Teaching Strategies In Older Adults In Nursing Education
Factors Affecting Teaching Strategies In Older Adults
Learning in older adults can be affected by such sociological, psychological, and cognitive factors as retirement, economics, mental status, and information processing abilities (Crandell et al., 2012: Miller & Stoeckel, 2016; Santrock, 2017). Understanding older persons' developmental tasks allows nurses to alter how they approach both well and ill individuals in terms of counseling, teaching, and establishing a therapeutic relationship.
Nurses must be aware of the possibility that older patients may delay medical attention. Decreased cognitive functioning, sensory deficits, lower energy levels, and other factors may prevent early disease detection and intervention. A decline in psychomotor performance affects older adults' reflex responses and their ability to manage stress. Coping with simple tasks becomes more difficult.
Chronic illnesses, depression, and literacy levels, particularly among the oldest old, have implications with respect to how they care for themselves (eating, dressing, and taking medications) as well as the extent to which they understand the nature of their illnesses ( Best, 2001; Katz. 1997; Mauk, 2014; Phillips, 1999). In working with older adults, reminiscing is a beneficial approach to use to establish a therapeutic relationship. Memories can be quite powerful.
Talking with older people about their experiences marriage, children, grandchildren, jobs, community involvement, and the like can be very stimulating. Furthermore, their answers will give the nurse insight into their humanity, their abilities, and their concerns.Too many times nurses and other health professionals believe the adage, “You can't teach an old dog new tricks.” Gavan (2003) warns that it is easy to fall into the habit of believing the myths associated with the intelligence, personality traits, motivation, and social relations of older adults.
Myths to Prevent Harmful Outcomes and Nursing Education Strategies
She outlined the following prevalent myths that must be dispelled to prevent harmful outcomes in the older adults when these myths are assumed to be true:
Myth No. 1: Senility. Intelligence test scores indicate that many older adults maintain their cognitive functioning well into their 80s and 90s. Mental decline is not always caused by the aging process itself but rather by disease processes, medication interactions, sensory deficits, dehydration, and malnutrition.
Myth No. 2: Rigid Personalities Personality traits, such as agreeableness, satisfaction, and extraversion, remain stable throughout the older adult years. Although diversity in personality traits among individuals in the older population exists as it does in all other stages of life, labeling older adults as cranky, stubborn, and inflexible does a disservice to them.
Myth No. 3: Loneliness. As mentioned earlier, the belief that older adults are more frequently vulnerable to depression, isolation, and feelings of being lonely has not been upheld by research, which indicates that their satisfaction with life continues at a steady level throughout the period of adulthood.
Myth No 4: Abandonment. It is untrue that older adults are abandoned by their children, siblings, or good friends. The number of contacts older adults have with significant others remains constant over time. Successful aging depends on an extended family support network.
Crandell et al. (2012) also point out that American culture is preoccupied with youthfulness and has distorted notions about late adulthood that perpetuate negative views of this generation. There is no typical older adult-not all individuals in this age group are unhealthy. unhappy, fearful, institutionalized, or disengaged; dwell on their own mortality; or find themselves in financial straits. Stereotypes can have a very powerful impact on older adults in both a positive and negative way, affecting their physical and cognitive functioning.
Positive stereotypes. can bring out the best in a person, whereas negative ones can lead to fulfillment of a pessimistic state (Bennett & Gaines, 2010).Nurse educators may not even be aware of their stereotypical attitudes toward older adults. Furthermore, healthcare providers make assumptions about older clients that cause them to overlook problems that could be treatable (Gavan, 2003).
Nursing Assumptions and Education in Older Adults
To check their assumptions, nurses can think about the last time they gave instructions to an older patient and ask themselves the following questions.
Did I talk to the family and ignore the patient when I described some aspect of care or discharge planning?
Did I tell the older person not to worry when he or she asked a question? Did I say. “Just leave everything up to us”?
Did I eliminate information that I normally would have given to a younger patient?
Did I attribute a decline in cognitive functioning to the aging process without considering common underlying causes in mental deterioration, such as effects of medication interactions, fluid imbalances, poor nutrition, or sensory impairments?
Health Professionals and Older Adults Educational Strategies
All health professionals must remember that older people can learn, but their abilities and needs differ from those of younger persons. The process of teaching and learning is much more rewarding and successful for both the nurse and the patient if it is tailored to fit the older adult's physical, cognitive, motivational, and social differences.
Because changes during aging vary considerably from one individual to another, it is essential to assess each learner's physical, cognitive, and psycho social functioning levels before developing and implementing any teaching plan (Miller & Stoeckel, 2016). Keep in mind that older adults have an overall lower educational level of formal schooling than does the remainder of the population.
Also, they were raised in an era when consumerism and health education were practically nonexistent. As a result, older people may feel uncomfortable in the teaching-learning situation and may be reluctant to ask questions.As the older population becomes more educated and in tune with consumer activism in the health field, these individuals will likely have an increased desire to actively participate in decision making and demand more detailed and sophisticated information. Nurse educators must take steps to support older clients in making decisions affecting their health (Mauk, 2014).
This increased participation by clients can assist in managing chronic diseases, promoting quality and safety in healthcare organizations , and ensuring effective redesign of care and treatment related processes (Longtin etal. 2010). Further, the involvement of clients in deciding the course of their own care is supported by Healthy People 2020 (USDHHS, 2014).
Health education for older persons should be directed at promoting their involvement and changing their attitudes toward learning ( Ahroni , 1996; Weinrich & Boyd, 1992). A climate of mutual respect in which they are made to feel important for what they once were as well as for what they are today should be cultivated. Interaction needs to be supportive, not judgmental.
Interventions work best when they take place in a casual, informal atmosphere. In the primary care setting, where time is often limited, it may be beneficial to schedule additional time, if possible, to allow for a more relaxed environment. Individual and situational variables such as motivation, life experiences, educational background, socioeconomic status, health or illness status, and motor, cognitive, and language skills may all influence the ability of the older adult to learn.
A recent report found that 59% of those persons older than age 65 are engaged in. some type of computer use (Smith, 2014). Thus, although many older adults routinely use computers, a good number do not. Assuming the client has the computer skills necessary to look up healthcare information or engage in self-education can derail learning.
As the population continues to age, computer use will be more prevalent and preferred by clients who have been comfortable using technology to increase their knowledge (Mauk, 2014). However, despite the cognitive comfort some aging clients have with technology, the nurse may need to suggest adaptive devices for the computer to accommodate the physical changes of aging.
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