PALLIATIVE CARE

The aging of the population and most difficult survival prognosis disease has prompted the authorities to develop specific programs for geriatric care and hospice.

Palliative care and pain treatment are essential to improve or maintain the quality of life of many patients affected by processes incurable, chronic or terminal.
It is necessary to provide palliative care to elderly patients with advanced disease and irreversible. The implementation of palliative care to these patients will present ethical challenges, so the comprehensive geriatric assessment in each case will help resolve the various conflicts.


The purpose of the nurse is:

• Providing the best quality of life for patients and their families.
• Philosophically, getting relief from suffering.

By: communication, control of symptoms and family support.

The Palliative Care Nurse goes beyond providing direct assistance to physical needs only. Rather care plans from the continuity, flexibility and accessibility. What accounts for poise and support in the daily life of patients and their families, also integrating it in the act of caring. Supports from the listener, must be sensitive and are awaiting the details that give comfort to the patient.


The properly care for the patient must be:

• Know and understand, through training and appropriate training and multifaceted.
• Want to do, based on the voluntary and personal qualities.
• Have the opportunity and means: financial, material and human resources.
• The idea of ​​caring often promote him food, hydration, rest.

CONCLUSION

• It is very important nurse caring for the patient.
• Communication is a way to meet the needs of the sick or affected, do not forget that in many cases the most important tools for providing care are the word and listening from this listener can be made better care.
• It is important to the proper conduct of palliative care for terminal ill patient.

BIBLIOGRAPHY


Astudillo Alarcón, W. Albo Diaz, E. Garcia Calleja, JM Palliative care and pain management in international solidarity, 2009. Available at: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1134-80462009000400007&lng=es&nrm=iso

DIFFERENT FORMS OF ASSISTANCE TO THE ELDERLY

Good care for the elderly are mainly based on interdisciplinary work that must be good coordination between specialized care, health centers, social workers and specialized geriatric care.
The correct use of levels of care and expertise guarantee optimal care for elderly.

Unfortunately, there is a saturation of working both in primary care and specialized care and attention prevents hospitals can be done properly.

A primary care, multi-disciplinary work should involve all professional functions they must perform will be aimed at the promotion of health, prevention activities and early detection and treatment of disabling processes.


The work of the nurse is very important in order to perform a comprehensive health education patient and family. Will be assessed:

• Deficiencies at their home
• Lack of resources
• Hygiene
• Detentions
• Constant monitoring
• Cures
• Sampling
• Apply chest physiotherapy techniques 
• Oxygen therapy
• Urinary catheterization

It is very important for health education aimed at explaining a proper diet, adequate physical exercise, control toxic habits, self-medication, body cleansing, prevention of accidents, etc..

The activities of nursing home hospitalization are practically the same, including health education, hygiene and mobilizations.

The specialized care units which include:

• Aimed at geriatric patient admissions for assessment of their pathologies
• Medium-stay units aimed at functional recovery of medical procedures, surgery or trauma
• Inpatient units intended for chronic or nursing homes whose impaired functional capacity leads them to a zero level of independence.
• Acute Treatment Unit (ATU)

There are also day hospitals that are specialized day care centers in frail patients with physical disability in which rehabilitation once again made ​​his home.


CONCLUSION

Fair enough there are additional measures to elder care, since it involves a number of increasingly large population, and need further assessment exhaustive.

But overall prevention.

BIBLIOGRAPHY

Tratado de Geriatría para residentes [Internet]. Madrid: Sociedad Española de Geriatría y Gerontología [acceso 22 de Marzo de 2012]. De Fernández M, Solano JJ. Niveles asistenciales en geriatría. Disponible en: http://www.segg.es/download.asp?file=/tratadogeriatria/PDF/S35-05%2006_I.pdf

HEALTH EDUCATION IN GERIATRIC

We begin by defining two important terms in the world of healthcare:
The health promotion is a group of measures implemented in order to promote an optimal state of physical, mental and social development in the population. This group of measures includes actions in the field of health education, public health policy, disease treatment and preventive measures.

Health education is a basic tool in promoting health and preventive action. It is a method of intervention that is also part of the care provided.



