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One of the observable trends that emerges from a review of literature and research on gerontology nursing is the increasing development of specific frameworks and perspectives for use in the learning and practice of gerontology nursing (Deschodt et al. 2010; Toslon et al. 2011; Foreman et al. 2010). By developing specific educational programs for gerontology nursing and establishing learning environments that are dedicated to the specialization, the practice of gerontology nursing can be greatly improved and made more efficacious (Deschodt et al. 2010). Such educational programs also help to codify and concretize specific values that are important in gerontology nursing, ensuring that patient needs are met not only at medical but also at social and emotional levels (Tolson et al. 2011). These values can be translated into specific care practices and standards, which have also been developed through extensive research and evidence regarding the varying efficacies, efficiencies, and necessities of…
Deschodt, M., Casterie, B. & Milisen, K. (2010). Gerontological care in nursing education programmes. Journal of Advanced Nursing 66(1): 139-48.
Foreman, M., MIlisen, K. & Fulmer, T. (2010). Critical care nursing of older adults: best practices. New York: Springer.
Grando, V., Buckwalter, K., Maas, M., Brown, M., Rantz, M. & Conn, V. (2009). A Trial of a Comprehensive Nursing Rehabilitation Program for Nursing Home Residents Post-Hospitalization. Research in Gerontological Nursing 2(1): 12-25.
Phillips, L., Rantz, M. & Petroski, G. (2011). Indicators of a New Depression Diagnosis in Nursing Home Residents. Journal of Gerontological Nursing 37(1): 42-51.
The Charlson Comorbidity Index (CCI) is another tool frequently used with older adults (Charlson, Pompei, Ales & Mackenzie, 1987). It is comprised of 19 comorbid conditions that give a complete indication of the patient's state of health.
The basic activities of daily living (ADLs) include bathing, dressing, toileting, transferring, continence, feeding, communication, visual capability and walking. These functions are assessed through direct examination of the specific activity. Instrumental activities of daily living (IADLs) are those needed to live an independent life. They include the functional ability to shop, prepare food, clean house, do laundry drive or use public transportation and administer medications. These functions are assessed through house visits and as a cumulative evaluation of general geriatric assessment and psychiatric assessment tools.
Physicians commonly use the Mini-Mental State Examination (MMSE) and the Geriatric Depression Scale (GDS) to perform a cognitive and mood assessment respectively (De Vriendt, Gorus, Bautmans & Mets,…
Charlson M.E., Pompei P., Ales K.L., Mackenzie C.R. (1987). A New Method of Classifying Prognostic Co-Morbidity in Longitudinal-Studies -- Development and Validation. Journal of Chronic Diseases, 40, 373-383
De Vriendt, P., Gorus, E., Bautmans, I., Mets, T. (2011). Conversion of the Mini-Mental State Examination to the International Classification of Functioning Disability and Health Terminology and Scoring System. Gerontology, [Epub ahead of print]
Elsawy, B., Higgins, K.E. (2011). The geriatric assessment. Am Fam Physician, 83, 1, 48-56
Martin, T.A., Bush, S.S. (2008). Ethical considerations in geriatric neuropsychology. NeuroRehabilitation, 23, 5, 447-54
Martorello loves deep sea fishing, while I cultivated an interest in farm animals. I spent time as the Treasurer of the Campbell Chapter of the Future Farmers of merican (FF). My sheep won the Grand Champion award in the 1985 Santa Clara County Fair, a significant accomplishment. I also developed interest in the martial arts and I earned my black belt in Tai Kwon Do. Thus, Martorello and I share a passion for life that includes a wide variety of outdoor and sports activities.
Both Martorello and I were strongly influenced by his mother, who we called Nana. Nana worked as a contractor for the United States Government and her job allowed her to travel around the world. Martorello remembers the recipes she would bring back from overseas, whereas I remembered the tangible souvenirs. I was also influenced strongly by my maternal grandmother, who was a nurse. It was Big…
A positive attitude on life is one of the core character traits that Martorello and I share in common. Some of our fondest memories were us racing dirt bikes together, something that helped me appreciate outdoor and athletic activities throughout my whole life. Martorello loves deep sea fishing, while I cultivated an interest in farm animals. I spent time as the Treasurer of the Campbell Chapter of the Future Farmers of American (FFA). My sheep won the Grand Champion award in the 1985 Santa Clara County Fair, a significant accomplishment. I also developed interest in the martial arts and I earned my black belt in Tai Kwon Do. Thus, Martorello and I share a passion for life that includes a wide variety of outdoor and sports activities.
Both Martorello and I were strongly influenced by his mother, who we called Nana. Nana worked as a contractor for the United States Government and her job allowed her to travel around the world. Martorello remembers the recipes she would bring back from overseas, whereas I remembered the tangible souvenirs. I was also influenced strongly by my maternal grandmother, who was a nurse. It was Big Grandma, as she was known, who inspired me to pursue nursing as a career. Big Grandma was a nurse for 55 years and she taught me the fundamentals about caring and professionalism in the field of nursing.
Although Martorello was not a nurse, his caring attitude toward family has influenced my own parenting style. I now have two grown children who have inspired me just as Martorello was inspired by his children. Watching them grow and develop their likes and dislikes reminds me of how important family ties can be in developing self-esteem. Like both my grandmothers, Martorello remained loyal to one career throughout his entire life. Times have changed and long-term career options are less possible now but I do intend to have a fulfilling career as a nurse. Martorello's strong family background has persisted throughout the generations.
The interview subject is from Germantown, Pennsylvania, the third of seven children. For the purposes of this report and to preserve her anonymity, we will call her Ms. S. Ms. S's mother did everything she could to keep her family together through difficult financial times. They had to squeeze the entire household into their grandmother's house, and even had to go "junking," sifting through trash to find valuable things people had tossed out. As she reflects, Ms. S bears a lot of joy and pride in her face. She remembers learning how to sew her own prom dress and other worthwhile tools of survival many people neglect to learn now. Although it was a struggle, her family stayed together and because of their love and support for one another, they retained something money cannot buy.
As a black woman, Ms. S was never told that she should prepare herself…
The research study framework explains the theory or a part of the theory that is to be tested in the research study. The framework shows the relationship between the different variables and helps to create the hypothesis which is to be tested in the research.
The important concepts of quantitative study design are introduction, methods, results, discussion, conclusion and recommendation.
List the type of quantitative research design and briefly describe how each would be used in a research study.
There are four types of quantitative research design (Gay, L.. 1996):
Descriptive: This type of research is used to test hypothesis or answer a question regarding the current status of subject.
Correlational: This type is used to find out the relationship between two or more quantifiable variables.
Cause Comparative: This quantitative research creates the cause-effect relationship and also compares the relationship without manipulating the cause.
Experimental: This research is similar…
Gay, L.R. (1996). Educational research: Competencies for analysis and application.
Upper Saddle River, NJ: Merrill.
Polit, H and Beck, T. (2008). Nursing Research. 8th ed. Williams and Wilkins: New Delhi.
World Health Organization and Public Health Agency of Canada. (2005). Preventing chronic diseases. A vital investment. Retrieved (online) December 20, 2011 from http://www.who.int/chp/chronic_disease_report/en/index.html
(McCormack, 2003, p.1)
V. Seven Concepts that are 'Key' to Client Centered Practice
The work of Law et al. (1995) relates seven concepts that are stated to be 'key to client centered practice' as follows:
(1) Autonomy and Choice
(2) Partnership & Responsibility
(4) Contextual Congruence
(7) Respect for diversity. (McCormack, 2003, p.1)
VI. Patient and Informal Expertise and Knowledge
The work of Loeb, et al. (2003) entitled: "Supporting Older Adults with Multiple Chronic Conditions" states that nurses "have studied the experience of chronic illness within relational and social contexts, depicting persons who live with chronic illnesses as active agents of their own health." (p.3) This view involves the individual as "active agents of their own health…" who "develop expertise both in awareness of their bodily responses and in managing the self-care required by their unique types of chronicity." (Loeb, et al., 2003, p.4)…
McCormack, Brendan (2006) Development of a framework for person-centered nursing. Journal of Advanced Nursing. Vol. 56 Issue 5. Blackwell Publishing.
McCormack, Brendan (2004) A Conceptual Framework for Person-Centered Practice with Older People. International Journal of Nursing Practice. Vol. 9 Issue 3. Blackwell Publishing Asia Pty Ltd.
Loeb, S. et al. (2003) Supporting Older Adults Living with Multiple Chronic Conditions. Journal of Nursing Research. 2003 25(1).
Personal data: fill as you see fit
Referral: depressed, poor sleep,
Family Background: raised by parents and older siblings
Family medical/psychiatric history: brother had heart attack; mother had issues with drugs and alcohol
Marital/family relationships: widow with four children and eight grandchildren
Social development: maintains friendships, supportive friends, attends social functions
Strengths: kind, nurturing, empathetic, understanding, calm
Weaknesses: can be impatient, overbearing with family members
Educational history: middle school
Employment history: retired; worked as live-in housekeeper for over twenty years
Military history: none
Spiritual assessment: attends Catholic Church regularly
Financial history: dependent on others
Patient health and psychiatric history: hypertension
Alcohol and drug abuse: none
Sexual identity and history: heterosexual
Physical, sexual, and emotional abuse and neglect history: none
Current living support system: lives with family
Identity: has insight
Ethnicity, culture, and values: Hispanic
Legal status and history: none; person entered U.S. As illegal immigrant but later acquired…
Black women enjoy most of these same relationships, which the study creators did not anticipate. The studies also discovered that even those aging blacks with few family members are good at establishing a network of close friends and distant relatives for support and kinship. For example, the study found if a man has no children, he might become increasingly close to his nieces, nephews, and cousins in an attempt to create a network of support and family ties. To the people in the study, kinship and family seems to become more important as they age, and without a network of friends, the aging person can become lonely, depressed, and disassociated from the outside world. One of their important results notes that more studies about black family relationships should be conducted over a larger demographic area.
