Healthy Aging and Chronic Conditions
Aging is an inevitability of life that inspires an ambivalence of perspectives, with some seeing it as a pleasant experience and others viewing it as a tragedy. The latter may be ascribed to the loss associated with aging—the loss of loved ones, financial independence, vitality, and mobility. Although there are several classifications for this demographic, many studies categorize elderly persons between the ages of 65 and 74 as the youngest-old, those between the ages of 75 and 84 as the middle-old, and those above 85 years as the oldest-old (Lee et al., 2018).
Theodore Papadopoulos, the 83-year-old patient described, fits into the middle-aged group, accounting for 1.7% of the population in Western Australia aged 80-84 years (Australian Bureau of Statistics, 2018). Aging increases the risk of multiple comorbidities, including cardiovascular disease, diabetes, chronic obstructive pulmonary disease, cancer, and osteoarthritis, among others, due to waning immunity, long-term exposure to hazardous materials, and long-term engagement in health-risk behaviors such as smoking and alcohol consumption.
Treatment of the aged population, therefore, involves a healthcare professional who understands the population’s health and social requirements and designs age-appropriate treatments. The purpose of this paper, with reference to Theodore Papadopoulos’ case study, is to address multicultural aging in Western Australia and, more broadly, the plight of the elderly.
Question 1: Multicultural Aging in Australia
The economic and social makeup of the older population, especially the culturally and linguistically varied population of Australia, is critical for strategic planning at all levels of government. Australia has one of the world’s most culturally diverse populations, with one in every four of the country’s 25 million people born overseas, 46% having at least one parent born overseas, and approximately 20% of Australians speaking a language other than English at home (Australian Bureau of Statistics, 2022).
In 2013, overseas migration accounted for 60% of Australia’s population growth, and Greek ancestry, to which Theodore Papadopoulos belongs, is one of the largest ethnic groups, accounting for over 375000 people (Australian Bureau of Statistics, 2022). Greeks face prejudice in Australia since they are an ethnic minority, and certain races may perceive them as inferiors.
Furthermore, Greek immigrants may experience difficulties obtaining health and social services, as well as finding work, and hence may be financially grotesque. As a result, nurses providing care to the elderly Greeks must be culturally competent to comprehend their plight and provide appropriate treatment.
Question 2: Health Literacy
Information is a crucial determinant of health behaviors. Liu et al. (2020) define health literacy as the capacity of people to find, comprehend, and use information and services to guide health-related choices and behaviors. Mr. Papadopoulos is an 83-year-old patient who may be experiencing cognitive deterioration due to age or his recent diagnosis of dementia, which may jeopardize his health literacy. He also has hearing and vision problems, which may restrict his capacity to learn new health information.
A nurse must consequently explain to Mr. Papadopoulos’ daughters how to care for the patient at home upon discharge. Mr. Papadopoulos will need assistance with medications, movement, hygiene, and turning on the bed to avoid pressure ulcers, all of which the nurse must explain to his daughters. Adherence to healthy habits and assistance with many aspects of everyday life will hasten his recovery.
Question 3: Pain, Assessments, and Actions
Pain may be a challenging symptom to assess and treat in the aged population due to the various illnesses that may exist concurrently and induce pain independently of each other. It is unknown if the patient’s pain is caused by diabetes, osteoarthritis, or both. Diabetics, especially those who have had the illness for a long time, such as Mr. Papadopoulos, have advanced glycation end products (AGEs) deposited on nerves, leading to neuropathy, which causes pain, numbness, and tingling sensations (Papachristou et al., 2021).
Furthermore, degenerative disorders such as osteoarthritis are major causes of pain in the aged population. Physical examination, including gross light touch and pinprick sensation, is required to examine the patient for peripheral neuropathy. Doppler and angiography may be performed to check for ischemia, and laboratory testing may include random blood glucose, complete blood count, and hemoglobin A1C. Plain radiography of the suspected joint is essential for assessing osteoarthritis.
Diabetic neuropathy is managed using a tier system that includes paracetamol, amitriptyline, duloxetine, gabapentin, or pregabalin, with opiates as the final resort (Cernea & Raz, 2021; Penman et al., 2022). Non-pharmacologic therapies such as physical therapy, pharmacotherapy such as NSAIDs, and surgery as a last option, such as arthroscopy, osteotomy, arthroplasty, or fusion, will be required for the management of osteoarthritic pain (Bannuru et al., 2019). To improve pain relief, his loneliness and mental health issues must be addressed.
