For older adults, hypertension remains one of the main causes of many adverse cardiovascular outcomes such as stroke and death. The burden of this chronic disease is feared to escalate given the world’s aging population. Accordingly, the present study focuses on T, an elderly patient with arterial hypertension. T is a 72 year-old, 155-centimeter-tall white immigrant, weighing 68 kilograms. Although long divorced, the immigrant lives with an adult daughter and a teenage grandson, both of whom help her adhere to her treatment regimen and avoid being severely affected by her chronic condition. Her story reveals that a healthy diet, physical activity, and other lifestyle modifications can successfully mediate hypertension albeit to the extent that the environment permits.
Prioritizing T’s Care Needs
The key to prioritizing T’s support needs lies understanding the care requirements for a typical arterial hypertension patient. Many experts advocate for, among other measures, maintenance of ideal weight, regular physical activity, stress reduction, and limiting of alcohol intake (Oliveros et al., 2019). For T, the first care need would ranks as follows:
- Peer support – T needs her family members to help her take the right medication in a timely manner and adhere to necessary lifestyle and dietary changes.
- Weight loss; she has a body mass index of 28.3, which puts her in the range of overweight-almost obesity according to the official BMI computational formula.
- Increased physical activity; to reduce the risk developing complications from arterial hypertension, T needs to engage in aerobic activity, lasting about thirty minutes, thrice a week.
- Stress management reduction; T becomes nervous, anxious, or stressed about three times per month, prompting her to take three drops of 2% Nifedipine as a regulatory measure.
A professional caregiver, such as a nurse, can offer T certain interventions. First, a nurse is needed to conduct patient assessment, which involves frequent and routine measurement of blood pressure according to a preferred schedule. Although T does not take antihypertensive medications daily, the nurse will need to obtain her complete history to assess any indicators of organ damage. Nursing assessment will also be needed to determine effectiveness of T’s medication and reveal the condition of the apical and peripheral pulses.
The central objective of nursing care for patients with hypertension is to lower and control the blood pressure without subjecting the patient to undue cost or adverse effects. Accordingly, it will be necessary for the professional to encourage T to develop, with the help of a dietitian if need be, a strategy for enhancing weight loss. Additionally, the nurse may need to help T develop a suitable exercise regimen and adhere to it, implement physical activity, and educate the patient on other important lifestyle modifications to manage her condition.
Implementing Objectives of Healthy People 2030 to Increase Wellness
The Healthy People 2030 framework hinges on five overarching objectives whose ultimate fulfillment is expected to enhance wellness. The first aim is to eliminate preventable injury, diseases, disability, and premature death, thus attaining healthy, thriving lives. Secondly, it seeks to eradicate health disparities, make health equitable, and to make everyone health-literate. The third goal is to have the human population live in economic, physical, and social environments in which full potential for health and wellbeing is realizable. The next objective is to ensure that each life stage has its members fixated on healthy behaviors, wellbeing, and development. Finally, Healthy People 2030 seeks to get all stakeholders – the public, leaders, professionals, organizations – to cooperate in making and implementing policies and actions that enhance wellbeing.
Implementing the ambitious Healthy People 2030 requires a lot of dedicated effort to inform and equip relevant parties with necessary knowledge and tools. The Office of Disease Prevention and Health Promotion outlines an eight-step action plan for the Healthy People 2030 (“Healthy People 2030 framework,” n.d.). The first step is to set measurable objectives to guide evidence-based interventions that seek to promote health and wellbeing. In the present case, T’s treatment regimen will need to be organized around SMART goals and pursued through measures that are backed by research. Achieving these objectives further requires accurate information about the at risk populations, such us T, to be made accessible in a timely manner to drive targeted remedial actions.
