Trauma in Older Adults
- : Melbourne VIC 3000
Seemingly trivial trauma can result in severe harm in older adults. As older adults represent a huge proportion of people that many nurses care for on a daily basis, understanding these vulnerabilities and how we can prevent unnecessary anguish is everyone’s responsibility. This conference looks at how nurses can prevent the consequences of trauma in older people. This conference looks at:
- Why “routine” procedures can cause trauma in an older adult
- How to assess an older adult following trauma
- Speaking up against unnecessary interventions in older adults
- Psychological impacts of trauma – PTSD in older adults
- Calling out elder abuse
- When wounds won’t heal…
- Professional and legal obligations around advocacy and much, much more…
Schedule Day One
8:30AM REGISTRATION FOR DAY ONE
Welcome and Introduction
How Trauma Affects the Ageing Body
Because of the ageing process, trauma usually has a profound impact on the older adult. Frailty and multiple concurrent co-morbidities can dramatically impact the remainder of a person’s quality of life, creating a cascade of unexpected consequences that occur following trauma. This opening session looks at:
- What do we mean by “trauma”?
- How does the effect of physical trauma differ in an older person?
- Is a head-to-toe assessment the right approach in an older person?
Trauma-Informed Care with Older Adults
Origins of trauma-informed care stem from a large study which investigated the correlation between adverse childhood events (ACE) and long-term health problems later in life. Understanding the impact of adverse childhood events and cumulative stressors later in life is essential if we are to create a safe environment that promotes resilience and enables healing for older adults. This session explores:
- How do adverse childhood events increase the risk of long-term health complications?
- What are the effects of chronic stress and trauma in older adults?
- What is the role of trauma-informed care?
- How can nurses incorporate a trauma-informed approach to their care of older adults?
10:30 MORNING TEA
The Problem with Falls: A Prevention Strategy
Accidental falls are common for older people of advancing age and are a huge trigger for trauma. In the community, falls contribute significantly to hospital admissions, Similarly, falls in hospitals can also result in serious health problems or even death. Nurses are well positioned to drive change in risk minimisation and fall prevention. This session includes:
- The problem with falls – the extent, risk factors, and impacts
- The keys to prevention – screening, assessment, planning, and education
- Reporting and incident management following a fall
Stand Up Please – A Look at Spinal and Rib Trauma
Cervical spine injuries and incomplete spinal cord injury are more prevalent in older adults. This includes central cord injuries, often without fractures; cervical distraction “open book” injuries, and odontoid fractures that may involve multiple levels of spine injury. This session examines the impact of osteoporosis, spondylosis, and increasing rigidity on older people and includes:
- Why is a physical assessment notoriously inaccurate in identifying vertebral fractures?
- Why does seemingly trivial trauma often cause significant injury?
- How are spinal and rib traumas managed in an older adult?
12:30PM LUNCH AND NETWORKING
Fractured Hips – NOF Injuries in Older Adults
Decreased bone density makes an older person at increased risk of hip fractures. Sometimes a person may not know they have sustained a fracture as, in some cases, it is possible to walk on a fractured hip. This session explains:
- What makes NOF injuries the most common hip trauma?
- How should an older adult with a suspected fractured hip be assessed?
- What makes an older adult more susceptible to complications?
- What are the correct indications for joint replacement surgery?
- What are the recovery and long-term outlook in older adults?
Is This Necessary? Preventing Unnecessary Treatments
A new light is being shone on unnecessary interventions. While literature has traditionally explored this concept in childbirth, evidence is emerging that unnecessary interventions are related to trauma in the older person. The consequences of this are serious. This session looks at an area that causes uneasiness in many nurses, including:
- What constitutes an unnecessary medical or surgical intervention at the point of care?
- How can this result in harm to an older person?
- How can you navigate the challenges of withholding and withdrawal of treatment?
3:00 AFTERNOON TEA
Advocacy – A Legal, Moral, or Professional Obligation?
Advocacy is a fundamental aspect of holistic nursing care. In a time of trauma, when an older person may be very vulnerable, advocacy is essential. This session looks at how nurses can and should advocate for patients at a time of profound need. It includes:
- What are the principles of advocacy and how do they relate to holistic nursing practice?
- Why are the challenges particularly difficult when advocacy involves older people?
- Do we have a professional, legal, or moral obligation to advocate?
- What are the challenges of speaking up – how is communication key?
- How can you enable relatives to be advocates?
4:30 CLOSE OF DAY ONE OF CONFERENCE
9:00AM COMMENCEMENT OF DAY TWO
Associate Professor Louis Roller
When Medicines Are the Cause of Trauma
In an older person, risks associated with medicines, such as falls, are well known. Situations such as the inappropriate use of medicines or polypharmacy may exponentially increase the risk. This important session looks at the relationship between medicines and the risk of trauma, including:
- Which medicines pose the most risks and why?
- What makes certain older people more at risk than others from the effect of medicines?
- Does crushing medicines enhance risk?
- How can polypharmacy be managed to diminish trauma?
