Elderly patients make up for the largest vulnerable population in the USA. According to the demographics chart, nearly 13% of the American population is aged 65 or older. That’s around 40 million people, and the number keeps increasing as the population gets older (“13.3 percent,” 2013). Older patients are also the most frequent patients of hospitals and other healthcare institutions. As such, many medical studies are dedicated to this vulnerable group, to improve the quality of healthcare. Despite this, several preconceptions exist regarding this vulnerable age group. The purpose of this paper is to relay the experience with the target population’s health needs, initial impressions, and reflections about how my perspective changed after working with the representatives of this social group.
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Elderly patients have many healthcare needs, and not all of them are of medical nature. Elder patients rely extensively on the availability and cheapness of medical services and drugs, and they are often limited by the constraints of their own pension (Bascu et al., 2012). In many cases, elderly patients live a solitary life, while their children have moved away to create their own families and deal with their own lives. Social isolation is a very serious problem for elderly patients and is the root of many psychological afflictions and diseases (Steptoe, Shankar, Demakakos, & Wardle, 2012). Social isolation is expressed in many ways – as people grow older, their list of friends and acquaintances becomes shorter and shorter, as people die, move away, or are simply unable to visit as often as they could (Steptoe et al., 2012). This causes social skills to atrophy and creates feelings of being unneeded and unwanted. Depression is very common among elder adults, and can often lead to suicide. According to Conwell (2011), suicide rates in the USA among the oldest age group is over 45 per 100,000 per year, which is almost four times higher than the overall suicide rate of 11.5. Aside from that, isolation creates other health-related problems – elderly patients cannot perform physical activities the same way used to, which leads to a variety of discomforts and potentially health-threatening situations (Johanessen, & LoGiudice, 2013). Should a health emergency happen, an older person may find himself or herself unable to call for help, which is a great risk.
Due to reliance on medical assistance, the subject of health insurance is very important for older patients, as paying out of their pocket is very expensive and may become an overwhelming burden on a personal budget. Through Medicare, elders receive considerable cuts on their yearly health insurance programs, but the sums they pay remain substantial (Vasiliadis et al., 2013). Often, elder patients require a variety of medications not covered by their insurance program, which has to be paid for by the client. This makes elders reluctant to ask for medical assistance when they think they can handle it, which in turn leads to further aggravation of the disease (Vasiliadis et al., 2013).
Dietary choices and exercises are very important to keep elders in good shape and prevent diseases and malignancies from occurring (Bascu et al., 2012). Despite that, very few older patients practice such due to a lack of knowledge on the subject. Many older patients are not familiar with modern technology, and their computer skills can be considered average at best, meaning they could not look up the information available on the Internet. This makes elderly care centers and information campaigns aimed at the older populations extremely important, as they provide the knowledge and the means of leading a healthy way of life.
Lastly, older patients require advanced healthcare facilities to be in their immediate vicinity. Many diseases acquired with age, such as coronary heart disease, congestive heart failure, diabetes, and others, require medical supervision (Bascu et al., 2012). Reports say that heart and lung diseases are the primary causes of death in the USA, and rates of survival largely depend on how quickly help can be administered to the patient. Older patients are in greater danger of trauma, as their bones become more fragile and brittle with age, and the body’s restoring capabilities are diminished.
When I approached my practice with this vulnerable population group, I was aware of all these factors but had several assumptions affect my judgment. First, I thought that medical issues were my primary concern, while social aspects of my patients’ lives were negligible. I severely underestimated the importance of social interaction and counteracting social isolation. It is a healthcare issue, as many of my patients had signs of depression caused by the lack of human contact. Isolation affected the health of elderly patients in ways more than one – some patients were having trouble coming to the hospital and often skipped appointments due to the distance between the facility and their home while having nobody to help them out. Lastly, I noticed that some of my patients were coming with false reports of their illness, just to have a bit of conversation with me, during their visit. Their desire for social interaction, thus, inadvertently puts the hospital staff at a greater workload, as nurses have to spend time dealing with non-existing symptoms, instead of spending it on patients that actually need help.
I conclude that hospital nurses should pay as much attention to the community aspects of healthcare as they do for their clinical practice when it comes to patients aged 65 years and older. Preventive action, information campaigning, and social contact would help reduce the chances of developing various psychological disorders such as depression. In addition, personal medical visits should become a more frequent practice, especially for those patients who have trouble leaving their homes. This may present a challenge to hospitals and other healthcare facilities in some distant communities, where personnel capabilities are limited. Nevertheless, nurses throughout the country should strive to cover as many older patients as it is humanly possible. Such activities will promote healthcare, vastly improve the quality of outcomes, and likely reduce hospitalization rates, as older patients will be able to take care of themselves and live healthily. It is said that the majority of diseases and health issues are easier to prevent than to treat later. By addressing community healthcare needs and paying attention to this particularly vulnerable population group, healthcare facilities would be able to reduce the workload on their hospitals, thus freeing up time and personnel to address these needs in full. As a result, the action will become a self-fulfilling prophecy, and the community will be better for it.
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13.3 percent in U.S. are seniors. (2013). Web.
Bascu, J.R., Jeffery, B., Johnson, S., Martz, D., Novik, N., & Aboniy, S. (2012). Healthy aging in place: Supporting rural seniors’ health needs. Online Journal of -Rural Nursing and Healthcare, 12(2), 77-87.
Conwell, Y., Van Orden, K., & Caine, E.D. (2012). Suicide in older adults. Psychiatric Clinics of North America, 34(2), 451-468.
Johanessen, M., & LoGiudice, D. (2013). Elder abuse: A systematic review of risk factors in community-dwelling elders. Age and Ageing, 42(3), 292-298.
Steptoe, A., Shankar, A., Demakakos, P., & Wardle, J. (2012). Social isolation, loneliness, and all-cause mortality in older men and women. PNAS, 110(15), 5797-5801.
Vasiliadis, H.M., Dionne, P.A., Preville, M., Gentil, L., Berbiche, D., & Latimer, E. (2013). The excess healthcare costs associated with depression and anxiety in elderly living in the community. The American Journal of Geriatric Psychiatry, 21(6), 536-548.