Preventative measures are classified according to the disease stage where they develop. So we can speak of:

• Primary prevention, when we try to prevent the occurrence of injuries and disease through risk factors and promoting healthy lifestyles.
• Secondary prevention, which attempts to detect and treat early asymptomatic disease and existenes although so far.
• Tertiary prevention, which attempts to avoid consequences, relapse, and promote the rehabilitation and recovery of the same.

The goal of health promotion in the elderly population is to maintain the highest degree of autonomy and prevent the onset of disease, ie preservation of health.

NURSING ACTIVITIES

To achieve these goals we have set, we will have an impact on a number of parameters for health promotion:

• Control of blood pressure at least 1 time per year.
• Lipid Control every 5 years to prevent dyslipidemia
• Annual ECG over 75 years to prevent arrhythmias
• Bone Densitometry at 65 years to prevent osteoporosis
• Annual fasting glucose to prevent diabetes mellitus
• Annual review of the mental state by Pfeiffer or MEC to prevent cognitive decline
• Annual review of the state of mind to prevent depressions
• Control of TSH every 5 years to prevent hypothyroidism, especially in women
• Control of vitamin B12 every 5 years to prevent pernicious anemia
• Annual monitoring fecal occult blood to prevent colon cancer screenings making up to 75-80 years in patients with good health
• Mammogram every 1-2 years to prevent breast cancer until 70 years or more if life expectancy is 5 to 10 years
• Pap smear every 3 years to prevent cervical cancer
• Digital rectal exam and PSA test for prostate cancer prevention
• Annual audiometric study to prevent hearing loss
• Study yearly eye to prevent presbyopia, cataracts, glaucoma, diabetic retinopathy and macular degeneration

BIBLIOGRAPHY

González Sánchez, R. Educación para la Salud. Influencia en ancianos hipertensos, 1999. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-21251999000400003

URINARY INCONTINENCE

We defined urinary incontinence as the involuntary loss of urine, objectively demonstrable, which causes a social or hygienic problem as it comes at a time and place unsuitable.


It is a dysfunction that occurs in both healthy individuals and patients with persistent, and originates various causes. It is a major health problem because of its connotations often as psychological, social and economic. Although it is associated with a severe prognosis, limited autonomy, self-esteem and reduces significantly impairs the quality of life of those who suffer.
It's a problem more common in women than in men and often clearly increases with age, and this factor most closely associated with urinary incontinence.


TYPES

There are several types of incontinence and the same person may have several to see.
The types of urinary incontinence are:

• Urgency
• Effort (or stress)
• Mixed
• Transitional
• Overflow
• Functional

NURSING ACTIVITIES

As nurses we must conduct a comprehensive evaluation of the needs of each patient, as it is a disease that generates high healthcare spending.

Contents: History, physical and psychological exploration, laboratory tests, diagnosis, plan actions, inform the patient and psychological support this.

NURSING TIPS

• Drinking 2L of fluids a day, being higher intake in the morning than at night, to improve sleep.
• Performing Kegel exercises to improve the muscles and control incontinence.
• Organize urination schedule.
• Analyze what happens or what makes a person go to urinate.
• Organize group exercise classes
• Facilitate access to the bathroom, clothing, home lighting ...
• Promote hygiene
• Notify your doctor at the feeling of fever, chills, lower abdominal pain in the lower back, flank, urgency, change in color, odor, amount of urine, signs of infection.

BIBLIOGRAPHY

Zunzunegui Pastor, M.V. Rodriguez Laso, A. Prevalencia de la incontinencia urinaria y factores asociados en varones y mujeres de más de 65 años, 2003. Disponible en: http://www.taiss.com/publi/absful/prevalencia%20de%20la%20incontinencia.pdf

DYSPHAGIA

Swallowing is a complex neuromuscular process by which food from the mouth pass through the pharynx and esophagus into the stomach.

Dysphagia is defined by the presence of difficulty swallowing. Data normally is a sign of underlying disease of the esophagus or esophageal neighboring organs, which may be due to gastro-oesophageal reflux, cancer, thytoid disease, stroke and various neurodegenerative diseases such as Alzheimer's, Guillain Barre, Syndrome or Amyotrophic Lateral Sclerosis.
Dysphagia, besides be a risk factor for malnutrition of the patient, in this case, the elderly, can cause complications, some so severe and frequent as aspiration (passage of food into the airwai), where the performance nursing staff and medical practitioners should be fast and efficient, because in a few minutes you can produce the death of the patient.

