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Assessment and Adjustment of the Living Environment for the Elderly课程教案、知识点、字幕

WHO发布的

《关于老龄化与健康的全球报告》

中指出

老年人居住的生活环境

以及老年人与生活环境的相互关系

是决定健康老龄化和老年人福祉的主要因素

对于能力处于任何一个水平的老年人来说

能否完成自己认为很重要的那些事情

最终要取决于他所生活的环境中

存在的各种资源和障碍

环境中有哪些资源可以为老年人所利用

哪些障碍需要为老年人消除呢

本次课

我们就以家庭环境为例

来谈谈关于老年人居家安全环境

的评估与调整

居家环境危险因素很多

但评估起来较难

较为成熟的居家安全环境

标准化评估工具有

美国的老年居家环境综合评估与改造方案

瑞典的老年人居住改造促进评估

加拿大的功能与康复环境安全评估

澳大利亚的居家跌倒与意外筛查工具等等

评估内容涉及到

老年人日常活动能力

及环境相关的信息

居家养老环境改造需求

外围环境

居室入口环境 室内环境等

通过观察

访谈等方式由健康相关专业人员进行专业评估

相关的环境要素按居住空间部位不同

可从以下几个方面来评估及调整

一般居室内

关注光线是否充足

温度是否适宜

地面是否平整 干燥 无障碍物

地毯是否平整 不滑动

家具的放置是否稳固 有序

未阻碍通道

床的高度是否合适

电线如何安置

是否远离火源 热源

取暖设备是否设置妥当

紧急电话号码

是否放在容易看见 取到的地方

厨房关注地板有没有防滑措施

燃气开 关的按钮标志

是否醒目

浴室关注浴室门是否内外都可以开放

地板有没有防滑措施

便器的高低是否合适

有没有设置扶手

浴盆的高度是否合适

盆底有没有垫防滑胶

楼梯部分关注光线是否充足

台阶是否平整无破损

高度是否合适

台阶之间有没有色彩差异

有没有扶手

如果以上项目都能给予肯定的判断

说明家庭环境具备有适老化 安全的特性

如果居住环境中存在障碍

会导致老人跌倒 坠床

触电 烧伤 烫伤等安全隐患

就需要调整环境

尽量去除妨害老年人生活行为的因素

或者调整环境使

其能补偿老人机体缺损的功能

促进老人独立生活能力的提高

室内环境中

要查看室内的温度 湿度

采光 通风等是否符合老人身心特点

老年人的体温调节能力降低

室温应以22℃~24℃为宜

湿度以50%~60%为宜

老年人视力下降

尤其是暗适应力低下

室内光线要充足

夜间保持适当的照明

最好能在卧室内安装床头灯或地灯

在走廊或厕所安装声控灯等

整体空间总体色彩宜淡雅

可适当地在客厅或餐厅等大房间

通过壁画或窗帘

使用一些比较强烈显眼的颜色

活跃气氛 使人心情愉悦

室内陈设越简单越好

有床 柜 桌 椅即可

家具的转角处尽量用弧形

或者贴上防撞角或防撞条

避免碰伤老年人

床和座椅的高度

应该使老年人膝关节与床成近直角

坐下时两脚足底完全着地为宜

一般是52~57cm

如果是卧床老人

床高一些就更便于照护者进行各项操作

如果条件允许

最好能够选用可调高度

有活动护栏的护理床

卧室 卫生间 客厅等主要空间

要设置呼叫铃或紧急求助报警系统

避免活动或如厕时发生意外时无人知晓

床边 走廊 客厅活动区等

如需要扶手

高度应能达到或略高于

老年人站立时的手功能高度

一般为72~80cm

具体高度应根据老年人的

身高 习惯 臂部力量等因素综合考虑

有条件的情况下室内应该要有冷暖设备

不宜使用煤油炉或煤气炉取暖

因为对嗅觉降低的老人来说

这很有可能会造成煤气中毒

同时容易造成空气污染或者火灾

电热毯也不宜长时间使用

容易引起脱水

冬天使用暖气

可使用加湿器

或放置水培植物以保持一定的湿度

并注意经常通风换气

厨房 厕所与浴室

是老年人使用频率较高

而又容易发生意外的地方

因此这几个部分的设计不仅要注意安全

还要考虑到不同老年人的需要

厨房地面应该要注意防滑

水池与操作台的高度应适合老年人的身高

煤气开关应尽可能便于操作

用按钮即可点燃比较好

如果是旋转按钮

可以贴上开和关的标志

以防老人忘记

厕所应设在老年人卧室附近

中间不能有台阶或者是其他障碍物

有条件的家里两侧墙壁

都应装上扶手以防跌倒

便器选择坐式马桶

因为老年人腿部力量不够而不宜使用蹲厕

坐便器的高度一般以52~57cm为宜

同时坐便器两侧应设置扶手

以帮助老人起 坐

以高于坐便器15~20cm为宜

老年人身体的平衡感下降

因此浴室周围设有扶手

地面一定要铺防滑砖

必要时使用防滑垫

如果使用浴盆

应带有扶手

浴盆底部还应放置橡皮垫

沐浴时浴室温度应保持在24℃~26℃

设有排风扇以便将蒸汽排出

免得湿度过高从而影响老年人的呼吸

对于使用轮椅的老人来说

洗脸池上方的镜子

应适当向下倾斜以方便自己洗漱

另外还有如移动马桶 沐浴椅

拐杖 步行器 轮椅 楼梯升降机等

辅助用品的使用

根据老人需要进行配置

放置地点要固定

老年人居家环境调整首要是安全

核心是维护老年人健康和预防疾病

其次才是要考虑兼顾老年人与照顾者

使用要求的适用性

希望大家能够灵活运用上述介绍的调整要点

为老人营造一个安全 便捷并且舒适的家

老年护理学(Gerontological Nursing)课程列表:

CHAPTER 1: General Introduction to Geronological Nursing

