The following question was asked of a random group of Journal of Gerontological Nursing readers:
What are the three most important wellness concepts every nurse should teach the elderly?
1. Have a primary care provider who knows you well and listens to you well.
2. Don't allow others (or yourself) to teat you as if you are "old."
3. Stay connected to your friends and family (They're not the same thing!).
4. Reach out and touch someone who may be lonely /isolated.
Clan M. Wohlgemuth, MS, RN, CS
Nursing Diredor/Gerontologic Clinical
Boston University Geriatric Services
1. Involvement - Share you talents with church, family, friends, school, clubs, etc.
2. Grooming - Like your image.
3. Organization - Decrease confusion by scheduling day and time for all activities - both essential "needs" and pleasurable "wants."
Alice Hall Beck, BSN, RNC
Adult Health Management Center- A
Brooklyn, New York
1. Wellness of body.
2. Wellness with family.
3. Wellness with God.
l+2+3=Formula for progression
through the "golden years."
Rose Maldet, RNC
Good Samaritan Nursing Care Center
1 work primarily with the old-old (over 85). The three most important wellness concepts I believe every nurse should teach are:
1. Maintain mobility, strength and flexibility through daily walking, stretching and toning. This promotes physiological function of almost all body systems as well as giving the individual a psychological boost. Its role in maintaining independence is invaluable.
2. Eat well, providing the body with all the nutritional requirements it needs to maintain and repair itself. The nutritional pyramid is a good resource for monitoring intake. To prevent weight gain the individual should focus on nutrient-dense foods.
3. Be socially active. Maintain contact with friends, family and neighbors. Engage in activities that you enjoy, especially those that involve others.
Mary Ann Anichini, RN, MS, CS
Geriatric Nurse Practitioner
St. Benedict Home for the Aged
As a geriatric nurse on a rehabilitation unit I am frequently faced with the challenge of trying to motivate my patients, some of whom are facing major deficits from their health event. Although rehab potential is always considered, the caregiver must work to uncover and develop the unique person within the patient. Thus, many geriatric nurses see patients in various stages of physical decline.
Rather than teach, lef s nurture the patients themselves, their personalities. I am always relieved when I find my patients expressing their sense of humor The ability of the patient to mink momentarily beyond their self shows me their readiness for recovery. Many times we as nurses need to show the patients that it is okay to share humor within this setting.
Another attribute we need to foster in our patients is the ability for joy. All too often they need to be reminded of the joy they bring to others as well as the simple joy that can be found throughout the day's events. Many patients have rich life histories that bring joy and perspective to those around mem. Enjoy in the sharing.
To me the most important aspect of all our lives, no matter the age, is the sense of belonging. The ability to maintain one's relationships with our community and those about us fosters in us our sense of connectedness and purpose in life. We as caregivers need to develop, reinforce and highlight the ways in which our senior patients belong to the community.
This is a pivotal time in health care. Nationally our elderly population is growing and will soon involve a large percentage of our health care dollar expenditures. Although many nurses don't consider themselves geriatric nurses, few would disagree that their patient population is evolving toward a geriatric mode. In addition to thinking wellness, let us not forget wholeness as we foster our geriatric patients, for who they have become. Along my career journey, I have met a lot of interesting people in my geriatric patients, and I'm sure you will too.
Patricia E. Hogan, RN-C, CRRN
University of Virginia Health Science Center
The following wellness concepts would be pertinent for teaching the elderly:
1. Exercise: Exercise minimizes the effects of osteoporosis and deteriorating muscle tone that comes with aging. Exercise promotes better sleep patterns, promotes increased selfesteem, and decreases depression.
2. Nutrition: Well-balanced meals high in fiber and low in fat promote energy, minimize atherosclerosis, and reduce one's risk of cancer.
3. Routine preventative screening: Preventative care is necessary to detect physical or psychological health problems. Early detection can add quality years to one's life.
Karen A. Schwarz, PhD, RN
Assistant Professor of Nursing
The University of Akron
The three wellness concepts that every nurse should teach the elderly are physical, mental and social.
Within the wellness concept, I would teach the importance of a well-balanced diet. I would take the time to explain the importance of adequate fruits and vegetables, i.e.., added fiber, lowered fat intake and complex carbohydrates. I would work out sample menus taking into consideration food likes and dislikes, ethnic background and other dietary restrictions, e.g., diabetes. I would explain the reasons for drinking plenty of fluids , especially water.
I would encourage them to get plenty of aerobic exercise, e.g., a brisk walk with a partner several times a week, stressing the importance of not becoming overtired. At this time, I would also mention physical safety in and around the home.
In the mental concept, I would teach the importance of keeping the mind active. With more leisure time, keep up an interest in reading, crafts, civic duties or volunteering. This may be the time to sign up for that college course or adult enrichment program. Many colleges offer reduced tuition to the elderly. I would tell them that it is important to set goals or ambitions. People who have an organized pattern of daily activities and interests are likely to live longer and enjoy life more.
