Objective 3 JC PDF

Obj. 3: Discuss factors that influence health and wellness By Mike Vance, (August 21, 2011). Health and Wellness  Health & Wellness cont’d Health In later life is related to functional abilities not just absence of disease. Ability to do what is important to the individual. I...

Obj. 3: Discuss factors that influence health and wellness By Mike Vance, (August 21, 2011). Health and Wellness  Health & Wellness cont’d Health In later life is related to functional abilities not just absence of disease. Ability to do what is important to the individual. Includes a person’s strengths, resilience, capabilities & resources- not pathology.  Health & Wellness Wellness: The state of complete physical, mental, and social well-being and not merely the absence of illness or infirmity. (World Health Organization) Varies & is dependent on culture, & ones’ perception. More common term today is‘Holistic Health’including all aspects of an individual.  Health & Wellness cont’d Wellness Striving for an optimal level of health. Independent of situation e.g. disability, functional ability, illness or terminal illness. Focus’ care on promotion of wellness even if outcome is not going to restore health. Growth Potential: Crisis as a Challenge (Fig 1-4) All Components Contribute to Healthy Aging /Wellness (Fig. 1-3)  Healthy Aging - component Psychological: Self-efficacy, feeling in control of one’s life. Taking responsibility for one’s own health. Effective coping, health choices.  Healthy aging - Component Spirituality and Aging The spiritual aspect of people’s lives transcends the physical & psychosocial to reach the deepest individual capacity for love, hope, and meaning. Nurses must be knowledgeable and respectful of the rites & rituals of various religions, cultural beliefs, and values. 7-8  Healthy aging - Component Biological Age-related physical changes, lifestyle factors & genetics all influence wellness. *E.g., smoking cessation & physical fitness  Healthy aging - Component Social: Satisfying roles & relationships. Social support has positive impact on health.  Healthy aging - Component Environment Physical: including structural living arrangements: e.g., Maintaining safe environment to prevent falls, air pollution. Social: Healthy relationships, effective role transitions.  Healthy aging - Component Culture Affects health beliefs Health disparities Socio-economic challenges  Determinants of Health Income & Personal Social Social Health Status Support Practices & Networks Coping Skills Employment Health Working Determinant Services Conditions s of Health Biology & Physical Genetic Endowment Environme nt Healthy Child Developme Education nt Determinants of Health – Older Adult (Chp. 1) 12 Key Determinants of Health: 1.Income & social status (socioeconomic factors) Seniors have lowest income compared with other age groups. Especially for women who are unattached, outlive husband, large % didn’t pay into CPP (didn’t work outside the home). Determinants of Health – Older Adult (cont’d) Those with low income have more physical & mental problems than those with more economic resources. Those with middle to upper incomes are more likely to report excellent to very good health than those with lower incomes. Determinants of Health – Older Adult 2. Social Support networks Linked to health, protective factor against depression. 3. Education & literacy The more educated the lower the prevalence of chronic conditions. Determinants of Health – Older Adult 4. Employment & working conditions 5. Social environments Quality of relationships, support 6. Physical environments Living conditions Determinants of Health – Older Adult 7. Personal health practices and coping skills 8. Healthy child development 9. Biology & genetic endowment 10. Health services 11. Gender 12. Culture Determinants of Health – Older Adult Lalonde report (1974) claimed that socioeconomic, environmental, & biologic factors are equally or more important in influencing health than health care. *Income and poverty have a major impact on health. Determinants of Health – Older Adult *In effort to promote healthy aging, nurses must consider the impact of the determinants of health when planning care.  Theories of Aging (Chp. 7) Theory: An explanation, rationale or hypothesis used to support a particular view. Sociological / Psychological Theories: propose why individuals & groups behave / interact in the way they do.  Sociological Theories of Aging 1) Disengagement Theory: Time when the older adult & society engage in mutual separation from each other (e.g. retirement). Disability may impact engagement from others (this is not an expected pattern of disengagement). Adjustment is key.  Sociological Theories of Aging 2) Activity Theory: Staying active is the key to successful aging. Research supports that physical activity, staying socially engaged, maintaining productive roles lead to better health outcomes. (e.g. volunteering)  Sociological Theories of Aging 3) Continuity theory: As a person ages, there is consistency in patterns of behaviour that represents ‘who the person is’. It doesn’t mean that change doesn’t occur, however, the person is able to adapt to changes of aging.  Psychological Theories of Aging 1) Developmental Theory: Erikson’s theory - the last stage of life. ‘Ego Integrity versus Despair’ Looking back at your life and feeling satisfied instead of having regrets.  Psychological Theories of Aging 2) Gerotranscendence: A gradual move away from a value of a material world to a cosmic world. Life’s challenges bring about this shift. Associated with wisdom and spiritual growth.  Cognition and Aging Cognition: “mental processes involved in acquiring and processing information that are necessary for everyday living” (Magni & Bilotta, 2016, p. 411). This Photo by Unknown Author is licensed under CC BY-SA-NC  Normal Cognition & Aging Despite aging changes in the brain & in neuronal activity / transmission – the aging brain remains resilient. Older adults are able to function & compensate. Cognition remains intact – despite age-related changes. Normal Patterns of Cognition & Aging Age associated memory impairment (AAMI). (some memory loss is normal with aging) Age associated sensory losses (obj. 10) Basic intelligence remains unchanged Tasks may be slower to perform  Cognitive Function & Aging Regular input & exercise of the brain necessary to maintain intact cognitive function The aging brain needs to be regularly stimulated in order to keep cognitive function sharp.  