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- 1. Respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Jessica Rincon St. Thomas University NUR 417 AP2 Prof. Yedelis Diaz 10/25/2022 Role of Nurses in Disease Prevention and Health Promotion in Older Adults Healthy aging and health promotion behaviors among older adults are strongly related to self-efficacy (Wu & Sheng, 2019). However, most older people struggle with self-efficacy due to economic, social, and environmental factors, leading to poor health outcomes. From this perspective, nurses have the primary role of promoting self-efficacy among older adults. One of the strategies to achieve this outcome is advocacy. According to Lecture Notes (Slide 28), older adults are able to continue to control their lives with the help of nurses’ advocacy. For instance, nurses can advocate for the allocation of more resources toward social support programs for older adults. Wu & Sheng (2019) argue that social support from friends and neighbors of older adults is more impactful on their healthy aging and self-efficacy compared to family support. Hence, nurses should be at the forefront in fighting for adequate resources for such programs as a way of disease prevention and health promotion in older adults. Nurses should also make recommendations and encourage older adults they interact with to join available social support programs within their communities. I make such recommendations at work every time I see an older adult receiving little support from family due to the positive health outcomes I have noticed in those that have similar characteristics but have benefited from being part of
- 2. such programs. Screening/Preventive Procedures for Older Adults Caring for older adults is often complex due to comorbidities and concurrent factors that influence their health outcomes. This makes preventive or screening procedures critical in caring for them. Some of the procedures include screening for sensory impairments, screening for functional impairment, and fall-risk assessment (Seematter-Bagnoud & Bula, 2018). Screening for sensory impairments mainly involves assessing visual and hearing abilities, as these factors rank high on geriatric impairments. Sensory impairments have adverse implications on cognitive functioning, psychological well-being, and fall risks (Seematter-Bagnoud & Bula, 2018). Screening for functional impairment assesses the ability of the older adult to perform usual day-to-day activities, predict future functional trajectory and obtain prognosis information. Lastly is fall risk assessment, which is performed for effective preventive interventions. According to Seematter-Bagnoud & Bula (2018), one in ten older adults have significant injuries every year as a result of falls. These injuries pose a serious threat to their functional independence, which, in turn, impedes self-efficacy and healthy aging. Common End-of-life Documents Nurses must Familiarize Themselves with Power of attorney is a common end-of-life document nurses must familiarize themselves with when caring for older adults. This is a document that identifies the agent to make health care decisions on behalf of a person when it comes to a point that they are unable to (Lecture Notes, Slide 22). Another important document is Do not resuscitate (DNR). According to Bloomer et al. (2018), the document gives care providers guidelines on what to do during the last stages of an older adult’s life, such as in the event of a cardiac arrest or when the heart stops beating. Lastly, these documents or wishes can be included in a general one referred to as advance directives. Advance directives are instructions written when the patient is competent enough to
- 3. make decisions and communicate (Douplat et al., 2019). Nurses then rely on such directives to provide care when the patient is in a vegetative state. The importance of knowing these documents for nurses is for ease of decision-making during end- of-life care, which is usually characterized by many complexities. References Bloomer, M. J., Botti, M., Runacres, F., Poon, P., Barnfield, J., & Hutchinson, A. M. (2018). Communicating end-of-life care goals and decision-making among a multidisciplinary geriatric inpatient rehabilitation team: A qualitative descriptive study. Palliative medicine, 32(10), 1615-1623. Douplat, M., Berthiller, J., Schott, A. M., Potinet, V., Le Coz, P., Tazarourte, K., & Jacquin, L. (2019). Difficulty of the decision‐making process in emergency departments for end‐of‐life patients. Journal of evaluation in clinical practice, 25(6), 1193-1199. Lecture Notes. (n.d.). Chapter 7: Socioeconomic and Environmental Influences. Seematter-Bagnoud, L., & Büla, C. (2018). Brief assessments and screening for geriatric conditions in older primary care patients: a pragmatic approach. Public health reviews, 39(1), 1-13. Wu, F., & Sheng, Y. (2019). Social support network, social support, self-efficacy, health-promoting behavior and healthy aging among older adults: A pathway analysis. Archives of gerontology and geriatrics,
