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What are some of the difficulties you might experience as a nurse who has to take care of older adults with sensory deficits? What skills would be most important for you to gain in order to overcome these difficulties?

Communication disorders constitute the nations number one handicapping disability. Conditions such as stroke, cancer, degenerative neurological diseases, and trauma can affect the older persons ability to communicate. The aging process brings about changes in hearing, taste, smell, vision and touch. Listening is a vital communication skill. After asking questions of older people, wait for their answers. Many times they need extra time to process your question and formulate an answer. Unless you need to transport immediately, take time to listen patiently for answers to your questions. Make sure that the patient can hear and understand you. Listen to more than just the words of the patients you care for. Listen to the way they Say the words because their tone can convey fear or confusion. Always introduce yourself and ask the patient their name. Address them as Mr. or Ms unless they invite you to call them by their first name. Use their name as much as possible. No honey, sweetie, baby, oldtimer etc this is disrespectful. Look directly at the patient. Speak slowly and distinctly. Use simple terms to explain equipment and procedures. Listen to the answer the patient gives you and be sure they are finished before you talk. Show the patient respect. Do not assume the patient is hard of hearing i.e. Dont yell at blind people. Be patient! Remember older patients have more difficulty communicating clearly when They are stressed! Folks will start to ask people to please repeat what they just said and slowly but surely the frustration grows. Some people may not admit they are having trouble hearing. Older people who cannot hear well may become depressed or withdraw from others to avoid the frustration or embarrassment of not understanding what is being said. It is easy to call older people confused, non-responsive, or uncooperative just because they dont hear well. If you know your patient has a hearing problem, face the person and talk clearly; stand where there is good lighting and low background noise; speak clearly and slowly; do not hide your mouth, eat or chew gum; use facial expressions or gestures to give useful clues; re-word your statements if necessary. Use short sentences. Be patient, stay positive and relaxed; ask how you may help the listener (does the patient have a hearing aid they would Like to use); remember that the hearing- impaired patient will not hear and understand as well when they are tired or sick For many older people, it is difficult to produce speech that is loud enough, clear and easy to understand. Disorders of speech and communication that affect the elderly population may result from stroke, cancer, disease of the larynx, Parkinsons disease, or other neurological disorders. They may include difficulty speaking or understanding verbal and/or written information. Many times the effects of the speech impairments are overwhelming and frustrating for the patient and the family and/or caregiver.

With cognitive impairment do not assume that the patients are incapable of effective communication. Many times they can understand simple facts and questions. Enlist the help of a relatives or friends. Be patient! You may need to repeat information or questions that have already been given. Allow time for the patient to respond. As a person gets older their reaction time may be slower. Speak slowly. Use short phrases. Emphasize key words. Keep messages short and simple. Ask one question at a time. Ask questions that can be answered by yes or no. Give simple, one step directions. Provide encouragement. Do not correct. If you dont comprehend what the patient is saying, say im sorry i did not understand what you were saying. Suggest an alternative method of communication or rephrase the question to a simple yes or no response. 2. Choose an age-related disease in which you have a particular interest and discuss how this disease might impact the functional ability, independence, and psychosocial well-being of an older adult.

Osteoporosis is an enormous public health problem that is responsible for at least 1.5 million fractures in the country each year. Vertebral fractures that occur as a result of postmenopausal osteoporosis of the spine are exceedingly common. Some may experience an osteoporotic fracture of the spine by age 60 and others may have had an osteoporotic fracture by age 75 osteoporotic fractures of the spine with attendant pain, deformity, and threat to independence affect many areas of life for older women and their families. Osteoporosis is defined pathologically as an absolute decrease in the amount of bone leading to fractures after minimal trauma, genetic, mechanical, nutritional, and hormonal factors appear to be responsible for bone loss and subsequent fractures. Genetic factors influence fracture risk in that large boned persons are more protected than smallboned persons; black women, who have a greater bone mass than white women at all ages, have a lower incidence of symptomatic osteoporosis. Physical exercise that places stress on the bones is responsible for variations in bone mass around the genetically determined level. Increased stress through exercise results in increased bone mass. In general, physical activity declines with age. Since bone mass is adversely affected by lack of physical activity, it follows that bone mass decreases as people age. There is also growing evidence that nutritional, hormonal, and chemical factors such as calcium intake, vitamins, estrogen levels, and alcohol use affect the attainment and maintenance of peak bone mass. The person most likely to be affected in osteoporosis is a sedentary, postmenopausal, woman with a lifelong calcium deficiency. Few studies have focused on the impact on the lives of women who have suffered a postmenopausal vertebral fracture. Some research described the stress and adaptation patterns of women diagnosed with osteoporosis. Forty-eight percent of the participants in the study had experienced a vertebral fracture. All of the women perceived more stress in their lives since being diagnosed with osteoporosis, whether or not they had sustained a fracture. Pain, loss of roles, and other physical limitations were the variables identified that contributed to their feelings of stress.

Constant pain, loss of independent function, changes in physical appearance, feelings of isolation, a sense of vulnerability, and an uncertain future were the hallmarks of the experience of patients with osteoporosis. An intervention program that incorporates education, programs to regain or maintain function, pain management, techniques to reduce stress and isolation, and promotion of self-care ability has the potential to enhance the quality of life for the elderly with postmenopausal spinal fractures or those with signs and symptoms of osteoporosis. Sometimes elderly become suspicious of medications and, sometimes, even doctors. As a patient advocate and caregiver you can assure them that the doctor is looking out for their best interest. The medications are correct, and also make sure that medications are taken as prescribed. Being a patient advocate during doctors visit would also be helpful. It is important to not only take the person to the doctor, but remain in the examination room as an advocate and a second set of ears. This helps you to be on the same page with the doctor regarding the patients care.