Week 6 Discussion
Tiffanie McLeod
Aspen University
Health Assessment
Instructor
November 2 2022
The first hazard for older adults is immobility. A common sign of immobility is the inability to sit up without assistance. The mechanism of immobility is the patient's inability to coordinate muscles. Many older adults are in a frozen position and unable to sit up without assistance. Some patients may have limited ability to speak, such as slurred speech or difficulty speaking clearly. In addition, some can't move their arms, legs, or other body parts because of injury or previous illness (Melino et al., 2022). Earlier detection and treatment of immobility would increase a patient's comfort level and mobility, which could lead to improved outcomes. The second hazard for older adults is delirium.
Delirium is characterized by an acute change in personality, level of consciousness, and cognitive functioning. It can be caused by an infection or injury; light therapy may help treat patients who suffer from this condition. Furthermore, delirium can progress to increase in severity as the patient becomes more debilitated (Pereira et al., 2021). Delirium may also increase in severity for reasons such as: being on a drug that causes excessive sedation, lack of oxygen to the brain, or being alone. In addition, there is an association between delirium and decreased stay time within hospitals. Delirium is associated with an increased risk of death and physical limitations after hospital discharge. Improving a patient's awareness and comfort level may reduce their risk for delirium while in the hospital.
The last potential hazard for older adults is medications side effects. Examples of these side effects include increased swelling, confusion, and breathing problems. These side effects may lead to a longer hospital stay. As a result, there is less time for recovery. Medications may have interactions that are harmful to the patient; these conflicts need to be resolved before they worsen or cause more serious medical problems while in the hospital. Medications side effects are often evident throughout the hospitalization, but can also appear and affect patients after discharge. For example, some medications may interact with certain types of pain medications, which can cause side effects such as difficulty breathing or drowsiness. In addition, some medications may cause constipation and disrupt sleep during sleep. Patients should be educated about these medications prior to admission to the hospital. In addition to educating patients, physicians and nurse practitioners can substitute certain medications for others that may pose fewer side effects. Patients should be comfortable when in the hospital and feel safe about their surroundings. If a patient is uncomfortable, they are likely to have higher levels of agitation and confusion. To reduce the likelihood of agitation, patients should be brought into a safe environment.
Reference
Melino, K., Wagner, L. M., & Capezuti, E. A. (2022). Restraints and immobility. Pathy's Principles and Practice of Geriatric Medicine, 2, 1478-1491. https://doi.org/10.1002/9781119484288.ch118
Pereira, J. V. B., Aung Thein, M. Z., Nitchingham, A., & Caplan, G. A. (2021). Delirium in older adults is associated with development of new dementia: a systematic review and meta‐analysis. International Journal of Geriatric Psychiatry, 36(7), 993-1003. https://doi.org/10.1002/gps.5508