The nurse assessment at admission and during the stay in the institution it is essential, in addition to being a disease with a high incidence in the elderly.
It´s important the education directed toward these people, or their caregivers which not only has to compose for advice on dietary care but also must be of postural care and training, which can improve the patient's situation in the areas of nutritional, functional, relational, welfare and autonomy.

TREATMENT

The best performing treatment offers these patients, treatment is multidisciplinary, therefore, we treat the pathology from viewpoints of nursing, nutrition, medicine, with the following objetives:

• Getting a good nutritional status
• Reduce aspiration with oral diet
• Reduce other complications associated
• Rate supplements
• Power evaluate other channels, in the case where the oral feeding is contraindicated.

NURSING MEASURES IN PATIENS WITH NUTRITION DYSPHAGIA

• Avoid distractions during feeding
• Upright posture with slight flexion of the neck
• Perform proper cleaning pre and post oral intake
• Start with small amounts. Smell and taste food as it should be adapted to the tastes of the patient
• Give enough time and did not suppress the cough
• Select foods with texture, consistency, flavor and temperatures
• Instruct family and caregives

There are two types of patients for whom these measures are not fully developed:

• Patients with stroke.
• Patients with advanced dementia.

BIBLIOGRAPHY

Ferrero López M. I., Castellano Vela E., Navarro Sanz R.. Usefulness of implementing dysphagia care programme at an intermediate and long stay hospital, Nutr. Hosp. [serial on the Internet]. 2009 Oct [cited 2012 May 23]; 24(5): 588-595. Available from: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0212-16112009000500011&lng=en

Irles Rocamora J. A., Sánchez-Duque M. J., Valle Galindo P. B. de, Bernal López E., Fernández Palacín A., Almedia González C. et al . A prevalence study of dysphagia and intervention with dietary counselling in nursing home from Seville. Nutr. Hosp. [serial on the Internet]. 2009 Aug [cited 2012 May 23]; 24(4): 498-503. Available from: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0212-16112009000400016&lng=en

THE FALL IN THE ELDERLY

The aging process is associated with several changes that predispose to falls. Falls are a result of any event that precipitates the patient down against your will. This will occur in the elderly with high morbidity and mortality. The fall is the interaction between risk factors (chronic diseases, impaired balance and gait, drugs, etc..) And exposure to risks or opportunities falling to be taken into consideration together. Also remember that there is an unpredictable or unavoidable fact therefore prevention plays a very important role.


The elderly often accept it as an inevitable part of aging and therefore frequently fail to inquire about this.
The fall of an elder is not an unpredictable or unavoidable due to chance or normal aging individual. In most cases it is a mismatch between the old man and his environment.
The house is where falls happen most frequently, highlighting the bedroom, bathroom and stairs.

FACTORS THAT CAUSE THE FALL IN THE ELDERLY

• Chronic diseases 

• Visual disturbances

• Vestibular System: The loss of age-related balance, can occur as a result of osteoporosis, it can also occur from trauma, ear infections and drug consumption.

• Locomotor system: musculoskeletal disorders associated directly or indirectly with age, and foot problems may be a cause of disturbance of equilibrium and gait, and thus lead to falls.

• Neurological system: Structural changes in the cerebral cortex, either vascular or degenerative disorders of the pyramidal tract, extrapyramidal or cerebellar, are major causes of gait instability.

• Acute Diseases: The infectious, and exarcerbación of some chronic diseases such as congestive heart failure, may precipitate falls.

• Polypharmacy: The 81% of the elderly take their medication and the 2/3 parts over a drug ingested regularly. This figure increases with age, and so 30% of those over 75 years take more than 3 drugs.

• Misuse of drugs: together with the presence of comorbidity, is that advese reactions are more frecuent among the elderly, and therefore increases the risk of falls.

