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Geriatric Nursing Protocols

Nursing protocols for geriatric patients, elderly patients over the age of 65, help ensure that proper nursing care is administered. Special care is necessary for aging people, who can be slower and more fragile. For instance, up to 75 percent of nursing home residents injure themselves when they fall. Geriatric nursing protocol for a fall dictates that the nurse assess the patient for physical and psychological risk factors. They also must assess the environment for external risk factors and help create safer surroundings for patients.

  1. Advance Directives

    • Advance directives like Durable Power of Attorney and Living Wills are based on the idea that all people have a right to determine the direction of the medical treatment they receive. Rational patients who can communicate verbally or otherwise can make decisions about the level of care they will accept as their health diminishes. Nurses must respect patient decisions, talk to family members and remain sensitive to sociological influences involved in the patient's treatment decisions.

    Depression

    • A high prevalence of depression is noted in medically-ill elderly patients who live in institutions. Nurses identify high-risk factors such as alcohol and substance abuse and conduct focused assessments to determine the frequency and patterns of depression and its symptoms.

    Elder Mistreatment and Abuse

    • Nurses are trained to look for and detect signs of physical, emotional and sexual abuse in the elderly. Other types of abuse include caregiver neglect, financial exploitation and self-neglect. Nursing protocols require nurses to ask patients specific questions that can identify abuse and lead to intervention to end it. They also perform physical assessments to look for specific signs and symptoms of abuse.

    Nutrition

    • Nursing protocols require that patients at risk for poor nutrition have a conference with a dietitian. Nurses may consult pharmacists to review all patient medications to determine whether negative drug-nutrient interactions are involved.

      Nurses also help patients improve their oral food intake by talking with them and family members about more palatable foods and more frequent meals.

    Palliative Care

    • Geriatric palliative care focuses on quality of life issues that include relief of pain and suffering. Nursing protocols manage symptoms and reduce patient stress and exertion by providing bedside call buttons or bedside care. Protocols to reduce constipation include encouraging fluid intake. Pain is managed with appropriate medications.

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