University of the Visayas

Cebu City, Philippines

College of Nursing Graduate Studies

NSG. 512
NSG. CARE OF GERIATRIC AND INSTITUTIONALIZED CLIENT
FINAL EXAMINATION

I. ESSAY: Briefly discuss the following:

1. Discuss briefly the importance of home care, relocation and institutionalization of client as a
nurse. Cite home care overseas or local with references. (30pts)
The importance of home care is that it allows patients to receive personal care in the
privacy and comfort of their own homes. For aging and homebound individuals, in-home care
facilitates them in remaining as functional and independent as possible, providing a much higher
sense of security and dignity. Receiving home health care helps to reduce unavoidable
readmissions to the hospital, and studies have shown that patients recuperating from illness,
injury, or surgical procedures heal more quickly and more successfully when recovering at home
versus in a medical facility.
The greatest advantage of institutionalization of the elderly is that the elderly may be
placed in a facility where there is specialized medical care to cater for individual needs. This
means that the elderly may also be in less danger than by living at their home or with relatives
and this alone may be a deciding factor for institutionalization. There is also the benefit of the
elderly having companionship with other residents of these facilities who may be within the
same age group or have similar ailments. The advantages to the relatives caring for the elderly is
often overlooked but sometimes the institutionalization of an elderly family member eases the
stress within the home environment and reduce the financial impact of caring for a senior.

2. Point out or give the best practices in giving health education to the geriatric patient.
Knowing the learner is the key to successful teaching!Some features of adult and older adult
learners constitute the key:
a. Self-concept:
The self-concept of an adult learner is to be able to direct h imself or herself and to be mature
and positive in society. Adults want to make their own decisions and take the responsibility for
the consequences of these decisions. They expect to be respected and regarded as unique
beings (DeYoung, 2009; Co rnett, 2011).
b. Life Experiences:
An older adult has considerable background information and life
experiences in her/his lifetime. Life experien ces are rich sources for learning. When an
adults experiences are supported and approved by others, positive feelings come into bein
g since these experiences constitute her or his self-identity. If these experiences are not
noticed, the person might feel rejected (Tabloski , 2010)
c. Being ready to learn:
Before an effective education, adult learners should be ready for learning. When an
individual is ready to learn, he or she will make the most of it (Gokkoca, 2001).
d. Problem-oriented or Goal-oriented:
Adult learners are motivated when there is a problem or crisis concerning them. In other
words, they have a different point of view when compared to the young (Cornett, 2011,
Gokkoca, 2001). They see learning as a way to overcome these problems and learn the things
that are relate d to them and helpful to the fulfillment of responsibilities.
 University of the Visayas
Cebu City, Philippines
College of Nursing Graduate Studies

3.How are you going to implement nursing care to a critically ill elderly client. What is your model?
Say something about DNR. What is your stand?

I will treat the patient wholistically as a person with mind and soul regardless of his state of
consciousness. I believe that as a nurse we should remember that relief of suffering, whether physical,
emotional, or spiritual, should be made available to all patients from the moment of diagnosis with a
life-limiting or debilitating illness.

I will follow the model of nurse leaders: Florence Wald, Dame Cicely Saunders (also a
physician),Jeanne Quint Benoliel,and Betty Ferrell who has highlighted the need for
competent,evidence-based care to be provided in a way that is compassionate, respectful, and
appreciates the needs of the whole person and their family (HPNA, 2011d). They have emphasized the
value and an alternative way of taking care of patients which is hospice care.

Hospice care provides support for people in the last phase of life-limiting illness through expert
medical care, pain and symptom management, and emotional and spiritual support so that they may
live as fully and comfortably as possible (NHPCO, 2010). When it has been determined by two physicians
that the patient has 6 months or less to live, and the dying person and family prefer care and comfort
over aggressive medical intervention, hospice is often sought.

For me DNR is a very important tool for elderly clients to be able to ensure that they will die
with dignity, autonomy and self-respect. It is necessary so that the client who has a bad prognosis can
die peacefully knowing that his and his familys request is being granted.

4.Is pharmacology essential to an elderly client? Why? Defend by making one Journal Reading.

Knowledge about pharmacology is essential to an elderly client because the physiological changes of
aging and resulting altered drug metabolism frequently cause serious side effects as well as drug
toxicities. The older person often has more than one clinical problem and may be taking over-the
counter drugs as well. A complete history and physical as well as baseline tests should be done to
determine baseline function. It is important to determine all the medications and doses the older person
takes. Medication should be added to the regimen in the most safe and effective manner. Drug dosage
should be based on age and renal function.

Ramsay, L. E., & Tucker, G. T. (1981). Clinical pharmacology: Drugs and the elderly. British Medical
Journal, 282(January), 125127.

(Ramsay & Tucker, 1981)