DRUGS THAT CAUSE FALL

1. Benzodiazepines.
2. Antihypertensives: Considered second only to the sedatives, may influence falls or postural hypotension by decreasing cerebral blood flow.
3. Diuretics: For hypotension especially when they are used in cardiac diseases.
4. Phenothiazines: Your reactions are extrapyramidal and parkinsonism. Can you explain some association with falls.
5. Tricyclic antidepressants increases the propensity to fall especially when combined with other drugs that cause postural hypotension, and its main exponent Imipramine. Besides this group caused heart rhythm disorders and anticholinergic effects may be involved in falls among the elderly.
6. Nonsteroidal anti-inflammatory drugs: instability and confusion.

Considering the amount of drugs that cause instability and insecurity in the elderly, we must be wary of imposing treatment where these drugs are combined, because of a potential fall that entails.

In conclusion, in this case is very important the prevention of falls, and they can save a lot of problems for the elderly.

BIBLIOGRAPHY:

Días Grávalos, G. Gil Vázquez, C. Andrade Pereira, V. Alonso Payo, R. Factores asociados con la aparición de caídas en ancianos institucionalizados: un estudio de cohortes, 2009. Revisado en: http://www.elseiver.es/en/node/2080328

André da Silva Gama, Z. Gómez Conesa, A. Sobral Ferreira, M. Epidemiología de caídas en España, 2008. Revisado en: http://scielo.iscii.es/scielo.php?script=sci_arttext&pid=S1135-57272008000100004&Ing=es&nrm=iso&tIng=es

ALZHEIMER

Dementia is the progressive loss of cognitive function due to damage or brain disorders.

Within dementia is Alzheimer's disease, which is the most common form of dementia among older people. Dementia is a brain disorder that seriously affects a person's ability to carry out daily activities.

The Alzheimer's begins slowly. First involves the parts of the brain that control thought, memory and language. People with AD may have trouble remembering things that happened recently or names of people they know. A related problem, mild cognitive impairment, causes more memory problems than normal for people of the same age. Many, but not all people with mild cognitive impairment will develop Alzheimer's. Over time, in Alzheimer's, symptoms worsen. People may not recognize family members or have trouble speaking, reading or writing. They may forget how to brush their teeth or comb their hair. Later, they may become anxious or aggressive, or wander away from home. Ultimately need total care. This can be very stressful for family members who must care for their care.

It usually begins after age 60. The risk increases as people age. The risk is higher if there are people in the family who had the disease.


The progress of the disease can be faster or slower depending on the environment of the person with Alzheimer's. It's not an easy situation and the family will have to make great efforts to provide the person with Alzheimer most favorable environment possible.

Accelerators disease

- Family Stress
- Sudden changes in daily routines
- Switch to a new, unknown address (such as nursing homes).

Retarders of disease

- Happy family atmosphere
- Exercise
- Socialize with your friends or others

TREATMENT

No treatment can stop the disease. However, some drugs may help prevent a limited time symptoms worse.


There is some evidence that stimulation of the cognitive helps slow the loss of these functions and abilities. This stimulation is to work those areas that still retains the patient so that training to compensate for the losses that the patient is suffering with the disease.
Psychosocial interventions are used in conjunction with drug therapy and are classified as behavior-oriented approaches, emotions, cognitive and stimulation. Research on the effectiveness of these interventions are not yet available and, in fact, rarely are specific to Alzheimer's, focusing on dementia in general



BIBLIOGRAPHY:

Vernooij-Dassen M. Draskovic I. McCleery J. Downs M. Cognitive reframing for carers of people with dementia. Cochrane Database of Systematic Reviews 2011, Issue 11. Art. No.: CD005318. DOI: 10.1002/14651858.CD005318.pub2. Disponible en: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD005318.pub2/abstract

Enfermedad del Alzheimer y degeneración macular asociada a la edad, 2006. Revisado en: http://scielo.isciii.es/scielo.php?pid=S0365-66912006000200006&script=sci_arttext&tlng=pt

IMMOBILITY

The immobility means the loss of autonomy for ambulation, grooming and transfer. That is the decreased ability to perform activities of daily living impairment of motor functions.

