3805NRS Health & Illness In The Older Person

Aim: 

Registered nurses work with individuals, groups and communities to improve health. One way to do this is to analyse how risks to health can be reduced during changes to natural, social and/ or governmental elements in our society. As clinical leaders, registered nurses are expected to collect information about an emerging health risk from a variety of sources and collate this information into a meaningful analysis with recommendations for a specific audience. The audience for these analyses can be the public, older people or carers of older people, or nurses working in a range of practice contexts. This aim of this assignment requires you to apply your theoretical knowledge

Your poster and written justification must:

1. Recommend and justify the nursing requirements for older people diagnosed with, or at risk of, complex health conditions and/or cognitive decline; and
2. Evaluate the implications for nursing care related to changes in the environment (natural, social and governmental) that impact the health of older people.

Answer:

Audience:

The audience of the poster would be the old population of the nation who are above 65 years of age and are vulnerable to the development of the cardiovascular disorders. This poster would be also helpful for the nursing professionals to teach the old cohort about the ways by which they can reduce the risks of being affected by the disorder.

Justification for the selection of the audience:

Cardiovascular disorders are considered to be the highest contributors to the disease burden in the nation of Australia which is followed by dementia and that of COPD disorder. This is especially a growing concern for the aged individuals because they remain at a  higher risk for the development of the disorder. Reports provided by the Heart Foundation shows that about 490000 hospitalisation had taken place in the year 2014 to 2015 and the number had increased by a percentage of 8% from 2004-2005 to 2014-2015 (Sparling et al., 2015). Reports by Australian Institute of Health and Welfare had found that the percentage of being affected by the disorder is 35% from the cohorts of the age 55-65. This percentage increased to 64% among people aged 75 years and above. Therefore, people of the older age cohort are more prone to this disorder. This shows how the older people who are 65 or above are at increased risk for being affected by the disorder. Therefore, this audience needs to be educated so that they can take preventive measures for the disorder and so this audience is selected.

Included content and aesthetic features:

Cardiovascular disorders are mainly seen to occur because of greater number of modifiable risk factors among old patients than the non-modifiable risk factors. If the risk factors can be appropriately handled and lifestyle management are done properly, the risk of development of this health disorder would invariably reduce. Nursing professionals should aim in reducing the suffering of the patients and ensuring them a fitter life and healthy aging strategies (vanRiet et al., 2016). These would help them to manage the modifiable risk factors and accordingly protect them from the grasps of such chronic disorders. Illness associated with CVD has significant impact on the Australian economy. This is mainly because of the direct financial costs associated with the health system and this system includes higher healthcare costs as well as higher demand on the healthcare services (Bonder et al., 2017). These services include specialists, allied health professionals, general practitioners, pharmaceuticals, administration and many others. Indirect costs are also seen to be associated with the disorders like that of the productivity losses as well as the costs of the caregivers. Welfare payments, forgone taxation revenue and different other costs like that of the healthcare aids, equipment transport, accommodations, respites and other governmental programs are the indirect costs associated with this disorder(Ding et al., 2015). Healthcare expenditure faced by the patient and the families and the healthcare resources spent by the organisations can easily be saved if the healthcare professionals providing service in the home- community settings can undertake effective preventive measures and help in managing the disease  burden of the nation.

Nurses in the community health setting should first need to know the urgency of the situation in order to understand how the health issue is affecting the health of the older population and is affecting the economy of the nation. Then only, nurses will be able to develop appropriate interventions for tackling the situations. The nurses first need to know the statistics to develop an idea about the aspect of the emerging health issue (Bauman et al., 2016). Following this aspect, the second criterion that the nurses need to know to tackle the disorder is to develop knowledge about modifiable risk factors. These factors contribute to the disorder and poor health condition of the patients (Winter et al., 2014). This will help in developing ideas about how each of the risk factors causes cardiovascular disorders and how such risk factors need to be handled with development of health literacy and effective health behaviour change. Moreover, it is also significant that nurses should developed detailed idea about the interventions like changes in food, physical activity, smoking, and drinking and other factors. These would help them to advise and educate the patients and thereby ensure best health of the patients. Moreover, effective screening sessions should be conducted and people should be also made to know about the important of undertaking diagnostics tests from time to time with regular monthly check-ups (Petite et al., 2015). All these interventions would help in reducing the disease burden of the nation making the nation a healthier one.

