AGING PERSPECTIVE AND DEMOGRAPHY

NCM114 GERONTOLOGY
➔ All nursing settings from acute care,
intermediate, skilled care, extended facilities
AGING PERSPECTIVES and also in community
➔ Aging : normal process of time-related ➔ Hospice care etc.
change

DEMOGRAPHICS OF NURSING
AGEISM ➔ Stages/ Phases of Older Adult
➔ A bias against older people ➔ Global Aging
➔ Based perception solely on their chronological ➔ Aging in the Philippines
age not on their functional stats ➔ Life Expectancy
➔ Stereotyping characteristics of elderly ➔ Life Span
◆ Examples:
● Weak
● Memory loss
AGING
● Poor ➔ Starts at age 60 years old (PH) in america, 65
● Burden ➔ Or elderly, older adults/people, late adulthood
● Dependent or senior citizen
● Unreliable ➔ It is the fastest growing age group than the
● Lonely rest of population (esp. in other countries like
US)
➔ Composed of 12.8% of the population in
GERIATRICS america, 5% in PH
➔ The branch of medicine that is use to study old ➔ In 2030, it increase to 22% of population
age ➔ Increasing aging population (very old people)
➔ Focuses on physiology, pathology, diagnosis, ➔ Because of declining fertility rate and rising
and medical management of the disorders and life expectancy
diseases of older adults ➔ Baby boomers - born between 1940 - 1960

GERONTOLOGY STAGES OF OLDER ADULT

➔ Refers to the combined biologic,
psychological, and sociologic study of older
adults within their environment
➔ Applying holistic patient care
➔ General health being of the patient
➔ 3 Phases/ Stages
◆ Young Old: 60 to 69 years
◆ Middle old: 70 to 79 years
◆ Oldest Old: Above 80 years (fastest
growing group)
◆ Centenarians: people over 100

GERONTOLOGIC NURSING
➔ The field of nursing that specializes in the
nursing process
➔ It includes assessment, nursing diagnosis,
planning, implementation and evaluation of
older adults
GLOBAL AGING
➔ United Nations (2020)
◆ The global populations aged 60 years
old and above accounts 962 million

ADHARA 2023 1
AGING PERSPECTIVE AND DEMOGRAPHY

NCM114 GERONTOLOGY
◆ In the USA, around 53.7 million aging ➔ In the Philippines, it was estimated that there
population are 4.6 million senior citizens (less than 5% of
the population)

LIFE EXPECTANCY
➔ Definition: Average number of years a person
NURSING IMPLICATIONS
is expected to live ➔ Nurses are challenged to develop strategies to
◆ U.S Census 2010 have reported that life address high prevalence of chronic illness to
expectancy increased to aging population
◆ Men: 75 ◆ Mas maraming matatanda = mas
◆ Women: 80 maraming illness
◆ Ano yung maximum age niya na pwede ◆ Nurses -> campaign
siyang mabuhay ➔ Sufficiency and availability of health services
◆ Mas marami dapat ang health care
facilities
LIFE SPAN ➔ Assess their children who face competing
➔ Refers to the maximum number of years an demands to care for their aging parents while
individual is expected to live in absence of taking care of their own dependent children
disease ◆ Mas may focus sa mga lolo/lola dahil
◆ Namatay sa katandaan mas malaki/marami yung demand
➔ US Census (2010) have reported that
➔ Life Span
◆ Men : 85 y/o
◆ Women 87 y/o

AGING IN THE PHILIPPINES

● How older adults in america
○ 53.7 millions are older adult

LIFE EXPECTANCY
➔ In Philippines it was estimated that there are
4.6 million senior citizens
➔ For Filipinos 57.4 for males and 63.2 years for
females Annual Deaths and Death Rates for the 10
➔ By 2030, life expectancy is projected to Leading Causes of Death in People 65 years and
increase of 4.0 XXX Olders

AGE STRUCTURES
➔ The Philippines resembles many other
developing countries
➔ There is a greater proportion of younger
filipinos in comparison to older people

ADHARA 2023 2
AGING PERSPECTIVE AND DEMOGRAPHY

NCM114 GERONTOLOGY
● Provides guidelines for anticipated patient
HEALTH CARE COST
care needs for family, insurance company,
→ Health care financing like government health attorney, medical professionals
programs
→ PhilHealth: Philippines IMPACT OF AGING MEMBERS IN THE FAMILY
→ MediCare: America ● Implications
○ The tradition of caring the old still
lingers in Filipino family
DEFINITION
○ The older filipinos enjoy a significant
➔ Health care financing like government health amount of care and support form their
programs spouse and children
➔ Medicare/ Medicaid: major dominant payer in ○ Support: Family, emotional, financial,
USA that fund nursing homes costs, hospital companionship
services cost
➔ Philhealth: elderly enjoy 20% discount plus REPUBLIC ACT (RA) 9994 OR THE EXPANDED
VAT exemption during private hospital SENIOR CITIZEN ACT OF 2010
confinement ● Caring for the older persons by the family
➔ Private companies that finance ○ To encourage their families and the
healthcare/institution: MaxiCare; IntelliCare communities they live with to reaffirm
the valued Filipino tradition of caring
for their senior citizen
○ To provide a comprehensive health
care for senior citizens to foster their
capacity to attain a more meaningful
and productive ageing