Johnson, C.L. (Summer 1999). Family life of older black men. In Journal of Aging…
Johnson, C.L. (Summer 1999). Family life of older black men. In Journal of Aging Studies, 13, p145. Retrieved September 07, 2006, from Expanded Academic ASAP via Thomson Gale: http://find.galegroup.com/itx/infomark.do?&contentSet=IAC-Documents&type=retrieve&tabID=T002&prodId=EAIM&docId=A55240799&source=gale&userGroupName=lom_accessmich&version=1.0
The DPAHC permits a person to name a successor to their proxy in the event that the proxy dies or otherwise not capable to assist in making choices at the time of need. It also permits a person to ascertain other constraint for boundaries of power. In most states it would also be legal to unite the two documents if a person wanted to (Cranston, n.d.).
Discussions with relatives, legal personnel, healthcare and other appropriate experts should take place before anyone signs an Advance Health Care Directive. It is mainly important to talk with everyone who might be concerned about a persons wish because in times of strain, others may confuse their own wishes with the persons in question. People responsible for overseeing directives often come up against opposition from care providers, friends and other relatives. In order to stay away from possible conflict, and even court action, people must…
Cranston, Robert E. (n.d.). Advance Directives and "Do Not Resuscitate" Orders. Retrieved November 2, 2010, from The Center for Bioethics & Human Dignity Web site:
Law for Older Americans: Health Care Advance Directives. (n.d.). Retrieved November 2, 2010,
from American Bar Association Web site:
One can effectively build a senior market campaign around newspaper, radio and direct mail. One thing to take into consideration is that seniors like to learn. This means that one can draw in seniors via educational opportunities. ecently the financial services industry capitalized on this attribute by attracting seniors through seminars. The medical industry also uses seminars in order to gain new clients. Seniors go because they want to learn about issues that they feel are important in their lives. Seminar offerings can be expanded into a lot of fields as a way to take advantage of senior's desires to learn (Marketing to Seniors, 2006).
Along these same lines, seniors like to read. They have the time to do so and recent research has shown that the senior audience is the main reader group of daily newspapers. It appears to be clear that if one wants to market to seniors,…
Accessibility Laws and Regulations -- Residential. (2000). Retrieved August 10, 2010, from ToolBase Services Web site: http://www.toolbase.org/Home-Building-Topics/Universal-
Aging in Place Solutions to a Crisis in Housing and Care. (2002). Retrieved August 10, 2010,
from Neighbor Works Foundation Web site:
This does not mean that culture excuses a student from learning -- far from it -- only that teachers need be mindful of the specific values of different student's culture when imparting specific batteries of knowledge.
It is also important to remember that because culture does attach meaningful significance to identity issues such as race and gender, and what is remembered generates meaning, that our culture remains lopsided in its inequitiable treatment of women in prominent fields is. A 1996 survey of major American newspapers revealed that 85% of front page stories were about men. (Cited by Moyer, 1997, 1) hen participants in a study were asked to 'remember' on the spot ten prominent people, the figures were mostly Caucasion and male. However, with appropriate cuing, a 1995 study found that instructions intended to activate either a category of famous men or a category of famous women succeeded in altering…
Cherry, Katie & Martin W. Jones. (Jan 1999) "Age-related differences in spatial memory: effects of structural and organizational context." Journal of General Psychology. Retrived 27 Jan 2005 at http://www.findarticles.com/p/articles/mi_m2405/is_1_126/ai_54626720/pg_5
Lutz, John, Amanda Briggs, Christy Cain. (April 2003) An examination of the value of the generation effect for learning new material. Journal of General Psychology. http://www.findarticles.com/p/articles/mi_m2405/is_2_130/ai_101939295
McDougall, Graham J. (2004) "Memory Self-Efficacy and Memory Performance Among Black and White Elders." Nursing Research. Sept./Oct. 2004. 53(5), 323-331. Retrieved from Medline 26 Jan 2005 at http://intapp.medscape.com/px/medlineapp/getdoc?ord=1&searchid=2&have_local_holdings_file=1&local_journals_only=0&searchstring=McDougall+white+and+black+elders+memory
Moyer, Robert S. (Oct 1997) "Covering gender on memory's front page: men's prominence and women's prospects." Sex Roles: A Journal of Research. Retrived 27 Jan 2005 at http://www.findarticles.com/p/articles/mi_m2294/is_n7-8_v37/ai_20383104
Gerontology called Psychological Aspects Aging
Retirement can have a strong effect on a person's life and on how he or she comes to perceive society in general. The fact that people end a long chapter in their lives when they retire means that they are likely to be somewhat confused and unsure regarding their future. One of the most intriguing aspects of this process involves the person's identity and the way that it is transformed. Many are inclined to believe that their jobs kept them active and gave them a sense of purpose. These respective individuals can thus feel that they abandoned an important part of their lives when they retired and that even though they have more time at leisure they are unable to actually appreciate it to the fullest.
The fact that people currently have access to substances that make it more likely for them to live longer…
Barrett, A.E. & Redmond, R. "Avoiding Aging? Social Psychology's Treatment of Age." Am Soc (2012) 43:328 -- 347 DOI 10.1007/s12108-012-9157-2
Knight, B.G. & Durbin, K. "Aging and the effects of emotion on cognition: Implications forpsychological interventions for depression and anxiety." PsyCh Journal 4 (2015): 11 -- 19 DOI: 10.1002/pchj.84
Osborne, J.W. "Psychological Effects of the Transition to Retirement," Canadian Journal of Counselling and Psychotherapy / 45 Revue canadienne de counseling et de psychotherapie ISSN 0826-3893 Vol. 46 No. 1 © 2012 Pages 45 -- 58
For example, one-75-year-old may be running a corporation, whereas another may need nursing home care" (Morgan, 2003, p. 1592).
Additionally, the long duration of psychoanalytic therapy may demand that even for very vibrant older individuals, a more directive approach is necessary for the therapist to speed things up and meet therapeutic goals within a realistic time frame. This can be challenging to the analyst, as the patient's unconscious beliefs and associations, given the person's age may be more complex, personal, deeply-rooted and therefore harder to eradicate. Additionally, "unfocused reminiscing may not be suitable for persons who have trauma histories, such as Holocaust survivors, or for persons who have early dementia" (Morgan, 2003, p. 1592). However, it was the psychoanalytic theorist Erik Erikson who first developed a stage-based theory about the needs of the aged and Erikson's theory can inform the process of psychoanalysis in an effective manner and provide a…
Arehart-Treichel, Joanne. (2001, January 19). Psychotherapy changing lives of elderly patients.
Psychiatric News, 36 (2): 12-44. Retrieved July 8, 2010 at http://pn.psychiatryonline.org/content/36/2/12.1.full
Armstrong, Thomas. (2007, May1). Maps of the human life cycle. The Human Odyssey.
Retrieved July 8, 2010 at http://www.thehumanodyssey.com/2007/05/maps_of_the_hum.html?cid=6a00d8341d195853ef012875bdd6cc970c
It is therefore also my duty to provide families and older people with counseling and educational services that take all these factors into account. With an increasing number of people aging in society today, it is vital for professionals in the field to help family make decisions at crucial points in their lives. This would provide both families and older people with the power of decision-making that would ultimately result in the best quality of care that older persons may expect when entered into institutions.
Specifically, my educational role could take several forms, but would also mean focusing on the greatest benefit to all parties involved. This would mean providing information to the public regarding the decision to make use of caregiving services, either at home or in an institution. This can be done by means of seminars, office or home visits, or by means of simply making pamphlets available…
Holstein, M.B., Parks, J.A., and Waymack, M.H. (2011). Ethics, Aging, and Society. New York: Springer Publishing Company.
Geriatric patients between the ages of 70 and 95 have very different needs from those of their younger counterparts. In part, these are due to differences that have clear physiological bases. These structural and physiological differences necessitate different assessment and interview techniques. It is necessary to ensure that one gets all the correct and up-to-date information about any patient, and in the cases of both children and geriatric adults, this can become problematic.
Cognitive deficits that may be related to dementia are one possible hurdle that must be overcome in the case of interviewing older patients. It is important to recall that not all dementia is Alzheimer's-related, and many cases are a natural result of the aging brain. (It is useful for the health care professional to recall that the original disease diagnosed by Dr. Alzheimer related to pre-senile dementia: in other words, a dementia occurring physiologically much earlier than…
Carey, M. (2011). Geriatric assessment: Essential skills for nurses. American Nurse Today. Retrieved March 11, 2016, from http://www.americannursetoday.com/geriatric-assessment-essential-skills-for-nurses/
Comprehensive Geriatric Assessment. (n.d.). Retrieved 2016, from http://ocw.tufts.edu/data/42/499797.pdf
Nursing Students Attitude Towards the Elderly: Literature Review
The changing demographics in many of the populations in industrialized countries has changed the aggregate needs of the nursing workforce and this trend is expected to continue into the future as the population continues to age. One issue that has arisen is that the younger generation of nurses have demonstrated through various means that their preference for their nursing roles within organizations is not for working with the elderly patients. Therefore, a gap exists between the demand for nursing jobs that deal with elderly patients and the supply of nursing students that are willing to fill these positions. This article will look at two research efforts that try to focus on this precise trend and provide information about how this trend could possibly be reversed and finding a more optimal point in the supply and demand for nursing positions in the future.…
Bleijenberg, N., Jansen, M., & Schuurmans, M. (2012). Dutch nursing students' knowledge and attitudes towards older people - A longitudinal cohort study. Journal of Nursing Education and Practice, 1-8.