Recommendation about risk reduction:

Bimonthly or tri-monthly screening sessions should be attended by the vulnerable patients to identify the presence of absence of any risk factors of the disorder. They should learn to self-measure the blood pressure levels and immediately contact healthcare centres when abnormal results are found. They should also conduct blood tests to identify levels of cholesterol and check BMI with healthcare experts to understand fitness status whether obesity is present or not. They should also conduct overall health check up twice a year. They should learn about the risk factors, worsening symptoms of heart issues and report them immediately if such symptoms are felt.

Treatment for the audience:

The poster will be helping in developing a systematic procedure of developing knowledge about the health risk of the patients of the older cohort. It will help them to visualise the disease burden and understand the urgency. Following that, they would be able to understand the contributing factors (Khan et al., 2015). Therefore, this would be helping to understand the arenas where patients should be made careful about. Then, they would learn about the interventions for preventative management and patient education (Stamatakis et al., 2015). This poster would be an interesting image for developing knowledge to both the patients and the nurses. This aspect would help in easy understanding of the situation and help them to strategise their caring procedures.

Approach to treatment:

Curative services of the individuals already affected with the disorders are always linked with physical and mental suffering of the patient, huge financial flow, longer stays at hospitals, increased threats to life and many others. Healthcare organisations also face huge outflow of healthcare resources. Preventative services are the idea approach where nurses need to provide primary prevention. It is crucial for reduction of the burden of the disorder before it affects the individuals and it is done by modifying the modifiable risk factors. The modifiable targets should be physiological factors like “dyslipidemia, hypertension, and diabetes mellitus; behavioral factors including a poor diet, smoking, and physical inactivity; and environmental and social factors such as air pollution, stress, and financial inequalities”

Treatment strategies:

Educating patients about dietary factors that should be included in the meals is one treatment procedures. It includes lowering cholesterol and blood pressure levels, eating plenty of vegetables, fruits and whole grains, low fat dairy products, poultry fish and legumes, non tropical vegetable oils, nuts. It also includes limited intake of sweetened beverages, sweets and red meats, reducing saturated and Trans fat intake and consuming no more than 2400 mg of sodium a day and reducing the sodium intake to 1500 mg a day

Physical activity recommendations should be also provided. Regular physical activity reduces cholesterol and blood pressure thereby reducing chances of heart disorders. aged adults should engage in aerobic physical activities 3-4 times in a week with each sessions lasting for 40 minutes (consult with expert regarding capability). Moderate activities like brisk walking, jogging to that of vigorous exercises like running or biking as per the capability for reduction of cholesterol levels should be advised.

Consumptions of less alcohol and tobacco should be promoted. Reduction of the number of cigarettes and drinking of alcohol to minimum and gradually quitting the practices is best option. Undertaking quit tobacco planning with experts and undertaking motivational interviewing and cognitive behavioural therapy to overcome such habits should be also discussed with the audience.

Conclusion:

From the above discussion, it becomes clear that the cardiovascular disorder is one of the most important health risks in the nation of the Australia especially among the cohort of the older population. It is increasing the disease burden affecting the health economy of the nation. It is important for the professionals to make aged people above 65 years aware of the consequences of the disorder and provide preventive interventions. The healthcare workers need to identify the risk factors and develop detailed knowledge about them. These would help them in managing the risk factors in patients and educating patients to be able to take proper self-care. Moreover, it is also important for the nursing professionals to undertake screening programs to identify the venerable population who can develop the disorders. Therefore, the poster, which is represented, gives a clear idea about the every important aspect that aged people above 65 years and the community-nursing professionals need to develop in order to ensure high quality care of the patients. This approach of the professionals would be helping the nation to control the prevalence of the disorder in the older generation and ensure better growth in economy and more quality health of older population.

