Running head: OPTIMAL AGING
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Stacey Tekansik
HS5522
Dr Brenda Harms
January 26, 2019
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The most important thing to note the care of the geriatric population is to understand
the physiology and pathology of aging this is informed by the fact that the human body
undergoes a multiplicity of physiological changes each second. Also, the consideration of
social, psychological, cognitive, and economics of the aging is paramount to meet the needs
of the aging population. Sadly, most elderly people feel that they have no control over their
emergencies and fixed incomes. These factors more often than not lead to depression and
decreased efficiency. The elderly population is growing at a very fast rate as the years go by.
Notably, the prevalence of falls increases with age. It is evident from research that falls are
one of the leading causes of injuries among the elderly population in our society. In the year
2015 33,000 deaths were reported as a result of falls among the elderly. It is also estimated
that there are 28-35% falls each year amongst people within the age bracket of 65 years and
above. Falls are mainly associated with mobility as well as neurological and cardiovascular
causes. The several physical changes in the bodies of the elderly contribute greatly to the
negative influence on functional balance that interferes with the daily activities. The falls
normally lead to the escalation of costs for treatment (Phelan et.al, 2016). .
Optimal aging refers to the capacity to function across many domains which includes
the physical, functional, cognitive, emotional, social, and spiritual to an individual’s
satisfaction despite one’s medical conditions. There are two theories that support aging that is
disengagement and activity theory. The disengagement theory talks about successful aging
being about withdrawal from activities and social interaction. The activity theory on the other
hand, proposes that for one to age successfully one should remain engaged in activities and
social interaction (Aldwin & Igarashi, 2015).
Also, there is a multi-dimensional approach which encompasses many factors which
include being free from disease, maintaining relationships, doing the things that make the
person happy, having financial stability, and having good coping skills. Other characteristics
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include high degree of satisfaction which encompasses feeling that life is rewarding because
the goals have been met, has few regrets, has maintained a positive attitude about the future,
feels that life is stimulating and sets new goals, is able to relax and is able to relax and has
good habits. The next characteristic is having a harmonious integration of personality through
developed ego strength, unity, and maturity over the years, demonstrates self-actualization,
satisfaction, and authenticity. The next characteristic is the maintenance of a meaningful
social system that is involved with the caring network of family and friends. Also, personal
control over life which he makes his/her own decisions. In a number of ways the optimal
aging and successful aging share a number of similarities. However, the absence of sickness
can be attributed to both.
Most importantly, aging theories mostly describe aging in relation to behaviour,
personality, and attitude that change throughout the aging process. Therefore, the ego
development and the challenges they have faced by an individual at different stages that helps
in analyzing the personality, mental processes, and attitudes influence an individual’s
adaptation to the changes that are there in life. The ever evolving roles, relationships, and
status within the culture are also taken in to consideration. This has an impact on the society
and these calls for a concern for everyone. The increasing age calls for the increasing amount
of the issues that having a longer life brings.
The world health organization, International Federation on Aging, American
Association of Retired Persons, American Society on Aging, American Planning Association,
and National Association of Area Agencies on Aging have tried as much as possible to give
attention to the aging friendly communities and these reflects the importance of physical and
social environments for the healthy well-being at all ages and especially in the later life. The
identification of aging- friendly communities help in the individual processes. It is important
to note that the functional perspectives that conceive the aging processes that is observable in
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the physical, mental, and social functioning as reflected in the terms of active aging. The
functional criteria includes the avoidance of disease and disability, maintenance of high
levels of physical and cognitive functioning as one ages, and the active engagement in social
and productive activities. Some of the most critical activities have to do with physical
activity which contributes to reduce the risk of a number of diseases that are attributed to a
number of cardiovascular diseases, metabolic diseases, and osteoarthritis. Some cognitive
simulation include reading, practicing crossword puzzles, and playing board this has been
attributed to the reduction of incidence of cognitive diseases such as dementia. Others include
the nutritional interventions which are believed to extend the lifespan and reduce morbidity.