Haron, Y., Levy, S., Albagli, M., Rotstein, R., & Riba, S. (2013). Why do nursing students not want to work in geriatric care? A national questionnaire survey. International Journal of Nursing Studies, 1558-1565.
Mr. P is suffering cardiomyopathy, congestive heart failure, 4+ pitting edema, labored breathing, and an inability to stick to a restricted diet or manage his polypharmacy. He is 76-years-old and in a state of declining health. The medical bills are mounting (and indeed have become overwhelming for Mrs. P who has never had to deal with the couple's financial affairs, as they were always taken care of by Mr. P). The couple is depressed/despondent: Mr. P over his inability to understand why God allows him to linger in this condition rather than just take him immediately, Mrs. P over her inability to have a moment of rest outside the home, where she tends to her husband. Life is difficult for the two. This paper will consider the condition of Mr. P, how it affects Mrs. P, and how the situation can be approached so as to provide a high degree…
Barry, C. B. (2000). Teaching the older patient in the home: Assessment and adaptation. Home Healthcare Nurse, 18(6): 374.
Connor, S. (2009). Hospice and Palliative Care. CRC Press. Boca Raton, FL: CRC
Older Americans Act (OAA) was first passed in 1965, alongside Medicare and Medicaid. Whereas Medicare and Medicaid offered extended insurance benefits through the federal government, the OAA established "the foundation for a system of services and supports that enables millions of older adults in this country to continue to live independently as they age," ("The Older Americans Act: Aging Well Since 1965," (The Older Americans Act: Aging Well Since 1965," n.d.). Along with its federal provisions, the OAA freed up grant money for the states to develop " community planning and social services, research and development projects, and training personnel in the field of aging," (The Older Americans Act: Aging Well Since 1965," n.d.). Basically, the OAA created an actual infrastructure to support America's aging population.
The OAA is currently comprised of seven titles:
• Title I: Declaration of Objectives
• Title II: Administration on Aging (Aoa)
• Title III:…
Simulation #1 -- Degenerative Arthritis and Macular Degeneration
In this simulation, I placed Band-aids around the middle joints of my fingers and I wore an athletic wrist support on one hand that severely limited my wrist motion. The Band-aids were tight enough to make it almost impossible to bend my fingers except with considerable discomfort. I also placed a smudge of Vaseline in the center of the lenses of clear protective construction goggles to simulate the loss of center vision associated with age-related macular degeneration. The purpose of this set up was to simulate the types of arthritic symptoms in my hands and wrist that elderly people deal with routinely. The plan was to go about my day at home and encounter some of the problems associated with aging.
Immediately, I encountered difficulty doing my normal morning chores. Brushing my teeth took much longer, made a mess of…
real encounter with nursing. The encounter occurred when I first accompanied my mother to the hospital to get her treatment. That day, I felt an urgent need to become a nurse. This is because I saw that most of the nurses and other health professionals in the hospital were always pressed for time and patients, including my mother, had to wait for long periods of time before getting attended to. That experience revealed to me a gap that I was confident I could help fill in however little way I could. Realizing that the only way I could get to pursue my dream of becoming a nurse was through education, I started putting a lot of effort in school and my academic performance is proof of that. However, being brought up by a single mother compounded what was already a difficult situation. My mother had to go through a lot…
If anything, such a person may have regrets over having wasted too much of life on impersonal achievements and selfish pursuits.
6. Do you agree that in later life men become more nurturing and women more assertive? What do you think are the findings that could support or challenge that observation?
The observation that men tend to become more nurturing, less competitive, less aggressive, and "gentler" in later life and that women tend to become less emotional and more confident or assertive would seem to be substantially true. That is largely attributable to hormonal changes; specifically, aging males tend to produce much less testosterone and post-menopausal females secrete less estrogen in their later years (Pinker, 2002). Naturally, those hormonal changes would be expected to result in various behavioral changes in areas where human behavior (and gender-specific behavior in particular) are products of the secondary sex hormones (Gerrig & Zimbardo, 2008;…
Bearon LB. "Successful Aging: What does the 'good life' look like?" Concepts in Gerontology Vol. 1, No. 3, (Summer 1996).
Birren JE. And Schaie KW. (2006). Handbook of the Psychology of Aging. Burlington,
MA: Elsevier Academic Press.
Gerrig R. And Zimbardo P. (2008). Psychology and Life. New York: Allyn & Bacon.
Vitamin D Supplementation increases Voluntary Physical Activity Levels in Nursing Home Patients
Over the course of a semester does vitamin D3 supplementation, and the resultant increase in muscle strength and bone density, lead to increased physical activity in nursing home residents in the absence of added encouragement?
The elderly often suffer from low serum levels of vitamin D, reduced muscle strength, and decreased bone density (reviewed in: Hamilton, 2010). Muscle biopsies have revealed that the muscle fibers most affected in the elderly are type II, the 'fast twitch' fibers. When a person begins to fall they instinctively attempt to prevent or break their fall and this reaction depends heavily on fast twitch muscle fibers. The elderly therefore suffer from an increased risk of falling down and bone fractures. Although conclusive evidence has yet to be found that low serum levels of vitamin D cause this condition, there is a large…
Hamilton, B. (2010). Vitamin D and human skeletal muscle. Scandinavian Journal of Medicine & Science in Sports, 20, 182-190.
Williamson, J.D., Espeland, M., Kritchevsky, S.B., Newman, A.B., King, A.C., Pahor, M., et al. (2009). Changes in cognitive function in a randomized trial of physical activity: Results of the Lifestyle Interventions and Independence for Elders pilot study. Journal of Gerontology, 64A, 688-694.
Semba, R.D., Houston, D.K., Ferrucci, L., Cappola, A.R., Sun, K., Guralnik, J.M., et al. (2009). Low serum 25-hydroxyvitamin D concentrations are associated with greater all-cause mortality in older community-dwelling women. Nutrition Research, 29, 525-530.
European Organization for Research and Treatment of Cancer (2010). QLQ-C30 questionnaire. Retrieved from http://groups.eortc.be/qol/downloads/modules/specimen_20qlq_c30.pdf
Not only that, the results of eating badly is harmful. Holland and Barrett magazine reports: "If your diet isn't as balanced as you'd hope for, there's a chance you could be missing out on L. Trytophan - an important amino acid that plays a vital role in the production of brain chemicals." If one's diet is lacking it, the safest way to get this supplement is in the form of 5-HTP - a natural compound that the body produces from L-Trytophan. 5-HTP is believed to help the body produce serotonin, a chemical that regulates mood, sleep and other brain-related functions. (Pearce, 1999)
In aging people who seem to have no appetite, there actually may be a sensory dysfunction, which keeps that person from enjoying food and other things that are sensed through taste and smell. Susan S. Schiffman, Ph.D. pointed out that in the elderly these senses are not entirely…
About Dementia. http://www.about-dementia.com/.2006.
Davis, Alison. "Stress -- it might be even worse than you think," a Summary of the Conference "Biology of Stress" co-sponsored by the OBSSR and NIGMS, April 12, 2006.
Huang, Cindy S., et al. "Common Molecular Pathways Mediate Long-Term Potentiation of Synaptic Excitation and Slow Synaptic Inhibition." Cell (Journal), Volume 123, Issue 1, 7 October 2005, Pages 105-118.
Pearce, Gillian. Depression Antidotes Newsletter. Thu, 15 Jul 1999-18:35:21 -0400.
While it is true that in many countries like Canada there has been a reduction in vulnerabilities such as poverty among the elderly, it is equally true that;
some 3.3 million seniors still live below the poverty line Good housing and proper medical care are often out of reach for the poor elderly -- or so expensive that little money is left over for other needs. Hundreds of thousands of elders go hungry every month. (Callahan, 1999, p. 74)
Poverty is however also a strong indicator of elderly vulnerability in Canada; where the lack of resources is also linked to safety and security issues. Many elderly people live alone and they become more vulnerable to abuse and attack if they so not have enough funds to afford adequate home security. As one Canadian resource notes; "Examples include safety devices that would reduce their chances of a fall or an alarm…
Abuse of the elderly. Retrieved February 10, 2009, at http://whqlibdoc.who.int/publications/2002/9241545615_chap5_eng.pdf
Ageism: Canadian Network for the Prevention of Elder Abuse. Retrieved February 10, 2009, at http://www.cnpea.ca/ageism.htm
Barer M. And Hertzman C. (1972) on Being Old and Sick: The Burden of Health Care for the Elderly in Canada and the United States. Journal of Health Politics, Policy and Law, 17(4), pp.763-782.