PHILIPPINE GOVERNMENT’s PROGRAM FOR THE

CARE OF OLDER PERSON
● Home care support for senior citizens
department of social welfare and development
Health Care Cost ○ The need to improve capacities of
family members, kinship careers in
LIFE CARE PLANS caring for sick, frail, bedridden or
● Individualized document that assess and disabled elderly family members
evaluate elder’s present and future health care ○ To promote stringer family
and living needs relationship and social responsibility
● Average cost 250,000 - 1m
● Example: Sunlife, Manulife , PhilAm Life
● Blueprint for what is expected in long term
care
● Standardized and efficient guidelines for
medical and ancillary quality- of- life services
● Provides information about factors affecting
individual’s health care and quality of life

ADHARA 2023 3
 LEC. 3 COMMUNICATION & DOCUMENTATION

NCM114 Geriatrics “COMMUNICATION”

● More powerful than spoken words, accompanies
verbal communication
OUTLINE
○ Examples: elderly patient’s facial expressions,
1. Communication head nod, gestures, body posture/movement,
1.1. Modes of Communication touch, eye contact voice tone
1.1.1. Verbal ○ [@] Hindi nagsasalita, nagtatampo, not okay,
1.1.2. Nonverbal wala sa mood. Giving a Handkerchief.
1.1.3. Written 1.1.3 WRITTEN
1.2. Therapeutic Communication
1.2.1. Art of Therapeutic Communication ● Most formal mode of communication
1.3. Guidelines For Communication With Patient’s ● It can be types, printed, or hand written
Family ○ Examples: Letter, white board, pen and paper,
1.4. Techniques For Communication With Elders patient’s chart, nurse’s notes, doctor’s notes,
1.4.1. Establishing The Setting physician order, endorsement
1.4.2. Tips For The Staff ○ [@] usually sa Philippines hand-written parin.
1.5. Verbal Communication Skills Whatever you do to your patient, document it.
2. Keep in Mind ○ [@] Pen and paper is very powerful especially if
3. Information the patient cannot speak
3.1. General Format “EASY WAY OUT”
3.2. Figure Inserts ● Verbal - Most intimate
3.3. Lists and Tables ● Non-verbal - More powerful than verbal
3.4. Citation ● Written - Most formal
3.5. References FIGURE 1. Stages of Communication Cycle
LEGEND
No logo - From PPT [@] - Prof’s Notes [$] - From Book

