Health Needs of Older Adults

Kimberly Greer, R.N.PAMF

Learning Objectives

• Understand the physiological changes of aging

• Gain awareness of chronic diseases and their impact on older adults

• Understand the importance of health promotion activities

Program Overview

• Aging and Health

• Chronic Disease in Later Life

• Health Promotion~ Lifestyle changes~ Screening and prevention

Aging and Health

The Aging Process

• Generally involves slowing down of systems

• Varies greatly among individuals

• Influenced by genetics, environment, lifestyle factors

Physical Changes of Aging

Heart

Muscles

Brain

Skin

Kidney

Vision

Hearing

Bones

Taste

~ Pumping effectiveness decreases~ Muscle mass decreases~ Some loss of cell structure and function~ Dryness, slower healing~ Less efficient~ Decreases in depth perception, color

perception, and peripheral vision~ Decreased acuity, esp. higher pitch~ Mineral loss faster than replacement~ Decreased taste buds, saliva production

What’s Normal, What’s Not?

• Aging vs. disease process vs. external factors

• “Normal changes” of aging may actually be part of a disease process

• Don’t assume symptoms are due to normal aging

Chronic Disease in Later Life

Definition

Chronic disease:

• Prolonged health condition• Can last for many years • Rarely cured completely• Care is aimed at managing symptoms,

preserving function, and minimizing further damage

Examples

• Diabetes

• Heart Disease

• Arthritis

• High blood pressure

• Cancer

• Low Vision

• Depression

• Kidney Disease

Why is it Important?

• Chronic diseases are the most prevalent and disabling conditions facing the elderly

• Four of every five elders have at least one chronic disease

• Chronic disease can dramatically reduce quality of life

• Chronic diseases account for over 75% of U.S. medical care costs (CDC, 2005)

Consequences/Impact

• Loss of function• Loss of mobility• Loss of

independence

• Disability• Pain• Death

Risk Profiles Combination of Causes

• Aging

• Lifestyle

• Environment

• Heredity

• Stress

• Unknown

Common Chronic Conditions

Condition Prevalence Results in…

Arthritis

Inflammation or wearing down of joints

Over 40 million Americans Stiffness, chronic pain, deformity, loss of independence

Hypertension

High blood pressure

30 million Americans

One in four adults

Cardiovascular disease, blindness, kidney disease, stroke

Coronary Artery Disease

Hardened or narrowed arteries going to the heart

Number one killer of adults

Most common form of heart disease in older adults

Heart Attack

Chest pains

Congestive Heart Failure

The heart is unable to pump effectively

5 million Americans Shortness of breath

Chronic disability and dependence

Diabetes

Inadequate insulin function

20% of older adults affected Heart disease, blindness,

Kidney damage, neuropathy, amputations

Cancer 50% of cancers occur in the elderly population

Illness, disability, death

DiscussionCommon Chronic Conditions

• What does this condition mean to you?

• What are the causes?

• What is the treatment?

• Who are the providers of care?

• Discuss any underlying attitudes or

beliefs that may affect care?

Health Promotion

Definition

Health promotion involves making lifestyle andbehavior changes in order to move toward optimal health. Health promotion efforts include:

• Increasing awareness of health issues• Promoting healthier behaviors• Creating supportive environments• Developing preventive strategies• Encouraging early detection and treatment

(Am J Health Promot. 1989;3:3–5)

Why is it important?

Improve quantity and quality of life

• Reduce risk of developing chronic conditions

• Reduce the damage or limitations that result from an already existing chronic condition

• It’s never too early and it’s never too late to start healthy habits

What can we do to promote health?

• Stop smoking

• Get active

• Eat a healthy diet

• See a doctor regularly

• Get immunized

• Get screened

Why Stop Smoking?