- 4. 85, 103934. Daniela Abreu Abreu St Thomas University NUR 417 Instructor: Yedelis Diaz Date: 10/25/2022 Health Promotion and Disease Prevention Nurses are the middlemen for health promotion and the implementation of health promotion, health protection, and preventive services. Nurses are trained to treat each patient with an individualized approach by creating a plan that caters to that patient’s healthcare needs. Education is a key component of the care plans that are implemented both formally in health promotion classes and informally during health care visits. Nurses are up to date with the latest recommendations and will work with older clients in deciding what health behaviors they would like to engage in. As a nurse working at an outpatient endoscopy center, most of my work involves health promotion and disease prevention of colon cancer and other gastrointestinal diseases. Older adults often come into the facility in a bad mood due to the time they spent preparing for the procedure. Colonoscopies require 24- hour fasting and a solution that cleanses the colon. Those solutions usually are not tasteful and make the patient go to the
- 5. restroom nonstop. Therefore, by the time the patient comes into the surgery center for the procedure, they are hungry and sometimes still nauseous from the colon prep solution. This horrible experience usually makes clients not want to ever come back to get their colon checked but we have to educate them on the importance of coming back when the doctor recommends them too. We also educate them on signs and symptoms that should prompt them to visit their gastroenterologist if they do arise. Colorectal cancer screenings are recommended at age 50 for everyone. As per the CDC, screening can prevent colorectal cancer by allowing the removal of precancerous polyps before they develop into cancer. If everyone aged 50 and older were screened regularly, as many as 60 percent of deaths from colorectal cancer could be prevented (CDC 2019). When detected early and treated promptly, the five-year survival rate is 90 percent. Another screening recommended for older adults is screening for breast cancer in women aged 40 to 64. This population of women accounted for 61 percent of all breast cancer cases. Mammography screening is a valuable early detection tool because it can identify breast cancer at an early stage, usually before physical symptoms or complications develop, and reduce mortality (CDC 2019). Breast cancer screening cannot prevent breast cancer, but it can help find breast cancer early when it is easier to treat. It is important to make sure your client knows which breast cancer screening tests are right for them, and when they should have them. All women are at risk for cervical cancer, and it mainly affects women over age 30. Long-lasting infection with certain types of human papillomavirus (HPV) is the main cause of cervical cancer. Pap smears and HPV screening tests can help early detection of cervical cancer. It is recommended that women 30- 65 years of age get checked. By age 65 or older, if you have had normal results for several years, the doctor may tell you it is no longer necessary to screen for cervical cancer.
- 6. Nurses can guide caregivers and patients nearing the end of life by educating them on the three most common End-of-life documents: DNR, Living Will, and Advanced Health Directives. A DNR order is executed by a competent person indicating that if heartbeat and breathing cease, no attempts to restore them should be made and it must be signed by a Physician, Nurse Practitioner, or patient (state law dependent). A Living Will directs those extraordinary measures not to be used to artificially prolong life if recovery cannot reasonably be expected. These measures may be specified by patients or witnesses (state law dependent). Lastly, are the Advance Health Directive. This document explains a person's wishes about treatment in the case of incompetency or inability to communicate. Often used in conjunction with a Health Care Proxy or Power of Attorney (Meiner, S.E., Yeager, J.J., 2019). References Centers for Disease Control and Prevention, AARP, American Medical Association. Promoting Preventive Services for Adults 50-64: Community and Clinical Partnerships. Atlanta, GA: National Association of Chronic Disease Directors; 2019. Meiner, S., & Yeager, J. J. (2019). Gerontologic nursing(Fifth ed.). St. Louis, MO: Elsevier.