Care of the older adult notes Essay Example for Free

Care of the older adult notes Essay Many older patients are prescribed multiple drugs, take over-the-counter medications, and are often prescribed additional drugs to treat the side effects of the medications that they are already taking. The increase in the number of medications often leads to polypharmacy, which is defined as the prescription, administration, or use of more medications than are clinically indicated in a given patient. One widely used ADL tool is the Barthel Index : measure functional levels of self-care and mobility, and it rates the ability to feed and groom oneself, bathe, go to the toilet, walk (or propel a wheelchair), climb stairs, and control bowel and bladder. The original ADL tool was developed by Katz Several interventions that may help the prescriber to prevent polypharmacy include knowing all medications, by both brand and generic name, being used by the patient; identifying indications for each medication; knowing the side effect profiles of the medications; eliminating drugs with no benefit or indication; and avoiding the urge to treat a drug reaction with another drug. Patient education on the risks of polypharmacy may help the patient as well. The Mini-Cog: The screening consists of a three-item recall and a clock-drawing test. This reliable tool can assist nurses with early detection of cognitive problems. Mini Mental State Examination (MMSE): measure change in cognitive impairment. It measures orientation, registration, attention and calculation, short-term recall, language, and visuospatial function. *Dementia is a permanent progressive decline in cognitive function Of the five senses—hearing, vision, smell, taste, and touch—it is the occurrence of diminishe d vision and hearing that seems to have the greatest impact on older adults. Problems with vision or hearing can have negative effects on social interaction and hence on social and psychological health. Presbyopia refers to an age-related change in vision. Presbycusis refers to age-related progressive hearing loss. Age-related macular degeneration, the deterioration of central vision, Assessing Older Adults  cognitive-testing tools such as the Mini–Mental State Exam or the Orientation–Memory–Concentration Test (OMCT).3 Both tools assess orientation  to time and place, short-term memory, and concentration. The CAM is a standardized instrument developed for clinicians to identifydelirium, an acute change in mental status from baseline, quickly and accurately. Montreal Cognitive Assessment (MoCA © Version 7.1) was developed as a quick screening tool for MCI and early Alzheimer’s dementia. It assesses the domains of attention and concentration, executive functions, memory, language, visuoconstructional skills, conceptual thinking, calculations, and orientation End-of-Life Care The interdisciplinary group or team (IDG/IDT): Registered nurse—coordinates the plan of care for each patient Health Promotion Healthy people 2010- preventative measures for ages 50-64 Healthcare Policy and Reform Medicare is Title XVIII of the Social Security Act; it was passed in 1965, after years of trying to provide some kind of universal health insurance. It is an insurance program for those 65 or over who have paid into the Social Security system, the railroad fund, or are diagnosed with end stage renal disease. Activity: Healthcare Policy and Reform In general, you should apply for Medicaid if your income is low and you match one of the descriptions below. Medicare is a Federal health insurance program for people 65 years or older, certain people with disabilities, and people with end-stage renal disease (ESRD). Medicare Medicare is an insurance program. Medical bills are paid from trust funds which those covered have paid into. It serves people over 65 primarily, whatever their income; and serves younger disabled people and dialysis patients. Patients pay part of costs through deductibles for hospital and other costs. Small monthly premiums are required for non-hospital coverage. Medicare is a federal program. It is basically the same everywhere in the United States and is run by the Centers for Medicare Medicaid Services, an agency of the federal government. Medicaid Medicaid is an assistance program. Medical bills are paid from federal, state and local tax funds. It serves low-income people of every age. Patients usually pay no part of costs for covered medical expenses. A small co-payment is sometimes required. Medicaid is a federal-state program. It varies from state to state. It is run by state and local governments within federal guidelines. To qualify for Medicaid, an individual must fit into a category of eligibility and meet certain financial and resource standards. Medicaid provides three types of health protection: 1) health insurance for low-income families and people with disabilities, 2) long-term care (LTC) for older Americans and persons with disabilities, and 3) supplemental coverage for low-income Medicare beneficiaries for services not covered by Medicare Living Environment Annual vaccination against influenza is recommended for all adults 65 years of age or older because more than 90% of the deaths from influenza occur in this population. Periodic boosters of tetanus vaccine, traditionally given every 10 years in the United States, are recommended for older adults by the USPSTF. The Beers List of medications to be avoided in the elderly has become a national guideline for prescribers and pharmacists in the United States (Fick etal., 2003). These medications include long-acting benzodiazepines, sedative or hypnotic agents, longacting oral hypoglycemics, analgesics, antiemetics, and gastrointestinal antispasmodics. Maintaining Functional Independence â€Å"Elderly patients with unintentional weight loss are at higher risk for infection, depression and death† U.S. Public Health Service published the report Promoting Health/Preventing Disease: Objectives for the Nation. This 1980 report outlined 226 objectives for the nation to achieve over the following 10 years. Healthy People 2000, was initiated by the U.S. Public Health Service in another effort to reduce preventable death and disability for Americans. Healthy People 2010 initiative; however, the number of objectives has increased to 467, and these are distributed over 28 priority areas. Frailty is perceived as a general decline in the physical function of older adults that can increase vulnerability to illness and decline. Defining characteristics include unintentional weight loss of more than 10%  in the prior year, feelings of exhaustion, grip strength in the weakest 20% for age, walking speed in the lowest 20% for age, and low caloric expenditure.

