The idea and concept of healthy ageing is best described by the WHO and it includes the process of development of and maintenance of the individual’s functional ability which enables the well-being in older age. The idea of functional ability here, is the central, main concept to healthy ageing and is explained as the attributes that are related to health which help in enabling people to be able to do what they want to do and value as important for themselves. It includes the ability to meet own daily and basic needs, be able to move, and build and maintain own relationships and be as effective contributors to the society as they wish to be (Devi, 2018). Not having any disease is not a qualification of healthy ageing as co-morbidities in terms of presence of more than one disease is always present in the older adult. However, controlling the co-morbidities and maintaining the functional ability will help the elderly (Michel et al., 2016). The core concept should be to inculcate functional abilities in the older people so their functioning is established on their own and they gain the ability to function and develop skills improving, life quality (Wong, 2018). This essay will discuss a case study around the concept of healthy ageing and associated nursing care for the elderly.
The older Australians are being responsible for the increasing share of the population. It was estimated that in the year 2013 in the country, around 14% of the people (around 3.3M people) were aged 65 and over and around 1.9% were aged over 85 years. According to the Australian Bureau of Statistics, by the year 2053, around 21% of the people in Australia will be 65 and above and around 4.2 % will be in the age group of 85 and above (Australian Institute of Health and Welfare, 2014).
An ageing population in a country has far-reaching consequences in terms of direct challenges such as the changing profiles of health, increasing costs of healthcare and increasing demands for healthcare services. The challenges for healthcare in Australian ageing population are twofold and require concentration on two groups of diseases- age –related disorders, like dementia, arthritis, cancer etc. in 85 and above population; and lifestyle related disorders like type-2 diabetes, obesity in the age group of 65 and above. The health system’s challenge would be to be able to meet the growing health needs of the population as there will be increasing demands of healthcare with increase in the ageing population (Cristea et al., 2020).
Nurses play a major role in the provision of healthcare services to the elderly population. Cultural competency can help the nurses in establishing a better rapport with the patients and help in improved and effective communication as well. The level of communication and ability to put across a point and understand patient’s needs in a better way is based upon the cultural understanding and comprehension of the nurse. This improved communication can play a significant role in assessing the needs of the patient and developing treatments and interventions (Cai, 2016).
Health promotion is basically the act of enabling the people in increasing control over their own health and improving their own health by developing their own resources for the same. Health promotion strategies for the elderly focus more on activities or interventions that are able to show more effect immediately. The strategies have basic three aims for the elderly such as – increasing their functional capacity, stimulating or helping develop their social network and maintenance or improvement in self-care of the elderly as well. All these objectives primarily aim to contribute to a self-sufficient quality of life and promote healthy ageing for the elderly. Health promotion helps in changing attitudes, behaviors and outlook towards life and helps in better engagement of the elderly in their care. It helps in promoting the required behavior in the elderly in a better way than just medical treatment. It helps in improvement and integration of the elderly to maintain life at older age. Since, the elderly require more social inclusion and activities to help build social bonds and relationships to improve their health, it is imperative that health promotion is considered an effective strategy to help improve their quality of life and functional ability and promote healthy ageing (Golinowska et al., 2016).
The conditions that lead to the gradual development of bilateral hearing loss in Mrs. Russo include age related hearing loss; where gradual loss of hearing occurs due to changes in the inner ear. The mild cognitive impairment that she is suffering from, is also a direct cause of development of hearing loss (Nirmalasari et al., 2017). Also, another condition acting as a contributor is the major stroke attack she faced five years ago. Hearing loss is said to occur in around 60-80% of patients who have had a major stroke attack. Not to mention are conditions such as dementia; where study shows that half of the patients have developed or might develop hearing loss because of it. Impaired hearing becomes an increasingly social problem, where the older people might withdraw from other people because of frustration and embarrassment about not being able to understand what is being conveyed or said. It might lead to increased worry and depression as well in the elderly. Other challenge includes not being able to hear or understand or respond to what the other person is saying. Also, it might lead to the elderly coming across as confusing, uncooperative and unresponsive people because they do not hear well (Ciorba et al., 2012).
Mrs. Russo has chronic pain due to her neuropathy complication developed due to diabetes mellitus. She also has pain due to osteoarthritis and is currently experiencing pain post her left NOF fracture and total hip replacement surgery as well. Valid assessment of chronic pain is a vital part of proper diagnosis formation and also helps in understanding the severity of the condition. Assessment of pain can include measuring the sensory aspect of pain, temporal aspect of pain and other aspects as well. Sensory aspect will include the intensity and effect of the pain on the person. The temporal aspect will include the pain duration, variability and modifying factors that might increase or decrease the intensity of pain as well. Most domains of pain assessment are only self reported and cannot be changed (Fillingim et al., 2016). Actions to reduce her pain can include – physiotherapy and occupational therapy for her total hip replacement followed by pharmacological intervention for the same. The pharmacological intervention can include the following, depending on the intensity and severity of her pain- NSAID drugs- to help with mild pain, Weak opioids combined with non-opioids, or Opiods like Morphine, Fentanyl for severe pain. Supportive drugs such as anti-depressants and muscle relaxants can also be used in her case as she also has depression as well.
The occurrence of dementia, delirium and depression is a common occurrence in the cases of older adults. The elderly people, when admitted in hospitals find it highly stress-inducing and challenging to stay in the hospitals. Since the presenting symptoms of the three disorders are highly over-lapping and inclusive of each other, it becomes very distressing and disappointing and confusing for the patient to experience delays in proper diagnosis and effective treatment for the same by the nurses and health care professionals. This improper diagnosis might also cause an increase in the risk of morbidity for the individuals as well and delay the required treatment as well. Also, since the nurses come in primary and prolonged contact with the patients when providing care to the elderly, it is a pre-requisite for them to be able to differentiate between the three conditions and provide adequate help. It helps enable comprehensive assessment and look out for complications of the diseases as well. Hence, it is necessary that the nurses are able to clearly differentiate and establish separate diagnosis of the three conditions- dementia, depression and delirium (Yaghmour et al., 2016).
