Fallprevention among the elderly
Fallprevention among the elderly
Eachyear, the emergency department treats roughly 2.8 million olderpeople for fall injuries (CDC, 2015). Falls among the elderly can beattributed to chronic health conditions which cause dizziness, visualor muscle impairments, inactivity, and imbalance. One or acombination of several factors could be responsible for theseaccidents. They lead to physical injuries, internal injuries, fear offalling, loss of independence and death. Research has shown that mostof the incidences are preventable (Karlsson, Magnusson, Schewelov, &Rosengren, 2013). Intervention programs used to prevent falls includeaddressing health problems, exercises, and home proofing. Therefore,the report provides information on how training leads to diminishedfalls incidences.
Preventingfalls is important because the reoccurrence level is high (a historyof fall increases chances for additional falls) (Karlsson et al.,2013). The cost of treating fall-related wounds escalates with agewith the average hospital cost being over $30,000 (CDC, 2015).Furthermore, the patients spend time recovering at home which leadsto more costs to the caregivers. Inactivity causes weakness to thebody which leads to falls. Up to 75% of older American isinsufficiently inactive to achieve health benefits.
Reviewof the Literature
Agreat association occurs between aging and increased hazard ofchronic and cardiovascular conditions. Aging is also linked withincapacity to attain physical balance. Studies have shown thatlifestyle factors, for example, informally cohesive networks, mentalleisure movement, and bodily activity can slow down the negativeeffect of aging (Cadore,Rodríguez-Mañas, Sinclair, & Izquierdo, 2013 Karlssonet al., 2013). Among these factors, physical exercise has thegreatest impact and lowers the adverse effects of advancing age(Bherer, Erickson, Liu-Ambrose, & Corporation, 2013). Bhereret al. (2013), in a systematic review of studies, concluded thatexercise activity greatly helps alleviate the negative effectsassociated with aging physically and mentally. The authors reviewedintervention, longitudinal, and cross-sectional studies and found outthat training and exercise are an extensive non-pharmaceuticalmediation program to prevent age-related conditions. The review showsthat physical training enhances cardiovascular and motor responses,which have a great correlation to balance and strength. The assertionis supported by Best-Martini and Jones-DiGenova (2014) who posit thattraining enhances functional fitness, improves the quality of life,and sustain aspects of independent living. Best-Martini andJones-DiGenova (2014) provide valuable information on exercisefitness for the frail elders, especially on aspects relating todiabetes, cardiovascular, arthritis, and blood-related diseases. Thebook contains resources on how exercise reduces falls by increasingmotor responses and increasing body mass and strength.
Cadoreet al. (2013) conducted a systematic review of 20 studies toillustrate the effectiveness of training interventions in reducingfalls and enhancing gait ability. Twelve articles explored theeffects of training on gait ability while twenty researches examinedthe impacts of training on the occurrence of falls. Of the articlesexploring the correlation between exercise intervention and riskfalls, 7of them found out fewer falls occurrence after training.According to Cadore et al. (2013) majority of the studies revealedthat exercise led to increased muscle strength, enhanced vascularfunction, and power. These factors allowed the elderly to improvetheir gait and balance hence, decreased incidences of falls.Karlssonet al. (2013) reviews fall prevention programs that have beenhighlighted as effective in numerous randomized controlled trials.The authors suggest that fall occurrence increases with progressingage hence, the need to initiate multicomponent fall-precautionaryintervention strategies. Karlsson et al. (2013) show that consistentphysical exercise that encompasses numerous training modalities isgreatly effective in lessening falls. The studies show that physicalexercise should be cultivated as an intervention strategy, as it isnot only cost-effective, but is also highly efficient.
Contributionsand roles of the nurse
Nursesplay an important role by coordinating patient care to improve healthdelivery system. The transition period from the hospital to home forolder adults with chronic conditions is important for their survival.This is because these patients require safety measures that ensurethey do not risk their health. Such risks include falling, which is asignificant hazard for the elderly. Care coordination has helpedpatients improve their wellness and reduce costs (Camiciaet al., 2013).Older adults are likely to resist physical activities. The nursesensure that patients are motivated to begin the exercise by focusingon their individual goals and needs. A pre-participation screening isdone to determine the best exercise program for the patients. Thenurses, therefore, ensure that safe activities according to patient’sevaluation are carried out. With proper guidance, patients areunlikely to experience side effects such as chest pains andpalpitations during exercises.