1. COMMUNICATION
● This refers to the transfer of information and message
from one person to another
● It is an ongoing process of creating an interaction or
shared understanding between two people
● [$] It is a continuous dynamic process including verbal
and nonverbal signals.
1.1 MODES OF COMMUNICATION
● Verbal Figure 1. Stages of Communication Cycle
● Non-verbal
● Written ● Step 1 - Sender: the person who originates the
1.1.1 VERBAL message
● It refers to spoken words, message ○ [@] Data galing sa kanya
● Most intimate contact: mode - terminating employee, ● Step 2 - Encoding: Process of turning thoughts and
conflict confrontation feelings to communication
○ Examples: face to face, conversation, ○ [@] Development of thoughts into
one-on-one talk, telephone call communication
1.1.2 NON-VERBAL ● Step 3 - Message: Content of communication
● These are nonverbal messages or ● Step 4 - Receiver: Person who gets the message
meta-communication ● Step 5 - Decoding: Process of evaluating
● [$] It is thought to comprise 80% of the communication communication and making it meaningful
process and includes body languages such as position, ● Step 6 - Feedback: The return message
eye contact, touch, tone of voice , and facial 1.2 THERAPEUTIC COMMUNICATION
expressions. ● Nurse therapeutic relationship with a client is an
interpersonal helping process
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 LEC. 3 COMMUNICATION & DOCUMENTATION
● [$] Gerontological nurses need to communicate
effectively with older patients with a variety of physical
and cognitive impairments in order to develop
therapeutic relationships with each patient.
● Simply developing a good bedside manner
● Careful; to respond to patient’s questions in a helpful
and caring manner
● Correctly observe, evaluate and respond when patient
communicates with the nurse
1.2.1 ART OF THERAPEUTIC COMMUNICATION
● Nurses must relate their own experiences concerning
illness and death is that patient will be comfortable
● Nurses must use self-discovery, self-discussion and
self-awareness
● Nurse must develop skills, competence and expertise
in effective communication to elderly patient
● Encourage to promote reflection, reading and journal
writing
○ [@] Talking with your patient is a form of
communication but maintaining a therapeutic
communication is already a skill
○ [@] Each elderly patient may kanya-kanyang
concern so iba yung approach mo sa patient na
di makarinig at sa di makakita.
○ [@] Kapag di ka na aware sa sarili mo, hindi ka
magiging therapeutic sa patient mo.
○ [@] Take care of yourself (release stressors for
your mental health)
1.3 GUIDELINES FOR COMMUNICATION WITH PATIENT’S
FAMILY
● Simply being fully present during any opportunity for
questions, concerns, problems
○ [@] At the time nahihirapan si patient, wag mo
siyang iiwan. Be present at the time of question,
concerns etc. Especially kapag nasa end stage
na si patient, wag iwanan.
● Don't make promises you can't keep
○ [@] Older adults madaling mawala yung trust
nila
○ [@] Magpaalam sa patient bago umuwi after a
shift
● Accept and respect the patient decision
○ [@] Kahit pro life ka, kapag yung patient in DNR
status wala ka magagawa.
○ The patient is the best person to decide for
himself or herself
● Talk with patient, family members, friends and
colleagues
○ [@] Have the habit of talking to the support
system of the px. Establish a good interpersonal
relationship kasi they are good sources of
information especially during history taking.
○ [@]This can help gather more information about
your px
○ [@]The family is 2nd best source of information
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● Patient and family must be given adequate and
sufficient time to respond/speak/reply/absorb the
news
○ [@] Make a habit to provide adequate time to
respond sa patient kasi minsan mabagal
magsalita si patient. Ask for example, “maam
ano po?”
○ [@] Don’t be in a hurry
● Try not to overwhelm the patient with embarrassing or
personal question
○ [@] Ex. you want to know the patient’s sexual
history (“Maam buhay pa po ba yung asawa
niyo?”)
○ [@] Don't ask something embarrassing or
personal questions to the patient
1.4 TECHNIQUES FOR COMMUNICATION WITH ELDERS
1.4.1 ESTABLISHING THE SETTING
● Conducted in a safe, right, and conducive settings
● Provide a comfortable environment, quiet peaceful
area
○ [@] Ex. maraming puno, may mga park,
playground (for them it promotes safety,
comfortable, relax and quiet)
● Sit-down when speaking to the patient
○ [@] Hindi maganda yung ganon kasi chances are
ang tendency you will feel superior
○ [@] The patient will feel inferiority complex
(vice-versa)
● Sit face to face and maintain eye contact
○ [@] Alam ng matanda kung nagpa-pay attention
ka so maintain eye contact kasi baka
ma-disappoint siya, focus para di sila
mainterrupt
● Provide for privacy
○ [@] Close the door, close the curtain
● Disclosure of important information in private areas
○ Informations that you will open up to the patient
should be disclosed in a private setting
● Avoid disturbances, distractions, unnecessary
interruptions, noise
○ [@] Kaya dapat comfortable, quiet, and peaceful
to avoid unnecessary interruptions (noise,
disturbances, etc.)
1.4.2 TIPS FOR THE STAFF
● Schedule older patients earlier in the day
○ [@] Ex. itong mga patient na sobrang mainitin,
madaling uminit ang ulo. Pag sinabi mong 10
o'clock darating na si doc, dapat 10 talaga yan
kundi magagalit sila (probably part of their
disease)
○ Not too early, not too late
● Greet them to ensure they are comfortable
 LEC. 3 COMMUNICATION & DOCUMENTATION
○ [@] Establishing rapport will help develop trust ○ [@] Don’t give false reassurance
to the patient ● Avoid question which require only a simple yes or no
○ Tendency is that they will be more open to you answer
and you can extract significant information ○ [@] Use open ended questions kasi mas marami
about their health status kang makukuhang information from the patient.
● Seat in quiet/comfortable area “Ma’am kamusta po kayo? Ano pong
○ [@] “Maam, upo po kayo ng maayos. Relax..” nararamdaman niyo”
● Keep patient relaxed/focused ● Avoid canned responses: “i know just how you feel”
○ [@] Place them in a quiet, comfortable and ○ Hindi nila ma-appreciate yung mga OA na
relaxed environment responses
● Physically escort patient
○ [@] Usually kasi may tendency na mafall sila Effective Communication
● Check from time to time ● Convey honesty, empathy and trustworthiness
○ [@] Raise side rails; may mga elderly na ○ [@] You need to put yourself in the shoes of your
nababagok if left unattended patient. Kung anong nararamdaman ng patient,
● Always say goodbye dapat ganun ka rin.
○ [@] Ex. “Goodbye po. Ingat po kayo” ● Must speak clearly, slowly, loudly, short concise
○ Termination phase; para di hanapin yung nurse ○ [@] Communication should always be clear
incharge, wag ighost si patient between yourself and the patient.
PAHINGA MUNA, ADHARA! ● Allow for extra time for older patients
○ [@] Wag complex or lengthy yung sasabihin.
Simple questions lang
● Encourage simple conversation
● Offer large-print books, easy to read
○ [@] Ex. yung mata niya medyo di na makabasa,
make sure na easy to read yung health teaching
material mo at nababasa niya pa incase na
nakalimutan niya yung mga sinasabi mo
● Provide mnemonics, sensory cues, chart, models,
pictures
○ [@] That can help in providing effective
1.5 VERBAL COMMUNICATION SKILLS communication through using these things
○ [@] Charts, picture, infographics, pictographs
● Let the patient do the talking
● Ask patient to wear reading glass, magnifier, hearing
○ [@] Mag nod para mafeel nila na nakikinig ka
aids
● Ask one question at a time
○ [@] To promote effective communication para sa
○ [@] Wag niyong hahayaan na iba-iba yung
mga may sensory impairment.
questions na di na masagot ng patient.
Improving Communication Skills among Gerontology
○ [@] Don’t ask different questions at once.
Nurses
○ Isang tanong, isang sagot
● Have a clear, brief, simple, complete instruction
○ [@] Isa isang tanong, para makapagfocus si
○ [@] Hindi kailangan ng mahaba, dapat short lang
patient
ang health teaching
● Summarize the most important points
● Avoid speaking too fast or too slow
○ [@] After all the health teaching, give a summary
● Active and attentive listening is the key
● Give patient time to answer, to ask a question to
○ [@] Make sure may eye to eye contact
exp(ress ata) putol ppt awit
● Use short, simple, common words/sentences
● Use language that is understandable to the patient
○ [@] Wag masyadong lengthy
○ [@] Don’t use english kung di niya maintindihan.
● Pronounce words correctly
Dapat understable.
○ [@] Kapag nagbaby talk ang patient na baby,
○ [@] Make sure to use the level of language that
don’t tolerate kasi ginagaya nila yon
your patient understands
○ [@] Pronounce words correctly
● Avoid leading questions. You want the patient to tell
● Encourage feedback, summarize, redundancy, restate
you
and repeating information
● Avoid how or why questions, they tend to be
○ [@] Give a summary ng health teaching
intimidating
● Avoid the use of cliche statements like “don't worry”
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 LEC. 3 COMMUNICATION & DOCUMENTATION
● The nurse needs to be sensitive to the emotional
feelings of patient
○ [@] Pag nakita mong umiiyak si patient,
kamustahin mo. “Ma’am bakit po kayo umiiyak”
○ [@] To know when to interfere and to interact
● Offer therapeutic touch, handkerchief, tissue
○ [@] Know when to talk to them
○ [@] Be sensitive to their feelings
Advance Reading:
1. Who are the members of the geriartic care team
2. Give, identify the different Healthcare facilities for
elderly
CITATION
● Please use APA format for in-text citations (Guiyab,
2021)
REFERENCES
● APA citation guide. (2016).
http://www.bibme.org/citation-guide/apa/
● Lipson, C. (2011). Cite right: A quick guide to citation
styles – MLA, APA, Chicago, the sciences, professions,
and more (2nd ed). United States of America: The
University of Chicago Press, Ltd., London.
● Ferraro, A. (Photographer). (2014). Liberty enlightening
the world [digital image]. Retrieved from
https://www.flickr.com/photos/afer92/
14278571753/in/set-72157644617030616
● Tabloski, P. A. (2019). Gerontological nursing. Pearson.