In the social area, I would tell mem that it is important to continue strong bonds with people. Socialization with close friends and relations and sharing activities with people who they know and trust will not only make Hf e more fun, but will lead to better health outcomes.
I would urge them to continue spiritual ties with their church or synagogue.
It is especially important to have close friends and relatives available to help out in times of stress such as illness or upon the death of a loved one.
I would give them a list of health care resources and self-help groups which are available to the elderly.
Lastly, I would tell them mat their continued wellness depends on their physical, mental and social health habits.
Banbara M. Martin, RN
Elizabeth Nursing Home
Elizabeth, New Jersey
1. Eat a balanced varied nutritious diet with decreased calories, salt, sugar, cholesterol and fat and increased fruits, vegetables, legumes, and whole grains.
2. Participate in regular moderate exercise (walking or swimming) 20 to 30 minutes three times a week if not contraindicated by an existing condition. Warm up before and cool down afterward.
3. Take as few prescription and over-the-counter medications as possible and only those medically necessary. A good multívitamin/mineral preparation and calcium supplement should be considered.
Mildred O. Hogstel, PhD, RN, C
Gerontological Nursing Consultant
Fort Worth, Texas
1. The need to keep active socially.
2. The need to keep active physically by even the smallest amount of exercise.
3. Drinking plenty of fluids during the day, especially water to keep the bowels soft and regular (may need to add more fresh fruit to diet).
4. Being elderly can be difficult with a smaller income, so nourishing diets (e.g., vegetables and fruits) may be difficult.
5. Getting rest at night is important, so as not to suffer from sleep deprivation.
Mary A. Clauser, RNC, BS
Assistant Director of Nursing
The Lutheran Home of Greater Peoria
There are many wellness concepts appropriate to teach the elderly. In my experience, I have found that a strong social support network benefits clients cognitively, physically, emotionally, and spiritually. Social isolation is prevented. Functional independence and ability to retain autonomy is fostered.
Another important aspect of holistic wellness care of the elderly client revolves around interventions to support the growth and development of a person's spiritual nature. Interventions need to assist clients in identifying ways to bring peace, meaning, and purpose to life. These interventions should integrate but not offend a person's belief system. Increased spirituality is a developmental task of aging that gives focus to the later years. Thirdly, the importance of regular low impact exercise needs to be taught to the elderly. A 20-30 minute physical exercise plan 3-5 times a week that is pleasurable and within the person's comfort level needs to be developed by the nurse. Activity and exercise will restore and maintain muscle tone and strength providing the individual both physiologic and psychological benefits.
Lois A. Gerber, MPH, RN, CS
Director, Community Connections
Farmington Hills, Michigan
and Visiting Instructor
Community Health Nursing
Oakland University School of Nursing
The most important wellness concepts the elderly should know are:
1. The elderly need to be involved in something they care about,
2. They need to have an optimistic, positive attitude,
3. They need to keep active.
4. They need to have cultivated the ability to cope with loss.
Mary E. Amundson, BSN, RNC
Quality Assurance Consultant
Northstar of N.C., Inc.
Raleigh, North Carolina
I teach three important wellness concepts:
1. You want to have adequate fluid (preferably water) intake daily (8 to 10, 8 oz. glasses) to promote good hydration, kidney function and regular, comfortable, bowel movements.
2. Safety is your first concern, nothing is more important. Do not stretch to reach - come closer to it. Do not hurry, be especially careful in the bathroom. Remove hazardous things from your surroundings, e.g., foot stools, area rugs.
3. Make known your needs, be your own best advocate. Nobody knows you better than yourself. Communicate with family, friends, caregivers.
Kathleen S. Odadzin, RN, C
House of Loreto
1. Good communication skills both ways, even bilingual if necessary and possible.
2. Love, tact and respect for one another.
3. Positive outlook on situation, enhanced through attractiveness.
Elisabeth Katuszonek, ADN
Home Health Caregiver
This question was submitted by Dolores M. Alford, PhD, RN, FAAN, Gerontic Nursing Consultant from Dallas, Texas, and a member of the Journal's Editorial Advisory Board.
America can no longer afford to be a "sick" society; therefore, efforts must be directed toward helping citizens to be as well as possible. The traditional nursing model of caring for the ill and infirm in a dependency model is now changing to a wellness model.
The respondents to the "Your Turn" question did quite well in recognizing the holistic nature of older persons that must be promoted and maintained. They recognized that not only must the older person's body be maintained in optimum functional ability, but this must be done by making the person feel a sense of belongingness and personal worth in a social context. The respondents also showed that the utilization of biopsychosocial theories of healthy aging in a holistic framework is essential to modern gerontological nursing.
Nurses should not be afraid to teach the elderly. Older persons can learn and they can teach others. Emphasis must be placed on the concepts and techniques that optimize wellness, not just disease prevention. In other words, nurses need to look at teaching wellness from a positive way rather than negatively warning persons of dire consequences of their errors of living. Nurses need to learn how to adapt adult education principles to the unique needs of aging persons. Teaching wellness to older persons is very rewarding and hm.