Cusack and Harbin (2017), argue that failure to thrive refers to the inability to
maintain growth and this is very common among elderly citizens. In an adult, the symptoms
include loss of appetite, loss of appetite, less active than normal, memory loss, trouble
thinking, and trouble with daily activities. One can become more susceptible because of
social isolation, increased need for care, low income, dementia, chronic diseases such as
cancer and diabetes, side effects from medicine and drug abuse. Failure to thrive can be
classified into to two that is medical and environmental. The condition is diagnosed by the
Anthropometric criteria whereby the physician does a mental exam, blood or urine tests,
hearing and vision tests, and imaging tests. There are several symptoms which include severe
respiratory infection, recurrent vomiting, and depression. One can prevent the disease from
progressing by observing proper eating diet, encouraging social activities, ensuring that the
person drinks liquids as directed, and also, clearing paths to ensure that the person will not
trip on objects.
Falls
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It is important to note that falls are the leading cause of injury and death who are over
the age of 65 years. This is because as patients’ age they experience stiff joints, decreased
muscle strengths, and neurological feedback. Society et.al (2015), state that it is estimated
that at least 24 percent of those who fall certain serious injuries and 6 percent sustain
fractures. When an elderly person experiences a fall they often fear and this will lead to them
reducing their activities which make them frail as they increase in age this, in turn, leads to
them being more susceptible to falls. Risk factors for falls include depression, dizziness,
previous falls, decreased strength, diabetes, and arthritis. Physicians diagnose falls by making
use of time up and go test. The symptoms include difficulty rising from a chair, dizziness
upon rising, increased sway, and path deviation. The falls can be lessened by modification of
home environment, an exercise aimed at improving balance, management of foot problems,
patient and caregiver education, vitamin D supplementation and cataract surgery for patients
with poor vision.
Temporal Arteritis
According to Sammel et.al (2015), temporal arteritis is a vascular condition in which
the temporal arteritis that supplies blood to the head and brain become inflamed. The
condition is more common in people who are aged 50 years and above. The condition is
mainly caused by the body’s autoimmune response, excessive doses of antibiotics, and severe
infections. The symptoms of the condition include fatigue, loss of appetite, sudden loss of
sight on one eye, unintentional weight loss, throbbing headache in the temples, and
tenderness in the scalp and temple areas. In order to diagnose the condition, the doctor
conducts a physical exam, blood test, biopsy, and ultrasound. Since the condition cannot be
cured the treatment is meant to minimize tissue damage that occurs due to inadequate blood
flow.
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All the articles reviewed were pointing towards education by the nurses being one of
the major interventions in reducing the falls among the elderly population. In the first article
the authors recommended that their colleagues collect data and report on the same so that
they can be able to record the unintended outcomes as this will be able to guide the nurses on
which education programs to focus on (Manojlovich, Leo, & Lauseng, 2016). The second
article on the other hand, indicates that there should be increased messaging informing the
public that falls are preventable and should come from the staff and more specifically the
nurses providing care to this particular population (Phelan, Aerts, Dowler, Eckstrom, &
Casey, 2016). The third article on the other hand, recommends systematic review of articles
as this will enable the care givers improve on the quality of care including education as a way
of preventing the falls (Lannering, Bravell, &Johansson, 2017). Additionally, in the fourth
article the authors recommend that the elderly citizens participate in training as it will greatly
increase their flexibility, balance, and lumbar strength (Emilio, Hita, Jimenez, Lattore, &
Martinez, 2014). Finally, the last article recommend the use of low cost evidence based
approaches in the nursing homes which include education on how to prevent the falls as this
will go a long way in helping to reduce the falls hence helping save costs (Teresi et al., 2013).
The main overall recommendation is that the nurses should be able to take individual
responsibility towards ensuring that the elderly population is well educated on the causes of
the falls and how they can be prevented.
Stakeholders
Floor Nurses the strategy used will be training programs mainly focusing on care to provide
to the patients.
Nurse Managers- the strategy used is training them on the current interventions so that they
can pass over the message to their juniors.
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Nurse Administrators- train on how to effectively monitor the care being given to the elderly
patients.