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 NCM114N GERONTOLOGIC HEALTH CARE TEAM
○ [@] Can be found in extended care facilities,
OUTLINE nursing homes
1. Gerontologist Geriatrician ● Works in collaboration with older adults, their families
2. Gerontology Nurse Practitioner and communities
3. Gerontology Nurse ● Focuses healthy aging, maximum functioning, quality
4. Nursing Assistant of life
5. Occupational Therapist ● Provides routine assessment, physical care, administer
6. Physical Therapist medications, patient education, explain therapeutic
7. Dietician/ Nutritionist regimens
8. Case Manager
9. Medical Social Worker 4. Nursing Assistant
10. Spiritual Support Personnel ● Personal care attendant (PCA), patient support
11. References assistant (PSA), certified nursing assistant, licensed
practical nurse (LPN), nursing assistant (NA), nursing
LEGEND
aide and nursing olderly
No logo - From [@] - Prof’s Notes [$] - From Book
○ [@] also known as nursing orderly or nursing aid in
PPT
the Philippines, Practical Nurse
○ [@] In the US, nursing assistants (called nursing
1. Gerontologist Geriatrician
orderly in the US) take vital signs, change linens, I
● Or the Geriatric Health Care Team & O monitoring etc.
● A medical doctor who specializes in the care of the ○ [@] given other nursing roles that doesn’t require
ederly the accountability of the main nurse;
● Provides treatment of diseases affecting the older ○ [@] certification is needed in the US
adults as they age. ○ [@] Especially in the PH, orderly nurses can work
● It includes diagnosing and treating a wide range of even without passing the licensure exam, as long
conditions like dementia, alzheimer, cancer, as they have a BSN degree
hearing/visual loss, osteoarthritis, osteoporosis, ● These are health care staff who assume delegated
diabetes, heart failure. aspects of basic care
● Some of these provider may have standardized
2. Gerontology Nurse Practitioner education while others do not
● An advanced nurse practitioner (ANP) or clinical nurse ● Take care patients in hospitals, long-term care
specialist (CNS) with graduate level of education facilities, nursing homes
(master and doctorate degree ) in gerontology. ● These tasks include bathing, assisting with feeding
● Diagnose, treat, manage chronic illness while collecting specimen and transporting individuals
coordinating care with physicians ● Delegate unregulated nursing roles (mostly hygienic
● Risk assessment, immunization, screening test, care)
examines patient, counseling, health check-up, ○ take vital signs, cleaning/sterilizing treatment
preventive care, provides prescription area, serves meal/ feeding patient,
○ [@] they are nurses but can diagnose, prescribe bathing/dressing, personal grooming changing
medicines, and request laboratories, and linen, turning/moving patient, measuring I&O, bed
screenings. Job is to be like a doctor. making with supervision
○ [@] vocational nurse
3. Gerontology Nurse (Nurse Gerontologist)
● Nursing specialty that provides care for the older
adults
○ [@] GNP focuses on diagnosis
○ [@] GN- focuses on promoting healthy aging,
taking care of older adult patients