References:

Bauman, A., Merom, D., Bull, F. C., Buchner, D. M., & Fiatarone Singh, M. A. (2016). Updating the evidence for physical activity: summative reviews of the epidemiological evidence, prevalence, and interventions to promote “active aging”. The Gerontologist, 56(Suppl_2), S268-S280.https://doi.org/10.1093/geront/gnw031

Bonder, B. R., & Dal Bello-Haas, V. (2017). Functional performance in older adults. FA Davis.https://books.google.co.in/books?hl=en&lr=&id=sZtBDwAAQBAJ&oi=fnd&pg=PP1&dq=cardiovascular+disorders+in+old+people+in+australia&ots=lbwcI11IzR&sig=MnTgbvOIDddCe37-Fk5U0v1IQ74#v=onepage&q=cardiovascular%20disorders%20in%20old%20people%20in%20australia&f=false

Davis, C. R., Bryan, J., Hodgson, J. M., Wilson, C., Dhillon, V., & Murphy, K. J. (2015). A randomised controlled intervention trial evaluating the efficacy of an Australianised Mediterranean diet compared to the habitual Australian diet on cognitive function, psychological wellbeing and cardiovascular health in healthy older adults (MedLey study): Protocol paper. BMC Nutrition, 1(1), 35.https://doi.org/10.1186/s40795-015-0033-7

Ding, D., Rogers, K., van der Ploeg, H., Stamatakis, E., & Bauman, A. E. (2015). Traditional and emerging lifestyle risk behaviors and all-cause mortality in middle-aged and older adults: evidence from a large population-based Australian cohort. PLoS medicine, 12(12), e1001917. https://doi.org/10.1371/journal.pmed.1001917

Khan, B., Nowson, C. A., Daly, R. M., English, D. R., Hodge, A. M., Giles, G. G., & Ebeling, P. R. (2015). Higher dietary calcium intakes are associated with reduced risks of fractures, cardiovascular events, and mortality: a prospective cohort study of older men and women. Journal of Bone and Mineral Research, 30(10), 1758-1766.https://doi.org/10.1002/jbmr.2515

Petitte, T., Mallow, J., Barnes, E., Petrone, A., Barr, T., & Theeke, L. (2015). A systematic review of loneliness and common chronic physical conditions in adults. The open psychology journal, 8(Suppl 2), 113.doi:  10.2174/1874350101508010113

Sparling, P. B., Howard, B. J., Dunstan, D. W., & Owen, N. (2015). Recommendations for physical activity in older adults. BMJ: British Medical Journal (Online), 350.0 doi: 10.1136/bmj.h100

Stamatakis, E., Rogers, K., Ding, D., Berrigan, D., Chau, J., Hamer, M., & Bauman, A. (2015). All-cause mortality effects of replacing sedentary time with physical activity and sleeping using an isotemporal substitution model: a prospective study of 201,129 mid-aged and older adults. International Journal of Behavioral Nutrition and Physical Activity, 12(1), 121.https://doi.org/10.1186/s12966-015-0280-7

van Riet, E. E., Hoes, A. W., Wagenaar, K. P., Limburg, A., Landman, M. A., & Rutten, F. H. (2016). Epidemiology of heart failure: the prevalence of heart failure and ventricular dysfunction in older adults over time. A systematic review. European journal of heart failure, 18(3), 242-252.https://doi.org/10.1002/ejhf.483

Winter, J. E., MacInnis, R. J., Wattanapenpaiboon, N., & Nowson, C. A. (2014). BMI and all-cause mortality in older adults: a meta-analysis–. The American Journal of Clinical Nutrition, 99(4), 875-890.https://doi.org/10.3945/ajcn.113.068122