IMMOBILITY

The immobility is a disease that affects many elderly, and is based on the fear of joint pain. In my view, this fear is what makes that person stops moving, the pain really begins as something unbearable and typical of the years, but the person who fears thinks will suffer more and it may trigger that pain again. Thus gradually deterioration eventually ends up preventing everyday movements because as the person remains without any active muscles will atrophy.

The immobility is a disease that not only results in immobility, but also brings a number of other associated problems such as fear of social rejection, and even problems with constipation, intestinal pain, lack of sleep, chronic pain reflexes ... For this reason is important as nurse, prevent immobility is part of the life of the elderly, and for that the best solution is the motivation for physical activity.

There are several reasons involved in the loss of mobility in the elderly including: decreased motor function and the progression of chronic diseases. Especially after 70 years or after long convalescence acute illness in hospital. From 65 to 18% of older people have a reduced mobility. At 75 to 50% of older people need help to leave home.

The comprehensive assessment of the elderly is the basis of a nursing care in immobility for a successful recovery:

1. Comprehensive assessment of the elderly: personal, disease, assessment of the senses, functional status assessment, charting the activities of daily living that is able to play, for it will be used geriatric assessment scales such as the Katz index or the Barthel

2. Process specific tests of immobility about what triggers the causes and symptoms, time taken in this situation, process and impact of immobility in the quality of life.

3. Rating medication.

4. Rating of psychosocial aspects: depression, social isolation, lack of affection, loss of self-esteem.

5. Physical Assessment of the environment: architectural barriers, access to housing (entry stairs, use of braces), access to the rooms (doors, remoteness of bathrooms and kitchen), security (floor mats, cables, free space, furniture, light) , measures of chairs, bed and toilet.

Finally, I would add that the main goal of nursing care is to restore the old baseline as before the process of immobility. Care plans established should be individualized and include the patient, family and / or caregivers. I emphasize that physical exercise is the best activity to prevent immobility

Bibliography.

• Cornachione, M. Síndrome de inmovilidad. En: Libro Guía para el cuidado del  anciano con problemas. 2006.

• Millan, J. Inmovilidad, inestabilidad y caídas. En: Geriatria y gerontología. 2010

NURSING APPROACH FOR PRESSURE ULCERS.

We talked about pressure ulcer when referring to an area of ​​skin damage and underlying tissue and bony lining have been subjected to prolonged pressure on a plane. They occur mainly in patients with sensory disturbances or debilitated, emaciated, paralyzed or bedridden for a long time. Among the risk factors are immobility, nutritional deficiencies, circulatory disorders, urinary incontinence ... not to mention that the appearance is favoured by age.

In my opinion, the present and future of the ulcers are in the hands of nursing since no other professional has the capacity and experience of approach. The nurse holds a dominant position on the issue of pressure ulcers. But for proper treatment in the care of ulcers and wounds is necessary to consider the theoretical and practical scientific knowledge of the case to try appropriate action in the treatment of ulcers and wounds involves knowing well what we have in hand.

Among the objectives of the nurse are:

• Identify the individual at risk of developing pressure ulcers.

• Identify if the person or the primary caregiver is shown capable of skincare or pressure injury.

• Maintain the health of the skin, eliminating or decreasing the pressure and monitoring the nutritional status of the patient.

• Characterize by a unified parameter evolution of the lesion.

Finally returning skin its physical integrity.

To achieve these goals, the nurse must perform the following procedures: assessment of pressure ulcer risk, assessment of care environment, prevention of pressure ulcer assessment of the injury, treatment of pressure ulcers. The procedure cures always be reasoned, and the contrast is enriching dialogue with the experience and knowledge of other nursing professionals.

In my view, appropriate nursing care are not only based on the rationale and individualized proceed to heal, but also in the care of family involvement (with nurse supervision), nutrition and skin care and monitoring and evaluating continuity and care.

In closing, I would like to stress that the treating a pressure ulcer is much more difficult that prevent it, therefore, for a nurse, the prevention is the highest priority.

Bibliography.