Immobility can be: relative or absolute.The risk of relative immobility is bedridden, while in absolute immobility is a risk factor for institutionalization, morbidity and mortality and the appearance Caregiver Syndrome.

Causes of immobility:

• Musculoskeletal: joint degenerative processes, hallux valgus, corns, osteoporosis and  fractures.

•  Neurological Disorders: cerebrovascular disorders, Parkinson's and dementia evolved. This involves pathological gear styles.

•  Cardiovascular Disease: Heart failure, ischemic heart disease, peripheral vascular disorders and chronic respiratory disease.

•  Drugs: Sedatives, hypnotics, antipsychotics, antihypertensives.

• Psychological and environmental factors: depression, fear of falling, architectural barriers ...

Immobility risk factors: Female, sedentary Elderly, frail elderly, relative immobility, Being older than 85 years, Functional disability prior use walker.

The consequences of inaction are severe, so only bed rest should be saved when absolutely necessary, that is when the risk of the activity exceeds the inactivity.

Once the inmobility in the older people is important to star quickly as possible the specific care for the prevention of organ complications, psychological and social, and environmental adaptation of old to minimize the consequences of inmobility.
There are three main sections in the immobility syndrome treatment: general care, rehabilitation or progressive approach to movement and technical aids, and environmental adaptation.

As with any health problem, prevention is better than cure. In this regard, several studies have assessed the prescription of physical exercise and maintaining physical activity as the best way to prevent immobility and decrease the risk of progression to frailty in older people. The benefits of exercise do not decrease with age, still produced an increase in cardiovascular capacity of the muscles (both in volume and in strength) and bone density, decrease anxiety, aggression and depressive symptoms, and favor the socialization. The older person wearing a type of independent living and active with regular exercise conducting statistically has a lower risk of mortality. Seniors who exercise have always age better and have less functional disability, old age is healthier.

Regarding assistive techniques to maintain physical activity when present limitations to perform it, the main ones are: canes, crutches and walkers.

BIBLIOGRAPHY:

Escudero Sánchez, C. Delgado Antolín, J.C. Incidencia y factores predictores de inmovilización crónica en ancianos mayores de 75 años que viven en la Comunidad, 2001. Disponible en:  http://www.elsevier.es/sites/default/files/elseiver/pdf/124/124v36n02a10022132pdf001.pdf 

Morales Obregón, L. Nuñez Rodriguez, L. Riesgos biológicos y psicológicos de inmovilización en pacientes geriátricos. Sistema de información científica, 2004. Disponible en: 
http://redalyc.uaemex.mx/redalyc/pdf/2111/211117850007.pdf 

PRESSURE ULCERS IN THE ELDERLY

Pressure ulcers are areas of damaged skin caused by staying in one position for too long time. Commonly form where bones are closer to the skin, shuch as the ankles, heels and hips.

They are more frequent as age advances, by increased fragility and immobility in older people. Given their frequency of apperance in the geriatric and prognostic significance in this age group, has come regarded as a geriatric syndrome.

It is considered that 95% of pressure ulcers are preventable, using simple techniques such as postural changes and the exquisite care of skin and general condition of the patient. Once appeared ulcer healing can be long and cause significant morbidity, and major expense of health resources.

The most common site of pressure ulcers are the sacrum and the buttocks, heels, elbows, shoulder blades, shoulders and occipital.

They are classified into four grade levels, grade four is the most serius, because it destroys all the tissue to the bone.

As the lesion depth increases, increases healing time.

RISK FACTORS

The main cause of the occurrence of pressure ulcers is the same pressure to cause the closure of capillaries, reducing the supply of oxygen to tissues. However, there are a number of situations or risk factors that increase the likelihood of developing ulcers favorable situation.

The factors that contribute to the production of pressure ulcers can be grouped in this groups:

Pathophysiological

- Skin lesions

- Disorder in the transport of oxygen

- Nutritional deficiencies (default or excess)

- Immune disorders

- Altered state of consciousness

- Motor impairments

- Sensory impairments

Derivatives of treatment:

- Immobility imposed

- Treatments or immunosuppressive drugs

- Sedatives

- Drilling and vascular pathways

Situation:

- Immobility

- By rubbing effect of both clothing and other objects

Derivatives of the environment:

- Lack of health education for caregivers of dependents, infrequent changes of position, wet diaper too long, etc..

