Mention and discuss the Healthy People 2020 wellness goals and objectives for older adults. Define and discuss the aging process and the demographic characteristics of the elderly population in your community.

Senior Health

Read chapter 19 of the class textbook and review the attached PowerPoint presentation.  Once done, answer the following questions.

  1. Mention and discuss the Healthy People 2020 wellness goals and objectives for older adults.
  2. Define and discuss the aging process and the demographic characteristics of the elderly population in your community.
  3. Identify and discuss nursing actions that address the needs of older adults.
  4. Mention and discuss health/illness concerns common to the elderly population.

INSTRUCTIONS:

As stated in the syllabus present your assignment in an APA format word document, APA required font attached to the forum in the discussion tab of the blackboard titled “Week 12 essay” and the SafeAssign exercise in the assignment tab of the blackboard which is a mandatory requirement.  A minimum of 2 evidence-based references (besides the class textbook) no older than five years must be used.  You must post two replies on different dates to any of your peers sustained with the proper references no older than five years as well and make sure the references are properly quoted in your assignment. The replies cannot be posted on the same day; I must see different dates in the replies.   A minimum of 800 words are required and not exceeding 1,000 words (excluding the first and reference page).  Please make sure to follow the instructions as given and use either spell-check or Grammarly before you post your assignment.

Please check your assignment after the week is due or after it is graded because I either made comments or ask for clarification in some replies or the assignment that required your response.

The assignment must be submitted in the requested form..  You need to number the question and answer , no essay unless it is required.

Example;

  1.  Question one

Response

  1.  Question two

Response

Due dates:  Assignment – Wednesday, July 27, 2020, at 11:59 PM in the discussion tab of the blackboard, and in the SafeAssign exercise in the assignment tab of the blackboard.

Chapter 19

Senior Health

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

Aging is a natural process that affects all living organisms.

Chronological age

The young-old (ages 65-74)

The middle-old (ages 75-84)

The old-old (ages 85 and older)

The elite-old (more than 100 years old)

Functional age

Functional ability and the ability to perform activities of daily living (ADLs)

A better measure of age than chronological age

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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Why Do People Age?

Biological theories

Events that occur randomly and accumulate over time (stochastic theories)

Predetermined aging (nonstochastic theories)

Psychosocial theories: how one experiences late life (behavioristic)

Disengagement theory—withdrawal, decreased interaction

Activity theory—remaining active and involved is necessary to maintain life satisfaction

Continuity theory—continue through life as in previous years

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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Demographic Characteristics

Americans are living longer than ever before and the older population will continue to grow.

Older population is becoming more diverse.

Number of seniors differs by geographic location.

Older women outnumber older men.

Older men are more likely than older women to be married.

Educational attainment has increased among older adults.

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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Demographic Characteristics (Cont.)

Older women are more than twice as likely as older men to live alone.

Older adults want to live in their own home for as long as possible—“age in place.”

Alternative housing options are available with services to help seniors.

With aging, a good percentage of income is spent on health care.

The proportion of the older population living in poverty has decreased but is affected by gender, marital status, race, and ethnicity.

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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Psychosocial Issues and Role Changes Affecting Seniors

Retirement

Relocation

Widowhood

Loss of family and friends

Possibly raising their grandchildren

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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Physiological Changes of Aging

Occur in all body systems

Rate and degree of changes are highly individualized

Influenced by:

Genetic factors

Diet

Exercise

The environment

Health status

Stress

Lifestyle choices

And many other elements

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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Wellness is different than “good health.” Wellness exists at one end of a continuum with illness at the other end. Health promotion programs focus on helping individuals to maintain their wellness, prevent illness, and manage any chronic illnesses that the individual may have. Preventive health services are valuable in improving the individual’s health status to maximum wellness potential.

– Nies & McEwen (2015)

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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Recommended Health Practices

Encourage recommended health care screenings and examinations.

Encourage physical activity and fitness.

Evaluate the nutritional status and needs of older adults.

Monitor chronic illnesses.

Monitor medication use.

Monitor and accommodate sensory impairments.

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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Recommended Screenings and Exams for Health Promotion and Disease Prevention

For All Older Adults

Complete physical: Annually

Blood pressure: Annually

More often if hypertensive or at risk

Blood glucose: Annually

More often if diabetic or at risk

Serum cholesterol: Every 5 years

More often if at risk

Fecal occult blood test: Annually

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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For All Older Adults

Sigmoidoscopy: Every 3 to 5 years

OR

Colonoscopy: Every 10 years

More often if high risk

Visual acuity and glaucoma screening: Annually

Dental exam: Annually for those with teeth; cleaning every 6 months (every 2 years for denture wearers)

Hearing test: Every 2 to 5 years

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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Recommended Screenings and Exams for Health Promotion and Disease Prevention (Cont.)

For All Older Women

Breast self-exam: Monthly

Clinical breast exam: Annually

Mammogram: Every 1 to 2 years if age 40 or older

Check with HCP if 74 years+

Pelvic exam and Pap smear: Annually

Check with HCP about discontinuation at 65 or older with three consecutive negatives exams and no abnormal in previous 10 years and not otherwise at risk

Digital rectal exam: Annually with pelvic exam

Bone density: Once after menopause

More often if at risk

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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Recommended Screenings and Exams for Health Promotion and Disease Prevention (Cont.)

