risk factors:
‒ Hypertension - Diabetes
‒ Smoking - Excess Alcohol
‒ Obesity - High Cholesterol
‒ Poor diet - Lack of exercise
‒ Stress and Depression
 Symptoms of CVA
• Sudden numbness, tingling, weakness,
or loss of movement in your face, arm, or
leg, especially on only one side of your
body.
• vision changes
• trouble speaking.
• confusion or understanding simple
statements.
• problems with walking or balance;
• Sudden loss of consciousness
• A sudden, severe headache that is
different from past headaches.
 Management for CVA
• Prevent any risk for injury or fall
• Reducing high blood pressure, by making
changes to your diet and taking medicines that
lower blood pressure.
• Taking aspirin or another antiplatelet medicine
to prevent strokes and other medicines
prescribed by doctor
• Controlling diabetes. Keep your blood sugar
levels in a target range.
• A healthy diet and plenty of exercise will also
help.
• Speech, Occupational and Physical therapy
 UNCONSCIOUS OR
COMATOSE PATIENTS
 Patient who are bed ridden and cannot
function normally without the aid of the
caregiver
 Patients who are usually under the
support of hospital machines in order to
prolong life and survival
 Patients who are brain dead but not
clinically dead
 MANAGEMENT FOR
COMATOSE PATIENTS
Supportive Management:
• Maintaining patent airway
• Elevating the head end of the bed to 30
degree prevents aspiration.
• Positioning the patient in lateral or semi
prone position.
• Chest physiotherapy
• Protect the client
• Padded side rails and Restrains.
• Take care to avoid any injury.
• Talk with the client in-between the procedures.
Speak positively to enhance the self esteem and
confidence of the patient.
• Maintaining fluid balance and
managing nutritional needs
• Assess the hydration status.
• Liquid diet via Naso-gastric tube.
• Maintaining skin integrity
• Regular changing in position
to prevent bed sores
• Passive exercises, Back massage.
• Use splints or foam boots to prevent foot drop.
• Special beds to prevent pressure on bony
prominences.
• Preventing urinary retention by palpating for a full
bladder. 
• Providing sensory stimulation by keeping the usual
day and night patterns for activity and sleep.
• Orient the client to the day, date, and time
accordingly. Touch and talk. Proper communication
with properly addressing patient’s name.
• Potential complications: such as Respiratory
distress, Pneumonia, Aspiration
• Prevent Pressure ulcer : red, ulcerated wounds on
the bony prominences, commonly known as
“BED SORES or DECUBITUS ULCERS”
 MANAGEMENT FOR
BED SORES
• Clean the affected skin; mild soap and warm water
• Protect the skin; keep dry with talcum powder or lotion
• Change beddings daily; maintain smooth beddings
• Inspect the skin daily.
• Manage incontinence to keep the skin dry. Prevent
exposing the skin to moisture and bacteria. Frequent
diaper changes, protective lotions on healthy skin
• Nutrition: High CHON, High calorie, High vitamins and
minerals. Take dietary supplements, such as vitamin
C and zinc.
• Drink enough to keep the skin hydrated.
OTHER COMPETENCIES AND
SKILLS FOR CAREGIVERS
• Heat and Cold Therapy
– Hot – Sitz Bath
• Ideal temp. of water: 105 – 110 deg.F or
40.5 – 43.3 deg.C
– Hot water bag
• Not more than 15-20 mins. on affected
area. Use towel to prevent skin burns
– Ice Cap
• Not more than 30 mins.
• Topical Applications
a) Skin application – use gloves, cotton
swabs to prevent cross contamination
b) Eye ointment – start from inner to
outer canthus when putting medications
c) Ear solutions – let the patient sit
straight with head bend sideways or
side laying position to expose the inner
ear
d) Vaginal and rectal suppositories
• Personal Hygiene Measures
a) Oral hygiene care
b) Care of the Hair or Bed Shampoo
c) Early Morning Care
d) Evening Care
e) Applying Anti-Embolism stocking
– be careful with the skin of the
elderly to prevent wound abrasion
One person caring
about another,
represents Life’s
greatest value….

Thank you very much…