MMRI’S KAMALNAYAN BAJAJ NURSING COLLEGE

COMMUNITY HEALTH NURSING

SEMINAR
ON
GERIATRIC

Submitted To, Submitted by,

Ms. Pradnya Waghmare Ms. Laveena Aswale
Lecterer M.Sc. nursing 2nd year
Community Health Nursing Community Health Nursing
K.B.N.C K.B.N.C
 GENERAL OBJECTIVES:

At the end of the seminar students will gain in depth

knowledge regarding Geriatric and will utilize this
knowledge in their personal and professional life.
 SPECIFIC OBJECTIVES:

The students will be able to:

1)To define geriatric and geriatric Nursing
2)To explain the aging process in detail
3)To describe the theories of aging.
4)To discuss the myths and facts of aging.
5)To discuss the geriatric health assessment.
6)To explain about elderly abuse
7)To explain the care of elderly
8)To describe about home of elderly
9)Discuss the role of Geriatric nurse.
 INTRODUCTION:

 Development begins with conception and continues

until death. It is gradual and continues process and
involves many complex changes In all dimensions of
person through life span. There are various stages in
the growth and development of human life.
 These stages are infant, toddler, pre-schooler,
schooler age child, adolescent, adulthood, middle age,
old age.
 Society has taught us all kinds of things regarding
aging, including the process of aging and normal
changes that occur.
 Most of what we hear from others comes in the form
of myths of normal aging. However, knowledge of
these myths makes aswging a fearful, unhappy
approaching event for many of us
 And it should be the sight of a new beginning
 And understanding the aging process; what, why and
how changes occur; strategies to prepare ourselves
for these changes gives new life and appeal to a very
special time in all our lives.
 DEFINITION:

• Geriatric :Geriatric is the branch of medicine dealing

with the physiological and psychological aspects of
aging, with diagnosis and treatment of diseases
affecting older adult.
• Geriatric Nursing: Is concerned with assessment of
health and functional status of older adult, diagnosis,
plan and implementation of health care service to
meet the identified needs and evaluating the
effectiveness of such care.
AGING PROCESS AND CHANGES
 Aging brings some changes in all people. These
changes are continuous throughout life, from losing
baby teeth to the loss of taste buds. Some changes are
obvious in the way they alter physical appearance or
in their visible effect upon body systems. Other
changes are less apparent, in that they affect internal
body systems, such as the circulatory systems. These
changes vary in degree and rate from individual to
individual.
 A] Structural:

1. MUSCLES : Muscles lose mass and tone. While

exercise helps to maintain strength and tone, it does
not prevent some loss. This change is observable in
the looseness of underarm skin, sagging breast, and
thinner legs and arms reflecting the changes in
musculature.
2. SKELETON:
Another change affecting appearance is the flattening
of the spongy "cushion" between the vertebrae. Over
the years, this material loses its resiliency. Older
people may be shorter than they were in younger
years and have a stooped posture.
3. SKIN:
• There are several changes that affect the skin.
• The skin loses some elasticity, which results in
wrinkles. The skin does not stretch and conform to its
original shape as it once did. There is a loss in the
natural oils in the skin, which may lead to dryness
and scratchiness. Individuals may need to use
moisturizer to replace the loss in oils.
• The skin becomes thinner and thus more susceptible
to being broken or cut.
• reported to a physician.
• Older people may become more sensitive to
temperature changes.
• Some individuals may develop "aging" spots, which
are dark areas of pigmentation. The presence of such
spots does not indicate a problem with the function of
the liver. The spots are simple changes in the
pigmentation of the skin. Creams do not remove the
spots although they may temporarily camouflage
them. Spots on the skin of older people should be
closely observed for sudden growth or changes in
appearance.
 B] SENSORY:

 MOUTH: The bone structure of the jaws may

change, which can alter the way dentures fit. It is
possible for an individual to develop problems with a
set of dentures that he/she has had for years.
Problems with dentures may have a negative impact
on a person’s nutritional intake.
 TASTE: The sensitivity of taste buds decreases with
age, especially with men. The tastes that decline first
are sweet and salty, with bitter and sour decreasing
more slowly. Those changes mean that foods may not
taste like they used to older people. The elderly may
over season food or may accuse others of omitting all
seasonings in food preparation. Changes in taste may
lead to a loss of appetite, which can lead to nutritional
deficiencies.
 SMELL :Sensitivity to smell decreases as individuals
age. Older individuals may be less aware of certain
odors, even body odors, than younger people. The
decreased sensitivity to smell may also adversely
affect appetite.
 DISTANCE: The lens of the eye may lose some of its
ability to accommodate changes in distance vision.
That means that it may take a person a few seconds
longer to recognize someone who is across the room
when the older person has been reading or doing
handwork.
 VISION :There are several eye disorders that occur
more often in the aged, such as glaucoma and
cataracts. In the fourth decade of life, visual capacity
begins to decline.
 LIGHT :
o The pupil of the eye tends to become smaller with
age, permitting less light to enter the eye. This means
eyes have a decreasing ability to adjust to changing
amounts of light, and glare becomes a problem. Older
people need more light than younger people do.
o If an older person has been sitting in a semi-dark
room and opens a door to find a visitor standing in
bright sunlight, the older person may not immediately
recognize the visitor.
o That does not indicate a problem with mental
alertness, but it may indicate a longer than
usual period of time required to adjust to
differences in light.
 COLOR :
o Other changes in the lens of the eyes may make it
difficult to distinguish blues and greens or pinks and
yellows.
o An elderly person may comment on her green dress
when it is actually blue. That kind of mistake does
not necessarily indicate declining mental abilities; it
may indicate changes in color identification. Colors
that are very similar in shade like beige and brown
may be difficult for older individuals to distinguish.
o Contrasting colors such as black and white may be
more readily identified. Clothing can be tagged so
those older individuals know which colors are
complimentary.
 DEPTH:
o Changes in the eyes may affect an older person's
mobility.
o The floor may appear to be rolling so that older
people may shuffle along to ensure stable footing.
o Changes in depth perception can make it difficult to
judge the height of curbs or steps.
o A person may take a large step and receive a jolt.
o It is helpful to edge steps or curbs in a bright,
contrasting color to facilitate the elderly person's
ability to judge depth. Baseboards that contrast with
the walls and floor make it easier too.
 HEARING: Changes in hearing are multiple and can
have a profound effect upon the life of an older
person. Hearing loss can cause depression and social
isolation.
o When an individual with a hearing loss is in a group,
the person with the hearing loss may begin to think
that others are talking about him/her, or are
deliberately excluding that person from the
conversation.
o In reality, group members may not realize the need to
face the person and to speak so that he/she follows
the conversation. Individuals with hearing losses may
hear part of what is said and not know they have
heard only part of the statement or question.
o The mind may automatically compensate for
unintelligible conversation by inserting information,
which seems to make sense. The person may then
give an inappropriate response and not realize that the
communication has been misunderstood. There are
three major types of hearing loss
o High frequency loss: low, deep sounds are more
readily heard than higher sounds.
o Conductive hearing loss: sound waves are not
properly conducted to the inner ear making sounds
become muffled and difficult to understand.
o Central hearing loss: allows speech to be heard but
not understood. Signals from the ear either do not
reach the brain or the brain misinterprets them
 3] SYSTEMS:

A. CIRCULATORY SYSTEM :
o The heart, like other muscles, weakens and loses
pumping capacity.
o Arteries or veins may become rigid or blocked,
which restricts blood flow and circulation. Under
routine circumstances, these changes do not greatly
alter the daily functioning of an individual.
o These changes may be observed when an aged
person who has been sitting for a while suddenly
stands and walks across the room.
o Unless a few extra seconds are allowed for the
heart to supply sufficient blood to all the body
extremities, the person may stumble, fall, or
seem confused.
o After the heart has had sufficient time to pump
the blood throughout the body, the
unsteadiness or confusion disappears.
B. DIGESTIVE SYSTEM :
o One of the systems least affected by aging is the
digestive system. As in earlier years, diet and exercise
are extremely important to maintain proper
functioning.
o Teeth become more brittle. Saliva, necessary to
swallow food, decreases; the thirst response
decreases. Peristalsis (the movement of the intestines)
is slower, decreasing speed and effectiveness of
digestion and elimination.
o Choking on food is a greater risk because of a
decreased gag reflex.
C. URINARY SYSTEM :
o The urinary system experiences several changes.
o A general weakening of the bladder muscles means
that the impulse to urinate cannot be delayed as long
as in earlier years. When an older person says, "I have
to go to the bathroom," that usually means now.
o The bladder doesn't stretch to hold as much as it used
to, so urination may be more frequent.
o With weakened muscles the bladder may not empty
completely which increases susceptibility to urinary
infections.
o The kidneys filter the blood more slowly than in
younger years.
o As a result, medications remain in the bloodstream
longer than they do in younger people. That change in
functioning compounds the danger of over-
medication. Dosages of medicine need to be closely
and continuously monitored.
o Interaction effects between prescribed medicine and
over-the-counter drugs, even aspirin or Bufferin, are
more likely to occur.
D. REPRODUCTIVE SYSTEM :
o In the reproductive system there is little change.
o Vaginal secretions diminish; erections may require
more stimulation.
o In men, the prostate may become enlarged. Regular
check-ups are particularly important for men. Prostate
trouble may go untreated until it requires radical
treatment.
 4] PSYCHOLOGICAL ASPECTS OF
AGING:
 MEMORY:
o Short-term memory seems to decrease.
o It becomes more difficult to remember events in the
immediate past, like what a person ate for breakfast,
who came to visit yesterday, or the date and time of
an appointment.
o There are ways to compensate for any decreases in
short-term memory function.
o A person may write notes, which serve as
reminders if they are kept in a specific place.
Freedom from distractions or too much
stimulation may also help with remembering
immediate events or information.
o Long-term memory seems to improve with
increasing age. Events, which occurred forty
or fifty years ago, may become easier to
remember.
o As events are remembered and retold, they
become more vivid and detailed.
 ADAPTATION TO CHANGE:
o Reactions to change vary from person to person.
Change, whether positive or negative, is stressful.
o All individuals need time to adjust. Sometimes older
people are seen as resistant to change, or “set in their
ways.”
o It may be that their refusal to accept change is a way
of maintaining control. To say, “No,” is to keep one
area of their lives stable.
o At other times, change may be refused because it may
not be understood. They may need more information
or a clearer explanation, even if it is about a service
being offered.
o Older people may need more time to consider the
proposed change—to think it through, to decide.
They may need assurance that the change can be tried
on a temporary basis and then reevaluated.
o They need to be listened to in order to understand
their needs. Sometimes it is tough to find a balance
between trusting their own priorities and
understanding the enabling supports that they need
 5] REMINISCENCE:

o One method of coping with change is through

reminiscence.
o There are several positive benefits of engaging in
reminiscence. The present may be depressing or very
unsatisfactory.
o By recalling a happier time, an older person may
derive some contentment or the ability to endure the
present. The strength to adjust to change may be
derived from remembering previous successful
adjustments.
 6] INTELLIGENCE

o Intelligence does not decline with normal aging.

When tested, older people scored lower on timed tests
than do younger people.
o On tests without time limits, older people score
better than younger individuals.
7] SOCIOLOGICAL ASPECTS OF AGING

o As with individuals of any age, familial relationships

are important to older people. With increasing age,
family composition often undergoes some changes.
o Role Reversal: While it is true that an elderly person
may become more dependent in some capacities, the
person is still an adult. Sometimes individuals may
appear to act like children because they feel they are
being treated as children especially when living in an
institution.
o Older people need to be encouraged to do as much for
themselves as possible.
o Caregivers need to patiently allow sufficient time for
persons to respond to questions or accomplish tasks.
The emphasis should not be on perfection but on
personal accomplishment.
o We should reinforce the decision-making ability of
elders and expect and support as much independence
in as many areas as possible.
 8] CRISIS
o In families, it is helpful to anticipate potential
crises.
o Before a stressful situation develops, consider the
possibility that it may occur, and explore the
alternatives.
o Areas to discuss include living arrangements,
finances, wills, and funeral arrangements. It may be
helpful to mention the subject and then discuss it
more fully at a later date.
o Prior discussion helps prepare mental strategies for
resolving crisis situations. It is easier to make
decisions when everyone’s wishes are known.
 9] LIMITATIONS:
o There are limitations to familial support, both
financially and emotionally. Resources are limited
and families may be pulled in more than one
direction.
o It is not uncommon for a middle-aged couple to have
dependent children in the home and increasing
responsibility for elderly parents.
o A retired couple trying to adjust to less financial
flexibility, may be caring for aged parents.
o There may be little time to spend with older relatives
or to provide assistance. Priorities must be
established, limitations acknowledged, and
expectations discussed
 10] LOSSES:

o We experience losses throughout our lives.