Brownell P., Welty a., Brennan M. Elder Abuse and Neglect. Retrieved February 10, 2009, at http://www.aging.state.ny.us/explore/project2015/artabuse.htm
interview was to learn the life of Mr. Mike obinson, my 65-year-old retired neighbor from the town next to me, in Sudbury. I selected this person because it will allow me to understand some of the core issues related to aging. My interactions with Mike obinson before this interview were cordial and I believed that his example might shed light on some of the theories of aging we are covering in class. I believe that he is a good example of how aging theories can be applied to help people, because Mr. obinson is aging in a way that is healthy due to his strong social support system and positive attitude on life.
Within this report, I intend to learn about his life conditions as well suggest and inform ways to improve the person's life. After interviewing Mr. obinson on two different occasions, I gained some knowledge on how he…
Dowd, J.J. (1975). Aging as exchange. Journal of Gerontology 30(5): 584-594
Havighurst, R.J. (1961). Successful aging. The Gerontologist 1(1961): 8-13.
The Health Authority (2010).
Miller, S.M. & Barrow, G.M (2010). Aging, the Individual, and Society. Cengage.
reason I selected the University of Alabama at Birmingham School of Nursing for graduate studies in nursing is because I ultimately seek to become a leader in the field of nursing, and there are several facets of this institution that legitimize its "vision to sustain nursing leadership worldwide." In particular, I was attracted to the synthesis of different disciplines and areas of erudition that the UAB School of Nursing emphasizes as part of its graduate education in this field, which include various aspects of management, economics, information technology, marketing and consultation to equip graduates with the necessary skills to perform as leaders within this profession.
It is increasingly necessary for nurses in advanced positions to utilize evidence-based practices as part of their means to fulfilling their responsibilities. The UAB School of Nursing, with its research center providing funded opportunities to counter some of the most pressing health care issues in…
Egenes, K.J. (2012). The nursing shortage in the U.S.: a historical perspective. Chart. 110(4), 18-22.
Harper, D.C. (No date). About our school. www.uab.edu. Retrieved from http://www.uab.edu/nursing/home/about
Marelli, T.M. (2013). The good, the bad and the ugly in the changing healthcare landscape: the role of nurse practitioners in meeting increasing demand for primary care (the good), CMS and contractor oversight of home health agencies (the bad), and the sad demise of the Medicaid hospice benefit in Louisiana (the ugly). Home Health Care Nurse. 31(3), 121-123.
UAB Nursing. (2013). Nurse practitioner family primary care. www.uab.edu. Retrieved from http://www.uab.edu/nursing/home/images/stories/info_sa/MSN_Flyer_NP_Family.pdf
Social Construction of Aging in Nursing Homes
Aging is socially constructed. Using the perspective of symbolic-interactionism, it is possible to show the precise processes whereby the social construction of aging takes place inside specific institutional contexts, like the American nursing home. The American nursing home offers insight into the culturally constrained concept of aging, for attitudes towards aging bodies and aging as a philosophical concept are informed by cultural milieu, worldview, and value construction. Biological aging is not social aging. The positive aging movement and the harmonious aging movement offer counterpoints to traditionally antagonistic and negative views of aging. Especially as the population of the United States and other industrialized nations shifts towards the older end of the age spectrum, it becomes important to reconsider the biological, psychological, and social processes and functions of aging.
The nursing home offers the opportunity to examine aging from a multidisciplinary perspective, while using…
Bengtson, V.L. & Deliema, M. (2016). Theories of aging and social gerontology. In Gerontology: Changes, Challenges, and Solutions. ABC-CLIO.
Featherstone, M. & Hepworth, M. (1995). Images of positive aging. In Images of Aging. Taylor & Francis.
Gergen, K.J. & Gergen, M.M. (2000). The new aging. Social Structures and Aging. New York: Springer. Retrieved online: http://www.swarthmore.edu/sites/default/files/assets/documents/kenneth-gergen/The_New_Aging.pdf
Katz, S. (2005). Cultural Aging. Canadian Journal of Sociology Online, Jan-Feb 2006. Retrieved online: http://www.cjsonline.ca/pdf/culturalaging.pdf
, 2012). When considering housing for this group it is important to make sure that you do not isolate someone sharing their spiritual or religious beliefs. A social worker who does not keep up with the understanding of the individuals with whom they work could be inadvertently setting up a disaster for such an elderly individual. It is always important to discover, praise, and attend to new developments and changes regarding all aspects of the clients with which the social worker involved.
Christensen, H. (2001). What cognitive changes can be expected with normal ageing?
Australian and New Zealand Journal of Psychiatry, 35, 768 -- 775.
Escobar-Bravo, M.A., Puga-Gonzalez, D., & Martin-Baranera, M. (2012). Protective effects of social networks on disability among older adults in Spain. Archives of Gerontology and Geriatrics, 54(1), 109-116.
Hodge, D.., Horvath, V.E., Larkin, H., & Curl, a.L. (2012). Older adults' spiritual needs in health care…
Christensen, H. (2001). What cognitive changes can be expected with normal ageing?
Australian and New Zealand Journal of Psychiatry, 35, 768 -- 775.
Escobar-Bravo, M.A., Puga-Gonzalez, D., & Martin-Baranera, M. (2012). Protective effects of social networks on disability among older adults in Spain. Archives of Gerontology and Geriatrics, 54(1), 109-116.
Hodge, D.R., Horvath, V.E., Larkin, H., & Curl, a.L. (2012). Older adults' spiritual needs in health care settings: A qualitative meta-synthesis. Research on Aging, 34(2), 131-155.
Program Budget and Cost Analysis
Line-Item Budget for an in-Service Dementia Care Training Program
Florida now requires all direct-care staff working with dementia patients to receive specialized training. The curricula offered must be vetted by the Training Academy of the University of South Florida's Policy Exchange Center on Aging, otherwise assisted living facilities, nursing homes, adult day care, and hospices will be unable to accept patients with dementia into their facilities. In order to meet these statutory requirements and improve patient care, an in-service training program in dementia care will be instituted for a hospice facility located in Florida.
The Hospice House in Cape Coral, Florida maintains 36 beds for patients with terminal illnesses. On average, a little over 60% of the residents suffer from dementia at any one time, which is consistent with national trends (Williams, Hyer, Kelly, Leger-Krall, and Tappen, 2005, p. 98). The number of patients tends…
CMS (Centers for Medicare & Medicaid Services). (n.d.). Hospice Center. CMS.gov. Retrieved 13 Mar. 2012 from www.cms.gov/Hospice/Downloads.2011_Aggregate_Cap.pdf.
Goyder, Judith, Orrell, Martin, Wenborn, Jennifer, and Spector, Aimee. (2012). Staff training using STAR: A pilot study in UK care homes. International Psychogeriatrics, published online ahead of print, p. 1-10. Retrieved 13 Mar. 2012 from http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=8473487 .
Hobday, John, V., Savik, Kay, Smith, Stan, and Gaugier, Joseph E. (2010). Feasibility of internet training for care staff of residents with dementia: The CARES® Program. Journal of Gerontology Nursing, 36, 13-21.
Hyer, Kathryn, Molinari, Victor, Kaplan, Mary, and Jones, Sharmalee. (2010). Credentialing dementia training: The Florida experience. International Psychogeriatrics, 22, 864-873.
Right to Die
For the last few decades, the issue of a person's right to choose the time and method of his or her own death has been one of passionate debate in the United States, with emotions running high on both sides of the controversy as the meanings of liberty and freedom of choice, the morality of taking one's own life, the ethics of people involved in such actions, and the laws related to this issue take center stage in the arguments.
Since civilization began, suicide has existed in one form or another, with varying degrees of acceptance, such as the ancient Greeks who held tribunals for elderly people who requested to die, and if approved, were given hemlock and during the first century B.C. actually held annual banquets where the elderly were allowed to attend and drink poison if they felt they had lived long enough.
Brennecke, Shari J. "Right to Die: An Overview" Gerontology Manual. http://otpt.ups.edu/Gerontological_Resources/Gerontology_Manual/Brennecke.html .(accessed 12-03-2003).
Chachere, Vickie. "Judge appoints professor as guardian for brain-damaged woman in Florida." AP Worldstream. November 01, 2003. http://ask.elibrary.com/getdoc.asp?querydocid=1P1:86544618&dtype=0~0&dinst=0&pubname=AP+Worldstream&author=VICKIE+CHACHERE%2C+Associated+Press+Writer&title=Judge+appoints+professor+as+guardian+for+brain%2Ddamaged+woman+in+Florida&date=11%2F01%2F2003&query=Terry+Schiavo+and+the+State+of+Florida%2E&maxdoc=30&idx=2&ctrlInfo=result%3ASR%3Aprod.(accessed 12-03-2003)
Cruzan v. Director, Missouri Dept. Of Health." Citation: 497 U.S. 261 (1990)
Concepts: Right to Die/State Police Powers. http://www.tourolaw.edu/patch/CaseSummary.html .(accessed 12-03-2003).