• Smoking is the leading cause of premature death in the United States

• Cigarette smoking is known to contribute to many chronic illnesses including: several types of cancer, heart disease, stroke, pulmonary disease and others

• Stopping smoking, even at an older age, can significantly prolong life

Where to Get Help

• Your healthcare provider

• 1-800-NOBUTTS

• http://www.smokefree.gov/

• Clinics/Medical Libraries/Health Resource Centers

Get Active

• Lack of activity and poor diet are second only to smoking in contributing to cause of premature death

• A sedentary lifestyle contributes to many chronic diseases including:

•Heart disease•Cancer •Hypertension•Obesity•Lipid Abnormalities

•Diabetes•Depression•Osteoporosis•Stroke

(National Institute on Aging, 2004)

Benefits of Physical Activity

Increased energy

Increased muscle strength and flexibility

Better insulin response

Improved mood

Increased cardiovascular fitness

Increased bone mass

Better immune function

Increased independence

•

(National Institute on Aging, 2004)

What Can I Do to Be More Active?

• Work toward 30 minutes of aerobic activity most days of the week

• Do things that use your muscles

• Do things that make you use your balance

• Stretch to maintain flexibility

• Do things you enjoy or try something new:walk, bike, garden, yoga, tai chi, dance

• Mix it up!

Always talk to your doctor before starting an exercise program

Eat a Healthy Diet

Why is it Important?

• It has been estimated that 10 to 25 percent of elderly people suffer from poor nutrition

• Poor nutrition can contribute to:

•Heart disease•Cancer•Diabetes•Depression•Difficulty thinking

•Anemia•Frailty•Obesity•Osteoporosis•Isolation

Quick Tips for Healthier Eating

• Eat more fruits and vegetables

• Eat whole grains, nuts, beans

• Choose foods low in saturated fat, trans fat, and cholesterol

• Get enough calcium

• Get enough protein from low fat sources

• Cook with less fat

• Minimize foods high in sugar

• Drink enough water

Barriers to Good Nutrition

• Disability• Changes in appetite• Nausea• Medication side

effects• Dental problems• Difficulty shopping• Difficulty cooking

• Swallowing problems• Poor vision• Financial problems• Depression or anxiety• Social isolation• Transportation

problems• Other medical

conditions

Overcoming Barriers to Good Nutrition

• Chewing problems – Try juices, canned fruits, creamed or mashed vegetables, ground meats, eggs, cooked cereals

• Difficulty shopping – Look into grocery delivery or shopping services, ask friends, family, church members for help

• Difficulty cooking – Try microwaveable meals, group dining programs

Overcoming Barriers to Good Nutrition

• Poor appetite – Eat with others, ask your doctor if medicine side effects could be causing problems, try different spices

• Financial concerns – Use coupons, buy in bulk and share with someone, try low-cost options such as beans, bean soups, whole grain cereals, look into food bank programs or other community assistance

• For expert help – Talk to your doctor about a referral to a registered dietician

For More Nutrition Information

• US Food and Drug Administration “Eating Well as we Age” http://www.fda.gov/opacom/lowlit/eatage.html

• American Academy of Family Physicians“The Nutrition Screening Initiative”http://www.aafp.org/PreBuilt/NSI_DETERMINE.pdf

• National Institute on Aging “Age Pages”http://www.nia.nih.gov/HealthInformation/Publications/

• American Geriatrics Society “Aging in the Know”http://www.healthinaging.org/AGINGINTHEKNOW/chapters

Local Resources

• Meals on Wheels (510) 574-2092

• Senior Center Daily Meal Program (510) 675-5495

• Alameda County Food Bank (510) 834-3663

• Mercy Brown Bag Program (510) 742-4840

See Your Doctor Regularly

See Your Doctor Regularly

• Early detection usually means a better outcome and less invasive treatment

• Regular check-ups should include dental, vision and hearing checks

• Get recommended screening tests done

• Get recommended immunizations

General Screening Recommendations*check with your doctor for specific recommendations

