Wednesday, May 18, 2011

A New Direction in Gerontological Care

Overview: Traditionally eldercare has been provided within the extended family home or a nursing home facility. However, this is beginning to change due to factors such as greater life expectancy of seniors, the decreasing size of the average family, the widening geographical distribution of families, the tendency for women to work outside the home, and-- most importantly-- the dramatic increase in the aging population. These factors provide a monumental challenge for healthcare providers, and, therefore, their need to adapt in order to provide the best possible resources to maximize the social, mental, and physical well-being of this unique population.

Let’s examine some of the misconceptions that surround the care required for today’s elderly.

MYTH

Healthcare providers only need to treat the disease(s) of the elderly population.

FACT

Healthcare providers should improve preventive care, decrease premature morbidity, decrease unnecessary hospitalizations, provide emotional comfort, and promote a healthy life style.

MYTH

Dementia and delirium are the same problems and the words are used interchangeably.

FACT

Delirium is typically characterized by a sudden acute onset and may last hours to weeks. The level of awareness fluctuates, often being worse at night. The person usually experiences confusion, fear, and bewilderment. Typically the cause is an acute illness or even some medications. Dementia is typically a slow progression of decline in mental and intellectual abilities which is accompanied by changes in personality, behavior, and social functioning. The cause is typically related to the progression of Alzheimer’s or multiple infarcts, hospitalization, malnourishment, for example. Delirium is a cognitive or mental disorder, not a disease.

MYTH

Dementias and Alzheimer’s are part of the normal aging process. Very little can be done about these disorders, and they must simply run their course.

FACT

While memory loss problems are not a normal part of aging, increasing age is the greatest risk factor for Alzheimer’s and dementias. Early recognition is key to treating these disorders. There are specialized clinics that perform diagnostic neurological, neuropsychological, and psychosocial evaluations; brain imaging may also be included to determine the actual problem of the patient and the stage of the problem (when applicable). There are several medications currently available that can slow this process as well as alleviate or modify some of the behavioral and cognitive problems. Additionally, there are established memory units with specifically trained professionals who specialize in caring for these types of patients through various types of activity therapy, through behavior modification, and by providing a calm and consistent environment.

MYTH

All senior adults are placed in nursing homes if they cannot stay in their home.

FACT

Various levels of care are available to senior adults –beautiful independent and assisted living facilities with numerous activities for the residents, memory units with specialized staffs, environments and activities targeted to seniors with special memory problems, and in-home caregivers tasked with keeping the client independent in their own home as long as possible .

MYTH

The majority of seniors are content to live with (and be cared for by) their families.

FACT

Approximately 85% of senior adults would prefer to live autonomously in their own home. This allows them to maintain their independence, their dignity, and remain near their personal belongings, memories, and friends.

MYTH

Nurses and other health care professionals receive the necessary training to work curriculum to qualify them to work with senior adults.

FACT

Caring for senior adults require specific expertise, knowledge and skills that are not part of the majority of nursing training curricula. Specialized mandatory gerontological nursing courses are being offered in some of the major nursing programs to prepare the students for special gerontological certification. Additionally, one can receive specialized certification to become a professional Geriatric Care Manager (GCM). This is a health and human services specialist who helps families caring for older relatives. The GCM is trained and experienced in any of several fields related to care management, including nursing, gerontology, social work, or psychology and therefore, has certain areas of expertise to manage the challenges of geriatric caregiving.

For allied health professionals, further training is typically provided by the employer, and centers on problems that are unique to the elderly population, such as dementia and dietary and health issues. The employer may also have programs in place for on-the-job training as well as periodic in-services as issues of importance are identified.

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