A major factor underlying whether active or passive euthanasia is legal is whether the doctor intends to kill the patient or not (Lewis, 2009, p. 126). Rachels hits on the intent piece in one of his constructed examples, "Rather, the other factors - the murderer's motive of personal gain, for example, contrasted with the doctor's humanitarian motivation -account for different reactions to the different cases." The Colombian Constitutional Court actually ruled doctors are negligent if they ignore a terminally ill, competent patient's request for active euthanasia, a position which actually moves closer to Rachels' side of the debate (Michlowski, 2009, p. 192). The Canadian Medical Association's inquiry into Belgian euthanasia included asking about the doctors' "explicit intention of hastening the end of life or of enabling the patient to end his or her own life" (Chambaere et al., 2010, p. 896). This intent underlies the principle of "double effect,"…
Nor do professional associations provide a clear consensus to anyone outside their membership, because they often contradict each other. Many of them disagree with the AMA position Rachels frames his argument in terms of. The American Geriatrics Society (AGS) asserts "Most would choose to live if they had full confidence that the care system would serve them well," and so justifies continued prohibition of voluntary assisted suicide and monetary compensation for the practice thereof, using most of the criteria discussed in my research. On the other hand, the American Psychological Association's assertion that the cognition behind the terminally ill patient's decision to die differs from the logic employed by the clinically depressed in deciding to commit suicide is echoed by the American Public Health Association, the American Academy of Hospice and Palliative Medicine, and the American College of Legal Medicine, who justify their recommendation against the negative associations between suicide and what they describe as "the principles of personal autonomy and free will" on grounds of material difference long recognized by the U.S. Supreme Court (Tucker & Steele, 2007, p. 325).
A fourth commonality that runs through the discussion but with much less prominence is a qualification that a patient's decision can be overridden if euthanasia has significant effects on people other than the patient, although those effects are even more rarely, if ever, defined. The Columbian courts qualified their acceptance of personal autonomy as sovereign under the constitution with the competency requirement but also where the exercise of that autonomy carried only " private nonpublic effects" (Michlowski, 2009, p. 192). The petitioner who brought the Columbian complaint claimed in part that non-voluntary euthanasia ("mercy-killing" to the 1973 AMA) left the doctor free to "end the lives of those who are regarded as an obstacle, a nuisance, or whose health raises high costs" (Michlowski, 2009, p. 186), but the court took it upon itself to generalize this even farther. This 'externality' effect rarely appears in such abstract terms, but runs throughout the research and opinion on the ethics of euthanasia in various guises.
The newer AMA policy statement claims euthanasia "would pose serious societal risks," without elaborating specifically what those may be (1996). Numerous patients have included consideration of their family's emotional pain caused by prolonged terminal illness as a factor leading them to choose euthanasia (Chambaere et al., 2010, p. 897); but fewer overtly discuss the callous topic of monetary expense as a factor in that decision. Tucker and Steele mention that voluntary euthanasia consumers may consider the cost to their estate, but only in passing (2007, p. 322). Campbell (2005, p. 45) claims family concern is justified under some Buddhist and Hindu perspectives if the choice to take life is made out of compassion for
3. Early adulthood (17-45): characterized by greatest energy and abundance and likewise by greatest contradiction and stress. This is the era of drive, ambition, obligations, and attempts to succeed in all areas of life. Whilst potentially fulfilling, it can also provide enormous bouts of stress.
4. Midlife Transition (40-45): Levinson (in sync with Jung, Erickson, and Ortega) sees this era as constituting a sharp break between early adulthood and middle adulthood manifested by greater focus on others as opposed to self and by a more humane and reflective temperament and perspective.
5. Middle adulthood (40-65): Our biological capacities are somewhat weakened. Our focus transfers from ourselves to others, and we feel a responsibility for the future generation.
6. Late Adult transition (60 +) is a synthesis and linkage of both middle and late adulthood
Levinson defines "life structure" as consisting of the individual's relationship to significant others and/or to significant…
Finally, Levinson suggests that it is imperative to make key choices, form a structure around these choices, and to pursue values and goals. One's key choices are imperative to forming one's destiny.
Levinson, D. (1986). A conception of adult development, American Psychologist, 41, 1, 3-13
" (Stone, 2006) Treatment is stated by Stone (2006) to be "diagnosis dependent and may be medical or surgical." Practical modifications include simple steps such as crushing of pills or opening of capsules to ease and facilitate swallowing.
The work of Leibovitz, et al. (2007) entitled: 'Dehydration Among Long-Term Care Elderly Patients with Oropharyngeal Dysphagia" states that long-term care (LTC) residents in the nursing home "especially the orally fed with dysphagia are prone to dehydration. The clinical consequences of dehydration are critical. The validity of the common laboratory parameters of hydration status is far from being absolute, especially so in the elderly." (Leibovitz, et al., 2007) it is related however that "combinations of these indices are more reliable." (Leibovitz, et al., 2007) the study reported by Leibovitz et al. is one that assessed hydration status among elderly LTC residents with oropharyngeal dysphagia and in which a total of 28 orally…
Spieker, Michael R. (2000) Evaluating Dysphagia. American Family Physician 14 Jun 2000. Online available at http://www.aafp.org/afp/20000615/3639.html
Marik, Paul E. And Kaplan, Danielle (2003) Aspiration Pneumonia and Dysphagia in the Elderly. Chest. July 2003. Vol. 1224, No. 1. Online available at http://www.chestjournal.org/content/124/1/328.full
Bautmans, I., et al. (2008) Dysphagia in elderly nursing home residents with severe cognitive impairment can be attenuated by cervical spine mobilization. J. Rehabil Med. 2008 Oct;40(9):755-60. PubMed Online available at http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=18843429
Stone, Rebecca S. (2006) Dysphagia in the Elderly. Inpatient Times. October 2006. Online available at http://www.bmc.org/geriatrics/RStone_DysphagiaintheElderly.pdf
The explanation was that a restricted diet would not give enough material for the electron transport chain in the mitochondria to function fully. With fewer electrons to pass, there were also fewer oxygen free radicals produced. Aging, thus, slows down (Nelson).
Proponents of the free radical theory, however, believe that dietary antioxidants are not directly beneficial, as they do not reach mitochondrial DNA (Nelson 2000). The site remains vulnerable and susceptible to attack. However, supplemental antioxidants can indirectly increase lifespan by protecting other cell parts, like cellular proteins and membranes, from injury by free radicals. They still serve a valuable purpose in slowing aging down. The application of the free radicals theory has not reached perfection. Genetic change in achieving increased life span remains controversial and difficult to perform. Dietary restriction is un-attractive to most people and dietary antioxidants do not directly increase life span as they do not access…
Diamond, J., et al. (2002). Free Radical Damage: a Possible Mechanism of Laryngeal Aging. 4 pages. Ear, Nose and Throat Journal: Medquest Communications, LLC
Held, G. (2002). Research into the Aging Process: a Survey. 11 pages. North American Actuarial Journal: Society of Actuaries
Hood, E. (2003). Towards a New Understanding of Aging. 7 pages. Environmental Health Perspectives: National Institute of Environmental Health Sciences
King, a. (2004). Mitochondria-Derived Reactive Oxygen Species Mediates Blue Light-Induced Death of Retinal Pigment Epithelial Cells. 9 pages. Photochemistry and Photobiology: American Society of Photobiology
What is worth noting here is the fact that behavior disturbances, ranging in severity from repeated questioning to physical violence, are common (National Institute of Mental Health, 1989).
It is unclear whether Alzheimer's disease represents a single entity or several variants. Some experts believe that there are distinct subtypes of Alzheimer's disease, such as Lewy body disease (in which the signs of Parkinson's disease, visual hallucinations or alterations in alertness or attention, or all of these symptoms, are conspicuous) and frontotemporal dementia (in which disinhibition, misconduct or apathy, or all of these signs, are prominent). The well-established risk factors for Alzheimer's disease are age, a family history of the disease and Down syndrome (National Institute of Mental Health, 1989).
Confusions about Alzheimer's Disease and the Need for Alternative Actions
There have been numerous studies conducted in relation to Alzheimer's disease. At the same time, there are a number of reports…
U.S. Congress, Office of Technology Assessment. Summary, Confused Minds, Burdened Families: Finding Help for People with Alzheimer's and Other Dementias, OTA-BA-404, Washington, DC: Supt. Of Docs., U.S. Govt. Print. Off., 1990.
Vickrey, Peg Gray-. Advances in Alzheimer's Disease. Nursing: Springhouse Corporation, 2002
Whitehouse PJ. Genesis of Alzheimer's disease. Neurology 1997;48(5 Suppl 7):S2-7.
Sisco, Volland, and Gorin (2005) discuss the challenge the United States is likely to face in the near future because of the aging population increase alongside the shrinkage of social workers who are capable of caring for older people. Social workers, the authors argue, need to address this problem by learning from the experiences of a few organizations which have been active in this activity. They note that social workers need to carry out broad fund-raising activities, engage the government and the public, and promote educational and training programs to increase the number of social workers who can address the needs of the aging population in the future.
Sisco, Volland, and Gorin (2005) start the article by discussing A Blueprint for the New Millennium, prepared with the support of the Hartford Foundation and the Council on Social Work Education's Strengthening Aging and Gerontology Education for Social Work and aimed at…
Sisco, S., Volland, P., & Gorin, S. (November 01, 2005). Social Work Leadership and Aging: Meeting the Demographic Imperative. Health & Social Work, 30, 4, 344
Anti-Aging Medicine? Include Abstract eferences scholarly
This is a review of the article titled "Is There an Antiaging Medicine?" which was written by obert N. Butler, Michael Fossel, S. Mitchell Harman, Christopher B. Heward, S. Jay Olshansky, Thomas T. Perls, David J. othman, Sheila M. othman, Huber . Warner, Michael D. West, and Woodring E. Wright. The article was published in the volume 57A, issue no. 9 of the Journal of Gerontology: Biological Sciences in the year 2002 from pages B333-B338. The journal is published by the Gerontological Society of America.
