Older Adults and Nursing Education for Their Needs
Types of Needs In Older Adults
Physical Needs and Nursing Education
Change In Vision
To compensate for visual changes, teaching should be done in an environment that is brightly lit but without glare. Visual aids should include large print, well-spaced letters, and the use of primary colors. The educator should wear bright colors and a visible name tag. Use white or off white, flat matte paper and black print for posters, diagrams, and other written materials.
Because of older persons' difficulty in discriminating certain shades of color, avoid blue, blue-green, and violet hues. Keep in mind that tasks that require recognizing different shades of color, such as test strips measuring the presence of sugar in the urine, may present learning difficulties for older patients. Color distortions can have an especially devastating effect on learning if, for example, the type of pills is referred to by color in guiding patients to take medications as prescribed, green, blue, and yellow pills may all appear gray to older persons.
Accommodations should be made to meet older adults' physical needs, such as arranging seats so that the learner is reasonably close to the instructor and to any visual aids that may be used. For patients who wear glasses, be sure they are readily accessible, lenses are clean, and frames are properly fitted.
Compromised Hearing and Verbal & Non Verbal Communication
To compensate for hearing losses, eliminate extraneous noise, avoid covering your mouth when speaking, directly face the learner, and speak slowly. These techniques assist the learner who may be seeking visual confirmation of what is being said. Low-pitched voices are heard best. but be careful not to drop your voice at the end of words or phrases. Do not shout, because it distorts sounds and the decibel level is usually not a problem for individuals with hearing impairments. The intensity of sound seems to be less important than the pitch and rate of auditory stimuli.
Word speed should not exceed 140 words spoken per minute. If the learner uses hearing aids, be sure he or she has working batteries. Ask for feedback from the learner to determine whether you are speaking too softly, too fast, or not distinctly enough. When addressing a group. microphones are useful aids.
Be alert to nonverbal cues from the audience. Participants who are having difficulty with hearing your message may try to compensate by leaning forward, turning the good ear to the speaker, or cupping their hands to their ears. Ask older persons to repeat verbal instructions to be sure they heard and interpreted correctly the entire message.
Musculoskeletal and General Physical Weakness
To compensate for musculoskeletal problems, decreased efficiency of the cardiovascular system, and reduced kidney function, keep sessions short. schedule frequent breaks to allow for use of bathroom facilities, and allow time for stretching to relieve painful, stiff joints and to stimulate circulation. Provide pain medication and encourage the learner to follow his or her usual pain management routine. Also, provide comfortable seating.
Neurological Issues
To compensate for any in central nervous system functioning and decreased metabolic rates, set aside more time for the giving and receiving of information and for the practice of psychomotor decline skills. Also, do not assume that older persons have the psychomotor skills necessary to handle technological equipment for self paced learning, such as computers and mouse, ear buds instead of headsets, MP3 players, and DVD players.
In addition, they may have difficulty with independently applying prostheses or changing dressings because of decreased strength and coordination. Be careful not to misinterpret the loss of energy and motor skills as a lack of motivation. To compensate for the impact of hearing and visual changes on computer.
Cognitive Needs and Nursing Education
To compensate for a decrease in fluid intelligence, provide older persons with more opportunities to process and react to information and to see relationships between concepts. Research has shown that older adults can learn anything if new information is tied to familiar concepts drawn from relevant past experiences.
When teaching, nurses should avoid presenting long lists by dividing a series of directions for action into short, discrete, step-by-step messages and then waiting for a response after each one. For instance, to give directions about following different menus depending on exercise levels, they can use an active voice to personalize the message.
For example, instead of saying, “Use menu A if not active; use menu B if somewhat active, use menu C if very active,” they should say, “You should use menu A if you are not active.” Then wait for the learner's response, which might be. “That's what I should eat if I'm not very active?” The nurse educator can follow up with the response, “That's right. And if you are somewhat active, you should...
Older persons tend to confuse previous words and symbols with a new word or symbol being introduced. Again, nurse educators can wait for a response before they introduce a new concept or word definition. For decreased short-term memory, coaching and repetition are very useful strategies that assist with recall.
Memory also can be enhanced by involving the learner in devising ways to remember how or when to perform a procedure. Because many older adults experience test anxiety, try to explain procedures simply and thoroughly, reassure them, and, if possible, give verbal rather than written tests.