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 NCM114N GERONTOLOGIC HEALTH CARE TEAM
5. Occupational Therapist
● Providing therapeutic support for older adults
experiencing sensory changes, motor disabilities,
physical injuries, impaired functioning.
○ [@] Assist in activities of daily living, (eating,
writing, holding, walkin g, working, bathing) routine
activities
○ [@] PT: rehabilitation, while OT: more on activities
of daily living (eating, bathing, dressing, writing,
typing)
○ Goal: Patient will be able to function independently
● Help someone recover by improving their ability to do
their day-to-day tasks or everyday routinary activities
● Assist individuals with impaired functioning to function
better without assistance and with independence
● Helps patients to perform skills needed for activities of
daily living (cooking, feeding, bathing, dressing),
occupation/work and everyday activities(pick-up, write,
run)
6. Physical Therapist
Or Geriatric Physical Therapist, Physiotherapist
● Helps patients promotes and restore health by
restoring balance, improving mobility, movement and
exercise
○ [@] Assist in ROM
○ [@] Geriatric Physical therapist - care for the elders
and they focus more in promoting body
movements (e.g. balance)
● Assist older to recover from trauma, injuries, paralysis
○ [@] Can work at skilled nursing facilities, nursing
home, extended care
○ [@] Example: Stroke, arthritis, osteoporosis,
Alzheimer
● Reduce pain and prevent falls and contracture
○ [@] Contracture - mag extend lahat ng extremities
because walang ROM, (Prevention: ROM exercise
and breathing exercise)
● Work in nursing home, skilled nursing facility, extended
facility, community support service (long-term care
facilities)
7. Dietician/Nutritionist
● Nutritionist is a person with special knowledge about
nutrition and food
○ [@] Nutritionist - providing optimal nutrition, has
specialized knowledge in nutrition (Nutritionist
working in the hospital)
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● Dietitians have special knowledge about therapeutic
diets required to maintain health and to treat disease.
○ [@] Dieticians work in the hospital, knowledgeable
about therapeutic diet or prescribed diet in the
hospital
○ [@] Compute specific calories for each meal
○ [@] Prepares hospital food of patient (including
those with NGT)
● They are generally concerned with special diets
required to maintain health and to treat disease
● Supervise the preparation of meals to ensure that
individuals receive the proper diet
○ [@] most especially prescribed, therapeutic diets
● Recommends healthy diets and gives advice to
patients and families about balanced diet
8. Case Manager
● Role is to ensure that older adults receive sound and
appropriate care in the best setting.
● To ensure that the best care is delivered, oversees the
processes of care delivered
○ [@] Nurse:Patient Ratio in PH - 1:15, in America 1:5
○ [@] IDEAL Nurse: patient ratio in general wards-
1:5
○ [@] CCU/ ICU 1:2
○ [@] Case manager to patient 1:15
○ [@] The usual case manager in the hospital are
nurses (that’s why VPs in Nursing Service may
also be VPs in Care Management)
○ [@] Focuses on quality assurance
● This role often being the most involved in the person’s
care
● Serve as patient, family and facility advocate.
● Address individual’s concerns, needs; Manage conflict ,
issues, problems
○ [@] conflicts between patients and the doctor, or
towards the hospital
 NCM114N GERONTOLOGIC HEALTH CARE TEAM

9. Medical Social Worker

● A social worker counsels patients and significant
others regarding problems, such as finances, family
condition, living arrangement, day-to-day living
○ [@] Social workers that work in the hospital
○ [@] Counsels about non-nursing or non-health
problems
○ [@] Because there are problems that does not
cover nursing responsibilities
○ [@] Examples: Financial problems, negligence of
parents, ADLs, family abuse, and non-related
problems about health
● Provides support for and assists in cases unusual for
health problems
● Provide care by conducting psychosocial assessments
● To identify mental and emotional distress, crisis,
psychosocial help
○ [@] Psychosocial assessment; check if there’s an
elder abuse, or negligence of the family members

10. Spiritual Support Personnel

● Chaplains, pastors, clergy, rabbis, priests, spiritual
advisors
○ [@] Chaplain = priest inside the hospital who works
sometimes in the hospital especially if it is a
private hospital.
● Health care team attend the spiritual needs of the
patients
○ [@] hospital with religious affiliations have
chaplain rounds per ward or department to meet
spiritual needs/support of patient (Most especially
those at end-of-life)
● Services on a regular or on-call basis or full-time
chaplains, hospital affiliated
● They usually offer regular on call basis or full-time
chaplains, hospital-affiliated
● The nurse is often instrumental in identifying the
person’s desire for spiritual support
○ [@] UST hospital - chaplains (if gusto
mangumpisal bago mamatay)

REFERENCES
● Dr. Mejia P.C. (2021) Gerontologic Health Care
Team.