Question 4: Information on the Day of Discharge
Patients with dementia, alongside other medical comorbidities, may suffer twice as much since the condition causes severe cognitive deterioration. Learning and memory, language, and social ability may all deteriorate. Furthermore, dementia patients have severe interference with independence in daily tasks such as work and cleaning, necessitating the aid of close family members (Tisher & Salardini, 2019).
While discharging the patient, I will implore Mr. Papadopoulos’ daughters to assist him with medication adherence (antidiabetic meds, pain medications, etc.), cleanliness, and daily blood glucose measurement. Furthermore, I would advise them to prioritize nutritional care since their father exhibits signs of neglect (underweight, untidy). Moreover, since Mr. Papadopoulos is in danger of suicide due to loneliness and neglect, I would counsel his daughter to be as near to him as possible to offer him a feeling of love and belonging.
Question 5: Delirium and Assessment
In an emergency setting, delirium is easily mistaken for other medical problems. According to the American Psychiatric Association (2013), the fluctuation in attention and awareness is the hallmark of delirium. The disturbance in attention develops over a short period, usually hours to a few days, and other cognitive disturbances may be present, impacting memory, language, and perception (APA, 2013). In the acute care ward, Mr. Papadopoulos is unable to report if he has used his bowels in the last four days, and is confused, which may correlate to delirium symptoms of disrupted attention and cognition.
Delirium is an organic brain syndrome that has multiple causes. As a result, the nurse must do a comprehensive assessment of the patient to discover the cause of the delirium. Physical examination of all systems, evaluation of the history of drug addiction and modifications the patient is on, and laboratory testing such as complete blood count, urea, and electrolytes are among the assessments important in delirium (Lauretani et al., 2020). Helping the patient depends on the etiology of delirium, where medications, drug withdrawal, or just supportive care such as hydration and nourishment may be necessary.
Question 6: Continuum of Care
Care for the elderly needs the collaboration of various care professionals, as well as the patient and their family members. According to Thapa et al. (2020), a continuum of care is a notion that involves an integrated system of care that leads and tracks patients through time via a broad array of health services covering all levels of intensity of care. Mr. Papadopoulos will use health services and interact with healthcare specialists frequently since he has various diseases that need lifetime care. To ensure that his treatment runs well, care professionals must include the patient and his family in the care process.
This may be accomplished via regular physical encounters like clinic visits or through virtual interactions like telephonic calls, live audio-visual teleconferencing, text messaging, and other telemedical platforms. The technique is especially crucial for Mr. Papadopoulos in blood sugar management, where blood sugar measures will be taken and forwarded to their primary care physician, who will subsequently respond with further care guidance.
Question 7: Age-Related Changes in the Respiratory System
Aging is often associated with a decline in bodily system function. Peak airflow decreases with age, as do other measures of lung function such as vital capacity, the respiratory muscles weaken, and the efficiency of lung defense systems declines (Lin et al., 2020). The alterations make one more susceptible to respiratory diseases or worsen the effects of respiratory ailments.
Patients may have decreased exercise tolerance as a result of decreased lung function and weakening respiratory muscles. To improve their respiratory health, the elderly may benefit from respiratory physiotherapy and incentive spirometry, which expand the lungs and allow patients to breathe more deeply and thoroughly (Eltorai et al., 2018; Rodrigues et al., 2020). Furthermore, patients must refrain from risky health behaviors such as smoking, which increases the risk of lung cancer and weakens their immunity, rendering them prone to respiratory infections.
