Module 8 - Quality of Life for Older People

Question 1

The World Health Organization (WHO) defines health as:

Answer 1

“A state of complete physical, mental, and social well-being not merely the absence of disease . . .”.

Question 2

The WHO describes the following facets that contribute to a older person’s quality of life:

Answer 2

Older- specific facets: -Sensory abilities -Autonomy -Past, present and future activites -Participation -Death and Dying -Intimacy

Question 3

What does BRAVE stand for when assessing spiritual needs?

Answer 3

Build trust; be prepared to spend time talking about things meaningful to the person and engaging them with effective communication strategies Respect, respond and react appropriately to spiritual and religious needs of the person Actively listen to the person; Ask appropriate questions to deepen understanding and determine how you can meet their needs Value and validate the individuality of the person. Ensure privacy, time and the environment are facilitating the person’s needs Empower and encourage the person to be involved in their care planning, evaluating the effectiveness of the plan

Question 4

What is palliative care?

Answer 4

Palliative care is person and family-centred care provided for a person with an active, progressive, advanced disease, who has little or no prospect of cure and who is expected to die, and for whom the primary goal is to optimise the quality of life.

Question 5

What services does pallative care include?

Answer 5

Relief of pain and other symptoms e.g. vomiting, shortness of breath Resources such as equipment needed to aid care at home Assistance for families to come together to talk about sensitive issues Links to other services such as home help and financial support Support for people to meet cultural obligations Support for emotional, social and spiritual concerns Counselling and grief support Referrals to respite care services

Question 6

What are the 3 steps to relieving pain?

Answer 6

•Sharing information. •Choosing the right medicines. •Using medicines appropriately.

Question 7

Does everyone with a terminal illness experience pain?

Answer 7

NO

Question 8

What are some side effect of opioid medications?

Answer 8

Constipation Nausea and vomiting Drowsiness and confusion Dry Mouth Itchy Skin

Question 9

What is grief?

Answer 9

Grief is how we respond when we experience loss. Grief is a normal, natural and inevitable response to loss and it can affect every part of our lives.

Question 10

What happens to my Facebook page when I die?

Answer 10

Facebook has a option where your page can become ‘memorialised’. This means that privacy settings remain the same and friends can still post on the page and tag the deceased person in photos. Once a page is memorialised, it can no longer be changed back to a regular Facebook account. The page cannot be accessed by anyone, including family (unless you appoint a legacy contact).

Question 11

What is Deadsocial?

Answer 11

DeadSocial, for example, is a website that controls your accounts and can even make posts for you or send emails from your accounts after your death. They help you “Prepare for a digital Death and build your Digital Legacy”. DeadSocial is “the free social media tool that allows us to create scheduled messages. These are only distributed across our social networks after we die. This allows us all to say our final goodbyes on our own terms and for us to extend our digital legacy using the social web.”

Question 12

What is pain?

Answer 12

Pain is unpleasant sensation, suffering or distress of the body or mind. Pain hurts and it wears you down. lt can make it hard for you to be active and make you feel tired and tense. Pain often accompanies cancer and other progressive diseases and it can affect all aspects of your life- psychological, emotional and spiritual.

Question 13

What changes will you notice when someone is close to dying?

Answer 13

Appetite & Thirst may decrease. No desire to eat or drink. Sleep & Alertness - The person can spend a lot of time sleeping, be drowsy and difficult to wake. Temperature - May be hot or cold. Incontinence - Urine may become stronger and darker. Some people do not lose continence. Secretions - saliva and mucus may collect in the back of the throat causing gurgling, bubbling or other noises. Breathing patterns may change. Restlessness.

Question 14

What influences a persons pain?

Answer 14

Expectations Culture Mood Social Support Environment Fear Past medical history.

Question 15

What pain scale is used to measure pain of people living with dementia?

Answer 15

Abbey Pain Scale

Question 16

The Abbey Pain Scale measures what behaviors and physiological changes?

Answer 16

Vocalisation eg, whimpering, groaning, crying Facial expression, e.g. looking tense, frowning, grimacing Change in body language, e.g. fidgeting, rocking, guarding part of body, with­drawn Behavioural change, e.g. increased con­fusion, refusing to eat, alteration in usual patterns Physiological change, e.g. temperature, pulse or blood pressure outside normal limits, perspiring, flushing or pallor Physical change, e.g. skin tears, pressure areas, arthritis, contractures, previous injuries.

Question 17

The Senses. What happens to sight when we age?

Answer 17

The pupil becomes less responsive to changes in light. Difficult to see in the dark. The lens of the eye thickens and yellows over time. Loss is visual acuity.

Question 18

What eye disease are we more susceptible to when we are older?

Answer 18

Cataracts, Diabetic retinopathy, Glaucoma Macular degeneration

Question 19

The Senses. What happens to our sense of smell when we age?

Answer 19

Ability to detect and identify smells diminishes. This is as a result of the atrophy of the olfactory bulb (responsible for smell perception) at the base of the brain.

Question 20

The Senses. What happens to hearing when we age?

Answer 20

There is gradual hearing loss (presbycusis). The eardrum thickens and there is changes to structure and nerves in the inner ear.

Question 21

The Senses. What happens to our sense of touch when we get older?

Answer 21

As we age, our sense of touch can decline as a result of the changes in the integumentary system (skin) and reduced blood circulation, nerve conduction and neuron changes. We can become less sensitive to temperature, pain and touch.