- Guía de prevención y tratamiento. Cuidados de enfermería al paciente con úlceras por presión. [Web en Internet] .Dirección de Enfermería HUPM. Octubre 2003.Servicio Andaluz de Salud. Disponible en:

http://www.saludmultimedia.net/guests/gneaupp_files/guia_cadiz.

pdf

- Úlceras y heridas crónicas. Rev ROL. Enf Volumen 28 Nº 1. Enero 2005.

 - Manual de prevención y cuidados locales de úlceras por presión. [Web en

Internet]. Servicio Cántabro de Salud. 1ª edición. Marzo 2005.

Disponible en:

http://www.saludmultimedia.net/guests/gneaupp_files/cantabria.pdf

DEPRESSION IN THE ELDERLY

Depression is one of the most common geriatric syndromes among elderly, causing considerable disability and mortality. Depressive disorders are a major social and public health problem because it alters the quality of life of the sufferer and their environment. Also is a problem because it increases with age among other factors due to the progressive aging of the population.

Particularly depression and mood disorders in general, have a high prevalence and associated high morbidity. The prevalence varies by population group in which we study (elderly in community homes or in hospitals) and according to the diagnostic instrument used (with interview or scales).

In my view, depression in the elderly, although is underdiagnosed and undertreated, often not given enough relevance disease, having predominant physical or cognitive symptoms like any other disease.

The nursing intervention in this disease is vital, it must act on their diagnosis and assessing their improvement helping to decrease medical diagnosis of depression.

Bibliography.

Balmón Cruz Carmen, Dorado Primo Juan Alejandro. Detección y prevalencia de trastornos depresivos geriátricos en atención primaria. Rev. Asoc. Esp. Neuropsiq. [revista en la Internet]. 2004 Jun. Available in:

http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0211573520

04000200002&lng=es

Gorete Reis Mª, Gonçalves Silva Cláudia Mª, Longino Fernandes Toni. Depresión (humor deprimido) en los mayores residentes en la comunidad. Gerokomos [revista en la Internet]. 2009 Sep [citado 2012 Mar 30]. Available in:

http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1134928X20

09000300005&lng=es.

PROCESS OF CARE IN GERIATRIC AND GERONTOLOGICAL NURSING

Adapting to aging is not easy for adults older and requires professionals involved in their care characterized by a very special vocation and love to work with this group, resulting in an attitude values ​​as: respect for others, autonomy and compassion to provide care humanized the elderly and that extends to its direct group of caregivers.

 

Geriatric nursing professionals is responsible for the promotion, maintenance and restoration of health, prevention of illness or injury, and implementation of activities under diagnosis and treatment.

The elderly need a cash interdisciplinary care, which includes not only recovery but also, and most prominently, the promoting their health, individual and family growth, to achieve autonomy. It is at this general context in which the nurse must submit your complementing specific contribution to the science of healing.

Finally, I can note that among the most important objectives of geriatric nurse is the care and provide a comprehensive care based on the needs of the patient, disease prevention, and if necessary, help in the process of death . These functions and care will always be aimed at improving the care process, providing them both in their homes and health centers and in residential centers.

Bibliography

• Eliopoulos C. Gerontological nursing, 6th ed, Philadelphia, 2005.

• Interrelaciones Nanda, Noc y Nic. Elsevier Mosby. Segunda edición. Madrid, 2007

INDEX BARTHEL

Nursing professionals carry out important work evaluating the needs of patients and care-givers. They also provide the required care, as well as transmit the knowledge and skills of self-care. In the planning of care it is necessary to evaluate the Basic Activities of Daily Living (BADL), essential for self-care, such as cleaning and dressing oneself, using the bathroom among others.

Order to collect information about the ability of the elderly to perform normal activity, and maintain independence there are various scales to assess the activities of daily living. Among these is the index of Katz, Plutchik scale, index of Lawton and Brody or index of Barthel, which I will highlight in this publication.

The Barthel Index is a measure of the level of independence in life activities daily (ADLs). Measurement scale is the best known ADL, studied and disseminated at International. It was described by Mahoney FI and Barthel DW in 1965, designed to measure rehabilitative treatment outcomes in patients incapacitated by processes neuromuscular and skeletal muscle. Assesses 10 areas of ADL (eating, transferring between the chair and the bed, grooming, toileting, bathing, moving around, up and down stairs, dressing and undressing, bowel control and control of urine).