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 Name:
MINI-MENTAL Birth date: Age:
STATE Contact Number:
EXAMINATION Address:

(MMSE)
One point for each DATE: Sept. Sept. Sept.
answer

ORIENTATION ……/ 5 ……/ 5 ....../ 5

Year Season Month Date Day

Country Region Municipality Town Street ……/ 5 ……/ 5 ....../ 5

REGISTRATION
Examiner names three objects (e.g. apple, banana, orange) ……/ 3 ……/ 3 ....../ 3
and asks the patient to repeat (1 point for each correct. THEN
the patient learns the 3 names repeating until correct).

ATTENTION AND CALCULATION

Subtract 7 from 100, then repeat from result. Continue five ……/ 5 ……/ 5 ....../ 5
times: 100, 93, 86, 79, 65. ().

RECALL ……/ 3 ……/ 3 ....../ 3

Ask for the names of the three objects learned earlier.

LANGUAGE ……/ 2 ……/ 2 ....../ 2

Name two objects (e.g. ballpen, watch).

Repeat “Hindi, at, ngunit”. ……/ 1 ……/ 1 ....../ 1

Give a three-stage command. Score 1 for each stage. (e.g.

……/ 3 ……/ 3 ....../ 3
“Place index finger of right hand on your nose and then on
your left ear”).
Ask the patient to read and obey a written command on a
……/ 1 ……/ 1 ....../ 1
piece of paper. The written instruction is: “Close your eyes”.

Ask the patient to spell LAKAS” backwards: SAKAL

……/ 1 ……/ 1 ....../ 1

COPYING: Ask the patient to copy a pair of intersecting pentagons

……/ 1 ……/ 1 ....../ 1

TOTAL: ……/ ……/ ....../

MMSE scoring 30 30 30
24-30: no cognitive impairment
18-23: mild cognitive impairment
0-17: severe cognitive impairment
 Geriatric Depression Scale (GDS)

Direction: Choose the best answer for how you have felt over the past week
ITEMS September Comments
Yes No
1. Are you not satisfied with your life?

2. Have you dropped many of your activities and

interests?

3. Do you feel that your life is empty?

4. Do you often get bored?

5. Are you in poor most of the time?

6. Are you afraid that something bad is going to happen

to you?

7. Do you feel lonely most of the time?

8. Do you often feel helpless?

9. Do you prefer to stay at home, rather than going out

and doing new things?

10. Do you feel you have more problems with memory

than most?

11. Do you think it is not wonderful to be alive now?

12. Do you feel worthless the way you are now?

13. Do you feel lack of energy?

14. Do you feel that your situation is hopeless?

15. Do you think that most people are better off than

you are?

TOTAL SCORE

*Score 1 point for each YES answer. A score of more than or equal to 5 points suggest depression and requires further assessment

Declaration: I hereby acknowledge that the given information is correct and is in accordance to the best of my knowledge.

___________________________ _____________ _____________________________________
Name and Signature of Patient Date Name and Signature of Nursing Student
 Katz Functional Index
Independence in Activities of Daily Living
Activities of Daily Independence Dependence Points
Living (ADL) (1 Point) (0 Points) (1 or 0)

Description NO supervision, direction or WITH supervision,

personal assistance. direction, personal
assistance or total care.
BATHING
(1 POINT) Bathes self (0 POINTS) Need help with
completely or needs help in bathing more than one part
bathing only a single part of the of the body, getting in or
body such as the back, genital out of the tub or shower.
area or disabled extremity. Requires total bathing
DRESSING
(1 POINT) Get clothes from (0 POINTS) Needs help with
closets and drawers and puts dressing self or needs to be
on clothes and outer garments completely dressed.
complete with fasteners. May
have help tying shoes.
TOILETING
(1 POINT) Goes to toilet, gets on (0 POINTS) Needs help
and off, arranges clothes, cleans transferring to the toilet,
genital area without help. cleaning self or uses
bedpan or commode.
TRANSFERRING
(1 POINT) Moves in and out of (0 POINTS) Needs help in
bed or chair unassisted. moving from bed to chair or
Mechanical transfer aids are requires a complete
acceptable transfer.
CONTINENCE
(1 POINT) Exercises complete (0 POINTS) Is partially or
self control over urination totally incontinent of bowel
and defecation. or bladder
FEEDING
(1 POINT) Gets food from plate (0 POINTS) Needs partial or
into mouth without help. total help with feeding or
Preparation of food may be requires parenteral
done by another person. feeding.
*Score 1 point for each INDEPENDENCE answer. Compute the total score. Client score should be between 0 (lowest) and 6
(highest). A score of 6 indicates complete independence, 4 implies moderate impairment, and2 or less suggests
severe functional impairment

Declaration: I hereby acknowledge that the given information is correct and is in accordance to the best of my knowledge.


___________________________ _____________ _____________________________________
Name and Signature of Patient Date Name and Signature of Nursing Student
 CLOCK DRAW TEST (CDT)

Instruction/Administration
The test is administered as follows:
1. Instruct the patient to listen carefully, remember and mention 3 unrelated words (apple, yellow, and cloud)
2. Ask the patient to repeat the 3 words (apple, yellow, and cloud).
3. Instruct the patient to draw the face of a clock on a blank sheet of paper
4. After ask the patient to put the numbers on the clock face (1-12)
5. Ask him or her to draw the hands of the clock to read a specific time, such as 05:45.
6. These instructions can be repeated and give the patient as much time as needed to complete the task.
Remember: the CDT serves as the recall distractor.
3. Ask the patient to repeat the 3 previously presented word (apple, yellow, and cloud).