For All Older Men

Digital rectal exam and prostate exam: Annually

Prostate-specific antigen (PSA) blood test: Annually

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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Recommended Screenings and Exams for Health Promotion and Disease Prevention (Cont.)

Immunizations for Older Adults http://www.cdc.gov/vaccines/schedules/downloads/adult/mmwr-adult-schedule.pdf.

Immunizations for All Older Adults

Tetanus, diphtheria, pertussis: Every 10 years

Influenza (flu) vaccine: Annually

Pneumonia vaccine: Once after age 65

Ask physician about booster every 5 years

Hepatitis A and B: For those at risk

Herpes zoster (shingles): One-time dose

Varicella: If evidence of lack of immunity and significant risk for exposure

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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Encourage Physical Activity and Fitness

Physical activity …

Improves functional status

Reduces blood pressure and cholesterol

Decreases insulin resistance

Prevents obesity

Strengthens bones

Reduces falls

Walking is one of best forms of exercise.

Barriers: Pain, fatigue, lack of access to safe areas, impairment in sensory function and mobility

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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Assess Nutritional Status

Poor nutrition in older adults is common.

Obesity in adults over 70 years and older has been increasing.

Normal physiological changes related to aging affect nutritional status.

Income, functional status, medications, social isolation, transportation, and dependence on others affect nutrition as well.

Recommend myplate.gov for assessment of eating patterns.

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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Nutrition Checklist for Seniors: Warning Signs of Poor Nutritional Health

D isease

E ating poorly

T ooth loss/mouth pain

E conomic hardship

R educed social contact

M ultiple medications

I nvoluntary weight loss/gain

N eed assistance in self-care

E lder years (>80 years old)

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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Monitor Chronic Illnesses

Chronic disease is the leading cause of death among persons 65 years and older.

The prevalence of chronic disease increases with aging; many older adults have at least two chronic conditions.

The most common conditions are arthritis, hypertension, and diabetes.

Chronic illness is a major cause of disability and may cause limitations with activities of daily living (ADLs and IADLs).

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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Monitor Medication Use

Older adults consume more than one third of all Rx drugs, as well as many OTC drugs and “folk” remedies.

Age-related changes influence the effects of drugs.

Polypharmacy may lead to drug interactions and dangerous adverse reactions.

Most emergency hospitalizations for adverse drug events are caused by a few commonly used medications.

Closely monitor medication use in homes to ensure safety.

Older adults should be educated about potential adverse reactions, including drug-drug and drug-food interactions.

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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Monitor and Accommodate Sensory Impairment

Visual impairment impacts social abilities, depression, falls, and communication.

Cataracts, macular degeneration, diabetic retinopathy, and glaucoma

Hearing loss one of most common conditions affecting older adults.

Presbycusis and tinnitus

Dental problems are neglected because of inadequate dental care, limited mobility and transportation, poor nutrition, myths, lack of finances and reimbursement.

Incontinence affects quality of life and is a symptom of underlying problems.

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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Elder Safety and Security Needs

Falls

Traumatic brain injury (TBI)

Driver safety

Residential fire-related injuries

Cold and heat stress disorders

Elder abuse

Crime

Psychosocial disorders

Anxiety disorders

Depression

Substance abuse

Suicide

Alzheimer’s disease

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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Alzheimer’s Disease

Slowly progressive brain disorder: begins with mild memory loss; progresses through stages to total incapacitation and eventually death.

Diagnosing is difficult; often reached after all other conditions ruled out.

Assessment tools include:

Mini-Cog, MIS, and GPCOG

Clock drawing

No cure and limited treatment options are available.

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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Alzheimer’s Disease (Cont.)

Behavioral and physical changes create many challenges for caregivers.

Management strategies include:

Appropriate use of available treatment options

Management of coexisting conditions

Coordination of care among professionals and caregivers

Participation in activities and adult day care programs

Support groups and support services

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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Spirituality

Involves “finding core meaning in life, responding to meaning, and being in relationship with God/Other” (Manning, 2013)

Spirituality has health benefits—resilience

Nurses should address spiritual needs and concerns as part of holistic care.

Interventions include nurses’ presence, active listening, caring touch, reminiscence, prayer, hope, nonjudgmental attitude, facilitation of religious practices, referral to spiritual care experts.

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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End-of-Life Issues

Patient Self-Determination Act (PSDA)

Federal law enacted in 1990

Requires health care facilities that receive Medicare and Medicaid funds to ask patients on admission if they possess advance directives.

Living wills

Durable power of attorney

DNR (do-not-resuscitate) order

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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Nurse’s Role in End-of-Life Issues

Discuss and educate patients about end-of-life issues.

Inform other members of the health care team about advance directives.

Make sure that the document is visible and accessible in the patient’s chart.

Encourage patients to discuss their wishes with their family.

Encourage patients to discuss with physician so it becomes part of medical record.

Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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