-1.1 Human Life Expectancy and Age Classification of the Elderly

--Human Life Expectancy and Age Classification of the Elderly

--【Vedio Recommendation】 How do we measure life expectancy ?

-1.2 Population Aging

--Population Aging

--【Literature Recommendation】World Report on Ageing and Health: 2015

-1.3 Influence and Countermeasures of Population Aging

--Influence and Countermeasures of Population Aging

--【Literature Recommendation】World Population Ageing Highlights:2019

-1.4 Goals and Principles of Elderly Care

--Goals and Principles of Elderly Care

--【Book Recommendation】Evidence-Based Geriatric Nursing Protocols for Best Practice

-1.5 Theories Related to Elderly Care

--1.5.1 Personality Development Theory and Life Review

--1.5.2 Disengagement Theory and Activity Theory

--1.5.3 Self-efficacy and Chronic Disease Management

--【Vedio Recommendation】8 Stages of Development by Erik Erikson

--【Literature Recommendation】Activity Theory, Disengagement Theory, and Successful Aging

--【Book Recommendation】Self-Efficacy in Changing Societies

--【Literature Recommendation】Obstacles and Policies of the Social Capital Participates in the Combination of Medical Care and Pension: A Literature Review

-1.6 Elderly Support and Elderly Care

--1.6.1 Concepts of Elderly Healthcare, Elderly Support and Elderly Care

--1.6.2 Home-based Elderly Care Model

--1.6.3 Institutional Elderly Care Model

--1.6.4 Integrated Medical and Nursing Care Model

--【Vedio Recommendation】Day in the Life of Home Care

--【Website Recommendation】Official Website of the National Institutes of Health

-Concept Map

--【Concept Map】General Introduction to Geronological Nursing

-【Test】CHAPTER 1

-【Case Discussion】CHAPTER 1

CHAPTER 2: Elderly Health Assessment

-2.1 Aging Changes in the Elderly

--2.1.1 Aging of the Respiratory System

--2.1.2 Aging of the Cardiovascular System

--2.1.3 Aging of the Digestive System

--2.1.4 Aging of the Urinary System

--2.1.5 Aging of the Endocrine System

--2.1.6 Aging of the Motor System

--2.1.7 Aging of the Nervous System

--2.1.8 Aging of the Sensory System

--【Literature Recommendation】Exercise Attenuates the Major Hallmarks of Aging

--【Book Recommendation】Hazzard's Geriatric Medicine and Gerontology

-2.2 Comprehensive Health Assessment of the Elderly

--Comprehensive Health Assessment of the Elderly

--【Literature Recommendation】Instruments to evaluate mental well-being in old age: a systematic review