- Mattresses and seat cushions are too hard or too soft, easy to crush and become hard.

- Praxis poor by health teams.

All patients who are considered at risk of developing pressure ulcers should have a written care plan personalized prevention and a holistic approach that values ​​both the skin and the nutrition and hydration of the patient.

Regarding the treatment of ulcerative lesion, it must be individualized according to the degree of depth of exudate, presence or absence of infection and location.

CONCLUSION:Approximately up to 95% of pressure ulcers are preventable, so the need for prevention is a top priority, rather than focusing only on the treatment of established ulcers.

BIBLIOGRAPHY:

Baranoski S. Pressure ulcers: A renewerd awareness. 2006; 36(8):36-42

Zamora Sánchez Juan José. Conocimiento y uso de las directrices de prevención y tratamiento de las úlceras por presión en un hospital de agudos. Gerokomos [revista en Internet]. 2006 Jun[citado 2012 Mayo 23]; 17(2): 51-61. Disponible en: 
http://scielo.iscii.es/scielo.php?script=sci_arttext&pid=S1134-928X2006000200006&Ing=es.

PAIN IN THE ELDERLY

Due to advances in treatment, the life expectancy of the population and the proportion of elderly is increasing.The elderly population is, in turn, the age group most drugs consumed, the presence of comorbidity, and chronicity pluriprescripción disease.

The most common diseases in this group of the population are:

• Ischemic
• Oncological diseases
• Infections
• Above all, and most importantly, degenerative diseases

ASSESSMENT OF PAIN

The fundamental problem with the old man when assessing pain, is the needed to sit and listen.

the first thing to assess is evaluate the medical history, background and diseases.

You need a good physical examination and capture whatever is around the pain: 

Signs:

• Tachycardia
• Hypertension
• Sweating
• Hiccup
• Nausea and vomiting
• Anxiety/depression
• Excitation/apathy
• Insomnia

Symptoms:

• Allodynia
• Analgesia
• Anesthesia
• Hyperalgesia
• Paresthesia
• Hyperesthesia

CAUSES OF PAIN

As already said before the pathology prevalent in the geriatric population, the main causes are ischemic pain, infection, and neoplasic diseases, specially degenerative diseases. The other clear cause of pain is by trauma or surgery.

It's important to listen well whens the elderly complain of pain and different scales assesed by the extent of this.

BIBLIOGRAPHY

Álaba, J. Arriola, E. Prevalencia de dolor en pacientes geriátricos institucionalizados, 2009. Disponible en: http://scielo.iscii.es/scielo.php?pid=S1134-80462009000600007&script=sci_arttext

NURSING PROCESS IN GERIATRIC CARE AND GERONTOLOGY

The elderly require a comprehensive and interdisciplinary care include not only cash but also the recovery of their health promotion, and family and individual growth to achieve autonomy.
This is where the nurse should be part of it through their integrity and specific care that performed based on the nursing process.


The nursing process is a rational and systematic planning and provision of care that aims to:

• Identify the patient's health status and problems relating to health care.
• Establishing care plans that meet identified needs.
• Provide specific interventions to meet those needs.

The process of care in geriatric nursing is divided into 5 stages:

1. Assessment
2. Diagnosis
3. Planning
4. Execution
5. Evaluation

It is very important to obtain a comprehensive view of old and active aging to delay dependency and enhance functional capacity and autonomy. Based on an interdisciplinary approach, the objective is proposed to develop a nursing assessment tool, based on the conceptual model of Virginia Henderson and complemented with questionnaires and validated scales to detect the needs of the elderly, weigh the risk of geriatric syndromes and plan appropriate care (geriatric nursing care process).

BIBLIOGRAPHY: 

Vallejo Sánchez J M. et al. Valoración enfermera geriátrica. Un modelo de registro en residencias de ancianos, 2007. Disponible en:http://scielo.isciii.es/scielo.php?pid=S1134-928X2007000200003&script=sci_arttext

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

GERIATRIC ASSESSMENT

Geriatric assessment is called the process overall structured, multidisciplinary, which are detected, describe and clarify the multiple physical, functional, psychological and socio-environmental elderly patients presents.