Australia boasts one of the world’s most culturally and linguistically diverse populations. The diversity is due in part to a large number of immigrants from other countries, each of whom retains and practices their own culture. Mr. Papadopoulos’ Greek origin is one of the great ethnic minorities that have lived in Australia since antiquity. As a minority, they confront barriers to health and social services due to cultural disadvantages. As a result, healthcare practitioners must comprehend this group’s challenges and devise age-appropriate health and social interventions to address the concerns.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. American Psychiatric Association. https://doi.org/10.1176/appi.books.9780890425596
Australian Bureau of Statistics. (2018). Western Australia. Gov.au. https://www.abs.gov.au/census/find-census-data/quickstats/2016/5
Australian Bureau of Statistics. (2022). Population. Australian Bureau of Statistics. https://www.abs.gov.au/statistics/people/population
Bannuru, R. R., Osani, M. C., Vaysbrot, E. E., Arden, N. K., Bennell, K., Bierma-Zeinstra, S. M. A., Kraus, V. B., Lohmander, L. S., Abbott, J. H., Bhandari, M., Blanco, F. J., Espinosa, R., Haugen, I. K., Lin, J., Mandl, L. A., Moilanen, E., Nakamura, N., Snyder-Mackler, L., Trojian, T., … McAlindon, T. E. (2019). OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis and Cartilage, 27(11), 1578–1589. https://doi.org/10.1016/j.joca.2019.06.011
Cernea, S., & Raz, I. (2021). Management of diabetic neuropathy. Metabolism: Clinical and Experimental, 123(154867), 154867. https://doi.org/10.1016/j.metabol.2021.154867
Eltorai, A. E. M., Szabo, A. L., Antoci, V., Jr, Ventetuolo, C. E., Elias, J. A., Daniels, A. H., & Hess, D. R. (2018). Clinical effectiveness of incentive spirometry for the prevention of postoperative pulmonary complications. Respiratory Care, 63(3), 347–352. https://doi.org/10.4187/respcare.05679
Lauretani, F., Bellelli, G., Pelà, G., Morganti, S., Tagliaferri, S., & Maggio, M. (2020). Treatment of delirium in older persons: What We Should Not Do! International Journal of Molecular Sciences, 21(7), 2397. https://doi.org/10.3390/ijms21072397
Lee, S. B., Oh, J. H., Park, J. H., Choi, S. P., & Wee, J. H. (2018). Differences in youngest-old, middle-old, and oldest-old patients who visit the emergency department. Clinical and Experimental Emergency Medicine, 5(4), 249–255. https://doi.org/10.15441/ceem.17.261
Lin, C., Lin, P.-F., Wang, C.-H., Juan, C.-H., Tran, T.-T., Pham, V.-T., Nien, C.-T., Lin, Y.-J., Wang, C.-Y., Yeh, C.-H., & Lo, M.-T. (2020). Probing age-related changes in cardio-respiratory dynamics by multimodal coupling assessment. Chaos (Woodbury, N.Y.), 30(3), 033118. https://doi.org/10.1063/1.5134868
Liu, C., Wang, D., Liu, C., Jiang, J., Wang, X., Chen, H., Ju, X., & Zhang, X. (2020). What is the meaning of health literacy? A systematic review and qualitative synthesis. Family Medicine and Community Health, 8(2), e000351. https://doi.org/10.1136/fmch-2020-000351
Papachristou, S., Pafili, K., & Papanas, N. (2021). Skin AGEs and diabetic neuropathy. BMC Endocrine Disorders, 21(1), 28. https://doi.org/10.1186/s12902-021-00697-7
Penman, I. D., Ralston, S. H., Strachan, M. W. J., & Hobson, R. (2022). Davidson’s principles and practice of medicine E-book (Ian D. Penman, S. H. Ralston, M. W. J. Strachan, & R. Hobson, Eds.; 24th ed.). Elsevier. https://books.google.at/books?id=vhl2EAAAQBAJ
Rodrigues, A., Muñoz Castro, G., Jácome, C., Langer, D., Parry, S. M., & Burtin, C. (2020). Current developments and future directions in respiratory physiotherapy. European Respiratory Review: An Official Journal of the European Respiratory Society, 29(158), 200264. https://doi.org/10.1183/16000617.0264-2020
Thapa, R., Zengin, A., & Thrift, A. G. (2020). Continuum of care approach for managing non-communicable diseases in low- and middle-income countries. Journal of Global Health, 10(1), 010337. https://doi.org/10.7189/jogh.10.010337
Tisher, A., & Salardini, A. (2019). A comprehensive update on treatment of dementia. Seminars in Neurology, 39(2), 167–178. https://doi.org/10.1055/s-0039-1683408
Assignment Description: Pharmacology
Healthy Aging and Chronic Conditions
For this class\'s project, you are going to interview a client, preferably over 65, who is taking at least five (5) medications. Based on the person\'s various chronic conditions, you will write, in narrative format, a case study that should include, at a minimum, the following: Identify each drug, the condition it is given for, why it was ordered? How long have they been taking the drug? What side/adverse effects has the person experienced? What side/adverse effects should the person be aware of? How does the person know if the drug is effective? Is the drug still needed? Create a brief teaching plan for each drug. How much does the drug cost? (What does insurance pay? Is there a copay?) How much does the person pay for a month\'s supply? Is the drug trade or generic? Include any and all information necessary for a comprehensive understanding of the drugs used for this client. THIS PROJECT IS DUE BY THE END OF WEEK 7. The paper will be submitted in Week 7 Module 2. Please write this paper using APA format for documentation. There should be at least ONE reliable source of drug information for EACH drug cited.