Psychogerontology Comparison Report

Running head: OPTIMAL AGING 1 Stacey Tekansik HS5522 Dr Brenda Harms January 26, 2019 OPTIMAL AGING 2 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 OPTIMAL AGING 3 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 OPTIMAL AGING 4 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 OPTIMAL AGING 5 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.

OPTIMAL AGING 6 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. OPTIMAL AGING 7 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 OPTIMAL AGING 8 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 OPTIMAL AGING 9 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. OPTIMAL AGING 10 References Aldwin, C. M., & Igarashi, H. (2015). Successful, optimal, and resilient aging: A psychosocial perspective. Feltner, C., Jones, C. D., Cené, C. W., Zheng, Z. J., Sueta, C. A., Coker-Schwimmer, E. J., … & Jonas, D. E. (2014). Transitional care interventions to prevent readmissions for persons with heart failure: a systematic review and meta-analysis. Annals of internal medicine, 160(11), 774-784. 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 safety, 12(4), 173-179. https://doi.org/10.1097/pts.0000000000000093 More elderly people dying as the crisis deepens (2018, April 7), The Guardian. Retrieved from https://www.theguardian.com/uk-news/2018/apr/07/more-elderly-are-dyingafter-falls-as-care-crisis-deepens Older adults with a ‘fall prevention plan’ less likely to end up in hospital (2018, September 24), MedicalXpress. Retrieved from https://medicalxpress.com/news/2018-09-olderadults-fall-hospital.html 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 of falls. Frontiers in public health, 4, 190. https://doi.org/10.3389/fpubh.2016.00255 OPTIMAL AGING 11 Sharma, A., Lavie, C. J., Borer, J. S., Vallakati, A., Goel, S., Lopez-Jimenez, F., … & Lazar, J. M. (2015). Meta-analysis of the relation of body mass index to all-cause and cardiovascular mortality and hospitalization in patients with chronic heart failure. The American journal of cardiology, 115(10), 1428-1434. Vedel, I., & Khanassov, V. (2015). Transitional care for patients with congestive heart failure: a systematic review and meta-analysis. The Annals of Family Medicine, 13(6), 562-571.Psychogerontology Comparison Report

Running Head: OPTIMAL AGING 1 Optimal Aging Stacey Tekansik Capella University 2/6/19 OPTIMAL AGING 2 Optimal Aging As people age, their functionality decreases, for example, they can’t walk long distances, they find it hard to do menial house tasks such as folding clothes among others. Optimal aging ensures that an individual maintains their functionality in all areas, i.e., physical, spiritual, emotional, social, and cognitive despite their age. Optimal aging does not mean that the individual doesn’t get sick, but it means that even with the sickness, they find a way to adapt. There are medical conditions that accompany old age because their immune is not strong enough to fight off diseases. Some individuals easily adapt to their conditions while others don’t. The adaptation is what optimal aging is all about. There are programs and organizations whose main role is to help individuals to maintain their functionality despite their age. This paper will focus on these programs, services, and organizations whose concern for the older generation is helping improve the quality of life. Nascentia Health Optimal aging programs aim at helping old individuals stay in their homes for as long as they need. In nursing homes, they don’t have as much freedom as they do in their own homes. For example, they can’t wake up in the morning and go out without the company of an individual but when at home, they can wake up and decide to visit a friend. In the United States, there are plenty of healthcare organizations that deal with optimal aging. One such organization is Nascentia Health. The organization mainly deals with individuals at risk of falling. As people age, their bones and muscles get weak which makes it easy for them to fall. The most dangerous part of falling is not that they may break a few bones but that they may fall on a sharp object and hurt themselves. OPTIMAL AGING 3 They can also hit their head on a blunt object and sustain a head injury.

The organization believes that the best solution for falls and fall-related injury is putting in place, preventative measures. The organization outlines some of the characteristics of an individual who should seek their services. These individuals should have experienced unsteadiness when walking or doing any physical activity, they should have lost a lot of weight unintentionally, they are easily exhausted, and experience body weakness, meaning that they find it hard to lift items they initially lifted easily. These symptoms make it hard for the individual to do any task. For example, they have to take a taxi since they can’t walk for long distances. General body weak …Psychogerontology Comparison Report