During this process, register the qualities and capabilities of the person, this is dependent valorasi services and finally develops a progressive care plan, ongoing and coordinated targeted to meet the needs of patients and their caregivers.

Thanks to the different questions and test result is obtained gerontological global functional assessment of an elder. This shows the ability or inability of the individual to live independently in the community environment.

Most importantly, from the standpoint of clinical VGI (comprehensive gerontological assessment) is the systematic search for large geriatric syndromes.


Classic geriatric syndromes:

- Immobility
- Falls
- Incontinence
- Cognitive impairment

Geriatric syndromes broadly:

- Pressure sores
- Sensory Deprivation
- Malnutrition
- Dehydration
- Insomnia
- Fecal impaction Constipation
- Depression
- Hypothermia
- Fragility
- iatrogenic

BIBLIOGRAPHY:

Baos V. Estrategias para reducir el riesgo de automedicación. Información Terapéutica del Sistema Nacional de Salud Vol. 24–N.º 6-2000 Disponible en: http://www.msc.es/biblioPublic/publicaciones/docs/200006-2.pdf

San José Laporte A. La valoración de la multimorbilidad en personas de edad avanzada. Un área importante de la valoración geriátrica integral. 2012; 47:47-8

AGING

Aging is integral and natural part of life. The way we age and experience this process, our health and functional capacity, depend not only on our genetic structure, but also (and importantly) what we have done forour lives, the type of things that we have encountered along her, of how and where we have lived our lives. The duration of life is defined as the maximum survivability particular species.Life expectancy, in turn, is defined as the average number of years you live, in practice, from birth or from a particular age.


Despite recent advances, most basic biological mechanisms involved in the aging process remain unknown. What we do know is that:

• Aging is common to all members of any species;
• Aging is progressive
• Aging involves deleterious mechanisms that affect our ability to carry out various functions.

With the aging process, most of the organs undergo a decline in functional capacity and its ability to maintain homeostasis. Aging is a slow but dynamic process dependent on many internal and external influences, and genetic programming included the physical and social environments.Aging is a process that lasts a lifetime. It is multidimensional and

multidirectional, in the sense that there are differences in the pace and direction of change (gains and losses) of the various characteristics of each individual and between individuals.
Each stage of life is important. Therefore, the aging should be viewed from a perspective that encompasses the entire lifetime.

Achieving healthy aging depends on our way of life, so the two interventions are most effective to achieve a healthy diet and exercise.

On the other hand, social relationships are also key to healthy aging and to strengthen the individual physical and mentalemente plus they are directly related to the feeling of well-being and quality of life.

BIBLIOGRAPHY

Consideraciones generales sobre algunas de las teorías del envejecimiento, Universidad de Camagüey, Lic. Gilberto Pardo Andreu Rev Cubana Invest Biomed 2003;22(1)

QUALITY OF LIFE IN OLD AGE

Quality of life is a term that implies a state of feeling of being in the areas of health and socioeconomic psychophysics.

Its aim is to satisfy the needs and demands of the individual in each stage

pa of his life. This implies the existence of two elements:

• Basic human needs, defined as the set of conditions specific deficiencies, recognized by all human beings, who have the means to resolve them.

• Indicators of satisfaction of human needs, which are different measuring elements in each country.

The determination of what is needed and how it affects their lack, varies over time due to changes experienced by mankind. This has been raised fully realized, even in developing countries do not happen to be a theoretical statement, since in fact millions of people are excluded from the minimum conditions of quality of life that is waiting for every human being. It is said that, operationally, the quality of life is context reference. For example, quality of life in childhood, in terminal illness in the elderly, etc.. Man's life is multidimensional and therefore so is their quality of life. Therefore, for evaluation should be taken into account personal factors (health, life satisfaction, independence) and socio-environmental (support networks, social services, etc..).

In short, the quality of life is a subjective-objective assessments of personal and social satisfaction.

