Post a thoughtful response to at least two (2) other colleagues’ initial postings. Responses to colleagues should be supportive and helpful (examples of an acceptable comment are: “This is interesting – in my practice, we treated or resolved (diagnosis or issue) with (x, y, z meds, theory, management principle) and according to the literature…” and add supportive reference. Avoid comments such as “I agree” or “good comment.”

References:

• Response posts: Minimum of one (1) total reference: one (1) from peer-reviewed or course materials reference per response.

Words Limits

• Response posts: Minimum 100 words excluding references.

Peer discussion 1

This week discussion is about older adults as a vulnerable population. Do I agree or disagree? what puts this population at risk and what can be done to eliminate some of the risk? Why do I think these risks are important and what can be done to minimize them? I will discuss in the following paragraph.

I agree older adults as a vulnerable population. This age group has higher chronic conditions, visual impairments, cognitive decline, physical disability, neglect, abuse, and other functional limitations (CDC, 2016). The risks for this vulnerable population include, increasing age, medical comorbidities, cognitive impairment, malnutrition, impairment in ADLs, living alone, poverty, unsanitary living conditions, inadequate housing, and dependence on a care giver (Schroder-Butterfill & Marianti, 2013). Gait and balance of disorders are major cause of falls in this population. Falls are the second leading cause of unintentional injury death worldwide. Estimated 646000 die from falls globally and 37.3 million falls require medical attention each year. To prevent and eliminate this from happens, healthcare provider should screen the living environment, prescription appropriate, clinical interventions, community-based group program, muscle strengthening and balance retraining (World Health Organization, 2018). There is cognitive training, physical exercise, pharmacologic, and modification of vascular risk factors can slow down the cognitive decline in this age group (Naqvi, Liberman, Rosenberg, Alston, & Straus, 2013).

In conclusion, older adults will benefit and live a quality of life with all the preventative measure if these implemented correctly. There are many resources that available to aid this population. The referral to the right program is also very important.

Reference:

CDC (2016). Identifying vulnerable older adults and legal options for increasing their protection during all hazards emergencies. Retrieved from https://www.cdc.gov/aging/emergency/pdf/guide.pdf

Schroder-Butterfill, E., & Marianti, R. (2013). A framework for understanding old-age vulnerabilities. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC36728…

World Health Organization (2018). Falls. Retrieved from http://www.who.int/news-room/fact-sheets/detail/fa…

Naqvi, R., Liberman, D., Rosenberg, J., Alston, J., & Straus, S. (2013). Preventing cognitive decline in healthy older adults. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC37079..

Peer discussion 2

The purpose of this discussion board is to discuss why older adults are often categorized as a vulnerable population and how risks to this population can be eliminated and/or minimalized.

Prior to becoming a Registered Nurse, I was a county Child/Adult Protective Services worker. With this experience, I absolutely agree in the categorization of older adults as a vulnerable population. As an APS worker, I investigated claims including abuse (physical, emotional, and sexual), neglect (physical and medical), and misappropriation of finances. Unfortunately, there are many, many older adults who have fallen victim. Oftentimes, a relative or close friend is the alleged perpetrator. This makes it difficult to investigate these cases as these individuals are in a position of trust with the victim.

One of my most difficult cases involved an elderly man of advanced age who owned the house in which he, his son, and his son’s girlfriend lived. The man had been frugal his entire life; he had paid off his house and had a sizeable amount of money in the bank. As the man grew older, he relied more and more on others to help care for him. Instead of obtaining a caregiver with the man’s money, his son and son’s girlfriend began to “care” for him by physically and emotionally abusing him as well as withholding food from him for punishment of needing too much help with his ADLs. Meanwhile, the son was able to convince his father to sign over his house to him and make him a co-owner on his savings account. When it was all said and done, the son sold the house from under his father, drained the entire saving account, and worst of all, physically abused the father so badly that he required emergency medical care. Had it not been for a solicitor at the door, the man’s situation may have had a very different outcome.

According to Friedman, Avila, Rizvi, Partida, & Friedman (2017), female older adults are at a higher risk of victimization. In addition, those with dementia are also at a higher risk because of stress and burn-out by those who are providing care (Friedman et al., 2017). In general, from my experience, older adults are dependent on their caregivers or loved ones, can be more trusting than later generations, and can be unable to defend themselves due to chronic illnesses or disabilities.

To me, the most important take-away from the above story is “see something, say something.” As I noted earlier, oftentimes, those that are in a position of trust are the perpetrators of abuse, neglect, and misappropriation. There are also situations in which an older adult may be neglecting themselves and need additional help that they are too proud or even afraid to ask for due to the potential that they may lose their independence as a result. As noted in the video “Spiritual Care in Gerontological Nursing” (Westera, 2009), nurses will continue to encounter older adults in almost all settings due to the increases in the older adult population. Nurses are on the front lines of identifying situations that effect this population and can provide interventions such as providing caregiver resources, providing information on community programs available to the older adult, and making referrals to county social service agencies to ensure safety.

References

Friedman, L. S., Avila, S., Rizvi, T., Partida, R., & Friedman, D.. (2017). Physical abuse of elderly adults: Victim characteristics and determinants of revictimization. Journal of the American Geriatrics Society, 65(7), 1420-1426. doi:10.1111/JGS.14794

Westera, Doreen (2009). Spiritual Care in Gerontological Nursing [Motion Picture]. Canada: Nursing Education Res. Retrieved from https://blackboard.ohio.edu/webapps/blackboard/exe…