FINALS NCMB314 WK15 PDF

BACHELOR OF SCIENCE IN NURSING NCMB 314 CARE OF THE OLDER ADULT COURSE MODULE COURSE UNIT WEEK 3 13 15 Advocacy Programs Relevant to the Care of Older Persons...

BACHELOR OF SCIENCE IN NURSING NCMB 314 CARE OF THE OLDER ADULT COURSE MODULE COURSE UNIT WEEK 3 13 15 Advocacy Programs Relevant to the Care of Older Persons ✔ Read course and unit objectives ✔ Read study guide prior to class attendance ✔ Read required learning resources; refer to unit terminologies for jargons ✔ Proactively participate in online discussions ✔ Participate in weekly discussion board (Canvas) ✔ Answer and submit course unit tasks At the end of the course unit (CU), learners will be able to: Cognitive: 1. Discuss advocacy relevant to elderly. 2. Describe several model health promotion programs. Affective: 1. Listen attentively during class discussions 2. Demonstrate tact and respect when challenging other people’s opinions and ideas 3. Accept comments and reactions of classmates on one’s opinions openly and  graciously. Psychomotor: 1. Participate actively during class discussions and group activities 2. Express opinion and thoughts in front of the class Eliopoulos (2018). Gerontological Nursing 9th Edition.Wolters Kluwer Meiner (2019). Gerontologic Nursing 6 th Edition. ELS Miller (2019).Nursing for Wellness in Older Adults 8 th Edition. Wolters Kluwer Cuison (2017) The Philippine College of Geriatric Medicine’s (2017) https://academic.oup.com/gerontologist/article/47/2/150/683642 https://www.eria.org/uploads/media/Books/2019-Dec-ERIA-Ageing-And-Health-In-The- Philippines.pdf Advocacy Programs Relevant to the Care of Older Persons The role of an advocate in health and social care is to support a vulnerable or disadvantaged person and ensure that their rights are being upheld in a healthcare context. Health and social care advocacy means supporting people who are unable to ensure their best interests are being taken care of. In the medical profession, activities related to ensuring access to care, navigating the system, mobilizing resources, addressing health inequities, influencing health policy and creating system change are known as health advocacy. Advocacy services Advocacy services support the rights of anyone receiving or seeking to receive aged care services, and empower older people to make informed decisions about their care. An aged care advocate can assist things like:  interacting with the aged care system  transitioning between aged care services  knowing and understanding their rights  making decisions about the care they receive  options for having their aged care needs better met  resolving concerns or complaints with the aged care provider about the services they receive  speaking with their service provider at their direction  Increasing their skills and knowledge to advocate for them self. Who can access advocacy services? Anyone who is receiving or seeking to receive government-funded aged care services, including family and representatives, are entitled to access advocacy services. This includes people who:  live in an aged care home  receive aged care services in their own home  receive transition care  Are helping someone who is receiving aged care services. Legal advocacy is a recognized strategy to address social factors that influence the health of populations with complex care needs. Such advocacy can improve housing stability, increase access to public benefits that support a host of social needs, assure that medical and financial proxy decision makers are in place, and reduce psychosocial distress.  Older adults are disproportionately likely to have complex medical needs. Legal advocacy has been recognized as integral to the health and health care of older adults in the medical literature since 1988, and in current Medicare quality metrics. Additionally, since 1965, the Older Americans Act has provided legal assistance as an “essential service” among other aging supports such as nutrition, transportation, and in- home care. Under the act, state area agencies on aging must provide legal services free to adults older than age 60 with the “greatest social or economic need.”  Yet, while emerging care models for older adults with complex needs are highly multidisciplinary, none incorporate legal advocacy in their design. This is in some ways not surprising as clinicians are not trained to recognize or address legal needs of older patients, and older patients are unable to self-diagnose their legal problems, thus making it unlikely that they will articulate legal needs as such to health care providers, social workers, or case managers.  In addition, funding mechanisms for health care and social services—especially civil legal services—are highly soloed and deeply asymmetrical. Historical underinvestment in civil legal services for the poor has led to a shortfall in the legal workforce serving this population. This may provide another explanation for why legal advocacy has not been particularly visible to health systems: Legal advocates are focused on emergency legal needs such as loss of housing, neglect and exploitation, and loss of public benefits. Although these needs could be better served through preventive and primary legal advocacy delivered holistically in coordination with other social services and health care, funding levels have not enabled such an approach. HEALTHY PEOPLE INITIATIVES The federal government has been establishing goals for healthy aging since 1980 when the U.S. Public Health Service published the report Promoting Health/ Preventing Disease Objectives for the Nation. This 1980 report outlined 226 objectives for the nation to achieve over the following 10 years. It was referred to by some as Healthy People 1990.  