There have been studies of validity and reliability of the Barthel index at various places and with various pathologies. Regarding the validity of the fact that over 30 years Barthel index is used to measure the specific objective of independence in ADL makes it the gold standard for measuring ADL, on the other hand has conceptual validity allowed studies that demonstrated the predictive ability of this index.

The Barthel index provides information both from the overall score and each one of the partial scores for each activity. This helps us understand what are specific deficiencies of the person and facilitates the valuation of its evolution temporary.

Bibliography.

• Buzzini M, Secundini R, Gazzotti A, Lia Giradles R, Arbildo Castro RA, Druetta S,

         Sequeiros S, Rodríguez Vélez A, Li Mau L. “Valoración del Indice de Barthel”. Boletín

        

         del Departamento de Docencia e Investigación IREP. Vol 6, nº 1. 2002.

• Trigas Ferrin, M. Escalas de valoración funcional en el anciano, 2011

          Disponible en: http://www.galiciaclinica.info/PDF/11/225.pdf

FREE RADICALS THEORY

We know what means aging, however, scientifically is rather difficult to define because it is not only the passage of time, but is a complex biological process, difficult to assess at the cellular, tissue and organTo explain the aging process there is different theories. These explain physiological, psychological or social changes…Some of these theories are biologic theories and psychosocial theories.

Within biologic theories is the free radicals theory, a very interesting theory because it consists of molecules that are suspected to cause adverse effects on the body, as in the cells, DNA and immune system. And thereby cause aging and degenerative processes as a cancer, atherosclerosis and immunodeficiency.

Free radicals are molecules unstable and highly reactive with one or more unpaired electrons, which cause damage around through oxidative reactions. It is an oxidative damage in the cell and really is an oxygen poisoning, all aerobic organisms are sentenced.

After watching this video, I want to highlight that if aging is associated with the production of free radicals, but the elimination of these doesn’t prevent the aging, it is because they are not causes of aging but these are symptoms, as has been shown in some studies.

Therefore, it is not clear, is whether decreasing free radical damage, we will increase longevity. However the number of free radicals can be reduced by the use of antioxidants such as vitamins A, C, D, carotene, zinc, selenium and phytotoxic.

Bibliography.

• Vargas F; Rivas C; Nursanarnaa A; Zoltan T. Reacciones de radicales libres con relevancia biológica en la teoría del envejecimiento. Instituto Venezolano de Investigaciones Científicas. 2007. Disponible en:

          http://redalyc.uaemex.mx/src/inicio/ArtPdfRed.jsp?iCve=93320202

SOCIAL CHANGES IN AGEING

In ageing affect biological and psychological factors, but in this process, there are social changes too.

In my opinion these changes take second place, giving more importance to the physiological and psychic changes. 

On the one hand, the relationship with the family, change when his family considered admit elderly in a residence.

On the other hand, the ageing is a stage characterized by losses, for example emotional losses, as the death pf a husband or a wife, as the feeling of loneliness…

In addiction, the olds persons are conscious that death is near, and then their attitude towards death changes with age. By some old people this stage is accepted as the better way possible, and others feel fear and distress. 

Finally I don't want to forget mention that a big change is the retirement of the individual because the person must quit from their job. Thus it is a big difference in the social life of the old person because social relationships and economic resources  reduced after leaving the working environment.

                                                                                             

The elderly must adapt to the new stage of life in order to avoid negative consequences, and must maintain a good quality of life. So geriatric nursing besides giving great support to health care, she tries to get the final stage of life is lived in a happy and optimally, ensuring the satisfaction of physical and mental needs of older adults.

Bibliography.

ZAVALA, M. VIDA, D. CASTRO, M. QUIROGA, P. KLASSEN, G. SOCIAL FUNCTIONING OF ELDERLY, 2006. Available on:

http://www.scielo.cl/scielo.php?pid=s0717-95532006000200007&script=sci_arttext