Demographics

What are the elderly poverty levels?

33% of African American

22% of Hispanic-American

11% of Caucasian-American

Principles

What are the critical functions for NPs?

Health Promotion

Health Maintenance

Disease Prevention

Facilitation of Self-Care

-Understanding & interacting pathophysiologic & pyschosocial changes of aging and interventions for managing the changes r/t functional status, use clinical reasoning to determine customary & unusual findings

-Provide comprehensive services alone, to care givers, & interdisplinary team

-Promote health aging

-Identify & address ethical problems

-Provide consultation, education, leadership & advocacy

-Collaborate in, use and disseminate research

Provide leadership in developing & maintaining standards of practice

-Participate in continuing ed & certification

What are the top 8 common conditions in older adults?

1. Arhritis

2. HTN

3. Heart Disease

4. Respiratory Disease

5. DM

6. Cancer

7. CVA

8. Atherochlerosis

1. Heart Disease

2. Cancer

3. CVA

4. Pneumonia

5. Fracture

6. Bronchitis

7. OA

8. DM

9. Disease of nervous system or sense organs

10. BPH

1. Heart Disease

2. Cancer

3. CVA

4. COPD

5. Pneumonia & influenza

6. DM

7. Accidents

8. Alzheimer's disease

9. Septicemia

10. Atherochlrosis

11. HTN

1. Declining Health/Functional Status

2. Increased Mortality Awarness

3. Interest developement

4. Income & Empolyment Issues

5. Family Changes

6. Retirement

7. Shrinking Social World

8. Hearing & Speech deficits

• Difficult acceptance of declining efficiency of body
• Common result lead to illness & disability

• Widowhood
• Death of family members (siblings & friends)
• Recongnition of declining functions

• Fulfilling own dreams
• Deepening religious convictions
• Strengthening family ties
• Leaving a legacy

• Economic profile is poor (1/6 in poverty)
• Retirement income <1/2 salary
• Social Security many sourse of income
• Life Style Changes:
• --relocation
• --change in social practice
• --change in diet
• --lowering of independency

• Family unit source of satification
• Key source of support
• Adjustment to independency of children
• Limited extended family: children not responsible for aging parents
• Death of Spouse: affects more women

Remote Phase

Near Phase

Honeymoon Phase

Disenchantment Phase

Reorientation Phase

Stability Phase

Termination Phase

• Following retirement, euphoric period
• Attempt to do everything never had time to do before
• Limited by finances
• Leads to developement of stable lifestyle

• Understanding of retirement role achieved
• Some enter phase directily after honeymoon phase and other never fully reach it

Cultural & Ethical Influences/Considerations

African American

• Older age is personal triumph reflecting strength, resourcefulness, & faith
• May use caution in interacting or utilizing health services
• Look to family members for decision making before using health services
• Hold beliefs and practices measure which may be unconventional
• HTN major health issue affecting population

• Highly valve family: family members expected to care for elderly
• Care of body & health:
• --Balance -Yin & Yang
• --Use senses for assessing medical problems
• --Disagreement or discomfort not openly expressed
• --Old age is considered a blessing
• --Elderly held in high esteem

• Youth is valued
• Families many be geographically distant but often intergenerationally emotionally supportive
• Institutionalizations

• States of health & illness actions of God
• Medals & crosses worn for well-being
• Prayer plays important part in healing
• Older relatives held in high esteem
• Children are responsible for care of parents
• Institutionalization avoided at all cost

• Strong sense of indentiy & shared beliefs
• Positive feelings toward the elderly
• Religious traditions of great importance:
• --Head & feet should always be covered
• --Kosher Diet
• --Sabbath ( Sundown Fri to Sundown Sat)