To remain healthy as a older adult several factors come into play. All elements of the individual’s life have to be looked at and studied. Do they eat right? Do they exercise enough? What is their social situation? By providing for these elements correctly a well-managed health and wellness program will benefit the Senior.
Poor nutrition in older adults happens because of a variety of conditions. Many Seniors live alone and are unable to get around as easily as before. This may restrict grocery shopping and food preparation. Also, depression may affect the older adult. Depressed Seniors may suffer from a lack of desire to eat or prepare food. Declining oral health may contribute to the level of food intake. Some medications, medical processes and treatments may cause loss of desire to eat. Finally economic status plays an important role in nutrition as the lower the status the less capable the Senior is at obtaining the level of proper nutrition. Some of the health risks to poor nutrition are:
? Hypertension (high blood pressure)
? Heart disease
? Vision loss (glaucoma, cataracts and macular degeneration)
Proper diet contributes favorably to the Senior’s life expectancy, emotional welfare and physical abilities. “The definition of a proper diet … encourages eating a low-fat, high-fiber, low-salt, low-sugar, and moderate-calorie regimen.” This diet may be achieved with the aid of the Food Guide Pyramid. The aging adult should have:
? 6-11 daily servings of breads, cereals, rice and pasta
? 3-5 daily servings of vegetables
? 2-4 daily servings of fruits
? 2-3 daily servings of milk, yogurt and cheese
? 2-3 daily servings of meat, poultry, fish, dried beans, eggs and nuts
? minimal amount of fats, oils and sweets
In addition to a proper diet nutritional supplementation is important. Some of the medications taken by Seniors interfere with the absorption of vitamins and minerals. The body for its health requires a certain amount of vitamins and minerals. A program designed to maintain the heath of the older adult must take these various facts into consideration. The diet must be tailored to the individuals needs. But all Seniors should be encouraged to
? Eat as the Guide Food Pyramid states.
? Limit fat intake, avoid high cholesterol foods.
? Increase dietary fiber wherever possible.
? Prepare foods that are moister, softer and in smaller portions to aid eating.
? Limit salts and increase calcium intake.
? Avoid sugar where ever possible.
? Drink 8 glasses of water a day.
By producing a health and wellness program that promotes these aspects the Seniors will experience good mental health, a better quality of life, more energy, and be able to recover faster from illnesses.
The health program must include regular physical activity as it helps the body to maintain and repair itself. “A primary benefit of regular physical activity is protection against coronary heart disease. In addition, physical activity appears to provide some protections against several other chronic diseases such as adult-onset diabetes, hypertension, certain cancers, osteoporosis, and depression.” Most Seniors even those with disabilities or ailments can take part in a modest exercise program. Other benefits to exercise are:
? lower blood pressure
? strengthens heart and lungs
? helps with movement and flexibility
? helps to control weight
? promotes good mental health
? improves digestion
It is important to offer the Senior various forms of exercise as well as class types. They may want to exercise within a group, with a friend or alone. The program must also offer different levels/types of exercise – brisk walking, swimming, jogging to yoga and stretching. The exercise should be done for a maximum of 30 minutes per session. Any older adult that has been inactive should start out with a lower level exercise. It should be noted that a doctor can evaluate the Senior best and help them decide which activity best suits them. Seniors with the following conditions will require medical clearance before attempting to exercise:
? high blood pressure
? heart / stroke history or trouble
? lung trouble
? arthritis or osteoporosis
? muscle problems
? any other medical condition
While intense exercise is not needed with the older adult a regular routine of moderate exercise is beneficial. A well-managed community exercise program includes exercises that are repeated several times a week for a minimum of 10 minutes. This program will include exercises that target the cardiovascular system as well as strength training.
To implement a health and wellness program that encompasses all of these dietary and fitness aspects it would have to be done in conjunction with the local Senior Citizen’s center or Senior Service Organization. Encouragement for the Seniors to join the program will have to come from doctors, family, friends and various health agencies. Obstacles such as environmental and social will have to be breached. By the community working together this program will be able to operate and flourish.
Topic B –The “Institutional Care Decision”
I am the caregiver for my elderly father and I must decide whether to place him in a nursing home. Before doing so I research the following.
Families are the primary caregivers for elderly adults. The caregiver frequently feels that it is their responsibility to care for the elderly family member. “Caregivers are motivated by altruistic reasons (e.g., feelings of empathy and attachment), social norms (e.g., feelings of generational reciprocity and responsibility), and personal motives including avoidance of guilt, fear of public censure, or a sense of indebtedness.”
