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Learn about the impact of environment on older adults and the importance of safety, privacy, and personalization in various care environments.
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Chapter Twelve Environments of Care
Environmental Management • As far back as Florence Nightingale nurses were aware of the environment and the impact it had on patients • The goal of environmental assessment is to promote independence • Assess all aspects of an older adult’s living situation that can be seen, heard, touched, or smelled. • Assess how well the older person functions in the living areas. For example: • Is the environment as barrier-free as possible? • Can the older person walk unencumbered or wheel a wheelchair through the entire setting?
Environmental Management (cont’d) • Transpersonal Caring-when the nurse relates to the older adult in a holistic way based on caring • Climate of caring • People in the environment • Family members, neighbors, friends, paid caregivers • Environmental tone and atmosphere • Includes being positive, respectful, caring, privacy, encouragement, involvement, independence • Safety • In any setting, safety for the older person is a primary concern. • Assess for environmental hazards. • Keep environment free of fall risks.
Environmental Management (cont’d) • Stimulation and personalization • Personalized items maintain a sense of identity. • A caring climate facilitates optimal independence and autonomy. • Personal space territoriality • Personal space is important to everyone. • Personal space varies from person to person. • Viewed as an intrusion when someone comes into it • Territory space is used by a person and seen as owned by the person.
Environmental Management (cont’d) • Privacy • Provide opportunities for privacy. • Respect right to privacy. • Activity and involvement • Provide multiple and diverse opportunities for activity and involvement.
Which would be an example of personalization? • Creating new routines • Photos of family members • Turning on the radio • Encouraging activities
Answer B. Photos of family members
What is the term for the return to a space out of habit? • Privacy • Activity • Territory • Relocation
Answer C. Territory
Relocation Trauma • Moving from one environment to another can be stressful to older adults. • Transitional Stress- refers specifically to the emotional stress that occurs during the time a person is changing from one phase of life to another • Orient to new surroundings slowly. • Incorporate personal furniture and objects into the environment.
Environments of Care • Various settings where older adults may receive health-care services • Adult day services • Provide supervised activities for older adults • Provide specific services to meet physical, psychiatric, and social needs • Ongoing assessments of participants are important.
Environments of Care (cont’d) • Home care • Provide services for older adults in their homes • Provide nursing services, therapy services, medical supplies, and equipment • Care is provided on a daily basis or intermittently. • Community-based care • Community clinic, dialysis center, or physician’s office
Environments of Care (cont’d) • Hospice • Provide care for the dying patient and the family • Care given by interdisciplinary team approach • Allows nurses to give direct patient care to patient and family members
Environments of Care (cont’d) • Assisted living • Provide services for older adults with physical care needs • Person must be ambulatory and fairly independent. • Environment is home-like. • Nursing homes • Area of practice that has been available to practical nurses for many years
Environments of Care (cont’d) • Nursing Home (cont’d) • Two categories • Skilled and nursing facility • Licensed by state • LPNs supervise nursing assistants and give medications and treatments.
Environments of Care (cont’d) • Acute care • 40% to 65% of hospital admissions are older adults. • Patients are admitted for a short period of time. • Difficult to develop trusting relationships with patients • Requires all the basic skills the practical nurse possesses
Which environment of care involves the services to help achieve more independence for safe return home? • Acute care • Skilled care • Assisted living • Community-based care
Answer B. Skilled care
Which type of environment is a wound clinic? • Acute care • Skilled care • Assisted living • Community-based care
Answer D. Community-based care