John Brown The Sword and the Word Essays -- essays papers

John Brown The Sword and the Word â€Å"I act from a principle,† and â€Å"I say, break the law† are not only the names of two out of the five parts in this book, but the words by which John Brown lived so passionately everyday. At earlier times in his life he lived by his sword as well. The Sword and the Word illustrates John Brown’s own ideas and intentions and how he lived by them. A main issue of this book is that truly a man of his word who believed that morals should outweigh the law of the land, John Brown lived and died for the abolition of slavery and did as much if not more for that cause than many other slaves or free men. You could say this book is a biography but it really focuses on certain aspects and parts of John Brown’s life. It uses a kind of story-telling format, but many of the information and facts of the stories are given to the reader in the form of notes that are to and from many people including John Brown. Stavis’s major thesis is Brown believing â€Å"that a man has a perfect right to interfere by force with the slaveholder, in order to rescue the slave,† and that Brown fought for the freedom of the slaves and believed it was better he break inhumane rules and obey and follow God than to obey the law and sin. He followed his own set of principles and morals. He believed that a man should be honest, God-fearing, and loyal. If a man commits a crime he must be punished. Once he had a man re-arrested for the crime of theft where the man pleaded poverty. The man was thrown in jail but John Brown believed that the man’s family should not suffer for his wrongdoing while he was in jail so John Brown regularly supplied his family with an abundance of provisions. Not only was John Brown honest and fair, but also he was courteous and generous towards others even outside his well-taken care of family. To prove his points, the author includes several stories of things John Brown did in his life that exemplify his unselfishness. Upon hearing that a family miles away was starving and living in poverty one winter John Brown went to the man with a business offer to help the man because he wouldn’t accept just donations. The offer gave the man food and clothing in exchange for his labor the next summer. When the summer time came around, John Brown didn’t even let the man work for him. This is showing the good nature of John Brown’s pers... ...thor also composed the plays, ‘Lamp at Midnight,’ ‘The Man Who Never Died,’ ‘Harpers Ferry,’ ‘Coat of Many Colors,’ and ‘Refuge,’ and wrote Home, Sweet Home! and The Chain of Command. The Sword and the Word is actually a companion volume to Stavis’s ‘Harpers Ferry’ play. Publisher Thomas Yoseloff believes that the book is useful for anyone preparing a production of this story and thinks that it is well put-together with primary sources from history in conjunction with Stavis’s own views and ideas. I agree. We have not yet covered this time period yet, but soon enough we will discuss those crucial years before the civil war in class. However this has still aided and enlightened my studies in American History. It gave me a more in-depth and closer look at the slavery issue and how absurd it was. It gave me a sense of the feelings of the people of the time that John Brown was alive. Enough was learned from this book that the time spent reading it can be justified. I enjoyed reading the book and would recommend it to some one who enjoys learning about that time period in history and the exciting actions and events of a good-hearted man devoting his life for a good cause. John Brown The Sword and the Word Essays -- essays papers John Brown The Sword and the Word â€Å"I act from a principle,† and â€Å"I say, break the law† are not only the names of two out of the five parts in this book, but the words by which John Brown lived so passionately everyday. At earlier times in his life he lived by his sword as well. The Sword and the Word illustrates John Brown’s own ideas and intentions and how he lived by them. A main issue of this book is that truly a man of his word who believed that morals should outweigh the law of the land, John Brown lived and died for the abolition of slavery and did as much if not more for that cause than many other slaves or free men. You could say this book is a biography but it really focuses on certain aspects and parts of John Brown’s life. It uses a kind of story-telling format, but many of the information and facts of the stories are given to the reader in the form of notes that are to and from many people including John Brown. Stavis’s major thesis is Brown believing â€Å"that a man has a perfect right to interfere by force with the slaveholder, in order to rescue the slave,† and that Brown fought for the freedom of the slaves and believed it was better he break inhumane rules and obey and follow God than to obey the law and sin. He followed his own set of principles and morals. He believed that a man should be honest, God-fearing, and loyal. If a man commits a crime he must be punished. Once he had a man re-arrested for the crime of theft where the man pleaded poverty. The man was thrown in jail but John Brown believed that the man’s family should not suffer for his wrongdoing while he was in jail so John Brown regularly supplied his family with an abundance of provisions. Not only was John Brown honest and fair, but also he was courteous and generous towards others even outside his well-taken care of family. To prove his points, the author includes several stories of things John Brown did in his life that exemplify his unselfishness. Upon hearing that a family miles away was starving and living in poverty one winter John Brown went to the man with a business offer to help the man because he wouldn’t accept just donations. The offer gave the man food and clothing in exchange for his labor the next summer. When the summer time came around, John Brown didn’t even let the man work for him. This is showing the good nature of John Brown’s pers... ...thor also composed the plays, ‘Lamp at Midnight,’ ‘The Man Who Never Died,’ ‘Harpers Ferry,’ ‘Coat of Many Colors,’ and ‘Refuge,’ and wrote Home, Sweet Home! and The Chain of Command. The Sword and the Word is actually a companion volume to Stavis’s ‘Harpers Ferry’ play. Publisher Thomas Yoseloff believes that the book is useful for anyone preparing a production of this story and thinks that it is well put-together with primary sources from history in conjunction with Stavis’s own views and ideas. I agree. We have not yet covered this time period yet, but soon enough we will discuss those crucial years before the civil war in class. However this has still aided and enlightened my studies in American History. It gave me a more in-depth and closer look at the slavery issue and how absurd it was. It gave me a sense of the feelings of the people of the time that John Brown was alive. Enough was learned from this book that the time spent reading it can be justified. I enjoyed reading the book and would recommend it to some one who enjoys learning about that time period in history and the exciting actions and events of a good-hearted man devoting his life for a good cause.