Scoring
Give 1 point for each recalled word after the CDT distractor. Score 1–3.
O (regardless of CDT results)- positive screen for dementia.
1 or 2 with an abnormal CDT- positive screen for dementia.
1 or 2 with a normal CDT- negative screen/ absence of dementia.
3- negative screen/absence of dementia.

CDT Scoring
Normal CDT- all numbers are present, numbers in their correct sequence, correct position of second hand.
Abnormal CDT- some numbers are missing, not in the correct sequence, incorrect position of second hand.
Nursing Documentations

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___________________________
Printed Name and Signature

Student No.: _____________

Reflections

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HEALTH CARE INSTITUTIONS
NCM114 GERONTOLOGY
HEALTH CARE INSTITUTIONS
a. Hospital
○ An institution the primary function of
which is to provide in patient
diagnostic and therapeutic services for
a variety of medical and surgical
conditions
○ General hospitals admit individuals
requiring a variety of services
○ Ex. medical, surgical, obstetric, and
pediatric
○ St. Luke's Hospital
○ Philippine General Hospital
○ Pag malaki, hospital
b. Specialty Hospital
○ A hospital that admits only certains
types of patients or with specified
illnesses or conditions
○ Other hospitals offer only specialty
services
○ Example: psychiatric, pediatric, lung,
kidney, cardio, psychiatric, and
infectious disease
- Anything pertaining to the heart -
it provides specialization
- Pediatric - National Children
Hospital, Philippine Children
Medical Center
- Lung Center - located in Quezon
City Circle (the structure of the
building is the chambers of heart;
left ventricle is the largest)
- Infectious disease - San Lazaro
Hospital (such as HIV, rabies,
measles and others)
- Fabella Hospital - Cater labor and
delivery located in LRT Recto
- V. Luna Military Hospital (focused
on the military wounded soldiers)
- Dialysis Center
- East ave. - trauma center
- Veterans - for elderly
c. Health Care Facilities
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○ Maliit na hospital; mini hospital
○ Any facilities or establishment that is
engaged in direct patient care on site
○ Example: hospice care, nursing home,
extended facilities, and etc.
○ Like private health centers
○ Camillus Medhaven
○ Marikina - we have in Marist
(most popular healthcare facilities
in the Philippines)
○ Los abuelos nursing home
○ Marikina Dementia Village
○ Veterans Hospital
○ Dialysis centers
ACUTE CARE
● Short period of time, acute care, and episodic
care
- Less than 3 weeks, within days only
- Ex. sore throat
● GI resolves/ treating a new and acute illness
● Professional care, hoeatment, diagnostics,
emergency medical services
● More on disease prevention
● Hospital Providing
○ Central in planning for the older adult
upon discharge: follow up- care,
transportation, home health aide and
homemaking services, adult day care
○ Goals: health protection, health
promotion and wellbeing of the older
adult
○ Health promotion strategies
(smoking-cessation, stress
management, weight-loss, or exercise)
CHRONIC CARE
● The ongoing provision of care provides
medical, functional, psychological, social,
environment and spiritual care
- Maraming dimensions of care na
provided in this facility
- Holistic approach
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HEALTH CARE INSTITUTIONS
NCM114 GERONTOLOGY
- Ex. cancer, diabetes, heart failure,
hypertension
● For patients with serious and persistent health
conditions
● To help optimize older adults’ functional
independence and well-being
AMBULATORY CARE
● Institutional Organized Health Setting
○ It provides outpatient basic health
services (surgeries and treatments)
○ No overnight stay in hospital is
required to ambulatory patients
- Walang natutulog dito
○ Outpatient health services that can
perform operation (discharge also
within THAT day)
○ OPD - Outpatient Department -
check-ups
○ Ex. Vicky Belo, focused on minor
surgeries that doesn’t require long
hospital stay
- The longer you spent on the
hospital, the more expensive it is
ADULT DAY CARE
● Or Day Therapy Centers
○ Non residential facility that offers daily
nursing care and social opportunities
○ It enables family members to carry on
daily activities while the older person
is at the daycare center
○ Provides transitional care - health,
nutrition, daily living needs
○ When you say adult day care, ang
pumapasok sa isip natin yung
nursery/day care center nung bata pa
tayo so just like nung bata pa tayo,
yung adult day care, iiwan yung patient
doon buong araw and then after lunch
susunduin na
➢ Dadalhin yung mga lolo’t lola sa
adult day care (doon merong
socialization, art therapy, play
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therapy and other social
programs/activities na ginagawa)
➢ Habang andun sina lolo’t lola,
yung parents natin usually
nagwwork. Nilalagay na lang doon
sa adult day care para may
mag-aalaga pa rin sa kanila
COMMUNITY SUPPORT SERVICES
● Goal
○ Community based services helps the
older person maintain independence
● Informal sources of help
○ Family, friends, church members,
neighbours
○ Senior centers have social support,
health promotion activities, and
nutritious noontime meal services
● Community Services
○ It includes telephone reassurance,
friendly visitors, home health aides,
homemakers , home repair, home
delivered meals, chores services,
employment resources
● Examples
○ Respite care, Adult Day Care Center,
Home for the Aged, Senior Center,
Housing, Veterans Home Care
Programs
HOSPICE CARE
● Definition
○ It focuses on the promotion, improving
or maintaining quality of life, palliative
care, supportive services,
compassionate care to dying patients
○ Advanced, terminal, life-limiting
illness, not going to survive illness,
last phase of incurable disease, serious
illness a dying patient
○ Patient needs to live life fully, live as
comfortable as possible, relief of
symptoms, not saving life
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HEALTH CARE INSTITUTIONS
NCM114 GERONTOLOGY
○ These are a dignified alternative for
patient with an end stage disease who
is not expected to live long
○ Providing physical, psychological,
social, and spiritual dimensions of care
○ Facilitate early discussions about a
patient’s wishes and goals and for
end-of-life care
○ Ex. Hospicio de San Jose
Assisted Living Facility
Definition:
● Provide supportive residential housing and
appealing housing alternative, home-like
environment
○ The owner renting a house then
sinusupervise niya yung older adults
for 24 hours
● Older adults with minor to moderate
functional impairment
● 24-hour coverage supervision, three meals a
day with snacks
● Services - range from personal, health care
and recreational service
○ Provision sa billiards, board games
● Costly - monthly care, additional costs
○ If provided yung meal (naka-depend if
want mo na monthly yung meals.
Depende sa choice ng older
adult/family)
● Mild to moderate functional impairment
Nursing Home
● Meron siyang sariling lupa, bahay or
healthcare facility. Yung assisted living, wala
siyang sariling bahay nagrerent lang
● For patient na malala na yung sakit. Focused
on geriatric facility
● It specializes in services for older persons who
can no longer live independently
● Provide specialized care to seniors with severe
illness, injuries
● Services - acute, intermediate and long term
skilled nursing care
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● Ex. geriatric assessment, rehabilitation,
medical and nursing services, therapy services
and residential gerontological care
● All in one, hindi na kailangan dalhin sa hosp.
Kasi may residential doctors and geriatrics
● Different with hospice care
Skilled Nursing Facility
● Intermediate Nursing Care
● It provide 24-hour nursing care to older adults
who are unable to care for themselves
● Services - medication administration, nursing
care, wound care, daily assessment, meals,
and assistance with ADLs
● Other skilled services - physical therapy,
respiratory therapy, speech language
pathology services, and occupational therapy,
rehabilitative in the hospital
● Parang nursing home
Skilled Nursing Facility
> Residents may stay in SNFs
● Short-term - rehabilitation after surgery or
medical illness
○ Pag na-stroke
● Long term - reside in them throughout their
lives
● Note: Managing the health care needs of
individuals who do not meet the criteria for
remaining in the hospital
● Mas mababa yung cost compared to other
hospitals
Retirement Center
● Also known as Retirement Village, Continuing
Care Retirement Communities
● Full service communities offering long-term
contracts
● Continuum of care - retirement, assisted
living and nursing services all on one campus
● Purpose - to facilitate aging in place
Continuing Care Retirement Communities
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HEALTH CARE INSTITUTIONS