Thereare basically three health care policies by the federal government.The Affordable health care act enacted in 2010 has seen people whowere unable to access coverage get insured. Chronic conditions areamong the previously neglected by private policies. This has helpedthe aged access doctors at affordable costs. The policy is open toall and those who are not insured are legible for fines. The Medicaidpolicy insures the elderly who cannot afford insurance while theMedicare caters for the low-income earners and the unemployed. To beenrolled in Medicaid and Medicare, one has to be qualified for them.
Ethicalissues and decisions faced in healthcare
Thereare several ethical issues in the healthcare systems concerning theelderly. These are end-of-life care, stereotyping and healthproviders’ responsibility to their patients. Towards the end oflife, the aged may wish not to be treated and left to pass on athome. Often, the aged are subjected to persuasion to prolong or starttheir treatments against their wishes. Ethically euthanasia goesagainst the sanctity of life, may lead to killing of people againsttheir wish, affects other people’s rights associated with thepatient and may not be in the patient’s best of interest. It alsoundermines the medical commitment to the sickly. However, those whofavor it argue that people should be allowed the choice to live ornot to especially when in a critical medical condition that is notlikely to improve.
Nursesmust examine their beliefs and values about aging to avoidstereotyping. Their biases may affect the way they treat the aged interms of withholding treatment or providing informed consent. Thenurses are required by their code of ethics to treat everyone withrespect regardless of their social economic status, health conditionor personal attributes.
Itis important for the nurses to discuss exercises, religious beliefsand cognitive activities with the elderly. Through such discussions,the older adults feel involved and are likely to respond positivelyto them. The older adults should be regularly screened for depressionand other changes rather than waiting for adverse symptoms to appear.Health promotion among the older population is often neglected whichis unethical.
Evaluatevarious global healthcare delivery systems
TheCanadian health care system is usually comprehensive and free whereindividuals are offered care irrespective of the standard of living,medical history, or income. Unlike in the U.S., Canada publicly fundsinsurance coverage. Mostly, the coverage is available without out ofpocket charges and it is illegal to have private insurance forcovered service. In Germany, all individuals are required to havehealth insurance. The premiums are calculated based on income and notage or dependents. The Germany’s care system is similar to that ofUnited States in that, the insurance coverage is offered via a largenumber of minor autonomous plans. America has the highest expenditureon health care among the three countries but no national health careplan. However, due to privatization, waiting times are shortercompared to the other countries.
ProgramLevel Student Learning Outcomes
Theprogram level outcomes assessment is aimed at fostering studentlearning and to facilitate continuous program level improvement. Thestudents understand what is expected of them while the facultyensures that they give materials that are transferable and relevantto the real world. It is important to have a system that preparesstudents to care for the sick in an ethical manner. To enhance this,students may volunteer to care for the elderly and the sick so as togain tangible experience of what to expect.
Eachyear, the emergency department treats 2. 8 million older people forfall injuries (CDC, 2015). The cost of treating falls injuriesincreases as one age with the average hospital cost being over$30,000 (CDC, 2015). Up to 75% of older American are insufficientlyinactive to achieve health benefits. Most elderly people do notrecognize the need for training, which means the health system shoulddevelop home or community based exercise programs to help the aged.Physicalexercise through care coordination is cost effective and effective.Apart from enhancing cognitive responses, training increases bodymass hence, leads to better and balanced gait.
Best-Martini,E., & Jones-DiGenova, K. (2014). Exercisefor frail elders.Human kinetics.
Bherer,L., Erickson, K. I., & Liu-Ambrose, T. (2013). A review of theeffects of physical activity and exercise on cognitive and brainfunctions in older adults. Journalof aging research, doi:10.1155/2013/657508
Cadore,E. L., Rodríguez-Mañas, L., Sinclair, A., & Izquierdo, M.(2013). Effects of different exercise interventions on risk of falls,gait ability, and balance in physically frail older adults: asystematic review. Rejuvenationresearch, 16(2),105-114.
Camicia,M., Chamberlain, B., Finnie, R. R., Nalle, M., Lindeke, L. L.,Lorenz, L., … & Jones, T. (2013). The value of nursing carecoordination: A white paper of the American NursesAssociation. Nursingoutlook, 61(6),490-501.
CDC.(2015). Preventingfalls: A guide to implementing effective community-based fallprevention programs.Retrieved October 4 2016 fromhttp://www.cdc.gov/homeandrecreationalsafety/pdf/falls/fallpreventionguide-2015-a.pdf
Karlsson,M. K., Magnusson, H., Schewelov, T. V., & Rosengren, B. E.(2013). Prevention of falls in the elderly: A review. OsteoporosisInternational,24(3),747-62. doi: 10.1007/s00198-012-2256-7