o Some losses are more difficult to overcome than
others. Common losses include the loss of friends,
relatives, objects, and opportunities.
o Objects that are representative of special relationships
or of personal achievement may be particularly
important to an older person.
o Physical abilities may be lost: the use of an arm or
leg, eyesight may diminish, and/or manual dexterity
may decrease. These losses are usually accompanied
by losses in roles and activities.
o The activities or functions which once gave meaning
to one’s life may have been dramatically altered.
Opportunities to make new friends, acquire new
skills, or accomplish life long goals, may be gone or
greatly restricted. Recovery from losses may not be
as quick in late life as it is in younger years
 11] DEATH:
o Although death and dying may trigger strong
feelings, it is a natural part of the life cycle.
o There are five major reactions to death or dying,
which have been identified by researchers: denial,
anger, bargaining, depression, and acceptance.
Individuals do not always experience every stage,
nor do they always experience the stages in the order
listed.
o Stages may be repeated or skipped. Families or
friends of a dying individual may also experience
these reactions, and may do so at different times
than the individual.
 THEORIES OF AGING:

Aging is a normal process of human development.

Patterns of aging is what happens, how and when that
present vary greatly among older people.
 A] BIOLOGICAL THEORIES:

1] Immunological Theory:
• An ageing immune system is less able to distinguish
body cells from foreign cells. As a a result it begin to
attack and destroy body cells as they were of foreign
origin.
• This leads to diseases such as diabetes mellitus,
rheumatic heart diseases etc. there are several cellular
mechanisms capable of precipitating attack on
various tissues through auto aggression. The weight
of thymus gland decreases with age.
2] Wear and Tear Theory:
Wear and tear theory says due to repeated injury or over
use, internal and external stressors ( physical,
psychological, social and environmental) including
trauma, chemicals and build up of naturally occurring
wastes, body cells structures and functions wear out or
over used. Effect from the residual damage accumulate
and the body can no longer resist stress.
3] Somatic Mutation Theory:
Genetic Mutations occur and accumulate with age in the
somatic cell causing the cell to deteriorate and
malfunction accumulation of mutations result in damage
to the DNA. The theory states that aging is an imbalance
between DNA’S ability to repair itself and accumulating
DNA damage. When the damage exceeds the repair, the
cell malfunctions and this can lead to senescence.
B] PSYCHOLOGICAL THEORIES:
It tries to explain age-related changes in cognitive
function such as intelligence, ,memory learning and
problem solving.
1] Full – life development theory:
•Eric Erickson was one of the first psychological theorists to
develop a personality theory that extends to old age.
•Major concepts:
According to this theory, the ego is a positive driving force for
development. By this the ego’s job is to establish and maintain
identify and a lack of identify leads to lack of direction and non-
productivity. There are stages of personality and ego
development. The last stages are ‘Adulthood’ and ‘late stage’.
•Adulthood is characterized by a struggle between generativity and
stagnation.
•Generativity: indicates
1] Giving back to society.
2] Being productive at work.
3] Being involved in the community.
•Stagnation: means being unproductive feeling anger, hurt, and self
absorption. As one become mature, there is a struggle between ego
integrity.
•Despair when anybody not accomplishing life goals feeling guilty
about the past. The final pathway dissatisfied which leads to despair
and further leads to depression and hopelessness respectively.
2] Continuity Theory:
According to this continuity theory, The individual
remains essentially the same, despite life changes. It
focuses more on personality and individual behavior
over the time. Behavior will be reflect upon the
individual whether he/she will change or not.
HEALTH ASSESSMENT OF ELDERLY
Conceptually, comprehensive geriatric assessment
(CAG) involves several processes of care that are
shared over several processes of care that are shared
over several providers in the assessment team.
The overall care rendered by team can be divided into
six steps:
• Data gathering
• Discussion among the team
• Development of a treatment plan
• Implementation of the treatment plant
• Monitoring response to the treatment plan
• Revising the treatment plan
•Assessment tools:
•Although the amount of potentially important information may
seem overwhelming, formal assessment tools and shortcuts can
reduce this burden on the clinician. A pre-visit questionnaire is
given to the patient or caregiver prior to the initial assessment.
•These questionnaire can be used to gather information about
general history (e.g., Past medical history, medications, social
history, review of system), as well as gathering information
specific to geriatric assessment, such as:
 Ability to perform functional tasks and need for assistance.
 Fall history
 Sources of social support, particularly family or friends
 Depressive symptoms
 Vision or hearing difficulties
 Whether the patient has specified a durable power of attorney
 GERIATRIC ASSESSMENT
The geriatric assessment is a multidimensional,
multidisciplinary assessment designed to
evaluate an older person's functional ability,
physical health, cognition and mental health,
and socio-environmental circumstances. It is
