Through this course I have been able to get a much better perspective on the holistic, caring perspective, complex challenges, and unique adaptations that face aging adults. As a person in their twenties, I had not put much thought into the care and challenges that the elderly face. To have gone through four years of nursing school and wrap it up with elderly care I feel that it is a wonderful end to my nursing school career. This course took everything we have learned but portrayed the differences that are needed in an older adult. It was a good recap to go over what was learned in Adult Health and apply it but in the elderly perspective. For the elderly, the two insights I took away from this course to influence my practice going forward is to focus on the quality of life of the older individual, and drug pharmacokinetics and pharmacodynamics in older patients.
For the older adult, their care and choices are based more off their quality of life now for themselves, rather than in the younger adult, which would possibly by survival from a diagnosis for example. In the care for an older adult, the nurse wants to always be promoting the maximum independence for positive outcomes. If an older adult becomes recently diagnosed with a terminal illness, the approach for the individual should always be focused more on their comfort, based on what they choose to do for end-of-life care. It is often found that the older adult’s family members want to take control of the patient’s treatment plan, but in the end, this only causes more harm that the older adult most likely does not want. As a nurse, we want to always be advocating for our patients and in this type of situation, it is important to discuss with the family what the patient requests and to have the patient discuss their plans to their family. The older adult is more focused on the quality of life they have lived, and this often brings them joy.
Another important aspect to reflect on from this course was the changes that took place in the older adult related to pharmacokinetics and pharmacodynamics. Nursing knowledge is essential for the special considerations of medications in the older adult population. Medications act differently in older adults and require careful dosage adjustment and monitoring. Medication adsorption in the elderly is different because systemically the older adult goes through changes such as a decreased ICF, increased gastric pH, decreased gastric blood flow and motility, and reduced CO and circulation. The older adult has a slower metabolism can and that can slow the absorption of certain medications. With the older adult and the reduced blood flow and circulation, in the renal system this causes medications to accumulate more in the body, so the nurse needs to always be assessing medication half-lives. This is a broad discussion into the pharmacokinetics and pharmacodynamics of the older adult but it is most important for my practice going forward to understand these changes in the older adult before harm is done.