Question 22

The Senses. Taste: What happens when we get older?

Answer 22

The intensity of taste and the ability to identify different tastes can diminish. There is a decrease in the number of taste buds on the tongue.

Question 23

Older adults tend to maintain the ability to taste what type of foods?

Answer 23

Sweet.

Question 24

Older adults have difficulty tasting what type of foods?

Answer 24

Sour Salty Bitter

Question 25

How can nurses promote health and maintain the function of the Sensory System?

Answer 25

Encouragement to reduce or quit smoking Review medications (some medications produce metallic tastes in the mouth or can decrease sense of smell) Screen regularly for hearing loss and visual acuity Encouragement to wear sensory aids to facilitate communication (some people associate a stigma with wearing glasses or hearing aids)

Question 26

What is the term that describes “a progressive loss of hearing”?

Answer 26

Presbycusis

Question 27

What are some barriers that nurse face when discussing sexuality with older adults?

Answer 27

Lack of confidence is broaching the subject Limited understanding and communication skills Interruptions Limited ability to have a private conversation. Negative attitudes Sexual health not seen as a priority Assumptions that older people are asexual. Assumption that older people are not at risk of STIs.

Question 28

What tool can residential aged care facilities use to assess sexuality of its residents?

Answer 28

SEXUALITY ASSESSMENT TOOL (SexAT) This tool has been developed to help residential aged care facilities support the expression of sexuality of residents, both with and without dementia.

Question 29

The Genitals & Physiological Changes Associated with Ageing. How does sexuality change for males when they are older?

Answer 29

• Production of testosterone and sperm remain constant. - Erections may not be as firm - Ejaculation may take longer. - Libido may reduce but will not disappear.

Question 30

The Genitals & Physiological Changes Associated with Ageing How does sexuality change for females when they are older?

Answer 30

• Diminished secretion of ovarian hormones. - Ovaries and uterus shrink in size. - Breast tissues atrophies - Lubrication of the vagina decreases. - Clitoris is not as protected.

Question 31

What are some difficulties experienced by older people which can limit sexual function?

Answer 31

Erectile dysfunction (and sometimes there is an associated belief that condoms worsen the problem) Vaginal dryness following menopause, which can cause painful intercourse. Prostate enlargement Comorbidities, such as bladder weakness and pain which may limit sexual activity. Psychological concerns; embarrassment about ageing body, difficulty initiating sex, stigma/taboo associated with sexuality and older people.

Question 32

How can nurses promote the health and maintaining the function of the Genital System?

Answer 32

Use of lubricating gels for intercourse for women Creating a safe space to facilitate a conversation with an older person about sex and expression of sexuality Don’t assume all older people are heterosexual If an older person expresses they have a loss of libido, this is something that should be taken as seriously as it is in younger people.

Question 33

What apps are most popular with people over 75?

Answer 33

Weather Apps

Question 34

What is the most popular app for people between 50-64?

Answer 34

Facebook

Question 35

What app is most popular with adults around 65-74 years?

Answer 35

Google.

Question 36

_______________ is widely embraced by Australia’s 50+ population. It is significantly improving their lives.

Answer 36

Technology

Question 37

A decrease in the sense of taste leads to:

Answer 37

Reduced enjoyment of food. Reduced nutritional intake. Saliva production is decreased which leads to dry mouth, ore soreness and choking.

Question 38

What is xerostomia?

Answer 38

Dry mouth.

Question 39

What is dysphagia?

Answer 39

Difficulty swallowing

Question 40

What validated tool would you use to assess nutrition in older people?

Answer 40

Mini Nutritional Assessment (MNA)

Question 41

Who would you refer an older person to in regards to nutrition and hydration?

Answer 41

Dietitian - They can recommend targeted food and develop a meal plan. Speech pathologist - They can help with swallowing difficulties.

Question 42

What can nurses do to promote nutrition and hydration?

Answer 42

Record food and fluid intake Be aware of the dietary preferences of the older person (vegetarian, vegan, gluten free, halal, etc) Ensure access to preferred food and fluids Expose persons to smells of food cooking to stimulate appetite. Education and promote the oral health and cleanliness of the mouth

Question 43

What are the factors affecting sleep in a healthcare setting?

Answer 43

Worry and stress over current condition, potential diagnosis or upcoming procedure Pain (sleep and pain are interrelated and can have a huge effect on each other) Noise from surrounding environment (call bells, other people receiving care, intravenous pumps, staff members) Medication administration (may be given medications when asleep and is disturbed) Regular taking of vital observations (monitoring a person’s vital signs every four hours will keep them regularly disturbed overnight) Lighting; fluorescent lighting in hospitals can be irritating, lights may not be turned off at times of rest

Question 44

What is sleep hygiene?

Answer 44

Good sleep habits.

Question 45

What are types of good sleep habits?

Answer 45

1. Go to bed at the same time each day 2. Sleep when sleepy. 3.Get up & Try again. If you haven’t fallen asleep in 20 minutes. Get up and do something boring and calming. 4. Avoid caffeine & nicotine. 5. Avoid alcohol. 6. Bed is only for sleeping and sex. 7.No naps 8. Exercise. 9. Eat right.

Question 46

What can nurses do to promote sleep?

Answer 46

Ensure comfort of the person; check temperature, lighting and noise levels Encouraging physical activity during the day can promote sleep at night Education about appropriate sleep hygiene practices