-2.3 Principles of Elderly Health Assessment

--Principles of Elderly Health Assessment

-2.4 Assessment of the Functional Status of the Elderly

--Assessment of the Functional Status of the Elderly

--【Literature Recommendation】The Lawton Instrumental Activities of Daily Living (IADL) Scale

-2.5 Assessment of Cognitive Function in the Elderly

--Assessment of Cognitive Function in the Elderly

-2.6 Assessment and Adjustment of the Living Environment for the Elderly

--Assessment and Adjustment of the Living Environment for the Elderly

--【Literature Recommendation】Age-friendliness of living environments from the older person’s viewpoint: development of the Age-friendly Environment Assessment Tool

-Concept Map

--【Concept Map】Elderly Health Assessment(1)

--【Concept Map】Elderly Health Assessment(2)

-【Test】CHAPTER 2

-【Case Discussion】CHAPTER 2

CHAPTER3: Elderly Mental Health and Mental Health care

-3.1 Overview of the Psychological Characteristics of the Elderly

--Overview of the Psychological Characteristics of the Elderly

-3.2 Influencing Factors of Psychological Changes in the Elderly

--Influencing Factors of Psychological Changes in the Elderly

-3.3 Common Psychological Issues and Their Management in the Elderly

--3.3.1 Common Psychological Issues and Their Management in the Elderly (1)

--3.3.2 Common Psychological Issues and Their Management in the Elderly (2)

--【Book Recommendation】Development Through the Lifespan

-3.4 Depression in the Elderly

--3.4.1 Overview of Depression in the Elderly

--3.4.2 Clinical Symptoms of Depression in the Elderly

--3.4.3 Caring for Elderly Patients with Depression

--【Website Recommendation】

--【Documentary Recommendation】Depression:Out of the Shadows

--【Literature Recommendation】Management of depression in older adults:A review depression in older people

-3.5 Elderly Patients with Dementia

--3.5.1 Identification of Dementia Symptoms in the Elderly

--3.5.2 Intelligence Rehabilitation of Elderly Patients with Dementia

--3.5.3 Safety Care of Elderly Patients with Dementia

--【Website Recommendation】The Global Voice on Demaentia

-Concept Map

--【Concept Map】Elderly Mental Health and Mental Health Care

-【Test】CHAPTER 3

-【Case Discussion】CHAPTER 3

CHAPTER4: Elderly Daily Care

-4.1 Precautions for Daily Care of the Elderly

--Precautions for Daily Care of the Elderly

-4.2 General Care of Elderly Skin

--4.2.1 Characteristics and General Care of Elderly Skin

--4.2.2 Skin Itching and Its Management in the Elderly

--【Website Recommendation】American Academy of Dermatology

-4.3 Clothing Hygiene for the Elderly

--Clothing Hygiene for the Elderly

--【Literature Recommendation】The Design Methods of Functional Clothing for the Elderly

-4.4 Dietary Care for the Elderly

--4.4.1 Nutritional Needs of the Elderly and Influencing Factors of these Needs

--4.4.2 Dietary Care for the Elderly

--【Book Recommendation】Nutrition Care of the Older Adult: a Handbook for Dietetics

--【Website Recommendation】Nutrition for older persons

-4.5 Sleep Guidance for the Elderly

--4.5.1 Sleep Characteristics of the Elderly

--4.5.2 Sleep Guidance for the Elderly

--【Book Recommendation】An Occupational Therapist's Guide to Sleep and Sleep Problems

--【Website Recommendation】American Academy of Sleep Medicine

-4.6 Exercises Guidance for the Elderly

--4.6.1 Evaluation of Exercise Intensity in the Elderly

--4.6.2 Precautions Elderly Undertaking Exercises

--【Website Recommendation】American College of Sport Medicine

--【Book Recommendation】Handbook of Activities for the Elderly

-Concept Map

--【Concept Map】Elderly Daily Care

-【Test】CHAPTER 4

-【Case Discussion】CHAPTER 4

CHAPTER5:Medication Safety and Care for the Elderly

-5.1 Characteristics of Drug Metabolism and Pharmacodynamics in the Elderly

--Characteristics of Drug Metabolism and Pharmacodynamics in the Elderly

--【Website Recommendation】How Drugs Work In the Elderly

-5.2 Common Adverse Drug Reactions and Their Causes in the Elderly

--Common Adverse Drug Reactions and Their Causes in the Elderly

-5.3 The Principles of the Use of Medications in the Elderly

--The Principles of the Use of Medications in the Elderly

--【Literature Recommendation】The American Geriatrics Society 2015 Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults

-5.4 Prevention of Adverse Drug Reactions in the Elderly

--Prevention of Adverse Drug Reactions in the Elderly

--【Literature Recommendation】Drug-related falls in older patients: implicated drugs, consequences, and possible prevention strategies

-5.5 Medication Compliance in the Elderly

--Medication Compliance in the Elderly

-Concept Map

--【Concept Map】Medication Safety and Care for the Elderly

-【Test】CHAPTER 5

-【Case Discussion】CHAPTER 5

CHAPTER6:Nursing Care for the Elderly with Common Health Problems and Diseases

-6.1 Falls in the Elderly

--6.1.1 Epidemiological Characteristics of Elderly Falls

--6.1.2 Risk Factors for Falls in the Elderly

--6.1.3 Prevention of Falls in the Elderly

--【Website Recommendation】CDC STEADI(Stopping Elderly Accidents, Deaths & Injuries Tool Kit)

-6.2 Dysphagia in the Elderly

--Dysphagia in the Elderly

-6.3 Urinary Incontinence in the Elderly

--Urinary Incontinence in the Elderly

-6.4 Constipation in the Elderly

--Constipation in the Elderly

--【Literature Recommendation】Chronic Constipation in the Elderly Patient: Updates in Evaluation and Management

-6.5 Dry Mouth in the Elderly

--Dry Mouth in the Elderly

--【Website Recommendation】Academy of Nutrition and Dietetics

-6.6 Elderly Nutritional Deficiencies

--Elderly Nutritional Deficiencies - emaciation

-6.7 Visual Impairment in the Elderly

--Visual Impairment in the Elderly

--【Website Recommendation】Senior Eye Exams

-6.8 Senile Deafness

--Senile Deafness

-6.9 Elderly Delirium

--Elderly Delirium

-6.10 Elderly Frailty

--Elderly Frailty

--【Literature Recommendation】Frailty in elderly people/Frailty in older people

-6.11 Pneumonia in the Elderly

--Pneumonia in the Elderly

-6.12 Hypertension in the Elderly

--Hypertension in the Elderly

--【Literature Recommendation】2018 Chinese Guidelines for Prevention and Treatment of Hypertension

-6.13 Stroke in the Elderly

--Stroke in the Elderly

-6.14 Stable Angina in the Elderly

--Stable Angina in the Elderly

--【Literature Recommendation】2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes

-Concept Map

--【Concept Map】Nursing Care for the Elderly with Common Health Problems and Diseases

-【Test】CHAPTER 6

-【Case Discussion】CHAPTER 6

CHAPTER7 Hospice Care for the Elderly

-7.1 Concept of Hospice Care

--Concept of Hospice Care

--【Website Recommendation】 Definition of Palliative Care,WHO

-7.2 Death Education

--7.2.1 Death Education (1)

--7.2.2 Death Education (2)

--【Book Recommendation】The Meaning of Death by Herman Feife

-7.3 Nursing for Pain in the Dying Elderly

--Nursing for Pain in the Dying Elderly

--【Journal Recommendation】

-7.4 Nursing for Major Bleeding in the Dying Elderly

--Nursing for Major Bleeding in the Dying Elderly

-7.5 Nursing for Delirium in the Dying Elderly

--Nursing for Delirium in the Dying Elderly

-7.6 Nursing for Dyspnea in the Dying Elderly

--Nursing for Dyspnea in the Dying Elderly

--【Website Recommendation】The Hospice and Palliative Nurses Association,HPNA

-7.7 Psychological Problems and Nursing in the Dying Elderly

--Psychological Problems and Nursing in the Dying Elderly

--【Book Recommendation】On Death and Dying ,by Elisabeth Kübler-Ross

-7.8 Grief Counseling for the Widowed Elderly

--Grief Counseling for the Widowed Elderly

--【Book Recommendation】I Wasn't Ready to Say Goodbye,by Noel·Brook,Blair·Pamela

-Concept Map

--【Concept Map】Hospice Care for the Elderly

-【Test】CHAPTER 7

-【Case Discussion】CHAPTER 7

Assessment and Adjustment of the Living Environment for the Elderly笔记与讨论

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