Throughout the course NSG 409 Gerontology, I have had the wonderful opportunity to strengthen my nursing care skills with respect to the elderly population. By acquiring knowledge regarding the age-related changes an elderly population endures, I have gained insight into the interventions I should implement in practice going forward to provide holistic care, promote safety, and help foster an overall better life for these individuals. Subsequently, throughout this reflection, I will reflect on three key insights I have learned from this course and how these key insights will influence my practice going forward so that I can provide the best possible patient care.

One insight that I have taken away from this course is that elderly individuals face unique physical challenges and changes, which can affect their safety and overall well-being. Therefore, a nurse must perform a thorough physical evaluation to implement applicable interventions in order to optimize patient safety and overall health.  For example, during this course, I have learned that an older individual will undergo changes physically including alterations at the cellular level, as well as to the thermoregulatory system, respiratory system, cardiovascular system, gastrointestinal system, urinary system, reproductive system, musculoskeletal system, nervous system, sensory organs, endocrine system, integumentary system, and immune system. Likewise, age-related changes to the mind, including personality and memory, occur within the elderly population. Thus, a nurse must perform a thorough physical and mental assessment to identify potential complications an elderly patient may experience due to the many age-related changes that they could be enduring.  For the sake of the length of the reflection, I will provide one age-related example and subsequent nursing interventions. Because the elderly have a reduction of intracellular fluid, which makes them susceptible to dehydration, a nurse should encourage 1500 mL of water daily, monitor the consumption of water and output of urine, as well as, to assess the level of consciousness, skin turgor, mucus membranes, and lab values that indicate dehydration (e.g., specific gravity, BUN, etc.). As a result of this course, the knowledge I have gained, regarding the potential physical changes that the elderly population may experience as well as the nursing interventions that optimize safety and overall well-being I have learned, will influence my nursing practices going forward so as to allow me to provide the best patient care possible.

Another important component of this lecture that will influence my practices going forward is the importance of doing a medication reconciliation with elderly patients which is when a nurse identifies the most accurate list of all the medications the client has been prescribed in order to identify the correct medications the client should be taking. In the lecture, I heard about the common issue of polypharmacy, which is when a patient takes more than 5 or greater than 10 medications daily. With high volumes of medication, patients may experience the issue of taking more than one medication for the same diagnosis or taking a medication that may worsen a condition which both can cause negative consequences if not corrected. Moreover, I learned about other adverse effects of polypharmacy, including the high costs of medications; enhanced risk of adverse drug reactions; increased risk of patient falls; enhanced risk of dementia, and increased client susceptibility to be hospitalized all due to the adverse effects of medications. Moreover, if the client cannot afford their multiple, yet necessary, prescriptions and it results in them not taking their medication as a result, their condition(s) can worsen.  Consequently, after gaining knowledge and awareness of the danger polypharmacy poses to the elderly population, I will ensure to perform a thorough medication reconciliation with my elderly clients to enhance the overall well-being and quality of life of the elder population. Specifically, I will collect the names of all the patient’s medications; as well as, the strength of each medication; the formulation (XL, CD, extended-release, etc.) of each medication; the dosage of each medication; the route of each medication; and the frequency of each medication; the indication of each medication; and duration of each medication, for all over-the-counter medications, herbal supplements, vitamins, implanted/depot medications, radioactive therapies, respiratory therapy medications, diagnostic and contrast agents, and prescribed medications. In this way, I will provide the best possible care to the elderly population to enhance their safety and overall well-being.

Lastly, I have acquired further knowledge regarding delirium in elderly patients. Delirium has been recognized as a commonly occurring problem with increasing geriatric age. Specifically, delirium is a unique disorder of attention and cognition that occurs within minutes to hours and fluctuates throughout the day. Individuals with delirium may present with disorganized thinking, acute disturbance in cognition, psychomotor disturbances, disorientation, inattention, and fluctuating/acute mental status changes. In the lecture, I learned that causes of delirium include dementia, electrolyte disorders, medications/drugs, injury, pain, stress, unfamiliar environment, infection, metabolic conditions, and lung disorders, liver disorders, heart disorders, kidney disorders, and brain disorders. Thus, several factors can cause delirium and it is being overlooked more than fifty percent of the time, and therefore as a nurse, I must assess for delirium within patients to act promptly to treat them in attempts to reverse the condition. I have learned the key component of delirium within a patient is prevention. As such the nurse should ensure that the patient engages in frequent mental and physical exercise, gets adequate sleep, maintains hydration and good nutrition. The nurse should also provide the patient, if necessary, with glasses or hearing aids and manage their pain appropriately. Consequently, I will be able to help prevent and treat delirium in my future profession because of the valuable information I have learned during this lecture.

Overall, this course allowed me the opportunity to strengthen my skills and knowledge when caring for the elderly population, and these valuable insights will influence my practice going forward to allow me to provide optimum patient care.