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Posted: October 29th, 2022
After studying Module 2: Lecture Materials & Resources, discuss the following:
Describe and discuss the nurse’s role in health promotion and disease prevention in older adults. Share an example from your personal experience as a RN.
Name and elaborate on at least three screening/preventive procedure that must be done in older adults.
Define and discuss three common End-of-life documents that you as nurse must be familiar with to be able to educate older adults.
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Submission Instructions:
You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.)
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Respond to at least two of your peers' posts by extending, refuting/correcting, or adding nuance.
NUR 417 AP2
Nurses' Role in Disease Prevention and Health Promotion in Older People
Self-efficacy is strongly related to healthy aging and health promotion behaviors in older adults (Wu & Sheng, 2019). However, due to economic, social, and environmental factors, most older people struggle with self-efficacy, resulting in poor health outcomes. According to this viewpoint, nurses' primary role is to promote self-efficacy in older adults. Advocacy is one strategy for achieving this goal. According to Lecture Notes (Slide 28), older adults can maintain control of their lives with the assistance of nurses' advocacy.
Nurses, for example, can advocate for increased funding for social support programs for the elderly. According to Wu and Sheng (2019), social support from friends and neighbors of older adults has a greater impact on their healthy aging and self-efficacy than family support. As a result, nurses should be at the forefront of advocating for adequate funding for such programs as a means of disease prevention and health promotion in the elderly. Nurses should also make recommendations and encourage older adults with whom they interact to participate in community-based social support programs. I make such recommendations at work whenever I see an older adult who is receiving little support from family because of the positive health outcomes I've seen in those with similar characteristics who have benefited from participating in such programs.
Screening and Preventive Measures for Senior Citizens
Caring for older adults is frequently complicated due to comorbidities and other factors influencing their health outcomes. As a result, preventive or screening procedures are critical in their care. Some of the procedures include sensory impairment screening, functional impairment screening, and fall risk assessment (Seematter-Bagnoud & Bula, 2018). Screening for sensory impairments primarily entails assessing visual and hearing abilities, as these are among the most common geriatric impairments. Sensory deficits have a negative impact on cognitive functioning, psychological well-being, and fall risk (Seematter-Bagnoud & Bula, 2018). Screening for functional impairment evaluates an older adult's ability to perform daily activities, predicts future functional trajectory, and obtains prognosis information. Finally, fall risk assessment is performed in order to implement effective preventive interventions. According to Seematter-Bagnoud and Bula (2018), one in every ten older adults sustains serious injuries as a result of a fall each year. These injuries jeopardize their functional independence, thereby impeding self-efficacy and healthy aging.
Typical End-of-Life Documents Nurses must become acquainted with
A power of attorney is a common end-of-life document that nurses must be familiar with when caring for elderly patients. This is a document that identifies the agent who will make health care decisions on behalf of a person when they are unable to do so themselves (Lecture Notes, Slide 22). Do not resuscitate is another important document (DNR). The document, according to Bloomer et al. (2018), provides care providers with guidelines on what to do during the final stages of an elderly person's life, such as in the event of a cardiac arrest or when the heart stops beating. Finally, these documents or wishes can be included in a broader one known as advance directives. Advance directives are instructions written when a patient is capable of making decisions and communicating (Douplat et al., 2019). When a patient is in a vegetative state, nurses rely on such directives to provide care. The importance of knowing these documents for nurses is to facilitate decision-making during end-of-life care, which is often complicated.
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References
M. J. Bloomer, M. Botti, F. Runacres, P. Poon, J. Barnfield, and A. M. Hutchinson (2018). A qualitative descriptive study of communicating end-of-life care goals and decision-making among a multidisciplinary geriatric inpatient rehabilitation team. 1615-1623 in Palliative Medicine, 32(10).
M. Douplat, J. Berthiller, A. M. Schott, V. Potinet, P. Le Coz, K. Tazarourte, and L. Jacquin (2019). Difficulty in making decisions for endoflife patients in emergency departments. Journal of clinical practice evaluation, 25(6), 1193-1199.
