- The older the person, the more difficult the interpretation of findings
- Diligence is needed to interpret results within context of person's overall health and
normal changes of aging
- While there are no differences in what is normal result in a lab finding in older
compared to younger adult, deviations are more likely to occur and put person at
greater risk of poor outcomes
- This is especially true with atypical presentations of illness.
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Laboratory Findings in Older Adults- what is challenging?
The ultimate vision of culture change is to improve the lives of residents and staff by
centering facilities' philosophies, organizational structures, environmental designs,
and care around practices that support residents' needs and preferences
Institution-centered versus person-centered culture (Box 32-15)
Principles of culture change (Box 32-16)
Nursing home culture change competencies for nurses (Box 32-17)
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The Culture Change Movement
Importance of caring relationships and presence of a confidante is a buffer against
"age-linked social losses"
A caring person may be a significant survival resource
Friendships
- Are often a significant source of support in late life
- Research supports the value of friendship for older people across the globe in
promoting health and well-being
- Internet and social media offer new opportunities
- Nurses may include assessment questions about friendships
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Relationships in Later Life
Considered "persistent impediment to a person's normal pattern of sexual interest,
response, or both"
Influenced by factors such as culture, ethnicity, emotional state, age, previous sexual
experience, and age-related changes
Postmenopausal changes in the urinary or genital function as a result of lower
estrogen levels can make sexual activity less pleasurable
Women can experience arousal and orgasmic disorders resulting from drugs
Urinary incontinence may affect sexual activity
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Female Sexual Dysfunction
- Stabilize but rise > age 80 in men
- ? association with longevity
- Statin therapy
* No one size fits all for the components
* Family hx, cardiac risk factors, long term risk/benefit
- Unexplained low level (<200 mg/dL) and low triglycerides
- Risk for mortality, <160 mg/dL (cholesterol)
- Indicates severe condition, i.e., malnutrition
- Total >200 mg/dL, -risk factor -pancreatitis
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Cholesterol
Dementia, now referred to as a neurocognitive disorder, is not a normal part of aging.
It is NOT part of normal aging! It is a disease!
It is more than just forgetfulness - which is part of normal aging
It makes independent life impossible
Alzheimer's
Vascular dementia (multi-Infarct)
Lewy Body Dementia
Frontal-Temporal Dementias
Dementia
is an umbrella term that includes many cognitive loss conditions
includes some reversible conditions - so should be checked out carefully
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