Normal Cognition & Aging ‘Use it or Lose it’ is important to maintain brain health, cognitive function and cognitive reserve. Cognitive reserve is associated with the concept neuroplasticity - the capacity of the brain to adapt and respond to stress and changes in life. What are some cognitive stimulating activities or brain exercises?  Cognitive Stimulation Techniques Mnemonics. Cognitive games (chess, scrabble), word puzzles involves strategy & concentration. Montessori – based activities (often used with dementia) breakdowns task into steps, simple to complex, use of repetition, use of external cues.  What do we know about basic intelligence? It remains constant with increasing age. Limited literacy skills influence learning. Older persons should be provided with opportunities for continued learning.  Intelligence & Aging Fluid intelligence: Related to learning & problem-solving in new situations. Ability to draw conclusions about complex relationships. Abstract thinking. Flexibility in thinking & ability to adapt. Declines with aging.  Intelligence & Aging Crystallized Intelligence: Knowledge & abilities acquired throughout life. The knowledge ‘crystallizes’. Remains stable, older adults are able to learn & acquire new knowledge. Example: Many older adults are computer savvy, use technology to access health information.  Intelligence & Learning (Box 7-6 Strategies to Enhance the Learning of Older Persons) New learning must be relevant & have some recognizable importance to the older adult. Consider culture, language & education background. Ensure teaching tool is appropriate e.g. printed brochures, computer websites. Assess for readiness to learn, anxiety, past education.  Intelligence and Learning For older adults: teaching & new learning is most effective - when connections are related to past experiences and familiar knowledge. This Photo by Unknown Author is licensed under CC BY-SA-NC This Photo by Unknown Author is licensed under CC BY  Health Literacy The ability to access, understand & act on information concerning health 6 out of 10 adult Canadians do not have proficient health literacy. Consequences: poorer health outcomes.  Health Literacy Nursing Implications: Health education materials should not be higher level than grade 5. Use a ‘teach-back’ method - Present information in small chunks & then ask the person to restate / explain what they are supposed to do. (Box 7.8, Chp. 7) Ten Elements of Teach-Back Method of Health Education  Social Isolation: Impact on Health Social Isolation: “A state in which the individual lacks a sense of belonging socially, lacks engagement with others, has a minimal number of social contacts & they are deficient in fulfilling quality relationships”. (Nicholson, 2009, p. 1346)  Social Isolation This Photo by Unknown Author is licensed under CC BY-ND  Aloneness & Relationship to Aging More senior women live alone than men, longer life expectancy. Men who are alone tend to marry more often. Some seniors chose to be alone. Some do not have a choice because of financial reasons – so they live with others.  Aloneness & Relationship to Aging (cont’d) Transportation issues. Age-related sensory changes with hearing & sight make communication challenging. Retirement- some are more disengaged from society.  Social Isolation: Risk Factors Ageist attitudes: How? Living situation (living alone, children moved away, living in rural areas, institutionalization i.e. LTC). Changes in life roles (e.g., loss of spouse & or significant others). Chronic Illness (e.g., mobility limitations, declining health, hearing loss).  Social Isolation: Risk Factors Economic factors (e.g.,. retirement, loss of network, reduced income). Psychological factors (e.g., depression, substance abuse, lack of engagement in social activities), loneliness perception of disconnectedness. Sexual orientation.  Social Isolation: Impact on Health Impact: Negative Health consequences Loneliness Depression, Suicide Illness (e.g., cancer, common cold, heart disease, cognitive decline) Premature death  Social Isolation: Impact on Health (cont’d) Negative health behaviours: poor diet, smoking, increase in substance use. Events: falls, hospitalizations, rehospitalizations, institutionalization. Overall decline in health: resulting in an increase risk for illness & death.  Social Isolation: Impact on Health Very serious Not often assessed, overlooked in all settings: LTC, independent living facilities, living with family or alone. What can we do?  Nursing Implications / Interventions: Social Isolation Assessment: (verbal & non-verbal), risk factors? Involve family & significant others. Build relationship with individual. Ask questions to determine how they are feeling, coping with changes or losses, how they describe the quality of their life, relationships with family & friends, their living arrangement.  Strategies (cont’d) Listen to what is being said, or not said. Take time & show interest in getting to know the person, how he spent his life, commend them on their contributions to family or society. Be respectful & caring When an older adult is discharged from hospital, assess their risk factors and ability to manage on their own. Ask who their count on for support?  Nursing Implications and Strategies Encourage involvement in activities / community, e.g. programs for 50+, volunteering. Intergenerational activities. Technology. Pet therapy. Reminiscence communication / groups. Encourage relationships with peers & contact with family.  Nursing Implications and Strategies Pet therapy for seniors https://www.youtube.com/watch? v=z5a1mNs5HnE  Technology & older adults Types: Digital health, using smart phone apps or wearable devices to monitor health e.g., B/P, blood glucose, oxygen levels Emergency response devices Cameras: monitor safety by observing quality of care in LTC Social media, virtual video applications  Technology & older adults Benefits: Technology enables older adults to age in place Promotes a feeling of connectedness, thus reducing social isolation even for older adults with limited mobility Provide speedy information - maintaining healthy lifestyles  Technology & older adults Disadvantages: Overuse – technology is not a replacement for human interaction, may increase loneliness / social isolation  Technology & older adults Barriers: Cost Lack of guidance (? Ageism) Lack of knowledge, too complex Feelings of inadequacy *Despite this – many older adults have embraced technology (Locsin et al, 2021)