• Pap test – every 1-3 years up to age 65

• Lipid Screen – every 5 years, starting mid-thirties (male) or mid-forties (female) up to age 70

• Mammogram – every 1-2 years, age 40-74, then optional

• Fecal Occult Blood – every year, age 50-80+

• Lower GI Endoscopy – depending on individual factors, every 5-10 years, starting at age 50

• PSA – optionally, every year up to age 70 (men)

• Bone density – mid-sixties (women)

Immunization Recommendationsfor older adults

• Influenza – every year age 65-80 (optional age 50-64)

• Pneumonia – once at age 65

• Td/Tdap – every 10 years

• Zoster (Shingles) – once at age 60

DiscussionHealth Promotion

• What unhealthy habits are common in your community?

• Is there an increasing awareness of healthy lifestyle changes?

• What barriers to better health habits exist in your community?

• What are some nutritional issues affecting older people in your community?

• What resources are available in your community to help seniors get adequate nutrition?

Local Resources for Health Information

• PAMF Community Health Resource CenterFremont 510-623-2231

• Washington Hospital Health Library510-494-7030 http://www.healthlibrary.org

• Kaiser Fremont Health Education Center510-248-3455

• Fremont Main Library 510-745-1400http://www.aclibrary.org/branches/frm/

• The Health Library at Stanford1-800-295-5177 http://healthlibrary.stanford.edu/

Internet Resources• American Diabetes Association

http://www.diabetes.org/home.jsp• American Dietetic Association http://www.eatright.org • National Cancer Institute

http://www.cancer.gov/ • National Cholesterol Education

Programhttp://www.nhlbi.nih.gov/about/ncep/

• Healthfinder http://www.healthfinder.gov

• National Institute of Mental Healthhttp://www.nimh.nih.gov/

• American Association of Retired Persons Health Page http://www.aarp.org/health/

• National Center for Complementary and Alternative Medicinehttp://nccam.nih.gov/

• National Women’s Health Information Centerhttp://www.womenshealth.gov/

• Familydoctor.orghttp://familydoctor.org/online/famdocen/home.html

• MedlinePlushttp://medlineplus.gov/

• Family Caregiver Alliancehttp://www.caregiver.org/caregiver/jsp/home.jsp

• National Institute on Aging http://www.nia.nih.gov/

ReferencesAgency for Healthcare Research and Quality (2000). 20 tips to help prevent

medical errors. Patient fact sheet. Retrieved September 8, 2007 from http://www.ahrq.gov/consumer/20tips.htm

Agency for Healthcare Research and Quality (2002). Quick tips – When talking with your doctor. Retrieved September 8, 2007 from http://www.ahrq.gov/consumer/quicktips/doctalk.htm

American Academy of Family Physicians (2005). Determine Your Nutritional Health. Retrieved September 17, 2007 from www.aafp.org/PreBuilt/NSI_DETERMINE.pdf.

American College of Sports Medicine’s Strategic Health Initiative on Aging. Five steps to eating better. Retrieved September 1, 2007 from http://www.agingblueprint.org/PDFs/Eat_Better.pdf

American Journal of Health Promotion website (para.2). Retrieved September 15, 2007 from http://www.healthpromotionjournal.com/resource/instruct.htm

Cassel, C. (1999). The practical guide to aging. New York, NY.: New York University.

Centers for Disease Control and Prevention. (2005). Chronic Disease Overview. Accessed from the World Wide Web on January 11, 2008, at: http://www.cdc.gov/nccdphp/overview.htm

References

Institute of Medicine (1999). To Err Is Human: Building A Safer Health System. Kohn, L., Corrigan, J., & Donaldson, N. (Eds.) National Academy Press, Washington, D.C.

National Institute of Drug Abuse (2006) Trends In Prescription Drug Abuse. Retrieved September 20, 2006 from http://www.nida.nih.gov/ResearchReports/Prescription/prescription5.html