A decade later, in 1990, another10-year national effort, Healthy People 2000, was initiated by the U.S. Public Health Service in another effort to reduce preventable death and disability for Americans. A third effort is currently under way with the Healthy People 2010 initiative; however the number objectives has increased to 467, and these are distributed over 28 priority areas. There are some notable benefits to the healthy people initiatives. On the positive side, these initiatives give recognition to health promotion rather than focusing exclusively on wars on disease (e.g. tabulating the number of deaths from cancer or heart disease, and then organizing a campaign against them). The Healthy People initiatives are health oriented, and as such they recognize the complexity of the socioeconomic, lifestyle, and other nonmedical influences that impact our ability to attain and maintain health. Healthy People 2020 Healthy People 2020 was the fourth iteration of the Healthy People initiative. Launched in December 2010, Healthy People 2020 set an ambitious yet achievable 10-year agenda for improving the nation’s health. The vision for Healthy People 2020 was “a society in which all people live long, healthy lives.” Its mission was to:  Identify nationwide health improvement priorities  Increase public awareness and understanding of the determinants of health, disease, and disability and the opportunities for progress  Provide measurable objectives and goals that are applicable at the national, state, and local levels  Engage multiple sectors to take actions to strengthen policies and improve practices that are driven by the best available evidence and knowledge  Identify critical research, evaluation, and data collection needs Healthy People 2020 set overarching goals to:  Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death  Achieve health equity, eliminate disparities, and improve the health of all groups  Create social and physical environments that promote good health for all  Promote quality of life, healthy development, and healthy behaviors across all life stages Healthy People 2020 Law and Health Policy The Healthy People 2020 Law and Health Policy project aimed to raise awareness of the impact that legal or policy interventions can have on public health. The project was a partnership between ODPHP, CDC, the CDC Foundation, and the Robert Wood Johnson Foundation. These organizations worked with subject matter experts and federal stakeholders to create reports, webinars, and products to highlight laws and policies with the potential to impact specific Healthy People 2020 topic areas and objectives. Advancing Public Health Through Law and Policy Law and policy are among the most effective tools to improve health. Many of the greatest public health successes in the United States are the result of legal or policy interventions, such as smoke-free air laws and mandatory seatbelt laws. 1 Yet many people may not be aware of the precise impact these interventions and approaches can have on population health. Law and Health Policy Resources Project partners worked with subject matter experts and federal stakeholders to develop a series of Healthy People 2020 topic-specific reports, webinars, and other evidence-based products such as infographics and success stories, or Bright Spots. These resources and publications highlight laws and policies with the potential to impact specific Healthy People 2020 topic areas and objectives, including Leading Health Indicators. Review different resources produced by the Law and Health Policy project:  Disability and Health  Healthcare-Associated Infections  Health Equity  Healthy People 2030  Leading Health Indicators  Maternal, Infant, and Child Health  Mental Health and Mental Disorders  Nutrition and Weight Status  Oral Health  Policy Levers  Substance Abuse B. Model Health Promotion Programs for Older Adults One of the more recent efforts in this regard has been organized by the Health Promotion Institute (HPI) of the National Council in Aging. HPI started by summarizing 16 model programs or best practices and compiling them into a loose-leaf directory. The summarizes included information on the planning process, implementation of the program, and program evaluations. Six model health promotion programs that have been focused on older adults and have received national attention, received federal funding and foundation support to evaluate their effectiveness and to encourage their replication. 1. Healthwise The best-known older adult medical self-care program is Healthwise. It provides information and prevention tips on 190 common health problems, with information periodically updated. The Healthwise Handbook (Healthwise,2006)is now in its 17 th edition. This handbook includes physician-approved guidelines on when to call a health professional for each of the health problems its cover. With the assistance of a $2.1 million grant from Robert Wood Johnson Foundation, Healthwise distributed its medical self-care guide to 125,000 Idaho households, along with toll free nurse consultation phone service and self-care workshops. Thirty-nine percent of handbook recipients reported that the handbook helped them avoid a visit to the doctor. Blue Cross of Idaho reported 18% fewer visits to the emergency room by owners of the guide. 