Anti-aging medicine refers to any form of intervention that is given to delay the development of pathology that depends on the person's age and any other changes that are related to age that are not necessarily diseases. All what are there is false claims and bogus remedies which are not known to work. Slowing down the process of aging…
Butler, R.N., Fossel, M., Harman, S.M., Heward, C.B., Olshansky, S.J., Perls, T.T., . . . Wright, W.E. (2002). Is There an Antiaging Medicine? Journal of Gerontology: BIOLOGICAL SCIENCES, 57A (9), B333 -- B338.
Weindruch, R., & Walford, R.L. (1988). The Retardation of Aging and Disease by Dietary Restriction. Springfield, IL: Charles C. Thomas.
Taste and Smell
Age elated Changes in Perception of Flavor and Aroma
It has been posited that the perception of flavor and aroma are derived from the senses of chemical irritation, taste and smell (awson, 2003).
Together, these senses constitute what has been termed chemosensation, although these sensory systems are purportedly considerably variant in their physiology and anatomy. Nevertheless, they do have the ability to regenerate, and their noted susceptibility to aging and age associated diseases has been noted (awson, 2003). It has been reported that nearly one third of all older individuals report dissatisfaction with their sense of smell and taste, and the actual occurrence of sensory loss amongst the elderly is maintained to be even higher (Pelchat, 2001). Furthermore, it has been asserted that age related sensory loss affects both personal safety and quality of life (awson, 2003). Moreover, the impact of the loss on the elderly's physical…
Chodosh, S., et al. (1998). Efficacy and safety of a ten day course of 400 or 600
milligrams of grepafloxacin once daily for treatment of acute bacterial exacerbations of chronic bronchitis: comparison with a ten day course of 500 milligrams of Ciprofloxacin twice daily. Antimicrobial Agents in Chemotherapy, 42(1), 114-120.
Mathey, M., et al. (2001). Flavor enhancement of food improves dietary intake and nutritional status of elderly nursing home residents. Journals of Gerontology: Biological Sciences and Medical Sciences, 56(4), 200-205.
McConnell, R., et al. (1975). Defects of taste and smell in patients with hypothyroidism.
Furthermore, as Baltes makes clear, there are some events that are generally going to impact people at various stages in their lives. For example, an East European Jew who survived World War II would probably have a historical influence that changed other age-expectations, which could impact other longevity factors. Time in a concentration camp, which would be normative for the Jewish cohort in that place and time period, would also likely impact the age of marriage, parenthood, and other culturally normative behaviors that might impact health and longevity in one's old age. While that might seem to be a dramatic example, the reality is that most generations are going to have cohorts impacted by at least one event of similar magnitude. For the practitioner working with geriatric clients, knowing the historical events that are most likely to have impacted the client and how those are likely to interact with the…
Anstey, K., Stankov, L., & Lord, S. (1993). Primary aging, secondary aging, and intelligence.
Psychology of Aging, 8(4), 562-70.
Bee, H.L., & Bjorklund, B. (2010). Journey of adulthood, 7th Edition. Upper Saddle River, NJ:
Mechanisms of Aging
Mechanism of Aging
Aging is a syndrome that occurs as a result of changes that are progressive, deleterious, universal and therefore, irreversible. This aging damage occurs to the cells, molecules that forms the cells, and to the entire organ. The aging process is most commonly associated with old age diseases such as osteoporosis, arthritis, cancer, heart disease and Alzheimer's disease among others; this is because such diseases are associated with degenerative effects experienced by the cells. Scientist have over the years substituted the word "aging" with "senescence" since aging means that when time elapses so does deterioration takes place which is false especially during the early developmental stage Mackenzie, Bussiere and Tinsley ( 21)
Various researches are being conducted to establish the mechanisms of aging, and as part of these research, experiments have been carried out on various living organism so as to shade more light on…
Comfort, Alex. "Biological Aspects of Senescence." Biological Reviews 29.3 (1954): 284-329. Print.
Mackenzie, Danielle K., Luc F. Bussiere, and Matthew C. Tinsley. "Senescence of the Cellular Immune Response in Drosophila Melanogaster." Experimental Gerontology 46.11 (2011): 853-59. Print.
Nigam, Anjana. "Senescence (Ageing) @ 2011." Indian Journal of Dermatology 56.6 (2011): 615-21. Print.
.. we have goggles that mimic sight deficits. We use ear plugs, and ways to mimic the tactile changes elderly patients go through. We'll immobilize people, to show what it would be like if they had a stroke, and then ask them to do tasks. It makes them more sensitive to seniors' needs."
In Great ritain, nursing care follows a holistic approach to guiding the aging patient through the hospital stay and into 'step down', cottage hospitals, and community recovery centers. Through an empathetic and geriatric skill set, the geriatric nurse can thereby decrease her ultimate workload while maintaining a higher quality of life for the hospitalized patient.
Aging is no respecter of persons, countries, or races.
We all age. As a graying generation of millions of 'baby boomers' approach the golden years, medical care must shift much of its focus to the particular needs of this group.
"1999-2008, a 10-year Action Plan for Services for Older Persons," (1998), Eastern Health Board.
Bernard, M. & Phillips, J. (2000), "The Challenge of Ageing in Tomorrow's Britain," Ageing and Society, vol. 20, pp.33-54.
Dickinson E. (1996). "Long-term care of older people," BMJ, vol 312, no. 7035, pp.862-863.
"Fact Files - Ageing in Ireland, National Council on Ageing and Older People," (1997).
Clearly, since the focus of these articles are based on an institutional economics point-of-view of healthcare quality, a limitation of the study is that it does not take into consideration other variables that might influence the efficiency of nursing homes in providing quality healthcare. Among these unaccounted variables are the politics behind healthcare, specifically federal laws and policies related to the provision of healthcare. Apart from policies and laws, another variables unaccounted for in this study is a thorough look or analysis of the relational dynamics between patients and nurses, as well as other healthcare practitioners and professionals. This variable is vital in understanding the concept of quality healthcare because it provides an in-depth look at the 'experiential" dimension or perspective healthcare -- that is, healthcare quality as assessed by patients and healthcare professionals/practitioners.
In terms of socio-demographic characteristics, the literature collated regarding nursing home care does not…
According to a recent study, the elderly are hospitalized more often due to alcohol-related problems than for heart attacks (Doup). Another study found some 70% of elderly adults' hospitalizations are related to alcohol, medication, or a mixture of both (Doup).
Many seniors live alone either due to divorce or the death of a spouse, and many more still are retired and have children out of state, and so do not drive as much or as far as before (Doup). This isolation leads many seniors to develop alcohol and drug problems late in life, at a time when they are most vulnerable to medical conditions (Doup). The elderly make up some 11% of the U.S. population, yet they take more than 35% of the drugs prescribed, such as blood pressure medication, sleep medication, and tranquilizers, all of which created a toxic cocktail when mixed with alcohol, causing everything from dizziness to…
Bosworth, Michael F. "Alcohol abuse in the elderly." American Family Physician.
April 1, 1989. Retrieved October 07, 2006 from HighBeam Research Library.
Dooley, Pat. "For Best Nutrition, Elderly Should Socialize, Too."
The Virginian Pilot. July 5, 1996. Retrieved October 07, 2006 from HighBeam
articles seem to be saying same thing or do they contradict each other? Is the tone similar in each article, meaning can you tell what the researchers feel about the subject? Do they support the same idea, did they hypothesize similar ideas?
The following are two research essays on the burden of caregivers. The similarities of both essays are that both demonstrate the huge responsibility and unmitigated onus that caregivers carry that consequent in causing them stress and hardship. Differences include the fact that one was carried out on a population in Italy, whilst the other was carried out on a sample in America.
It is striking, too, to note, that although both concluded that caregivers needed more support, the American study recommended ways that individuals could create this for themselves, whilst the Italians-based study placed the responsibility on the community and social work profession. The tone of the articles,…
Sansoni, J et al. (2004) Anxiety and depression in community-dwelling, Italian Alzheimer's disease caregivers, retrieved from International Journal of Nursing Practice: 10: 93-100.
Hayslip, B et al. (2008) Predictors of Alzheimer's disease caregiver depression and burden: what noncaregiving adults can learn from active caregivers. Educational Gerontology, 34: 945-969, 2008
Cellular Function and Aging
Tumor Suppression Protein 53 and Effects on Cellular Function and Aging
The concept of aging has many intrinsic and extrinsic factors that act as markers on an individual organism. Ignoring mortality associated with external environmental factors, very few organisms can be said to have cellular immortality with no decrease in cellular function or repeat division in normal diploid cells. Cellular senescence is a normal process that halts cellular division after a set of cycles of replication. Senescent cells can remain completely functional but lose the programmed process of replication. The normal pathway for senescent cells is either aging with metabolic pathways continuing for the cell or programmed cell death which is known as apoptosis that occurs when cellular function changes, a specific lifetime is reached for the cell or the cell is damaged. The multicellular cnidarians known as a Hydra has been shown to have a…
Cappisi, J. (2005) Senescent cells, tumor suppression and organisimal aging: good citizens, bad neighbors. Cell 120 1-10.
