Peer Responses:
- Length: A minimum of 180 words per post, not including references
- Citations: At least two high-level scholarly reference in APA per post from within the last 5 years
- Reflect to other journal reading
Existing barriers in patient centered care include a perceived notion that older adults do not adhere to healthcare recommendations due to difficulty managing complex comorbidities, lack of willingness to learn new technology, and reluctance to change (Kim & Oh, 2020). To overcome these barriers, patient education for older adults must be tailored for the unique communication needs of adults aged 65 and older. Patient education for older adults should be delivered in brief sessions, delivered slowly, and repeated frequently to ensure comprehension (Kim & Oh, 2020). In addition, patient education for older adults requires appropriately designed materials that account for declining eyesight and hearing over the age of 65 (Kim & Oh, 2020). Many older adults are unfamiliar and lack confidence with technology, preferring materials that are printed and include simple text and illustrations. Also, vocabulary in the medical profession has changed rapidly with aid of medical technology, therefore when working with older adults nursing professionals must take time to define and explain unfamiliar concepts to geriatric patients.
According to the United States Preventive Services Task Force, all men aged 65-75, who have a history of current or past smoking, must be screened for abdominal aortic aneurysm (AAA) using ultrasonography (USPSTF, 2024). It is necessary to ask this patient if he has a history of smoking, especially when he was a young adult and the harms of cigarette smoking were unknown. It is also necessary to screen the patient for colorectal cancer as the United States Preventive Services Task Force also recommends colorectal screening for all adults aged 50-79 (USPSTF, 2024). Furthermore, any adult aged 65 and older who is at risk for falls must be referred for exercise intervention to prevent future falls and related complications (USPSTF, 2024). For this patient it is also necessary to provide education regarding the use of alcohol after the age of 65. For adults aged 60 and older, the threshold for alcohol misuse is met earlier than for patients who are under 60 years old (SAMHSA, 2020). The reduced ability to properly metabolize and recover from alcohol consumption accounts for the alarming rate of damage to physical and mental health older adults experience as a result of alcohol misuse (SAMHSA, 2020). Older adults who misuse alcohol have increased risk for developing diabetes, cancer, liver failure, and congestive heart failure (SAMHSA, 2020). The current patient must be referred to meet with a nurse educator regarding dietary modifications necessary to maintain overall health after the age of sixty-five, including the cessation of alcohol consumption. While in the clinic the patient must be screened for cognitive impairments, functional limitations, and common ailments that affect older adults such as heart disease and diabetes. To assess for cognitive decline in the clinic it is necessary to assess the patient’s complex attention, executive functional ability, language, social cognition, learning and memory capability, and motor-perceptual ability (Ranjit, et al., 2020). To assess for diabetes, a complete metabolic panel and hemoglobin A1C must be run using a blood draw. The patient’s pulse, respiration rate, oxygen saturation and blood pressure can be assessed in the clinic, however referral to a cardiologist is recommended for this patient. Finally, the patient will be referred to a nurse educator who will perform a home visit to assess the patient’s living situation and formulate a complete care plan that prioritizes the patient’s safety while continuing to live in the community.
In New Jersey, the state government has a division of Aging Services that provides resources, and free online courses for adults aged 65 and older who are New Jersey residents. According to the website, the NJ Division of Aging Services exists to streamline administration of services to older adults, to increase the percentage of older adults living well within the community (State of New Jersey, 2024). The NJ Division of Aging Services provides resources to aid older adults in enrolling for Medicare, applying for appropriate savings programs designed for older adults, and connecting older adults with community resources to ensure complete mental and physical well being. In New Jersey there are two prescription savings programs that the Division of Aging Services can help residents enroll in. The Division of Aging Services also provides information on adult day care programs, respite care programs, and meal delivery services (State of New Jersey, 2024). For more local and immediate assistance, the Division of Aging Services has 21 local community offices throughout the state that residents can visit in person to receive aid in connecting with needed support (State of New Jersey, 2024).
References
Kim, M. and Oh, S. (2020). Nurses’ perspectives on health education and health literacy of older patients. International Journal of Environmental Research and Public Health. 17(18). P. 6455. https://doi.org/10.3390/ijerph17186455.
Ranjit, E., Sapra, A., Bhandari, P., Albers, C., and Ajmeri, M.(2020). Cognitive assessment of geriatric patients in primary care settings. Cureus. 12(9). P. e10443. https://doi.org/10.7759/cureus.10443.
State of New Jersey, Division of Aging Services. (2024). Mission. Retrieved June 18, 2024 from https://www.nj.gov/humanservices/doas/about/missio….
United States Substance Abuse and Mental Health Services Administration (SAMHSA). (2020). Treating substance use disorder in older adults: Updated 2020 [Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2020. (Treatment Improvement Protocol (TIP) Series, No. 26.) Chapter 4—Treating Alcohol Misuse in Older Adults. Available from: https://www.ncbi.nlm.nih.gov/books/NBK571028/
United States Preventive Services Task Force. (2024). A and B recommendations. Retrieved June 18, 2024 from https://www.uspreventiveservicestaskforce.org/uspstf/recommendation-topics/uspstf-a-and-b-recommendations.
