Care of an older person during treatment
Older bodies change. The heart, lungs and kidneys work a little slower. Skin is thin. Bones are weaker. The body does not show illness loudly.
- Quiet signs: instead of a high fever, the person may be only tired, confused or not eating.
- Many medicines: older people often take several tablets. Some mix badly. The nurse checks the list and watches for side effects, such as dizziness.
- Communication: face the person, speak slowly and clearly, use glasses and hearing aids, and give time to answer.
- Safety: low bed, rails when needed, light on at night, dry floor, help to walk.
- Respect: use the person's name, ask before touching, keep privacy, and let the person choose when possible.
Acute phase
An acute illness starts suddenly. Examples: chest infection, a fall with a broken bone, severe loose motions or a stroke.
What the nurse does:
- Check temperature, pulse, breathing, blood pressure and how awake the person is. Do it often and write it down.
- Watch for dehydration: dry mouth, little urine, dizziness. Keep fluids going.
- Watch the mind. New confusion is a warning sign, not just old age. Tell the doctor.
- Prevent harm from lying in bed: turn the person, keep skin dry, and start moving as soon as the doctor allows.
- Tell the family what is happening in simple words.
Chronic phase
A chronic illness stays for months or years. Examples: high blood pressure, diabetes, arthritis, heart weakness and long-term lung disease.
- Teach the person and family about medicine, food, and warning signs.
- Build a routine: a pill box with one box per day, fixed meal times, a daily walk.
- Keep the person independent. Help only where needed. Let the person do what he or she can.
- Prevent falls and sores. Look after feet, teeth and eyes.
- Review medicines with the doctor from time to time, so that none are taken without need.
- Notice loneliness and low mood. Company is part of the treatment.
Terminal phase
In the terminal phase, the illness cannot be cured and life is near its end. The goal changes from cure to comfort and dignity. This is called palliative or end-of-life care.
- Ease pain, breathlessness and other discomfort. Give medicines on time.
- Keep the mouth moist and the skin clean and dry. Change position gently.
- Keep the room calm, warm and quiet. Let family stay close.
- Ask and respect the person's wishes, culture and faith.
- Speak honestly and kindly. Listen to the family's fear and grief, and support them after the death.
Try it
Try it: Ask an older relative how they like to be spoken to. Then practise saying one sentence slowly and clearly, looking at their face. In the 3D, press the three phase buttons and say aloud: "Acute, watch. Chronic, teach. Terminal, comfort."
Key formulas and definitions
- Acute = sudden: watch closely, act early
- Chronic = long: teach, routine, independence
- Terminal = no cure: comfort, dignity, family
- New confusion in an older person = look for a cause (infection, thirst, medicine)
Worked examples
1. An older woman with a chest infection has no fever but is suddenly confused. What should the nurse do?
Treat it as a warning sign. Check breathing, pulse, water intake and blood pressure, and tell the doctor at once. Older people often show infection as confusion, not fever.
2. A man with diabetes for 10 years keeps forgetting tablets. Which phase is this and what helps?
Chronic phase. Give a pill box with one box per day, teach the family, set a fixed routine and check later that he is using it.
3. A person in the terminal phase has pain and a dry mouth. What are two nursing actions?
Give pain medicine on time as ordered, and keep the mouth moist with gentle mouth care. Stay close and keep the family informed.
Common mistakes
- Saying "it is just old age" when there is a sudden change. A sudden change always has a cause.
- Waiting for a high fever. Older people may have an infection with little or no fever.
- Doing everything for the person. This makes him or her weaker. Help only where needed.
- Thinking terminal care means doing nothing. It means active comfort care.