Many older people perceive themselves as individuals with a load of experience to offer and wellbeing. They believe that age does not imply a progressive decline or, at least, uncontrollable. This satisfaction with life, however, must be supported by economic and social security, adequate nutrition, a state of relatively good health and family relationships continents. Failing either of these, the perception of well-being both transient and permanent changes. Meanwhile, socioeconomic factors gravitate powerfully in general well-being of the elderly. Low income retirement benefits, or lack thereof, and poor or no social medical coverage, generate different degrees of satisfaction with life altering.

However, it is paradoxical that both socioeconomic excellent and its counterpart, the lack of basic means for a decent living, resulting in a shortened life expectancy. In the first case, a high-fat food intake, that lead to an increase in cardiovascular disease and cancer and, in the second aspect, for lack of nutrients essential for health maintenance.

It is the former that have better living conditions in the year before his death. Also remarkable is the importance of family contention elderly life. Those old who maintain active bonding with your family (married, with children, grandchildren or nephews) live longer than those who lack social and family network. It is observed that the mortality rate is higher among the widowed during the first six months of mourning, then decreasing. Another point to consider is the lesser prestige of the elderly because of modernization. This is due to changes in values​​, education, nuclear family structure, smaller home, etc..

Regarding the independence of the elderly, there is an increase in their tendency to live in an independent household of children while maintaining close contact with them, rejecting possible institutionalization in a nursing home.

BIBLIOGRAPHY

Envejecimiento Saludable. El Envejecimiento y la actividad física en la vida diaria. Organización Mundial de la Salud, 2002.
Disponible en: http://www.imsersomayores.csic.es/documentos/documentos/oms-envejecimiento-02.pdf

Capítulo 9. Envejecimiento y ritmos biológicos. (2011, April 06). Retrieved May 26, 2012, from OCW Universidad de Cantabria. Disponible en: http://ocw.unican.es/ciencias-de-la-salud/biogerontologia/materiales-de-clase-1/capitulo-9.-envejecimiento-y-ritmos-biologicos/capitulo-9.-envejecimiento-y-ritmos-biologicos.

Otero, Puime, A. Relaciones sociales y envejecimiento saludable, 2006. Disponible en: http://econpapers.repec.org/paper/fbbwpaper/201039.htm

GERIATRICS AND GERONTOLOGY

To enter into the nursing care in the elderly is important to understand and differentiate these concepts:


The GERONTOLOGY is the science of aging and an aging population. It deals, in the area of ​​health promotion strictly health issues in addition to addressing biological, psychological and social.

GERIATRICS is the branch of medicine that studies the acute and chronic diseases of older patients in their clinical, therapeutic, preventive and social aspects.


GERIATRIC NURSING FUNCTIONS 


Welfare function

Is to help the healthy elderly or sick to keep or regain health so you can carry out the tasks that allow the greatest degree of independence possible.

Social function

The health statistics indicates that our society is aging and yet social resources are managed by the workforce. The social function of nursing is to be understood as a liaison between the elderly and the rest of the population.


Management and administrative function

The human and physical resources are always limited, so it is important to take care, take advantage and make the most of them.

Teaching Function

The wisdom, knowledge, practice and skills, is something that should be transmitted to advance and improve the quality of care.

 Research-training function

We assist with admiration to the changes that are taking place around us and wonder is greater if you look specifically at the evolution and medical-health changes.



BIBLIOGRAPHY

Base de datos del Instituto Valenciano de Investigaciones Económicas, 2009.
Disponible en:
http://www.ivie.es/downloads/np/NP_tablas_mortalidad_Ivie_240310.pdf
Vernet Aguiló F. Conceptos básicos de enfermería en la atención gerontológica según el Modelo V. Henderson, 2007. Disponible en:http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1134-928X2007000200004&lng=es&nrm=iso&tlng=es

Sociedad Española de Geriatría y Gerontología [sede Web]. Madrid: Sociedad Española de Geriatría y Gerontología; [acceso el 29 de abril de 2012]. Disponible en: http://www.segg.es2. 

PRESENTATION OF THE BLOG

Hi, I'm Paloma Agüeras, third-year nursing student at the Universidad San Jorge, and in this blog I will be posting information about what I think is important of the different topics that I give on the subject of elder care.

The blog will be in English, I hope that the translation is not too bad. Sorry for the mistakes.