NCM114 GERONTOLOGY
● Several levels of care - independent ● “Ageing in place” (from basic level to
living, assisted living, periodic home high-care level
care, skilled nursing, housing services, ● Offers temporary and intermittent delivery of
nursing care, basic recreational health care while remaining in their own
services home/patient’s home, stay in their home
● Very expensive - full daily rates for longer
long term care ● Ito yung mga family na ayaw umalis si patient
kaya nasa bahay lang si patient
9/6/2021 ● Supervised by a licensed health professional in
EXTENDED CARE FACILITIES a person’s home
● Residential aged care facilities ● Broadened services offered - showering,
● Are Permanent/long-term care facilities dressing and mobility or help with house
● High dependency residential care facility cleaning and basic home maintenance
● Need specialist knowledge to meet the activities, assist patient perform activities of
complex needs of these individuals and their daily living
families ○
● Personal care (assistance with ADL, ● Provide comprehensive care to acute, chronic
mobilizing, hygiene and nutrition) and terminally ill individuals
professional bedside nursing care, medical ● Early discharge of individuals from hospitals
attention, rehabilitative services ● Staff offer health education to individuals and
● Provide custodial care for elderly people families
● Substitutes to prevent hospitalization for frail,
RESPITE CARE elderly outpatients
● A short-term rehabilitation after surgery or
medical illness
● Note: Managing the health care needs of
individuals who do not meet the criteria for
remaining in the hospital
● Discharged earlier from acute care hospitals,
some individuals may still require
supplemental care before they return home
● The patient is still not totally well so kailangan
niya ng rehabilitation after surgery
● Parang extended facility and skilled nursing
facility but different is yung client sa respite ay
short-term lang. Once they recover, they can
return na sa home nila

HOME HEALTH CARE

● Private Duty Nursing
● Home as a care delivery site
● Provides home health services, private duty
nursing, primary care and professional
services

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