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Demonstrating empathy when communicating with older people
Empathy is an integral aspect of communication with older people and is central to person-centred care. As part of the provision of person-centred care, empathy supports effective communication, producing positive effects such as increased emotional well-being, increased adherence to treatment plans, reduced pain levels and improved wound healing. Empathy involves attempting to understand the other person’s perspective and feelings and communicate that understanding back to them. Empathic communication can help older people feel that they are being listened to and valued as partners in healthcare relationships.This article focuses on why it is important to demonstrate empathy when communicating with older people and how this can be achieved. It explains the origin of the concept of empathy in nursing and provides different ways of characterising empathy. It explores barriers to empathic communication in older people nursing and identifies verbal and non-verbal communication skills that nurses can use to enhance their empathy. Finally, it explains the importance for nurses to develop self-awareness and undertake self-care to preserve their capacity to demonstrate empathy towards older people.
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Holistic pain assessment in older people and older people living with dementia
Pain occurs in a wide range of diseases and long-term conditions associated with ageing and can affect every aspect of an individual’s life, reducing their ability to recover, their independence and their quality of life.The assessment of pain is an important aspect of nurses’ role and requires them to obtain detailed information on how the older person experiences pain and how pain is affecting their life. However, there are many challenges to effective pain assessment in older people, including challenges concerning communication and cognition.This article provides an overview of pain assessment in older people, particularly those living with dementia, based on the author’s expertise and on relevant literature, notably the recently revised UK national guidelines on the assessment of pain in older people.
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Sexual health and well-being in later life
Sexual health in later life is becoming increasingly important as more people are reaching older age and are remaining sexually active well into their seventies and beyond. Alongside this, as more older people seek new relationships following partner death or divorce, the rates of newly diagnosed sexually transmitted infections are increasing markedly.This article focuses on sexual health and well-being. It offers a definition of sexual health and explores the changes that people experience in sexual health, well-being and functioning in later life. It discusses common physical, psychosocial and sexual relationship issues, and identifies advice that nurses can offer to older people. Using the PLISSIT model, it then focuses on the role of nurses in promoting sexual health for people in later life.
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Osteoporosis and fragility fractures: risk assessment, management and prevention
Osteoporosis is a chronic skeletal condition characterised by low bone mass and microarchitectural deterioration of the bones that disproportionately affects older people. Older people with osteoporosis are at increased risk of sustaining fragility fractures, and this risk is compounded by factors such as falls and frailty. Fragility fractures can have several physical and psychological effects, potentially affecting an older person’s quality of life and reducing their life expectancy. Therefore, it is important that nurses can identify individuals at risk of osteoporosis and recognise the factors that may predict fragility fractures. This article outlines the main risk factors for osteoporosis and details the assessment and management of patients with this condition. It also explains the pharmacological interventions and lifestyle changes that can reduce the risk of fragility fractures in older people with osteoporosis.
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Practising cultural humility to promote person and family-centred care
The concept of cultural humility in nursing involves an awareness of diversity and how an individual’s culture can affect their health behaviours. Nurses can use this awareness to develop sensitive, tailored and person-centred approaches to patient care, which ultimately contribute to a positive healthcare experience. This article examines the concept of cultural humility with reference to person and family-centred care. It also explores how individuals and organisations can challenge discriminatory attitudes and behaviours in the workplace.
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Mallet finger injuries: the signs, symptoms, diagnosis and management
Patients commonly present to UK emergency departments with injuries to the tips of their fingers. Mallet finger is one of the most common injuries, resulting from an injury to the extensor tendon over the dorsal surface of the distal phalanges of the hand. Timely recognition, diagnosis and management are required to prevent complications. This article provides an overview of the pathophysiology, signs, symptoms, diagnosis and management of mallet finger injuries.
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Heel pressure ulcers: understanding why they develop and how to prevent them
Because of its anatomical location and the fact that it has no muscle or fascia and little subcutaneous tissue, the heel is highly vulnerable to pressure damage and pressure ulcer development. Heel pressure ulcers are often severe and challenging to heal. Heel pressure ulcers are caused by factors such as pressure, shear and friction and the vulnerability of the heel to pressure damage is increased by immobility, the patient’s skin status, the presence of previous pressure ulcers and/or scar tissue, and suboptimal tissue perfusion. The risk is also increased in patients with diabetes mellitus. The role of nurses includes assessing the risk and preventing the development of heel pressure ulcers. This article discusses the causes of, and risk factors for, heel pressure ulcers and describes techniques and devices that nurses can use to prevent them.
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Approaches to managing older people using opiates and their risk of dependence
There is little doubt that opiates have transformed healthcare, particularly in relation to pain management. However, many patients prescribed this type of drug develop problems such as dependency. Although we do not know how many older people have developed such problems due to opiate use we know that some will. It is important for nurses to understand the context in which opiates are used, as well as the specific needs of older people and how to respond to them.
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Sexuality and sexual intimacy in later life
Sexuality is as important in older age as it is throughout life, and its expression can be positive, empowering, joyful and life-affirming. The concept of sexuality has many dimensions including identity, need and desire, relationships and behaviour, all of which develop through ageing and life experiences. The evidence on all aspects of sexuality in later life tends to focus on biological dysfunction rather than fulfilment, well-being and quality of life, and does not acknowledge the enormous diversity of older people in terms of age, sexualities, ethnicity and culture. However, the evidence base is growing and, in broad terms, what older people want is becoming more clearly articulated.This article acknowledges the current evidence and, building on this, suggests ways in which nurses working in health and social care services can address some of the challenges, enhance their own understanding and skills, and work creatively with older individuals to offer services that help them to live, and end, their lives according to their individual identities, choices and deepest, most personal, priorities.
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Recognising and managing non-tuberculous mycobacterial pulmonary disease
Non-tuberculous mycobacteria (NTM) are organisms that live in water systems, soil and vegetation. Humans come into contact with NTM every day, but relatively few people become unwell as a result. In those that do, pulmonary symptoms are the most common effects. The incidence of NTM pulmonary disease (NTM-PD) is increasing worldwide. However, early diagnosis of the infection is challenging and treatment can be unsuccessful. Moreover, the effects of the coronavirus disease 2019 (COVID-19) pandemic are likely to have delayed diagnosis of many cases of NTM-PD.Patients with NTM-PD have multiple needs, so appropriate person-centred support should be in place. This article explains the epidemiology, risk factors, symptoms, diagnosis and treatment of NTM-PD. It also details the long-term follow-up care and support that healthcare services should provide to patients in the community and emphasises the need for community NTM infection services and NTM nurse specialist roles.