Medication In Use
Be aware of the effects of medications and energy levels on concentration, alertness, and coordination. Try to schedule teaching sessions before or well after medications are taken and when the person is rested. For example, the patient who has just returned from physical therapy or a diagnostic procedure will likely be too fatigued to attend to learning.
Compromised Learning
Be certain to ask what an individual already knows about a healthcare issue or technique before explaining it. Repetition for reinforcement of learning is one thing repeating information already known may seem patterning. Nurse educators should never assume that because someone has been exposed to information before that the individual, in fact, learned it. Confirm patients' level of knowledge before beginning to teach. Basic information should be understood before progressing.
Convincing older persons to use more complex information. foulness of what the educator is teaching is only half the battle in getting them motivated. Nurse educators may also have to convince patients that the information or technique they are teaching is correct. Anything that is entirely strange or that upsets established habits is likely to be far more difficult for older adults to learn.
Information that confirms existing beliefs (cognitive schema) is better remembered than that which contradicts these beliefs. Patients with chronic illnesses frequently have established schema about their medical conditions that they have embraced for years.As perception slows, the older person's mind has more trouble accommodating to new ways than does the mind of a younger person.
Find out about older persons' health habits and beliefs before trying to change their ways or teach something new. For example, many older adults were taught as children that pain is a sign that something is wrong and they should always stop whatever they are doing if it causes pain. Educators need to identify this belief before trying to teach them that they sometimes need to move through their pain to avoid stiffness and joint contractur.
Teaching Sessions
Arrange for brief teaching sessions because a shortened attention span (attentional narrowing) requires scheduling a series of sessions to provide sufficient time for learning. In addition, if the material is relevant and focused on the here and now, older persons are more likely to be attentive to the information being presented. If procedures or treatments are perceived as stressful or emotionally threatening, attentional narrowing occurs.
Recognize that the process of conceptualizing and the ability to think abstractly become more difficult with aging. Conclude each teaching session with a summary of the information presented and allow for a question-and-answer period to correct any misconceptions.
Psycho Social Needs and Nursing Education
Assess family relationships to determine how dependent the older person is on other members for financial and emotional support. In turn, nurse educators can explore the level of involvement by family members in reinforcing the lessons they are teaching and in giving assistance with self-care measures. Do family members help the older person to function independently, or do they foster dependency? With permission of the patient, include family members in teaching sessions and list their support.
Determine availability of resources. A lack of resources can sabotage any teaching plan, especially if the recommendations include expecting older adults to carry out something they cannot afford or lack the means to do, such as buying or renting equipment, having transportation to get to therapy or teaching sessions, purchasing medications, and the like.
Encourage active involvement of older adults to improve their self-esteem and to stimulate them both mentally and socially. Teaching must be directed at helping them find meaningful ways to use talents acquired over their lifetime. Establishing a rapport based on trust can provide them contact with others to reinforce their sense of self worth. is no other time in the life cycle that carries with it the number of developmental tasks associated with adaptation to loss of roles, social and family contacts, and physical and cognitive capacities that this time does. Teaching must include offering constructive methods of coping.
Identify coping mechanisms. There The older person's ability to learn may be affected by the methods and materials chosen for teaching. One-to-one instruction provides a nonthreatening environment for older adults in which to meet their individual needs and goals. This teaching approach helps them to compensate for their special deficits and promotes their active participation in learning. Group teaching also can be a beneficial approach for fostering social skills and maintaining contact with others through shared experiences.
Self paced instructional tools may be very appropriate, but it is important to know the client's previous learning techniques, mental and physical abilities, and comfort levels with certain approaches before assigning any such tools. Many older adults grew up in a time when technology was very different than it is today, and those who have always learned by reading and discussion may not like electronic devices.
Introducing new teaching methods and tools, such as the use of computer and interactive video formats, without adequate instructions on how to operate these technical devices, may inhibit learning by increasing anxiety and frustration levels and may adversely affect self esteem.Games, role play, demonstration, and return demonstration can be used to rehearse problem-solving and psycho motor skills if these methods, and the tools used to complement them, are designed appropriately to accommodate the various developmental characteristics of this age group.
For example, speed or competition should not be factors in the games chosen, and plenty of time should be reserved for return demonstrations. These teaching methods stimulate learning and can offer active learning opportunities to put knowledge into practice. Written materials, if appropriate in terms of literacy level and visual impairments in the older adult, are excellent adjuncts to augment. supplement, and reinforce verbal instructions.
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