Lack of Education Essay

Student life is full of charm and enjoy and everyone who is in practical life always seem to miss his/her student life. But the student life also has challenges and problems of its own. The students of developing countries like Pakistan have lots of problems, such as financial problems, poor transportation system, language barrier, incompetent teachers and many more. One of the problems faced by students is that usually they are not free to choose study programmes of their own choice. Parents normally impose upon them a field of study which may not be suitable for the child or which he doesn’t feel comfortable with to study. This is a very common problem of our society. A student may want to be a journalist or a photographer but his parents may select engineering for him. So when he gets admission to the engineering college, he does not perform well. He then starts to feel that he is not fit for the field. Parents should think about it and stop imposing study programmes on their children. They should only inform them about the scope and problems of every field, and let them choose a study programme. Students, after passing their matriculation examination, face too much confusion about the selection of their further studies. They don’t know which study area is best for them. Most of the students don’t even know different fields of studies other than engineering and medical due to lack of study and career counselling. They get admission to these programmes and then don’t get good marks. That’s when they can’t get admission to medical or engineering colleges, and become upset thinking about their career. We don’t have career counsellors in Pakistan other than a few institutions which hire career counsellors to guide their students. Students should have some basic knowledge about any profession before deciding to take it as their future profession. Students should be able to consult their teachers, parents and friends in this regard, particularly the persons that are already attached with the profession they are interested in.

The Issue of Free Speech Versus Censorship - 690 Words

In modern society, the issue of free speech vs. censorship often comes up. It is a hot topic among those interested in social issues, and represents two well meaning but very different arguments. The argument for freedom of speech says that communication and connectivity promotes progress, while the argument for censorship says that silence and isolation promotes security. Freedom of speech usually refers to a citizens right to the expression and distribution of their opinions. The Universal Declaration of Human Rights defines freedom of speech as a human right, stating that Everyone shall have the right to hold opinions without interference. It also states that all people have the right to express and share these opinions and exchange information through any medium of communication they choose. It is important that speech and expression of speech be distinctly defined, as the method of expression can be very subjective. For example, free speech in the United States has two limitations; disruption of the peace and incitation of violence. If the speech, or manner of expression of that speech is causing a stir in an otherwise peaceful area or group of people, the speaker can be legally censored by the police. The concept of freedom of speech has existed since at least 500 BC, where it was used in Athens, Greece. Athens was one of the first democracies, and possibly the birthplace of the concept of freedom of speech. (Freedom of Speech, Wikipedia) Free speech isShow MoreRelatedFree Speech Vs Hate Speech Essay769 Words   |  4 PagesFree speech versus hate speech is a very widespread debate as there are convincing arguments on both sides that are very compelling. Although there are many points commonly used to back up the argument that are false and inaccurate. 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Today’S1291 Words   |  6 Pagesbreakdown, or crime, for a moment of notoriety on a live feed is appalling in the least. How could social media, such as Facebook, allow a live airing of a murder and hold it as acceptable, or part of a first amendment right to freedom of speech and expression? With such issues in mind, Facebook should better censor or monitor their live newsfeeds to avoid further escalations of violence. One of the dangers of Facebook is the public can now view life as it happens, while allowing the author of the feed toRead More3d Printed Weapons : Unjust Censorship Of A Public Threat1508 Words   |  7 Pages 3D Printed Weapons: Unjust Censorship of a Public Threat 3D printing has become astronomically popular in the world of today. From toys and guitars to camera lenses and even houses, 3D printing can create just about anything. But with gun control being a prominent issue in American society and 3D printing becoming more readily available, controversy emerges. 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