- How can you advocate for a medicines review – in the hospital and the community?
Delirium and Trauma – A Challenging Conundrum
Delirium has a substantially high mortality. In older people, it can be caused by a raft of factors that include infection, medicines, and trauma. Early identification of the condition is imperative if morbidity is to be averted. In trauma situations, delirium could easily be confused with dementia. This session looks at delirium and trauma, how to identify it, and what to do when it occurs, including:
- How is trauma a trigger for delirium?
- What are the signs and symptoms of delirium and how do they differ from dementia?
- How can nurses realistically apply evidence of delirium management to practice?
11:00 MORNING TEA
Preventable Trauma - Skin Tears
Skin tears are traumatic wounds that require specific treatment. They are a significant risk for older adults. Skin tears can cause significant trauma to the older adult. In this session, preventing and effectively managing skin tears will be presented, including:
- What do we mean by “skin integrity” and how is it compromised?
- Which elements in a patient’s history would alert you that the person is at risk of suffering a skin tear injury?
- Are there any factors that increase the risk of skin tears in older adults?
- What types of situations may lead to increased friction and risk skin tears developing in the older adult?
- What is the current evidence-based assessment, management, and documentation of skin tears?
- Wound management – what types of products must be applied?
When Wounds Won’t Heal – What Next?
The healing of wounds in older people can be problematic. For instance, a skin tear can result in a chronic wound. What if a wound won’t heal? This session guides you through the principles of managing a non-healing wound. Topics include:
- What are key principles for wound healing?
- How does ageing affect healing?
- How can healing be optimised for older adults?
- If healing can’t be achieved, how can a person’s quality of life and comfort be optimised?
1:00PM LUNCH AND NETWORKING
Preventable Trauma – Catheter-Associated Urinary Tract Infections (CAUTIs)
Seemingly routine use of an indwelling urinary catheter (IDC) can result in serious harm in an older adult. Inappropriate use and management of an IDC may result in a catheter-associated urinary tract infection (CAUTI). CAUTIs are a major source of community and hospital-associated infections. Evidence is now strongly in favour of practices changing so that nurses are more proactive in suggesting of removing catheters. This session considers:
- Cost, prevention, and management of CAUTIs
- How long is too long? Evidence for removal of IDC's in healthcare settings
- Management of long-term urinary catheters – when are they necessary?
3:00 AFTERNOON TEA
What Caused That Bruise? Calling Out Elder Abuse
Elder abuse relates to harm to an older person committed by someone who is known and trusted. Disclosure by an older person may be difficult and traumatic in itself. This session will explore:
- What would make you suspect an older person was experiencing physical or other traumatic abuse?
- How to sensitively enquire to obtain the right information
- What is your duty of care in regards to reporting the suspected abuse?
- What considerations must you take into account if a person has cognitive decline?
4:30 CLOSE OF CONFERENCE AND EVALUATIONS
The Goal Need for Program
As Australians live longer, incidents of trauma in older adults increase. Seemingly trivial trauma can result in severe harm as older persons have less ability to compensate for their injury. The mortality from geriatric trauma is high, approximately 4-5 times that of younger patients. Falls are the most common cause of injury and result in high hospitalisation rates in people aged 65+ in Australia. Transfer to hospital increase further risk for trauma due to iatrogenic and other complications. Recognition, response, and management of risks are crucial to achieving the best outcome. The cost to all concerned can be significantly reduced when nurses are attuned to the causes and appropriate management of geriatric trauma.
Purpose of Program
This conference provides nurses with education that will enable better clinical decision-making relating to recognition, response, and management of trauma in older adults.
Your learning outcomes:
Identify older people in your care who are at risk of trauma and put in place measures to avoid injury
Educate relevant people and colleagues about the significance of trauma prevention in older adults
Apply new knowledge of holistic nursing interventions for trauma management of older persons to maximise their healing outcomes
Include principles of advocacy and holistic care planning to obtain the best possible long term quality of life for the person in their living situation
Fran Pearce is currently employed as an education coordinator at a large metropolitan teaching hospital. She has extensive experience in ... Read More
Geoffrey Ahern is a senior mental health clinician who works with the Victorian Police on a specialised mental health emergency ...Read More
Diana Clayton is a clinical nurse consultant who works for Peninsula Health in the Falls Prevention Service. She initially set ... Read More
Pierre Baume is a barrister at the Victorian Bar and practises in the areas of health law, family law, and ... Read More
Melinda Brooks has worked in wound management for more than 20 years in a variety of settings, from the Victorian ... Read More
Associate Professor Louis Roller has been an academic at the Faculty of Pharmacy and Pharmaceutical Sciences Monash University for over ... Read More
Robyn Attoe is a highly qualified Registered Nurse with a Graduate Diploma in Gerontology and Cert IV in Training and ...Read More
Amanda Wynne is a barrister at the Victorian Bar whose practice includes family law, child abuse, family violence, mental health, ... Read More
Michelle Bibby is a Registered Nurse with extensive experience in infection prevention and control. She is a principal partner in ...Read More