2. Chronic Disease Management Kate Lorig, a nurse-researcher at the Standford University School of Medicine, and her medical colleagues have been evaluating community-based, peer-led,chronic disease self- management programs for more than two decades, beginning with the Arthritis Self- Management Program (Lorig et ai.,1986) This program has since evolved into a curriculum that is applicable to a wide array of chronic diseases and conditions. Typically, each program involves about a dozen participants, led by per leaders who have received 20 hours of training. The peer leaders, like the students, are typically older and have chronic diseases that they contend with. The program consists of six weekly sessions about 2 ½ hours long each, with a content focus on exercise, symptom management, nutrition, fatigue and sleep management, use of medications, managing emotions, community resources, communicating with health professionals, problem solving, and decision making. The program takes place in community settings such as seniors centers, churches, and hospitals. The theoretical basis of the program has been to promote a sense of personal efficacy among participants by using such techniques as guided mastery of skills, peer modeling, reinterpretation of symptoms, social persuasion through group support, and individual self- managemant guidance. 3. Project Enhance Senior Services of Seattle/King County began the Senior Wellness Project (later renamed Project Enhance) in 1997 at the North Shore Senior Center in Bothell, Washington. It was a research-based health promotion program that included a component of chronic care self-management that was modeled after Kate Lorig’s program(Lorig et al.,1999) The program also included health and functional assessments; individual and group counseling; exercise programs; a personal health action plan with the support of a nurse, social worker, and volunteer health mentor; and support groups. A randomized controlled study of chronically ill seniors reported a reduction in a number of hospital stays and average length of stay, a reduction in psychotropic medications, and better functioning in activities of daily living. 4. Ornish Program for Reversing Heart Disease Dr. Dean Ornish, a physician at the University of California at San Francisco and founder of the Preventive Medicine Research Institute, has developed a program for reversing heart disease that has been replicated at several sites around the country. Dr. Ornish (1992) has recommended a vegetarian diet with fat intake of 10% or less of total calories, moderate aerobic exercise at least three times a week, yoga and meditation an hour a day, group support sessions, and smoking cessation. Dr. Ornish and his colleagues have reported that as a result of their program, blockages in arteries have decreased in size, and blood flow has improved in as many as 82% of their heart patients( Gould et al.,1995). A five year follow-up of this program reported an 8% reduction in atherosclerotic plaques, while the control group had a 28% increase. 5. Benson’s Mind / Body Medical Institute Dr. Herbert Benson is a physician affiliated with Harvard Medical School, and best known for his best-selling books on the relaxation response and for popularizing the term mind/body medicine. For individuals feeling the negative effects of stress, Benson’s program teaches them to elicit the relaxation response, a western version of meditation. The Benson- Henry Institute for Mind/Body Medicine’s clinical programs treat patients with a combination response techniques, proper nutrition and exercise, and the reframing of negative thinking patterns. 6. Strong for Life The Strong for Life Program is a home-based exercise program for disabled and nondisabled older adults. It focuses on strength and balance, and provides an exercise video, a trainer’s manual, and a user’s guide. The program was designed by physical therapists for home use by older adults, and relies on elastic resistive bands for strengthening muscles. The exercise program led to high rate of exercise adherence among older participants, as well as increased lower extremity strength, improvements in tandem gait, and a reduction in physical disability (Jette et al., 1999)  Advocacy - public support for or recommendation of a particular cause or policy. "their advocacy of traditional family values" Watch and Learn: https://www.youtube.com/watch?v=hpdjJakEV2U https://www.helpage.org/silo/files/advocacy-with-older-people-some-practical-suggestions-.pdf “ My Lolo and Lola: Our Heritage Heroes” Watch https://www.youtube.com/watch?v=NMHzIaYmlng 1. How could you advocate the older adult for healthy lifestyle (200 words)? Textbooks: Eliopoulos (2018). Gerontological Nursing 9th Edition.Wolters Kluwer Meiner (2019). Gerontologic Nursing 6 th Edition. ELS Miller (2019).Nursing for Wellness in Older Adults 8 th Edition. Wolters Kluwer Touhy ( 2018). Ebersole and Hess Gerontological Nursing and Health Aging Filit (2017). Brocklehurts Testbook of Geriatric Medicine and Gerontology Patińo, Mary Jane. (2016). Caregiving volume 1. Manila: Rex Book Store. F 649.1 P27 2016,v.1, c1 Doenges, Marylinn E. (2002). Nursing care plans: guidelines for individualizing patient care, 6th ed. Philadelphia: F. A. Davis Company. R 610.73 D67 2002, c5 Meiner, S. E. (2007). Gerontological Nursing 3rd Edition. Quezon City. pp. 310-311, 371. Wold, Gloria Hoffman. (2012). Basic geriatric nursing, 5th ed. MO: Elsevier.618.970231 W83 2012, c1 Mauk, Kristen. (2010). Gerontological nursing: competencies for care.MA: Jones & Bartlett Publishers.610.7365 G31 2010 Websites: https://www.helpage.org www.ebscohost.com www.doh.gov.ph http://www.pna-pjn.com