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Aging Patients

Understand the health issues attributed to aging, changes in family roles, communication styles, workforce issues, biocultural ecology and diseases, nutrition, death rituals, spirituality, and health care practices for older patients.

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Aging Patients

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  1. Aging Patients Essentials of Cultural Competence in Pharmacy Practice: Chapter 11 Notes Chapter Author: Dr. Jill Nelson

  2. Learning Objectives • Articulate key health issues attributed to aging. • Understand changes in the importance of multigenerational family members, such as grandchildren, in the health of aging individuals. • Understand changes in the role of social support and spirituality as Americans age. • Describe the increase in the elderly population in the United States.

  3. Aging Patients • Americans are living longer now than at any other time. • Americans 65 and older are the largest growing segment of the U.S. population. • Life expectancy is increasing due to advances and improvements in health care. • The average life expectancy for men is 75.2, whereas for women it is 80.4 years.

  4. Communication Styles • Communication may become increasingly difficult with aging due to changes in hearing, vision and cognition. • Physical changes • Hearing loss may impede a person’s ability to communicate • Vision • Structural changes in the eyes • Reduction in confidence related to recognition of others; driving. • Cognitive • Changes due to illness such as dementia • Part of the aging process (e.g., slowed ability to process information) • Generational communication differences • Practice patience and respect

  5. Family Roles and Organization • Positive relationships with family members play a major role in the psychological well-being of older adults. • Relationships with spouses • In 2000, 56% of people 65 and older were married, 32% were widowed, 7% were divorced, and less than 5% were never married. • Living alone can be related to a lack of social support, living in poverty, and higher reports of having poor health. • Relationships with children and grandchildren • Approximately 80% of older Americans are parents of children (most of whom are middle aged). • The quality of interactions with adult children can influence life satisfaction.

  6. Workforce Issues • As baby boomers enter their 60s, a larger proportion are remaining in the workforce. • Remaining in the workforce typically occurs when people are in good health and need the income to survive. • Most elderly people are retired from full-time work and many rely on Social Security benefits to live.

  7. Biocultural Ecology and Relevant Disease States • Adults 65 years of age and older account for 30% of the health care spending in the United States. • As aging occurs, physical and health declines become more apparent.

  8. Nutrition • Dietary practices and beliefs are as varied as the elderly population itself. • Elderly people are at risk for nutritional deficiencies due to difficulty absorbing some nutrients. • Some supplementation may be necessary. • Ideal diet for older persons is low in fat, cholesterol, sodium, sugar and red meat. • Diet should be high in fruits and vegetables, fish, chicken and other poultry, and low-fat dairy products.

  9. Death Rituals • Elderly think and speak about death more often in late adulthood. • Reasons for increased frequency of thoughts of death. • Six componsents of a “good death” : • Dying with minimal pain (including proper management of the disease symptoms) • Having a voice in their medical decisions and partnering with their physician in making the decisions. • Preparing for death by understanding what they can expect during the dying process. • A life review that encompasses resolving conflicts, spending time with family and friends, and saying goodbye to others. • Being able to help others with gifts, time or sharing knowledge. • Affirming themselves as whole persons instead of as their diseases.

  10. Spirituality • Spirituality plays a large role in the life of most elderly people. • Older adults place a high value on religious beliefs, and spirituality increases in the second half of adult life. • People increase their spirituality significantly between the ages of mid-50s to early 60s and older adulthood. • There appears to be a connection between spirituality and well-being. • Pharmacists can ask patients what role spirituality plays in a person’s life.

  11. Health Care Practices • Older people tend to have more health concerns than the general population, providing an opportunity for pharmacists • Older Americans are twice as likely as the general population to visit the doctor and 3 times more likely to be hospitalized. • Older people have an average hospital stay twice as long as the general population. • Even though older people seek health care more often, many elderly Americans consider themselves to be in good health. • Older Americans take twice as many prescription drugs as the general population.

  12. Reflection Questions • How do you see the emphasis of pharmacy practice changing as the percentage of older Americans changes? • What strategies will you use to treat patients with decreased communication skills? • How will you use your understanding of the religious and spiritual changes of aging adults in your pharmacy practice? • In what ways did the information presented in this chapter impact your view of the elderly population?

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