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Geregistreerd op: 09 Mei 2018
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 Geplaatst: 16-07-2018 10:36:57 Onderwerp: dentitions can affect |
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The United States currently has a shortage of 200 Deon Cain Jersey ,000 nurses. In 13 years, year 2020, the shortage is projected to be over 800,000. At that time, nursing homes will need 66 percent more nurses than they have today. The most common areas of elder abuse are directly related to nurse staffing issues. The essential medicine of elder abuse revolves around nursing care.
Understanding how normal aging affects the most common areas of elder abuse is important in discerning neglect by an administrator, employee, professional or non professional staff member providing care and services for elder or dependant adults. Understanding how the nursing care process involves custodial care, attending to basic needs, and the supervision of non professional staff is important in determining elder abuse.
The elderly and dependent adults are obviously an at risk population. Dementia puts this group at an even greater risk for abuse and neglect because of a greater degree of dependency and associated behavior problems. As a progressive brain dysfunction, dementia presents with a functional decline in cognitive and physical abilities which worsens over time. Advanced dementia is a common cause for nursing home placement. Studies have shown that aggressive behavior may be seen in over 65 percent of patients with dementia. Because of this, physical restraints are routinely used in this population, making it necessary to pay special attention to these patients to ensure that pressure sores do not result. The natural course of dementia can make it difficult to interpret sudden declines in health. Malnutrition, dehydration, poor personal hygiene, pressure ulcers, and falls may be indicators of abuse and neglect.
Malnutrition
Malnutrition is a common threat not only to dementia patients, but all elderly and dependent adults in health care facilities. The clinical signs of malnutrition include a decrease in body weight of more than 15 percent, low serum albumin levels, and a low total lymphocyte count. There are a number of conditions which can pre dispose patients to malnutrition ranging from restricted diet and dental issues, to depression, confusion, and cancer. Unintended weight loss occurs during the normal aging process as we lose muscle mass. It also often occurs with patients who require help with eating. Studies have shown that staff members take only 5 10 minutes to feed patients who are unable to feed themselves. Severe malnutrition causes a drop in the albumin level and lymphocyte count. Poor nutritional status impacts tissue healing in bed sores. Also, dehydration can cause a pressure sore to develop.
Dehydration
Patients require a minimum of six eight ounce glasses of water per day, or, as documented in medical records, 1500 to 2500 milliliters per day. At a minimum, intake must equal the fluid loss through urine, feces, skin, and lungs. When fluid is not replaced to cover the amount lost, then a loss of total body water content occurs. Clinically, this will present as an increased serum osmolality coupled with a rapid weight loss of greater than three percent of body weight. The physical signs and symptoms include concentrated urine, dry skin, dry mucous membranes, thirst, skin tenting, sunken eyes, rapid heart beat, low blood pressure, and mental confusion.
There are many conditions which pre dispose patients to dehydration, which are taken into account by medical and nursing staff when managing the fluid requirements: Certain chronic conditions, decreased renal functions, neurological impairments, diarrhea, and fever. The nursing staff should implement care to address the problem of a natural blunted thirst mechanism in the elderly, or a patient with dementia who needs to be reminded to drink. Additionally, certain medications will cause fluid loss, such as diuretics, tranquilizers, and sedatives.
The management of adequate fluid intake requires diligent adherence to the nursing process of assessment, planning, implantation, and evaluation to assure that dehydration is avoided. The consequences of which can be wide ranging, from urinary tract infections, pneumonia, pressure ulcers, and even death if undetected.
Poor Personal Hygiene
Poor dentitions can affect a patient?s ability to eat, contributing to malnutrition. 30 percent of people over 65 have no natural teeth. Personal hygiene is the most basic expectation of custodial care to maintain a person?s comfort. Oral care is challenging and time consuming for a caregiver, as it requires daily attention to brush the teeth and dentures. If the patient is compliant and the caregiver does not provide adequate care, neglect is often related to poor staffing. Elderly patients and those with aggressive dementia can be non compliant regarding personal hygiene by refusing to bathe andor refusing to allow the caregiver to complete tasks of hygiene. In the extreme, there is a behavior disorder of extreme self neglect called Diogenes syndrome. The non compliant situation requires good documentation and notification of the doctor and nursing supervisor.
Pressure Ulcers
Pressure ulcers, also called decubitus ulcers or bedsores, are the most common issue involved in elder abuse cases. They are called pressure ulcers because pressure is the single most important factor in ulcer formation. Normal capillary pressure usually ranges between 12 and 32 millimeters of mercury. Pressure sores develop when the outside pressure on the skin exceeds the mean capillary pressure, which reduces the blood flow and tissue oxygenation. When the skin is starved of nutrients and oxygen for too long, the tissue dies and a pressure ulcer forms. The most common sites of ulcers are areas of skin overlying bony prominences because one forms when soft tissue is compressed between a bony prominence and an external s
BEIJING, De. |
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