With the aging baby-boomer population, one of the largest patient populations a nurse will encounter in the field is the geriatric population. Care of elderly people presents several significant challenges, especially patients with impaired communication or cognitive status deficits. It takes a special health care team to give this unique population the care that they both need and deserve. Here are five tips to keep in mind that will help you provide the compassionate and competent care they are hoping to receive.
1. Meet the patient where they are.
Cognitively speaking, many geriatric patients are not completely intact. They may experience confusion, disorientation, or even delusions and hallucinations. Providing competent and compassionate care requires that you assess the patient for these deficits before providing care. Educate your aides about what a patient’s deficits are so that they can provide the best care possible. While you may be able to successfully reorient some patients, others are not able to be reoriented. These patients may require you to be understanding and compassionate of their orientation level, choosing not to challenge their beliefs and assumptions while providing care. If the patient is calm and relaxed in their disorientation, it may be a safer place for them than if you were to challenge these beliefs.
2. Assess for sensory deficits.
A patient who cannot hear or see well may become agitated when care is being provided simply because they do not understand what is going on. Imagine resting peacefully in bed with your eyes closed and having someone start to roll you or manipulate your body…what sort of reaction would you have? You would probably be startled and attempt to fight back. Taking the time to gently notify the patient that you will be providing care, and making the attempt to communicate through words, motions, or even written words, will help the patient be comfortable and confident in what to expect as you provide care. If the patient normally wears glasses or hearing aids, make sure they are in place before you start. The more a patient feels in control, the better their experience will be.
3. Engage with the patient.
Most health care professionals and ancillary staff know what it feels like to be overwhelmed and exceptionally busy. It often feels like there is little time to stop and converse with our patients before we need to move on to our next task. For a patient who is alone in a room all day, however, a bit of conversation may be what they are craving. Take a few moments before leaving the room to show interest in the patient. Be empathetic if they need to talk or complain. Do not patronize or assume they have little to offer conversationally. Many of these patients have so much to say and great stories to share…you may even learn something surprising about them! A few minutes of genuine, engaged conversation may be the bright spot in that patient’s day and it takes so little of a nurse’s shift, and is certainly worth the effort it takes.
4. Manipulate the environment to enhance comfort.
Harsh lighting and loud noises can be frustrating or even upsetting to patients with sensory deficits. If a patient seems resistant to care and easily upset, try altering the environment by decreasing background noise, eliminating distractions, and providing distance between yourself and the patient when you speak. These simple interventions may seem inconsequential but can be very effective in calming an anxious or agitated patient.
5. Involve the patient in their care.
Perhaps the biggest complaint you will hear from geriatric patients is that they feel they aren’t kept informed about what is going on with their health care. Whether it is a cognitive deficit, communication barrier, or perhaps even a lack of education to understand terminology, the geriatric population often feels powerless over the care they are receiving. Nurses can help this situation by taking time to ask their patients what they understand of their diagnosis and plan of care. Do not assume that they don’t have an interest in what is going on. Allow them to be front and center in their course of treatment by educating them at their level of understanding. Make sure they have an opportunity to ask questions. If they are able to read, written materials can go a long way in helping the patient to understand what is happening to them.
As nurses, we want to empower our patients and give them a positive experience. The geriatric population certainly presents challenges to providing our best care, but by incorporating some of these simple interventions you will likely make a big difference in the patient’s perception of their care.