Gerontological Nursing Chapters 12/13

1. Gerontological NursingChapters 12/13 Name Mrs. Maloney Title MSN/Ed RN

2. Sexuality and Intimacy • Attitudes: • Taboo subject in the US for many years. • Discouraged in many circles. • Interest in sex was considered improper.

3. Attitudes regarding Sexuality • Attitudes have changed over the past years. • Education, books, websites. • Sexual courses and counselors.

4. Point to Ponder • How comfortable are you acknowledging that you older parents or grandparents could be sexually active?

5. Nurses Role • Nurses need to respect and understand the sexual identity of any individual regardless of age. • Older adults are entitled to the same dignity and respect as sexual human beings that are afforded to persons of other ages.

7. Sexuality • Safe sex among the elderly may be ignored. • Incidence of HIV among adults over 50 has increased. • Sexually active older adults may not use a condom because they no longer fear the risk of pregnancy. • If they do become HIV –positive they are embarrassed to seek medical attention.

8. Menopause • The permanent cessation of menses for at least one year, usually in the fifth decade of life. • Some individuals view menopause as a time of experiencing and managing hormonal changes. • Menopause is an important transition in a woman’s life that can result in an awakening of a new wholeness of body, mind, and spirit.

9. Medical Management • Effective management of physical symptoms can enable women to experience a positive passage. • Menopause occurs when estrogen levels fall and there is a reduced number of ovarian follicles.

10. Physical Symptoms • Hot flashes • Fatigue • New onset migraines • Symptoms of arthritis, fibromyalgia • Heart palpitations, atypical angina • Restless leg syndrome • Vaginal dryness, itchiness • Insomnia • Decreased metabolic rate, weight gain • UTI’s

11. Emotional Symptoms • Moodiness • Depression • Memory problems • Fuzzy thinking • Lack of concentration • Quick to anger • Anxiety, restlessness • Paranoia, psychotic symptoms

12. Menopause

13. Treatment • Hormone therapy • Education • Exercise • Vitamins and minerals (C,D, & E) • Diet-foods rich in plant estrogen (apples, pears,carrots, celery, wheat, whole grains) • Exercise

14. Medical Conditions that interfere with sexuality in the elderly • Erectile dysfunction • Medications may decrease libido or orgasm • Vaginal dryness in the female • Prolapsed uterus • Arthritis • Stroke • Respiratory disease

15. Nursing Considerations • Nurse must be patient and caring and try to speak openly with the elderly about their sexuality. • Education • Health Promotion

16. Spirituality • Spirituality-the essence of our being that transcends and connects us to the Divine and other living organisms. • Involves relationships and feelings. • Differs from religion.

17. Spirituality

18. Religion • Religion-consists of human-created-structures, rituals, symbolism, and rules for relating to the divine. • Spirituality and religion are not synonymous.

19. Religion

20. Spitituality • All humans have spiritual needs , regardless of weather they realize or acknowledge them. • Some of these needs become more relevant in late life when the high prevalence of chronic illness and reality of death are evident.

21. Spiritual Needs • Love • Purpose • Hope • Dignity • Forgiveness • Gratitude • Transcendence • Faith

22. Love • Most important spiritual need. • Spiritual love is unconditional, offered unselfishly, completely. • People need to feel loved regardless of their physical or mental condition, social position, material possessions, or productivity.

23. Meaning and Purpose • According to Erickson’s description of the final developmental task, healthy psychological aging for the older adult involves achieving a sense of integrity. • This is supported by the belief that experiences-both good and bad-make sense and have a purpose.

24. Hope • Hope is the expectation for something in the future. • Hope consists of the anticipation that opportunities for new adventures, pleasures, and relationships will unfold with each tomorrow.

25. Dignity • Self-worth is often judged by appearance, function and productivity. • When older people lack the attributes that command dignity, they can derive a sense of value and worth through their connection with God or other higher power.

26. Forgiveness • It is human nature to err and sin. • Carrying the burden of the wrongs committed by or to oneself is stressful and can be detrimental to health. • For the older adult, forgiveness can facilitate the important process of putting things in order and achieving closure to unfinished business.

27. Gratitude • Western society sometimes takes too much for granted. • Instead of giving thanks, many are looking to obtain more. • Older individuals may benefit from a guided view of positive aspects of their lives.

28. Transcendence • People need to believe that they are connected to a greater power that surpasses logical thinking. • Transcendence affords people life beyond material existence and equips them to make sense of the difficult circumstances they face.

29. Expressions of Faith • Faith encompasses religious/spiritual beliefs and is expressed through religious/spiritual practices. • Practices may include: prayer worship rituals fasting

30. Expression of Faith • Spiritual distress can arise during illness from a person feeling resentful that God has seemingly abandoned him. • Nurse needs to be supportive of patients religious beliefs.

31. Assessing Spiritual Needs • Asking a patient about spiritual matters should be part of the nurses assessment process. • Fosters holistic care. • Sources for gathering information about spiritual needs may be part of the admission process, assess for verbal cues. “All I can do is pray”

32. Assessing Spiritual Needs • Look for the presence of religious symbols, such as books, Bible, the Koran, or inspirational books.

33. Addressing Spiritual Needs • Evidence suggests that strong spiritual beliefs fascilatatehealing. • It is therapeutically beneficial to support a patient’s spirituality.

34. Supporting Spirituality • Nurses can use a variety of methods to support a patient’s spirituality: • Being there (establish trust) • Honoring Beliefs and Practices • Providing opportunities for Solitude. • Promoting Hope.

35. Summary • People are Spiritual beings. • Realizing their connection to something greater than themselves empowers older people to rise above their physical, intellectual, emotional and social challenges and discover peace and well-being. • Self-worth and hope can be achieved for the elderly patient.