Notes for the lecture (n.d.). Socioeconomic and environmental influences are discussed in Chapter 7.
L. Seematter-Bagnoud and C. Büla (2018). A pragmatic approach to brief assessments and screening for geriatric conditions in older primary care patients. 1-13 in Public Health Reviews, 39(1).
F. Wu and Y. Sheng (2019). A pathway analysis of the social support network, social support, self-efficacy, health-promoting behavior, and healthy aging in older adults. 103934, Archives of Gerontology and Geriatrics.
Daniela Abreu Abreu NUR 417 St Thomas University
Yedelis Diaz is the instructor.
Date: 10/25/2022
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Disease Prevention and Promotion
Nurses serve as the go-betweens for health promotion and the delivery of health promotion, health protection, and preventive services. Nurses are trained to treat each patient individually by developing a plan that meets that patient's healthcare needs. Education is an important component of care plans that are implemented formally in health promotion classes and informally during health care visits. Nurses are up to date on the most recent recommendations and will work with older clients to determine which health behaviors they want to engage in.
As a nurse at an outpatient endoscopy center, the majority of my work involves colon cancer and other gastrointestinal disease prevention and promotion. Because of the time they spent preparing for the procedure, older adults frequently arrive at the facility in a bad mood. Colonoscopies necessitate a 24-hour fast and a colon cleansing solution. Those solutions are usually unappealing and force the patient to use the restroom on a regular basis. As a result, when the patient arrives at the surgery center for the procedure, they are hungry and, in some cases, still nauseous from the colon prep solution. This traumatic experience usually makes clients unwilling to return for a colonoscopy, but we must educate them on the importance of returning when the doctor recommends it. We also teach them about the signs and symptoms that should prompt them to see their gastroenterologist if they occur.
Everyone over the age of 50 should have a colorectal cancer screening. According to the CDC, screening can help prevent colorectal cancer by removing precancerous polyps before they turn cancerous. If everyone over the age of 50 was screened on a regular basis, up to 60% of colorectal cancer deaths could be avoided (CDC 2019). The five-year survival rate is 90% when detected early and treated promptly.
Breast cancer screening in women aged 40 to 64 is another recommended screening for older adults. This group of women accounted for 61% of all breast cancer cases. Mammography screening is an important early detection tool because it can detect breast cancer at an early stage, usually before physical symptoms or complications appear, and it can reduce mortality (CDC 2019). Breast cancer screening cannot prevent the disease, but it can help detect it early, when it is easier to treat. It is critical that your client understands which breast cancer screening tests are appropriate for them and when they should have them.
Cervical cancer affects women over the age of 30, but it affects all women. Cervical cancer is caused by a long-term infection with certain types of human papillomavirus (HPV). Cervical cancer can be detected early with Pap smears and HPV screening tests. It is recommended that women 30-65 years of age get checked. By age 65 or older, if you have had normal results for several years, the doctor may tell you it is no longer necessary to screen for cervical cancer.
Nurses can guide caregivers and patients nearing the end of life by educating them on the three most common End-of-life documents: DNR, Living Will, and Advanced Health Directives. A DNR order is executed by a competent person indicating that if heartbeat and breathing cease, no attempts to restore them should be made and it must be signed by a Physician, Nurse Practitioner, or patient (state law dependent). A Living Will directs those extraordinary measures not to be used to artificially prolong life if recovery cannot reasonably be expected. These measures may be specified by patients or witnesses (state law dependent). Lastly, are the Advance Health Directive. This document explains a person's wishes about treatment in the case of incompetency or inability to communicate. Often used in conjunction with a Health Care Proxy or Power of Attorney (Meiner, S.E., Yeager, J.J., 2019).
References
Centers for Disease Control and Prevention, AARP, American Medical Association. Promoting Preventive Services for Adults 50-64: Community and Clinical Partnerships. Atlanta, GA: National Association of Chronic Disease Directors; 2019.
Meiner, S., & Yeager, J. J. (2019). Gerontologic nursing(Fifth ed.). St. Louis, MO: Elsevier.
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