Another important way of achieving Healthy People 2030 goals is to forge relations and provide tools needed to fulfill various roles. For example, public and private sectors can be coordinated to amplify the positive impact of their efforts in promoting wellbeing. Another important way of achieving these goals is by gauging performance regarding health and wellbeing. Accordingly, policymakers, programs, public, and other relevant stakeholders should be equipped with tools for evaluating progress. The whole point of measuring performance is to make it know; thus regular reporting, biannually, for instance, would be appropriate throughout the decade. Additionally, stimulating research and innovation is a fundamental part of this ambitious undertaking. It can help make health promotion, disease prevention, and treatment affordable and efficient.
Advocacy Role of Nursing
Advocacy is a fundamental tenet of nursing practice, enshrined in Provision 3 of the American Nurses Association’s Code of Ethics. A nurse is expected to promote, advocate for, and protect the patient’s safety, health, and rights even as they get the patient to accept diagnosis and treatment. Nursing advocacy hinges on three patient-centric pillars: dignity, equality, and elimination of suffering. Nurses preserve human dignity by helping participants navigate unfamiliar medical situations, and, if need be, educating and encouraging them to go through appropriate diagnostic procedures. An essential part of this support is to understand how cultural differences may affect the participant’s experience and intervene to uphold standards and achieve positive outcomes.
In getting participants to accept diagnosis and treatment, the advocating nurse is further mandated to ensure equality. In the speedily changing health system, the nurse is expected not to be carried away by rapid technological and organizational advancements that are often accompanied by regulatory changes that inevitably affect health care delivery. In this fluid environment, the nurse’s advocacy role becomes essential. It helps ensure the preservation of the patient’s inherent dignity, worth, and uniqueness, regardless of their socioeconomic status, personal characteristics, and the medical condition in question. For example, an advocate nurse should ensure that T understands the need to be tested for any her arterial hypertension and other comorbidities, and that the health facility accords her the dignified, non-discriminative treatment she deserves. Moreover, hypertension must not be stigmatized to encourage T to take the test and seek the help she needs for a healthy living.
The third pillar emphasizes the need for a nursing professional to be available for the participant as an advocate for her wellbeing. For instance, a nurse assigned to T must be motivated by the genuine desire to help the patient prevent or manage suffering. The nurse should then understand the implications of a diagnosis and subsequent treatment on the participant’s physical, emotional, or psychological status and ameliorate it accordingly. Overall, the advocacy role of nursing requires the professional to be an effective and passionate communicator, liaison, educator, interpreter, and caregiver.
Impact of Environment on Patient’s Health
The profound impact of environment on a patient’s health makes it a crucial point of focus in health care discourse. It is known that environmental issues, such as poor infrastructure, inaccessibility of health care, pollution, and diseases-causing microbes can devastate an individual’s health. Incidentally, social determinants like education, social support networks, and socioeconomic status can play a huge role in patient care. For example, despite T being a senior, she has successfully kept her arterial hypertension in check with the help of her supportive family. Her daughter and grandson manage critical aspects of her life that enable her leave healthily: they keep her clean, relaxed, on a healthy diet, physically active, and appropriately medicated. By T’s account, she has never missed her medication because her daughter and grandson prepare all medicines for her and ensure she takes them as prescribed. In short, T’s social environment has played a huge role in promoting her wellbeing.
Conclusion
In conclusion, hypertension is a devastating condition that strikes once but requires a lifetime of management. This study draws from the experience of T, an elderly woman with arterial hypertension, showing that this condition is not a death sentence. With the right lifestyle adjustments, treatment, and supportive environment comprising professional caregiver and social support, senior patients can have a shot at Healthy Living 2030 vision. As the aging population increases and the word becomes more turbulent due to wars and Covid 19 pandemic, there is urgent need to assess whether local health system is still on track to achieving Healthy Living 2030.
References
Healthy people 2030 framework. (n.d.). Office of disease prevention and health promotion. Web.
Oliveros, E., Patel, H., Kyung, S., Fugar, S., Goldberg, A., Madan, N., & Williams, K. A. (2019). Hypertension in older adults: Assessment, management, and challenges. Clinical Cardiology, 43(2), 99-107. Web.