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1-Many nurses would probably be surprised at the rates of STD in the elderly population. Sometimes the infection is newly acquired or it could be residual from a prior infection (such as Herpes outbreaks). Ageist attitudes can cause people to think elders are not sexually active, resulting in a failure to recognize their symptoms of STD or give proper patient education.

2-A clinician's knowledge of an elderly patient's everyday concerns, social circumstances, mental function, emotional state, and sense of well-being helps orient and guide the interview. Asking patients to describe a typical day elicits information about their quality of life and mental and physical function (Brink, 2014). This approach is especially useful during the first meeting. Patients should be given time to speak about things of personal importance. Clinicians should also ask whether patients have specific concerns, such as fear of falling. The resulting rapport can help the clinician communicate better with patients and their family members (Brink, 2014). A mental status examination may be necessary early in the interview to determine the patient's reliability; this examination should be conducted tactfully so that the patient does not become embarrassed, offended, or defensive (Brink, 2014). Routine screening for physical and psychologic disorders should be done annually, beginning at age 70.

3-Disorders that are common among the elderly are frequently missed, or the diagnosis is delayed. Clinicians should use the history, physical examination, and simple laboratory tests to actively screen elderly patients for disorders that occur only or commonly in the elderly; when diagnosed early, these disorders can often be more easily treated (Brink, 2014). Early diagnosis frequently depends on the clinician's familiarity with the patient's behavior and history, including mental status. Commonly, the first signs of a physical disorder are mental or emotional. If clinicians are unaware of this possibility and attribute these signs to dementia, diagnosis and treatment can be delayed (Brink, 2014).

4-I found myself doing the same thing working on the oncology unit. I would float to the floor as an agency nurse and would automatically get depressed in the report. Hearing all of those sad stories of the young patients and their prognosis. Just to see these young people dying with babies at home, it did something to me. I told my staffing agency to please remove it from my profile. I didn't care if I was to go hungry, I couldn't do it. I still cry when I hear a grieving child crying at their mother bedside. It does something to me.

5-my family had a similar situation to yours. I think it happens to many people. No matter how much they would love to just drop everything and fulfill the wishes of their dying loved one, it's just not possible. There are still the children to take care of and job obligations. Knowing this helps us to encourage our patient's family that there are many other ways they can continue to show their love to a dying relative.

6-Thank you for sharing your personal experience with your Grandpa. I can imagine how difficult it must have been for you and your family. I can understand how your mom would have been far too stressed with her grieving process of her partner and then to prepare to go through it all again too soon would have been hard. I think as families, we do the best we can and hope for the best. As nurses, we have to understand that some families just can't drop their lives to be at the bedside. It's not that they don't care or love the person, it's just life.

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