NUR 4244 – Deliverable 4 – Vulnerable Populations Report

NUR 4244 – Deliverable 4 – Vulnerable Populations Report

As the global population ages, growing importance surrounds the understanding of health determinants affecting the vulnerable population of the elderly. These health determinants include the social and economic environment, physical environment, individual characteristics, and behaviors of the elderly.

The social and economic environment of older people affects the perceived quality of care for those wishing to age in place. Aging in place allows the elderly a level of autonomy, control, and dignity over their health. Social determinants include transportation, access and availability of services, nutrition, and safety. Having availability to these resource options can positively affect the health status of the elderly. Economic resources are fundamental to health because they are necessary to obtain goods and services needed for a healthy life (Nosratabadi et al., 2018).

When a person is in poor health, disabled, or has functional declines due to aging, health issues can be related to housing issues. The physical environment of homes can be both prosthetic and therapeutic to compensate for and help treat health problems. As a prosthetic environment, the home can compensate for functional ability limitations to allow individuals to safely and independently conduct basic activities associated with daily life, engage in social roles, and obtain personal assistance from caregivers. Therapeutically, by encouraging health-promoting practices and offering healthcare services, the environment can promote health maintenance and management (Lee et al., 2018). When homes are not designed to support an aging population, there is an increased risk of accidents and hazards when trying to perform activities of daily living independently. When there is a lack of space, the use of assistive devices or even personal assistance can become impossible (Lee et al., 2018). Environmental factors can directly impact an elder’s quality of life.

NUR 4244 – Deliverable 4 – Vulnerable Populations Report

When the elderly show characteristics of isolation and seclusion, it can lead to declines in nutritional, physical, and emotional well-being. These factors can even lead to increased mortality risk for the elderly population (Thomas et al., 2014). Other characteristics of vulnerability in old age include those who are childless, frail, and even isolated. These contribute to the elderly’s emotional well-being. Marital status can also have an impact on the quality of life perceived by the elderly (Gutierrez-Vega et al., 2017). Marital status, emotional support, physical assistance needs, and community are important factors affecting self-rated health and quality of life perceived by the elderly.

Throughout an individual’s lifetime, behavioral and lifestyle variables have a profound impact on well-being. The elderly population can help to prevent diseases and disabilities and improve their quality of life through healthy behaviors such as proper nutrition, exercise, use of preventive health care, and avoiding other bad habits. Identifying modifiable factors associated with chronic diseases is associated with prevention. Behaviors such as smoking, poor nutrition, and less physical activity can contribute to higher rates of chronic diseases in the elderly. The improvement of health behaviors among this vulnerable group is vital to increase longevity and enhance quality of life. A healthy lifestyle, such as smoking and drinking cessation, regular exercise, and a reasonable diet, are among the most important behaviors determinants of health status. These healthy behaviors help reduce the severity and risk of recurrent disease, improve the quality of life, and extend life expectancy for the elderly (Wu et al., 2017).

The role of the public health nurse is to understand and treat the complex physical and mental health needs of an elderly population. The public health nurse plays an important role in helping the elderly maintain an independent lifestyle by emphasizing preventative care, providing supportive and care services, and ensuring emotional and physical support to the elderly. Public health nurses work with diverse partners and providers to address complex challenges and chronic health problems to assist the elderly population in remaining at home (Meadows, 2009).

Social support is a multidimensional approach when assessing the influences on the elderly’s health outcomes. The health and well-being of this vulnerable population can be influenced by social factors such as emotional and physical support. Loneliness and isolation can negatively affect both the physical and mental health of an elder (Mikkelsen et al., 2019). Support for the elderly can be found in many places, including senior living facilities, meal delivery services, religious affiliations, and adult day care centers. Providing information and access to these support groups is an intervention for vulnerable adults that can improve their quality of life.

NUR 4244 – Deliverable 4 – Vulnerable Populations Report

Another multidimensional strategy aims to help older adults age in place, targeting both the home environment and individual physical function. Providing an inter-professional intervention to vulnerable older adults is an innovative approach that could incorporate a nurse, occupational and physical therapists, meal delivery services, and case managers for example (Pho et al., 2012). The nurse component of this inter-professional team would address key barriers to functional independence, such as pain, depression, medication management, and communication with providers. Therapy teams would assist the client with physical function and help carry out daily living activities. A meal delivery service, such as Meals on Wheels, would assist in providing nutritious meals, a quick safety check, and much-needed human interaction for the homebound client. Lastly, the role of the case manager would assist the client and their family in making decisions, achieving autonomy, and providing advocacy.

References

Gutiérrez-Vega, M., Esparza-Del Villar, O. A., Carrillo-Saucedo, I. C., & Montañez-Alvarado, (2018). The Possible Protective Effect of Marital Status in Quality of Life Among Elders in a U.S.-Mexico Border City. Community Mental Health Journal, 54(4), 480–484. https://doi.org/10.1007/s10597-017-0166-z

Lee, S., & Cheong, C. H. (2018). Effect of the Physical Environment on the Health-related Quality of Life of the Low-income Korean Elderly Population. Iranian journal of public health, 47(12), 1865–1873.

Meadows, Phyllis PhD, RN Community Health Nursing, AJN, American Journal of Nursing: January 2009 – Volume 109 – Issue – p 19 doi: 10.1097/01.NAJ.0000343102.62178.80

Mikkelsen, A., Petersen, S., Dragsted, A. C., & Kristiansen, M. (2019). Social Interventions Targeting Social Relations Among Older People at Nursing Homes: A Qualitative Synthesized Systematic Review. Inquiry: a journal of medical care organization, provision, and financing, 56, 46958018823929. https://doi.org/10.1177/0046958018823929

Nosratabadi, M., Nabavi, S. H., Rashedi, V., & Rarani, M. A. (2018). Socioeconomic determinants of healthcare and emotional needs among Iranian older adults in Isfahan. Journal of education and health promotion, 7, 111. https://doi.org/10.4103/jehp.jehp_174_17

Pho, A. T., Tanner, E. K., Roth, J., Greeley, M. E., Dorsey, C. D., & Szanton, S. L. (2012). Nursing strategies for promoting and maintaining function among community-living older adults: the CAPABLE intervention. Geriatric nursing (New York, N.Y.), 33(6), 439– 445. https://doi.org/10.1016/j.gerinurse.2012.04.002

Thomas, J. M., Cooney, L. M., Jr, & Fried, T. R. (2013). Systematic review: Health-related characteristics of elderly hospitalized adults and nursing home residents associated with short-term mortality. Journal of the American Geriatrics Society, 61(6), 902–911. https://doi.org/10.1111/jgs.12273

Wu, H., & Lu, N. (2017). Informal care and health behaviors among elderly people with chronic diseases. Journal of health, population, and nutrition, 36(1), 40. https://doi.org/10.1186/s41043-017-0117-x

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You are a new public health nurse working for the Department of Public Health, and you have been asked to create a report on one of the following vulnerable populations in your community: homeless population, ethnic or minority group, elderly, or pregnant woman and children in low socioeconomic areas. The report will provide your department with current information about your community as well as offer interventions for the selected vulnerable population within your community.