Their main roles of the stakeholders will be ensuring that there is adequate patient
assessment; proper communication between them to ensure that there is proper coordination,
that the hospital has proper protocols for safety practices, there is proper leadership in the
facilities, and adequate orientation of the staff working in the health facilities.
Barriers
The main barrier in the intervention would be the attitude by the stakeholders towards
the research this would bring a lot of problems when it comes to the implementation of the
interventions. The other barrier would be lack of proper education and training on the
intervention this would cause a major problem. This would cause a big problem since people
would lack adequate information on how to intervene therefore; it is advisable that there is
proper training and education.
Strategies to Overcome Barriers
The two main strategies to overcome the above barriers is adequate communication
and planning to counter both issues identified. For instance, to counter the issue of the
attitude it is important that the stakeholders are brought on board by adequately being
communicated to about the research that is being conducted and how it will be implemented.
Secondly, it is important that in the annual plans education and training are slotted in so that
they can run through without any interruption.
Education by the nurses to the patients should result in reduction in the number of
falls by the elderly population. This would be measured by data reports obtained in various
hospitals indicating how many elderly patients have been treated for injuries occasioned by
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falls after the education has been carried out by the nurses as compared to the number of
cases that were reported before the nurses started educating the patients. Research activities
involve significant time and resource investment by stakeholders, researchers, and
participants (Curtis, Fry, Shaban & Considine, 2017). This, dissemination of findings is an
important step in evidence-based research. For this EBP research, the preferred dissemination
pathways are conferences, peer-reviewed journals, professional newsletters, institutional
newsletters and materials for general audience consumption. The first point of dissemination
should be at the institution or hospital where the intervention was carried out to share
outcomes with colleagues, peers and hospital management and stakeholders. This can be
done using in-house newsletters, memos, news alerts on notice boards and online networking
platforms of the institution. Disseminating the findings to professionals is also critical to open
the space for peer review, extend the research to other settings and facilitate dialogue. This
can be done through educational sessions, presenting in conferences, publishing in journals
and professional publications (Curtis et al., 2017). News releases and other forms of media
engagement can be used to disseminate the research findings to the public to ensure that
future and current patients are aware. Lastly, holding presentations, making summaries that
highlight the costs and benefits of the intervention and educational sessions with
policymakers can help disseminate the research findings to this critical group. When
disseminating research findings, it is of importance that the findings are translated or
summarized in a way that the particular audience will understand. Thus, there needs to be a
plan on how to disseminate the findings, which audiences, where, when and how to ensure
not only sharing of research findings but also, spur the spirit of inquiry, facilitate
implementation of the intervention in other settings and peer-review and critique.
Conclusion
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Evidence Based Practice is an important component of the research on aging.
Readmission and mortality rates are vital statistics in the elderly citizen management.
Readmission is correlated with mortality rates and thus, the need to reduce the likelihood that
an elderly citizen will be readmitted. Interventions to achieve this reduction include nurse-led
patient monitoring and education. The target population is patients with a definitive diagnosis
of different conditions and the outcomes of interest are readmission and mortality rates. The
time components are at 30 days and six months. If implemented the findings are to be
disseminated to the public, policymakers, peers, and colleagues as well as the institution
through conferences, journals, educational seminars, newsletters, policy briefs, and news
releases.
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References
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Lannering, C., Ernsth Bravell, M., & Johansson, L. (2017). Prevention of falls, malnutrition
and pressure ulcers among older persons–nursing staff's experiences of a structured
preventive care process. Health & social care in the community, 25(3), 10111020. https://doi.org/10.1093/geroni/igy023.540
Manojlovich, M., Lee, S., & Lauseng, D. (2016). A systematic review of the unintended
consequences of clinical interventions to reduce adverse outcomes. Journal of patient
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Older adults with a ‘fall prevention plan’ less likely to end up in hospital (2018, September
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Phelan, E. A., Aerts, S., Dowler, D., Eckstrom, E., & Casey, C. M. (2016). Adoption of
evidence-based fall prevention practices in primary care for older adults with a history
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