usually initiated when the physician identifies
a potential problem
 • ASSESSMENT
A] Integumentary:
SKIN:
• When skin is pinched it goes to previous state immediately
(2 seconds).
With fair complexion.
With dry skin
Hair:
• Evenly distributed hair.
With short, black and shiny hair.
With presence of pediculosis Capitis.
Nails
• Smooth and has intact epidermis
With short and clean fingernails and toenails.
Convex and with good capillary refill time of 2 seconds.
Skull :
•Rounded, normocephalic and symmetrical, smooth
and has uniform consistency.Absence of nodules or
masses.
Face :
•Symmetrical facial movement, palpebral fissures
equal in size, symmetric nasolabial folds.
EYES AND VISION
Eyebrows :
•Hair evenly distributed with skin intact.
Eyebrows are symmetrically aligned and have equal
movement.
Eyelashes :
•Equally distributed and curled slightly outward.
Eyelids:
•Skin intact with no discharges and no discoloration.Lids
close symmetrically and blinks involuntary.
Bulbar conjunctiva:
•Transparent with capillaries slightly visible
Sclera:
•Appears white.
Pupils:
•Black, equal in size with consensual and direct reaction, pupils equally
rounded and reactive to light and accommodation, pupils constrict when
looking at near objects, dilates at far objects, converge when object is
moved toward the nose at four inches distance and by using penlight.
Visual Fields:
•When looking straight ahead, the client can see objects at the
periphery which is done by having the client sit directly facing
the nurse at a distance of 2-3 feet.
The right eye is covered with a card and asked to look directly at the
student nurse’s nose. Hold penlight in the periphery and ask the client
when the moving object is spotted.
Visual Acuity:
•Able to identify letter/read in the newsprints at a distance of fourteen
inches.
Patient was able to read the newsprint at a distance of 8 inches.
Auricles:
•Color of the auricles is same as facial skin, symmetrical,
auricle is aligned with the outer canthus of the eye,
mobile, firm, non-tender, and pinna recoils after it is being
folded.
Hearing Acuity Test:
•Voice sound audible.
 Watch Tick Test
•Able to hear ticking on right ear at a distance of one inch
and was able to hear the ticking on the left ear at the same
distance
 Nose and sinuses
External Nose:
•Symmetric and straight, no flaring, uniform in color, air
moves freely as the clients breathes through the nares.
Nasal Cavity:
•Mucosa is pink, no lesions and nasal septum intact and
in middle with no tenderness.
Mouth and Oropharynx:
•Symmetrical, pale lips, brown gums and able to purse
lips.
Teeth:
•With dental caries and decayed lower molars
Tongue and floor of the mouth:
•Central position, pink but with whitish coating which is
normal, with veins prominent in the floor of the mouth.
Tongue movement:
•Moves when asked to move without difficulty and without
tenderness upon palpation.
Uvula:
•Positioned midline of soft palate.
Gag Reflex:
•Present which is elicited through the use of a tongue
depressor.
Neck:
•Positioned at the midline without tenderness and flexes
easily. No masses palpated.
Head movement:
•Coordinated, smooth movement with no
discomfort, head laterally flexes, head laterally
rotates and hyperextends.
Muscle strength:
•With equal strength
Lymph Nodes:
•Non-palpable, non tender
Thyroid Gland:
•Not visible on inspection, glands ascend but not
visible in female during swallowing and visible in
males.
Thorax and lungs:
•Posterior thorax
•Chest symmetrical
Spinal alignment:
•Spine vertically aligned, spinal column is straight, left
and right shoulders and hips are at the same height.
Breath Sounds:
•With  normal breath sounds without dyspnea.
Anterior Thorax:
•Quiet, rhythmic and effortless respiration
Abdomen:
•Unblemished skin, uniform in color, symmetric
contour, not distended.
Abdominal movements:
•Symmetrical movements cause by respirations.
Auscultation of bowel sounds:
•With audible sounds of 23 bowel sounds/minute.
Upper Extremities:
•Without scars and lesions on both extremities.
Lower Extremities:
•With minimal scars on lower extremities
 • Mental Status
Language:
•Can express oneself by speech or sign.
Orientation:
•Oriented to a person, place, date or time.
Attention span:
•Able to concentrate as evidence by answering the
questions appropriately.
Level of Consciousness:
•A total of 15 points indicative of complete
orientation and alertness.
 MOTOR FUNCTION
Gross Motor and Balance
Walking gait
•Has upright posture and steady gait with opposing
arm swing unaided and maintaining balance.
Standing on one foot with eyes closed
•Maintained stance for at least five (5) seconds.
Heel toe walking
•Maintains a heel toe walking along a straight line
•Toe or heel walking
•Able to walk several steps in toes/heels.
 FINE MOTOR TEST FOR UPPER EXTREMITIES
Finger to nose test:
•Repeatedly and rhythmically touches the nose.
•Alternating supination and pronation of hands on knees
•Can alternately supinate and pronate hands at rapid pace.
Finger to nose and to the nurse’s finger:
•Performed with coordinating and rapidity.
•Fingers to fingers
•Perform with accuracy and rapidity.
•Fingers to thumb
•Rapidly touches each finger to thumb with each hand.
Fine motor test for the Lower Extremities:
•Pain sensation
•Able to discriminate between sharp and dull sensation when
touched with needle and cotton.
FUNCTIONAL ABILITY:
Functional status refers to a person's ability to perform
tasks that are required for living. The geriatric assessment
begins with a review of the two key divisions of
functional ability: activities of daily living (ADL) and
instrumental activities of daily living (IADL). \
 NUTRITION

