Health Needs of Older Adults

1. Health Needs of Older Adults Kimberly Greer, R.N. PAMF

2. 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

3. Program Overview • Aging and Health • Chronic Disease in Later Life • Health Promotion • Lifestyle changes • Screening and prevention

4. Aging and Health

5. The Aging Process • Generally involves slowing down of systems • Varies greatly among individuals • Influenced by genetics, environment, lifestyle factors

6. 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, salivaproduction Physical Changes of Aging

7. 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

8. Chronic Disease in Later Life

9. 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

10. Diabetes Heart Disease Arthritis High blood pressure Cancer Low Vision Depression Kidney Disease Examples

11. 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)

12. Loss of function Loss of mobility Loss of independence Disability Pain Death Consequences/Impact

13. Risk Profiles Combination of Causes • Aging • Lifestyle • Environment • Heredity • Stress • Unknown

14. Common Chronic Conditions

15. 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?

16. Health Promotion

17. 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)

18. 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

19. What can we do to promote health? • Stop smoking • Get active • Eat a healthy diet • See a doctor regularly • Get immunized • Get screened

20. 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

21. Where to Get Help • Your healthcare provider • 1-800-NOBUTTS • http://www.smokefree.gov/ • Clinics/Medical Libraries/Health Resource Centers

22. 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:

23. 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) Benefits of Physical Activity

24. 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

25. Eat a Healthy Diet

26. 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:

27. 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

28. 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 Barriers to Good Nutrition

29. 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

30. 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

31. 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

32. 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

33. See Your Doctor Regularly

34. 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

35. General Screening Recommendations*check with your doctor for specific recommendations • Pap test – every1-3 years up to age 65 • Lipid Screen – every5 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)

36. 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 Immunization Recommendationsfor older adults

37. 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?

38. 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/

39. American Diabetes Associationhttp://www.diabetes.org/home.jsp American Dietetic Association http://www.eatright.org National Cancer Institutehttp://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/ Internet Resources

40. References Agency 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. AmericanCollege 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

41. 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