CPD articles
Our continuing professional development (CPD) articles are designed to assist with your nursing skills and practice.
Sexually speaking: person-centred conversations with people living with a dementia
Why you should read this article: • To understand the importance of supporting the sexuality and sexual expression of people living with a dementia • To enhance your awareness of a new person-centred paradigm that can be used when undertaking conversations about sexuality and sexual issues • To recognise the issues related to sexual rights and consent that may arise in the care of people living with a dementia While sexuality is integral to being human and supporting sexual expression is fundamental to delivering person-centred care, many nurses find this area challenging. This is particularly true when working with people living with a dementia, irrespective of their age. However, it can be especially challenging in older adults. This article aims to support nurses in their work with individuals and couples living with a dementia. After briefly defining the term ‘sexuality’ and acknowledging the effects of the most common types of dementia, the article discusses the importance of person-centred conversations. It details a new person-centred paradigm that can assist nurses to learn about people’s sexuality and sexual wishes. Through enhanced understanding and increased objectivity, nurses can be better equipped to support people to continue living fulfilled sexual lives according to their choices and priorities. The article concludes by summarising the legal and professional context and nursing responsibilities involved in addressing sexuality with people living with a dementia, specifically when mental capacity becomes an issue.
Type 2 diabetes in older people: pathophysiology, identification and management
Exploring the implications of increased longevity and how this is linked to type 2 diabetes
Sexual health and well-being in later life
This article defines sexual health and explores the changes people experience in later life
How therapeutic communication can reduce distress in people with dementia
Newcastle Model’s biopsychosocial framework is revisited to understand the caregiving context
Osteoporosis and fragility fractures: risk assessment, management and prevention
Nurses need to be aware of the risk factors and identify at-risk patients
Understanding and managing depression in older people
Clinicians do not always recognise depression in older people as they attribute symptoms to the ageing process and the effects of failing health. Similarly, older people do not always appreciate that their symptoms relate to their mood. Understanding how depression affects older people can improve access to support, thereby improving overall health and quality of life. To ensure these outcomes we need a workforce with excellent communication skills that supports therapeutic relationships, promotes recognition of symptoms, and enhances assessment, diagnosis, treatment and management.
Helping people live with chronic obstructive pulmonary disease
How nurses can have a positive effect on the lives of people with COPD
Effective communication with older people
Nurses can overcome communication barriers through thoughtful interventions
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.
Ethical practice in dementia care
Case study examples of challenging ethical situations that might be encountered
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.
Maintaining skin health in older people
Skin changes associated with age are inevitable. Ageing is associated with structural and functional changes of the skin that result in increased vulnerability. The most common functional skin changes are dryness (xerosis), which causes itching and discomfort, and skin fragility, increasing patients’ vulnerability to skin damage. Dry skin and itching have a significant effect on older people, which can be further exacerbated by products used for washing and bathing. The management of dry skin and itching is fundamental to older people’s care and nurses should act in their best interests to ensure that the potential for skin damage is addressed. However, many older people are often reluctant to discuss the problem, are embarrassed and will self-treat or try to hide an underlying problem such as incontinence or worries about being infectious or dirty. This can be challenging when managing their skin care because of under-reporting, self-medicating or the assumption that it is ‘just old age’.