Caregiving usually begins in the home. The caregiver feels that they are able to provide the home-based care without difficulty. But home care is not without its burdens. The negative aspects of the home care of the elderly are financial, emotional and social. The caregiver is forced to assume financial responsibilities they may not have planed for such as home renovations or hiring help. Socially the caregiver is require to spend more time in the home leaving less time for friendships and other relationships.
The greatest burdens tend to be emotional. These can be feelings of guilt, isolation and resentment. But positive benefits also are found: “(1) past memories of meaningful relationships with the recipient, (2) feelings of appreciation from the recipient, (3) efficacy and satisfaction with the quality of care they provide, (4) positive relationships with the larger social system, and (5) enhanced feelings of self-worth, master, and individual growth as a person.”
Stress may be experience by the caregiver from the “caregiver burden”. “Caregiver burden refers to the stresses associated with providing care*” This burden has been separated into two types; objective and subjective. A intrusion on the world of the caregiver is objective in nature. This is when changes happen within the lifestyle of the caregiver. Emotional intrusions to the caregiver are subjective caregiver burdens. Women tend to experience emotional stress more than men do from caregiving. This is due to the psychological makeup. Women tend to view the caregiving from an emotional standpoint and men tend to view it on a physical level. Also women are more likely to give up employment and outside interests to accommodate for caregiving responsibilities.
Signs of stress are:
? Anger at the elderly adult
? Withdrawing socially
? Emotional reactions
? Lack of concentration
? Health problems
To combat stress most adults use two types of basic coping strageies: problem-focused or emotion-focused. Problem-focused coping is when the individual uses the outer environment to help solve or manage the stress and emotion-focused coping involves internal resources to manage the stress. Research has found that individuals who use the problem-focussed method of managing stress are better able to cope with anxiety. Most adults use humor, suppression, anticipation or sublimation to cope with stress.
When the care taking of the elderly adult become too much for the caregiver the Senior maybe placed in an institution. This in itself will cause stress to both caregiver and Senior. The caregiver may face guilt at being unable to care further for the individual. The Senior may become confused at the move and disorientated within the institution. They might remove themselves emotionally from the event for a period of time. They may feel deserted by family. To relieve some of the stress on the Senior the caregiver can:
? Involve the Senior in as much of the decision making process as possible
? Maintain contact with the Senior
? Understand the feelings the Senior is experiencing
? Try to make the move as less intrusive as possible
? Include personal items in the Senior’s new environment
After identifying the signs of caregiver stress I am better able to make the decision on whether to place my father in an institution or not. After deciding that I can not care further for him I have determined that the best possible place would be for him in a care home.
The next step is to select a nursing home. These are the questions that would ask to help make the decision.
1. Physical setting
? What are the hallways and rooms like? Do they convey a pleasant atmosphere?
? Can the residents furnish their rooms with photographs, radios, TV or small decorative items?
? Are the hallways and rooms free of clutter?
? Is there a common room?
? Does the government regulate the nursing home?
2. Size and Population
? How large is the home?
? How many residents does it house?
3. Quality of Care
? Are the residents clear and show no sign of untreated skin sores or any other afflictions?
? Are there strong urine odors?
? Are there qualified professionals with geriatric training available?
? Are there activities for the residents’ daily?
? Are they encouraged to do as much for themselves as possible?
? What is the general mood of the staff?
? Are they understaffed?
? Does the staff continue to receive education in elderly care?
? Does the staff remain relatively stable?
? Are the fees within our budget?
? Are there any programs to help with costs?
Once these questions are answer I will be better informed as to which facility is best for my father. I will attempt to involve my father in the final decision. With that I would feel comfortable with the placement.
Hoyer, W.J., Rybash, J.M., Roodin, P.A., Adult Development and Aging, Fourth Edition, 1999. P.243
Hoyer, W.J., Rybash, J.M., Roodin, P.A., Adult Development and Aging, Fourth Edition, 1999. P.104.
Hoyer, W.J., Rybash, J.M., Roodin, P.A., Adult Development and Aging, Fourth Edition, 1999. P.127
Hoyer, W.J., Rybash, J.M., Roodin, P.A., Adult Development and Aging, Fourth Edition, 1999.