Coppe, J.P. Patil, C.K. Rodier, F. Sun, Y. Munoz, D.P. Goldstein, J. Nelson, P.S. Desprez, P. Campisi, J. (2008) Senescence-Associated Secretory Phenotypes Reveal Cell-Nonautonomous functions of Oncogenic RAS and the p53 Tumor Suppressor. PLOS Biology, 6-12, 2853-2868
Faragher, R.G. (2000) Cell senescence and human aging: where's the link? Biochemical Society Transactions 28 221-226.
Kirkwood, T.B. Austad, S.N. (2000) Why do we age? Nature 408. 233-238.
The field of clinical psychology emerged as a viable method through which the theoretical foundations of cognitive studies could be effectively applied within the clinical setting to prevent and treat psychological syndromes. Derived from the first clinical psychology work conducted by Lightner Witmer in the late 19th century, and expanding throughout the 20th century as diagnostic tools were refined and classification systems for mental disorders were standardized, modern clinical psychology has been adapted to fulfill a niche within a whole host of divergent fields, including criminal justice, the social sciences and gender relations. Clinical psychologists premise their work on the use of empirical analysis to accurately investigate matters of cognitive processing, psychological assessment and mental illness, with the administration of personality tests, neurological scans and clinical interviews the most frequently utilized diagnostic resources. As clinical psychology expanded the base of knowledge pertaining to the human brain's highly refined…
Blackburn, R. (1993). The psychology of criminal conduct: Theory, research and practice. John Wiley & Sons.
Donohue, J., & Levitt, S. (2001). The impact of race on policing and arrests. Journal of Law and Economics, 44, 367-394. Retrieved from http://pricetheory.uchicago.edu/levitt/Papers/LevittDonohueTheImpactOfRace2001.pdf
Fite, P.J., Wynn, P., & Pardini, D.A. (2009). Explaining discrepancies in arrest rates between
Black and White male juveniles. Journal of consulting and clinical psychology, 77(5), 916. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2981137/ >.
Physiological Changes Associated With Aging
Aging is the complex and inevitable process of tissue and organ system degeneration. Though largely influenced by genetics, aging is also dependent upon a number of environmental factors including exercise, diet, childhood personality, and exposure to ionizing radiation, pollutants, or microorganisms. The physiological changes that occur as an individual's age advances can be grouped into three, with the first category encompassing changes in such homeostatic mechanisms as extracellular fluid volumes, blood, and temperature; the second encompassing changes related to decreasing organ mass; and the third, changes in the body's functional reserve systems. Promoting the health of an aging population is crucial not only because it ensures the well-being of ageing individuals, but also because it significantly reduces the burden imposed upon a country's medical system. It is with this in mind that this text collates knowledge and research to examine, in a deeper sense, the…
Bherer, L., Erickson, K.I. & Liu-Ambrose, T. (2013). A Review of the Effects of Physical Activity and Exercise on Cognitive and Brain Functions in Older Adults. Journal of Aging Research, vol. 2013. Retrieved 8 April 2014 from [HIDDEN]
Glassock, R.J. (2009). The GFR Decline with Aging: A Sign of Normal Senescence, Not Disease. Nephrology Times, 2(9), 6-8.
Heckman, G., Gray, L.C. & Hirdes, J. (2013). Addressing Healthcare Needs for Frail Seniors in Canada: the Role of InterRAI Instruments. Canadian Geriatrics Society Journal of CME, 3(3), 8-16.
Saber, A. (2013). Perioperative Care of Elderly Surgical Patients. American Medical Journal, 4(1), 63-77.
older patients over the age of 80 due to complications in health such as dementia and depressive symptoms, do not go for additional follow-ups. Yes, the authors explain repeated in person visits help better identify risk factors. There is no obvious research question however they do highlight the use of a study to confirm the hypothesis of whether or not repeated in person follow-ups help with problems experienced as patient's age. "We hypothesized that the type of visit would be related to key demographic, lifestyle, health and function characteristics and that the oldest aged participants would have the poorest retention for in-person visits, particularly clinic visits" (Strotmeyer et al., 2010, p. 697). This is a directional hypothesis because the retention rates are directly associated with increase in age. It is a simple hypothesis because it directly states a cause and effect. The hypothesis was tested and it revealed in-home visits…
Strotmeyer, E.S., Arnold, A.M., Boudreau, R.M., Ives, D.G., Cushman, M., Robbins, J.A., Newman, A.B. (2010). Long-Term Retention of Older Adults in the Cardiovascular Health Study: Implications for Studies of the Oldest Old. Journal of The American Geriatrics Society, 58(4), 696-701. doi:10.1111/j.1532-5415.2010.02770.x
Strotmeyer et al. (2010) research regarding long-term retention of older adults within a given health study. This review will examine the content and structure of this article to determine its practical applications and to reveal key learning points that may be used in future examinations regarding the same topic.
Firstly the aim of this study was to examine the aging population as its demographical influence is described as important and impactful. The object of this study was to understand the idea of retention as it applies to these older people. The article's definition of the word retention is cumbersome and requires some deep thinking to understand the complicated words of the definition. The authors defined retention as "retaining surviving participants enrolled at baseline for subsequent assessments in a longitudinal cohort study." The word "baseline" is never adequately contextualized in this article, requiring the reader to insert some assumptions.…
Stotmeyer, E.S., Arnold, A.M., Boudreau, R.M., Ives, D.G., Cushman, M., Robbins, J.A., Harris, T.B., & Newmann, A.B. (2010). Long-term retention of older adults in the cardiovascular health study: Implications for studies of the oldest old. The Journal American Geriatrics Society, 58(4), 696-701.
In addition, those who are emotionally troubled and who are overweight -- often a contributing factor to emotional difficulties -- do not receive extra counseling time." Seale, Seale & Zhang (2008, p.425) This is a serious concern and one that must be addressed immediately by physicians who are providing care for obese patients.
A lot of revamping has to be done to meet this increased need of obese elderly and this has to be done fast. The numbers are increasing by the day and unless some initiatives are taken right away, it can blow up into a full-fledged catastrophe in the future. The first and foremost step that is required is to change the present healthcare system to make it more effective and efficient. Changes have to be made in the delivery of service as well as payments to make it more accessible to the elderly.
Another important step…
Arterburn, David E. (2004). The Coming Epidemic of Obesity in Elderly Americans. Journal of the American Geriatrics Society. 52(11). 1907-1912
Odilia I; Bermudez; Tucker, Katherine L. (2001). Total and Central Obesity among Elderly Hispanics and the Association with Type 2 Diabetes. Obesity Research (9), 443 -- 451; doi: 10.1038/oby.2001.58
Thompson, Dennis. (2009, December 31). As U.S. Ages, Health Care May Need to Change. HealthDay Consumer News Service.
Dutton, Drake, D; Engelke. K; McAuliffe, M; Rose, M., (2005). Challenges that nurses face in caring for morbidly obese patients in the acute care setting. Surgery for Obesity and Related
" (AAF, nd)
The Health Maintenance Organization further should "…negotiate with both public and private payers for adequate reimbursement or direct payment to cover the expenses of interpreter services so that they can establish services without burdening physicians…" and the private industry should be "…engaged by medical organizations, including the AAF, and patient advocacy groups to consider innovative ways to provide interpreter services to both employees and the medically underserved." (AAF, nd)
One example of the community healthcare organization is the CCO model is reported as a community cancer screening center model and is stated to be an effective mechanism for facilitating the linkage of investigators and their institutions with the clinical trials network. It is reported that the minority-based CCO was approved initially by the NCI, Division of Cancer revention Board of Scientific Counselors in January 1989. The implementation began in the fall of 1990 and the program was…
Principles for Improving Cultural Proficiency and Care to Minority and Medically-Underserved Communities (Position Paper) (2008) AAFP -- American Academy of Family Physicians http://www.aafp.org/online/en/home/policy/policies/p/princcultuproficcare.html
Volpp, Kevin G.M. (2004) The Effect of Increases in HMO Penetration and Changes in Payer Mix on In-Hospital Mortality and Treatment Patterns for Acute Myocardial Infarction" The American Journal of Managed Care. 30 June 2004. Issue 10 Number 7 Part 2. Onlineavaialble at: http://www.ajmc.com/issue/managed-care/2004/2004-07-vol10-n7Pt2/Jul04-1816p505-512
Darby, Roland B. (2008) Managed Care: Sacruificing Your Health Care for Insurance Industry Profits: Questions You must ask before joning an HMO. Online available at: http://www.rolanddarby.com/br_managedhealth.html
This paper will focus on the geriatrics service line. Elderly patients are coming in at higher rates and the geriatric population is trending upward (Advisory Board, 2018). One problem the department is having is the identification of elder abuse among geriatric patients. Elder abuse has been defined as “a single or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust which causes harm or distress to an older person” (Jackson, 2016, p. 265). According to the World Health Organization (2002), elder abuse can take any one of or combination of forms: (a) physical abuse, (b) psychological abuse, (c) sexual abuse, (d) neglect, (e) abandonment, and (f) financial exploitation or theft. Recognizing and addressing elder abuse is important for the geriatrics service line because it will help to better serve the elderly patient and the geriatric community overall and it will…
The Grade Experience of Online Nurse Practitioner Students Who Took More Than One Clinical Course Per Quarter
The shortage in primary care physicians has increased the demand for nurse practitioners (NPs). Online NP programs are of interest to working students with other personal and professional life demands. This study examines grade experience differences for students of an online NP program who took more than one clinical course per quarter (OCCPQ) as compared to those who did not take more than OCCPQ. This retrospective study consisted of 3,760 NP students who graduated between fall 2013 through spring 2016. Those who took more than OCCPQ had a greater percentage of clinical course failures at first attempt as compared to those who did not take more than OCCPQ (2.1% versus 0.8%, p=0.001). Multivariate logistic regression adjusting for relevant covariates maintained these results with increased odds for clinical course failures for those…
Diversity of Aging Population -- Innovative Healthcare
Over the past several decades there has been an avalanche of research and scholarly narratives focusing on the aging of millions of Americans -- among them the "baby boomers" that were born between 1946 and 1964 -- including their numbers and their health vis-a-vis the impact on the sometimes struggling healthcare system. But there has been a dearth of research on how American healthcare services will respond -- and is currently responding -- to an increasingly diverse older population when it comes to racial, cultural and ethnic identities. This paper points to the numerous issues and challenges that not only face an increasingly diverse older American population when it comes to healthcare, but also the challenges that the healthcare system itself faces as these Americans move into the twilight of their lives.
hat should be the Vision and Mission of Healthcare Professionals in…
Administration on Aging. (2010). A Statistical Profile of Black Older Americans Aged 65+.