•A nutritional assessment is important because inadequate micronutrient intake is

common in older persons. Several age-related medical conditions may predispose
patients to vitamin and mineral deficiencies. Studies have shown that vitamins A,
C, D, and B12; calcium; iron; zinc; and other trace minerals are often deficient in
the older population, even in the absence of conditions such as pernicious anemia
or malabsorption.. There are four components specific to the geriatric nutritional
assessment:
(1) nutritional history performed with a nutritional health checklist;
(2) a record of a patient's usual food intake based on 24-hour dietary recall;
(3) physical examination with particular attention to signs associated with
inadequate nutrition or overconsumption; and
(4) select laboratory tests
 Statement
Yes/ No
• I have an illness or condition that made me change the kind or amount
of food I eat.
• I eat fewer than two meals per day.
• I eat few fruits, vegetables, or milk products.
• I have three or more drinks of beer, liquor, or wine almost every day.
• I have tooth or mouth problems that make it hard for me to eat.
• I don't always have enough money to buy the food I need.
• I eat alone most of the time.
• I take three or more different prescription or over-the-counter drugs
per day.
• Without wanting to, I have lost or gained 10 lb in the past six months.
• I am not always physically able to shop, cook, or feed myself.
note: The Nutritional Health Checklist was developed for the Nutrition
Screening Initiative.
scoring
•0 to 2 = You have good nutrition. Recheck your nutritional score in six months.
•3 to 5 = You are at moderate nutritional risk, and you should see what you can
do to improve your eating habits and lifestyle. Recheck your nutritional score in
three months.
•6 or more = You are at high nutritional risk, and you should bring this checklist
with you the next time you see your physician, dietitian, or other qualified health
care professional. Talk with any of these professionals about the problems you
may have. Ask for help to improve your nutritional status.
 ELDER ABUSE:

•Elder abuse is a problem that is under recognized

and underreported. And it has devastating
consequences.
•Definition: Elder abuse is defined as “intentional or
neglectful acts by a caregiver or any other person
that causes harm or a serious risk of harm to a
vulnerable adult”
National Center on Elder (2011)
 MAJOR CAUSES OF ELDER ABUSE:

The causes of abuse are multi-factorial:

 Abuser factors: unhealthy behaviors (e.g., substance abuse,
alcoholic, gambling, personality problems and mental/emotional
problems), dependent on the victim for financial resources,
greediness (which is especially common in case of financial
abuse), and burnt out from care-giving stress.
 Familial factors: poor communication, use of violence in problem
solving, poor living conditions.
 Societal/economic factors: economic recession, unemployment,
loss of job security and negative equity.
 FAMILY VIOLENCE PREVENTION AND
SERVICES ACT
 Passed in 1992
 Mandated national study of abuse
 Provided insight into the characteristics of the
abused, self-abused, and abusers.
• Person-Environment Fit Theory One of the newer aging
theories relates to the individual's personal competence within
the environment in which he or she interacts. This theory was
proposed by Lawton (1982) and examines the concept of
interrelationships among the competencies of a group of
persons, older adults, and their society or environment.
Everyone, including older persons, has certain personal
competencies that help mold and shape them throughout life.
•Lawton (1982) identified these personal competencies as
including ego strength; level of motor skills, individual biologic
health, and cognitive and sensory-perceptual capacities. All of
these help a person deal with the environment in which one lives.
As a person ages, there may be changes or even decreases in
some of these personal competencies. These changes influence
the individual's abilities to interrelate with the environment. If a
person develops one or more chronic diseases, such as
rheumatoid arthritis or cardiovascular disease, then competencies
may be impaired and the level of interrelatedness may be limited.
The theory further proposes that, as a person ages, the
environment becomes more threatening and one may feel
incompetent dealing with it. In a society constantly making rapid
technologic advances, this theory helps explain why an older
person might feel inhibited and may retreat from society.
 ELDERLY CARE AND NEEDS

1.Financial Needs of the Elderly

• If elderly individuals happen to be living on their own, i.e.
without anyone else's support, it is but natural that they will have a
certain amount of financial needs. They will need to fend for
themselves for everything such as food, groceries, medicines, etc.
Pensioners would have the benefit of a steady source of monthly
income (whatever be the amount trickling in). However, those senior
citizens who do not have any pension facilities or any other sources
of income, would have to live entirely on the basis of their savings or
through special senior citizen government finance schemes.
2. Health Care Requirements
Senior health is the most important requirement when it comes
to needs of the elderly. With advancing age, the body tends
to slow down and becomes less efficient. Elderly people are
prone to a few age-related health issues. This is a normal
aspect of life and one cannot help it. However, through
proper care and nursing facilities, one can definitely help in
keeping most of these health issues in check and preventing
them from causing any serious harm. Regular medical
checkups is necessary. They can help in anticipating
potential future health-related issues. At the same time, they
may help in identifying serious health problems at an early
enough stage during which treatment is possible.
1.Dietary Requirements
• As people age, their digestive system gradually starts weakening. Aged
and elderly people especially, face this problem wherein they start finding
certain foods indigestible or difficult to digest. What one must realize is that
their diet can no longer be the same as it was say, twenty years ago. Their diet
should now be modified accordingly such that it remains a
nutritious, balanced diet and yet, contains foodstuffs that their system is able
to accept, without causing them any discomfort or problems. Often, the diets
of elderly people need to be altered depending on their medicinal
prescriptions.
1.Nursing Requirements
• If you have an elderly family member whose mobility has become limited
due to aging , he or she would require a certain amount of assistance in his or
her daily routine. If it is not possible for someone in the family to be around
the aged person the whole day long, you could consider having a full-time
nurse to assist the elderly person. This could be beneficial, especially if the
elderly person requires assistance in basic activities like walking, eating,
bathing, dressing, etc.
5. Social and other Needs of the Elderly
• One thing that you should keep in mind is, to shower all your love
and care on your elderly relative or family member. Just because they
have become old and slow, does not mean that you should ignore them
or let them be confined to themselves. Remember, a few years down
the line, you yourself will be in their position. Spend time with them,
chat with them and make them feel wanted, cared for and loved. Pay
special attention to their room. You could consider installing a few
senior citizen friendly appliances which they would be comfortable
using. Also, you should consider installing certain medical alarms that
are specially made keeping in mind elderly citizens.
ELDERLY HOME
 Old age home in aurangabad

1] Jeewhala nursing bureau and health care centers.

2] Matoshree nursing services
3] Sahara Nursing bureau
4] Arogyan nursing bureau and care center.
5] Navijivan Nursing home services bureau.
 SUMMARY
We have seen the following points,
1)To define geriatric and geriatric Nursing
2)To explain the aging process in detail
3)To describe the theories of aging.
4)To discuss the myths and facts of aging.
5)To discuss the geriatric health assessment.
6)To explain about elderly abuse
7)To explain the care of elderly
8)To describe about home of elderly
9)Discuss the role of Geriatric nurse.
THANK YOU