THE CARE LEVELS

PRIMARY ATTENTION
In this institute are carried out activities of health promotion and prevention. Functions:
   - Health promotion: nutrition, medication…
   - Evaluate the health state.
   - Preventives activities.
   - Early detection and assistance.
   - Palliative cares.

Sanitary education with the patients and their families:
   - Nursing cares.
   - Identification of signs and symptoms.
   - Know the necessities of health to elaborate objectives.
   - Evaluate the faults in home.
   - Sanitary education.
   - Healing.
   - Hygiene.
   - Emotional support.

Health education:
   - Nutrition.
   - Hygiene.
   - Exercise.
   - Tobacco, alcohol and drugs.
   - Prevention of falls.
   - Mental hygiene.
   - Hypertension, diabetes, obesity, dementias, arthritis…

Health education to prevent the cancer:
  - Change of a mole.
  - Persistent cough.
  - Modification in intestinal habits.
  - Blood hides in feces.
  - Problems in the urination.

GENERAL HOSPITAL
The patients has been hospitalized have acute diseases or relapse of a chronic diseases. When the patients leave of the hospital, the attention must continue in the community and in home.

SPECIALISED ATTENTION
The geriatric services only attend to geriatric patients.

The Geriatric Acute Unit is for geriatric patients to evaluate them and heal their diseases (acutes or chronics).
  - Second and thirst prevention.
  - Progressive cares.
  - Comprehensive cares: clinic, mental, functional and social diagnosis.

Half stay unit: to the reestablish the medical, surgical and functional process.
  - Second and thirst prevention.
  - Continued cares.
  - Comprehensive cares: functional and social problems.

Residence for the elderly: to patients that have chronic deterioration in their functional capacity and they can’t
be maintained in their home.

Geriatric Day Hospital: to weak patients that need physical recovery, sanitary cares and training in the daily activities.

GERIATRIC HEALTH EDUCACTION

The most common diseases are:

  - Hypertension.

  - Ischemic stroke.

  - Cardiac failure.

  - Diabetes.

  - Dementia.

  - Depression.

RISK FACTORS

• Organics: hypertension, malnutrition, incontinence and sensorial difficulties.
• Environmental: inactivity, barriers…
• Relationships: lonesomeness and insomnia.

All of them can be associated to other diseases or trigger some others.

GERIATRIC PREVENTION OBJECTIVES

  - Decreased the mortality.

  - Maintain the functional independence.

  - Increased the hope of active life.

  - Improve the quality of the life.

Provide attention to the old persons and their surroundings are our labor like nurses. Inside of the care processes are:

• Reinforcement: the old person is independent and the carer only say him/her some action she/he have to do.
• Support: the carer gives to the old persons some advices and guides them to execute some actions. 
• Aid: the carer contributes in some activities because the old person has some physical and mental  problems.
• Substitution: the old person present incapacity to do all the activities, so the carer does the total action.

HEALTH PROMOTION 

1. Blood pressure: once a week. Prevention: hypertension.
2. Control of lipids: screening in adults without symptoms (more than 35 years in men and more than 45 years in women). Prevention: dislipemia.
3. Electrocardiogram: once per year in older than 75 years. Prevention: arrhythmia and fibrillation with anticoagulant and other medications.
4. Glycaemia: once a year. Prevent: diabetes II. 
5. Test of mental state: once a year. Prevent: cognitive deterioration.
6. Blood hide in feces. Prevent: colon cancer. 
7. Mammogram: each 1 o 2 years. Prevent: breast cancer.
8. Rectal touch: to prevent prostate cancer.

We have to insist in this health promotion to prevent some diseases. Our objective with this is avoid diagnose the disease when the incidence is elevated. If we catch the symptoms quickly the consequences will be less importants.