Retrieved April 2, 2014, from http://www.aoa.gov .
Bookman, A. (2008). Innovative models of aging in place: Transforming our communities for an aging population. Community, Work & Family, 11(4), 419-438.
Centers for Disease Control and Prevention. (2007). The State of Aging and Health in America
Vitamin D Supplementation
Vitamin supplementation has long been a popular way of ensuring that people receive the sufficient amount of vitamins. However as it pertains to Vitamin D, there is some amount of controversy as it pertains to Vitamin D supplementation (25-hydroxy) concentration and safety. The literature review will discuss the need for vitamin D supplementation and the findings of various studies and Vitamin D trials.
An article entitled "Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety" the daily allowance of vitamin D is 200 IU. The medical community has established that this amount will prevent the softening of the bones known as osteomalacia. However, there is also a consensus that more vitamin D is need to avoid other conditions such as hyperparathyroidism and osteoporosis.
In fact an article found in the Archives of Gerontology and Geriatrics confirms that the proper amount of vitamin D can reduce the chances of…
ALA-HOUHALA, M., T KOSKINEN, A TERHO, T KOIVULA, AND J. VISAKORPI. Maternal compared with infant vitamin D Supplementation. Archives of Disease in Childhood, 1986, 61, 1159-1163
Alouf B., MD and Grigalonis M. Incidental Finding of Vitamin-D Deficient
Rickets in an Otherwise Healthy Infant -- A Reappraisal of Current Vitamin-D Supplementation Guidelines. Journal of the National Medical Association. VOL. 97, NO. 8, AUGUST 2005
Bjorkman, Mikko. Sorva A., Rejo Tilvis. Responses of parathyroid hormone to vitamin D supplementation: A systematic review of clinical trials. Archives of Gerontology and Geriatrics 48 (2009) 160-166
Another study surrounding the use of restraints in non-psychiatric patients (Strumpf and Evans, 1998) reported that the nurses had difficulty reconciling the administration of restraints with concerns regarding patient dignity and autonomy. So it appears that the use of restraints is difficult on staff and patients alike. Interestingly enough, in a literature review for this paper, the writer could find no significant supporting data to recommend restraint devices as effective in the management of the confused or persistently agitated patient. In this case, it appears that many times patients are being placed into restraints more "because we have always done so with this kind of patient" rather than on the basis of any science that the use of restraint is beneficial to the patient.
Restraints and the Law
Any time a patient is to be considered for the application of restraint devices, it is important that all members of the…
Castle, NG, Mor V. (1998) Physical restraints in nursing homes: A review of the literature since the Nursing Home Reform Act of 1987) Nursing Home Reform 55:139-176.
Catchen, H. (1983). Repeaters: Inpatient accidents among the hospitalized elderly. The Gerontologist, 23, 173-176.
Difabio, S. (1981). Nurses' reactions to restraining patients. American Journal of Nursing, 81, 973-975.
Evans, L.K., & Strumpf, N. (1989). Tying down older persons: A review of the literature on physical restraints. Journal of the American Geriatrics Society, 37, 6-14.
Human Figure Drawing
Testing has become an integral part of psychological theory and practice. Rooted in historical perspectives and heated conversation of principles, wagering purpose and ethics, it involves the statistical conceptualizations of psychometrics and the connection of the validity of a test to the reality of a person. The field of psychological testing is characterized by the use of small samples to apply larger generalizations to a specific individual; samples of behavioral trends combine with observations over a limited time in which performance of prescribed tasks is compared to a the pre-studied responses of members of a norm group. These responses, compiled and analyzed before compared to the studied individual, are often crafted into statistical tables that allow the evaluator to compare the behavior of the specific person to the range of responses given by the norm group and make appropriate personality discussions therein. A common type of psychological…
Plubraarn and Theermonparp, p. S615.
Sturner, R.A., Rothbaum, F., Visintainer, M., Wolfer, J. "The Effects of Stress on Children's Human Figure Drawings." Journal of Clinical Psychology. Vol. 36, No. 1. January,1980. p. 324.
Wang, H., Ericsson, K., Winblad, B., Fratiglioni, L. "The Human Figure Drawing Test as a Screen for Dementia in the Elderly: A Community-Based Study." Archives of Gerontology and Geriatrics. Vol. 27, No. 1. August, 1998. p. 25.
With the help of a thorough clinical evaluation, the risk factors, risks associated with falling and working out adequate intervention methods to curb the rate of elderly falls can be achieved. As per the 2011 AGS / BGS guidelines, (Panel on Fall, 2011) certain particulars need to be incorporated in a particular clinical evaluation: 1: Patient history, physical examination, mental and physical functionality; 2: Number of falls occurring, number of medications taken; issues regarding mobility, balance and gait; blurred eyesight; various mental disabilities; weak muscular strength; uneven heartbeat and rhythm; postural hypotension; problems in feet and risks related to environment (Shubert, 2014).
Strategies to Prevent Elderly Falls and Health elated Consequences
Assistive Devices and Other Protective Equipment: Appropriate footwear is required for particular conditions, for instance, wintery weather necessitates anti-slip shoes whilst warmer weather requires cleated footwear, facilitating decreased falls (Panel on Fall, 2011).
Clinical Disease Management (Acute…
Clemson, L., Mackenzie, L., Ballinger, C. & Close, J.C.T. (2008). Cumming RG. Environmental interventions to prevent falls in community-dwelling older people: A meta-analysis of randomized trials. J Aging Health. 20(8):954-971.
Gillespie, L.D., Robertson, M.C., Gillespie, W.J., Lamb, S.E., Gates, S., and Cumming, R.G. (2009). Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. (2), Art.No.: CD007146
Panel on Fall prevention in Older Persons, American Geriatrics Society and British Geriatrics Society, (2011). Summary of the Updated American Geriatrics Society/British Geriatrics Society Clinical Practice Guideline for Prevention of Falls in Older Persons. J Am Geriatr Soc.;59(1):148-157.
Scott V, Gallagher E, Higginson A, Metcalfe S, & Rajabali F. (2011). Evaluation of an evidence-based education program for health professionals: The Canadian Falls Prevention Curriculum (CFPC). Journal of Safety Research. 42(6):501-507.
The theory of nursing is built in a dynamic process that develops from practice and is normally reproduced through research, by development and analysis of concepts and theories. There is need to investigate further the phenomena seen in nurses' experience during practice in order to identify the attributes. The most effective way of enabling nurses to deeply examine some phenomena is by defining a concept of interest. This would enable the development of theories that are directly related to a clinical practice. There has been a tremendous improvement and push for the analysis and development of nursing concepts mainly because researchers have attempted to clarify problems that were previously considered as common sense. The increase has been necessitated by concepts that look obvious having vague terminologies, inconsistent theories, and ambiguous definitions.
Quality of life is a terminology that is frequently used in nursing practice and in health care.…
Lok, N., Lok, S., & Canbaz, M. (2017). The effect of physical activity on depressive symptoms and quality of life among elderly nursing home residents: Randomized controlled trial. Archives of gerontology and geriatrics, 70, 92-98.
Mishra, S. I., Scherer, R. W., Snyder, C., Geigle, P., & Gotay, C. (2014). Are exercise programs effective for improving health-related quality of life among cancer survivors? A systematic review and meta-analysis. Paper presented at the Oncology nursing forum.
Mjorud, M., Rosvik, J., Rokstad, A. M. M., Kirkevold, M., & Engedal, K. (2014). Variables associated with change in quality of life among persons with dementia in nursing homes: a 10 months follow-up study. PLoS ONE, 9(12), e115248.
Nikmat, A. W., Hawthorne, G., & Al-Mashoor, S. H. (2015). The comparison of quality of life among people with mild dementia in nursing home and home care -- a preliminary report. Dementia, 14(1), 114-125.
Victimology and the Problem of Elder Abuse
Just as criminology is the study of crime and the criminal’s role in crime, victimology is the study of victimization and how victims are impacted by crime and how they in turn also impact crime. There are five typologies of victimization, each one illustrating different ways in which the perpetrator and the victim (if there is one) interact in the crime. For the specific population of elderly people, one problem in victimology is the focus on elder abuse, which is defined as “a single or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust which causes harm or distress to an older person” (Jackson, 2016, p. 265). According the World Health Organization (2002), elder abuse tends to be manifested in a variety of forms: (a) physical abuse, (b) psychological abuse, (c)…