As observed in Mrs. Russo’s case, she was suffering from some kind of neglect and poor care at home in terms of her disheveled and unkempt appearance, along with the presence of the state of weakness, underweight state and persistent dehydration as well. It clearly pointed out to neglect of care being given to her because of her daughters not giving enough care and attention to her condition. This neglect of care can be attributed to a type of elder abuse where the elderly because of their frail and old condition associated with their inability to take care of themselves on their own are left to fend for themselves and eventually neglected. A certain number of risk factors exist that lead to this kind of elder abuse or any kind of elder abuse, for that matter such as- the inability of the older adults to take care of themselves, their inability to stand up for themselves and their rights, their inability to stand up against any kind of bullying or neglectful behavior or fight back if needed. Their poor mental and physical state also makes them more susceptible to experiencing elder abuse in the form of neglect as their families might not be able to take up the responsibility of taking care of them and they might act as a burden for them leading to the neglect of care. Also, they might not be able to see, or listen or talk or think as clearly as they used to before, which could make people take advantage of them (Simone et al., 2016).
The aged-care facility is a place where the elderly come and live, like it is their home. They are taken care off in their new home and provided the sufficient help that is needed in terms of management of their conditions. As a registered nurse in an aged-care facility, the RN needs to practice care with utmost sincerity towards the elderly to make them feel comfortable and at home. The practice of care and taking care of the elderly involves the presence and practice of caring attributes like patience, emotional stability and strength and empathy towards the elderly. Patience helps in practicing proper treatment regimens and taking continuous care of the patient with utmost care and accountability without getting frustrated or fatigued. Empathy helps in understanding the mental, vulnerable and emotional state the elderly is in and taking it into account before providing treatment to them. Also, required is emotional stability so as not to get carried away and be able to take competent and knowledge-backed, rational decisions regarding their care and treatment plan without getting swayed by their emotions towards them. Also, most needed is effective communication skills, to make them feel comfortable and to convey and understand their thoughts, treatment plans and personal care goals.
The nurses along with other health care professionals play a major role in providing adequate end-of life care to the individuals. Their role includes provision of comprehensive and compassionate end-of-life care to the elderly. This will include recognizing when the end is near and conveying the same to the person and his/her family as well. They are also responsible for providing care and optimal and adequate management of symptoms as a part of the multidisciplinary team providing care to the patient and by collaborating with other healthcare workers as well. They also play a major role in providing support to the patient and family- emotional, physical and mental support. They are responsible for adequate pain management and care for the same. They are also responsible of taking care of the psychological, emotional, personal and interpersonal, and spiritual and religious dimensions of the care provision to the patient and help cope with the situation (Hickman et al., 2020). Nurses are also responsible in helping explain the advance care plan to the patients and helping develop it for the patients as well.
It can be effectively considered that healthy ageing is an essential part of health care and that it requires proper elder care and nurses play a significant and crucial role in doing the same. Nurses play a major role in taking care of the elderly, along with their co-morbidities and are adept in providing end-of-life care as well because of their personal skills such as effective communication, care and compassion. They help in ensuring healthy ageing and ways to improve the palliative care and end-of-life care experience for the aged population. Better health promotion strategies need to be effectively put into place to ensure optimal care outcomes for the elderly.
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Cai, D. Y. (2016). A concept analysis of cultural competence. International Journal of Nursing Sciences, 3(3), 268-273.
Ciorba, A., Bianchini, C., Pelucchi, S. & Pastore, A. (2012). The impact of hearing loss on the quality of life of elderly adults. Clinical Interventions in Aging, 7, 159.
Cristea, M., Noja, G. G., Stefea, P. & Sala, A. L. (2020). The impact of population aging and public health support on EU labor markets. International Journal of Environmental Research and Public Health, 17(4), 1439.
Devi, A. R., & Singh, K. R. (2018). Healthy ageing. Geriatric Care: Need For Integration, 8.
Fillingim, R. B., Loeser, J. D., Baron, R. & Edwards, R. R. (2016). Assessment of chronic pain: Domains, methods, and mechanisms. The Journal of Pain, 17(9), T10-T20.
Golinowska, S., Groot, W., Baji, P. & Pavlova, M. (2016). Health promotion targeting older people.
Hickman, S. E., Parks, M., Unroe, K. T., Ott, M. & Ersek, M. (2020). The Role of the palliative care registered nurse in the nursing facility setting. Journal of Hospice & Palliative Nursing, 22(2), 152-158.
Michel, J. P., Dreux, C. & Vacheron, A. (2016). Healthy ageing: evidence that improvement is possible at every age. European Geriatric Medicine, 7(4), 298-305.
Nirmalasari, O., Mamo, S. K., Nieman, C. L., Simpson, A., Zimmerman, J., Nowrangi, M. A. & Oh, E. S. (2017). Age-related hearing loss in older adults with cognitive impairment. International Psychogeriatrics, 29(1), 115-121.
Simone, L., Wettstein, A., Senn, O., Rosemann, T. & Hasler, S. (2016). Types of abuse and risk factors associated with elder abuse. Swiss Medical Weekly, 146(0304).
Wong, R. Y. (2018). A new strategic approach to successful aging and healthy aging. Geriatrics, 3(4), 86.
Yaghmour, S. M. & Gholizadeh, L. (2016). Review of nurses’ knowledge of delirium, dementia and depressions (3ds): systematic literature review. Open Journal of Nursing, 6(3), 193-203.
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