Physical Activity Is The Medicine For Older Adults Discussion Paper

Potential Impacts Of Health Complications On Seniors

Being diagnosed with acopia at admission could have several impacts on Elizabeth, some of which could be lethal. Diagnosis of acopia simply means that Elizabeth is unable to cope with activities of daily living. Previous researchers have documented that patients hospitalized with acopia always have more wanting health complications that warrant for urgent medical action but are not diagnosed. This explains the high mortality rate for such elderly persons (Theou & Rockwood, 2015). Elizabeth could also be suffering from more serious complications but is simply labeled as social admission. On close observation, the RN in charge could find out that there is a prevailing pathological condition calling for an advanced check. Additionally, by Elizabeth being diagnosed with acopia, some level of bias may prevail and subsequently lead to omission of some important medical diagnosis being missed.

Medical personnel also tend to show limited concentration on acopia patients who could develop complications over time since admission. With her age also, Elizabeth could be in a condition of sub consciousness. This means that she cannot even express her state adequately. Consequently, a deteriorating health condition may not be brought into the limelight and she may, therefore, miss crucial medical attention (Dening & Thomas, 2013). With evidence of certain terms such as ‘bed-blocker’ used by medical staff to refer to patients of social admission, sufficient attention may not be given to Elizabeth. It is also possible that an early discharge will be given to Elizabeth who will head back home where patient-centered care is not available. As a result of all the aforementioned, Elizabeth could end up passing on in the near future due to a worsened health condition.  Physical Activity Is The Medicine For Older Adults Discussion Paper

With her current age and condition, it is most likely that Elizabeth will be bed-ridden most of the time. She will, therefore, be lying in one position for long periods and exerting pressure to certain parts of her body such as her buttocks and the back of her head (My-aged-care-Staff, 2016). I many situations, untamed pressure area usually results to pressure ulcers.  Also, diseases associated with old age and affecting the skeletal muscle and the neuromotor are likely to influence Elizabeth’s functional capacity and subsequently interfere with her nutrition, mobility, moisture, and sensory perception. All the aforementioned are classic factors that accelerate pressure ulcer development. Due to her advanced age, Elizabeth is also likely to have fecal and urinary incontinence. These are most likely to speed up the development of pressure ulcer in pressure areas due to the caustic nature of fecal matter and excessive moisture that her skin will be exposed to.

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Benefits Of Physical Activity For Older Adults

Ageing also causes an elderly person to change from the conscious state to the sub-conscious state. Consequently, while in that state, Elizabeth will not be able to turn herself nor make requests to nurses to turn her after lying on one side for long. Pressure area will subsequently develop on the side that she has been lying on for long. Ageing in Elizabeth is also likely to cause weakening of the skin tissues. Subsequently, her skin will not be able to withstand the high pressure exerted on it. Pressure ulcers are therefore most likely to occur.

Pradip being 66 years old, there are several reasons that make him more vulnerable to adverse drug reactions to drugs that could be prescribed to him to treat his chronic illnesses. First, elderly people have smaller bodies as well as different body composition. Compared to younger adults, older people weigh less generally. They also have smaller water content and significantly larger proportion of fat. At the age of 40-60 years, adults experience an increase in body weight which then decreases at the age of 60-70 years. Subsequently, the drug per body weight pound ratio or drug per body water pound will always be higher for an older adult than in a younger adult whenever similar amounts of drugs are administered for both parties (Davies & O’Mahony, 2015). Pradip’s liver could also have a decreased ability to process drugs. With an increase in age, the functional ability of the liver decreases and subsequently, processing and excretion of certain drugs is slowed or even halted completely.

Increase in age also results in decreased ability of the kidney to clear drugs from the body. At the age of sixties, Pradip’s kidneys have already lowered their filtering ability by 30%. With multiple prescriptions, adverse drug reactions and interactions are likely to result from the many drugs that Pradip is taking. The commonest form of adverse drug interactions is that certain drugs could cause others to accumulate to toxic levels in his body. Two or more drugs could also react adversely to the body resulting in toxic productions that could be of harm to his body (O’Connor, Gallagher, Byrne, & O’Mahony, 2012).

There are several advantages that Pradip will draw from having one general practitioner and one pharmacist. His choice should be however well thought of before settling on a specific specialist. First, having one general practitioner and one pharmacist will aid in the development of an open two-way communication channel. One general practitioner will take his complete history, ask him numerous questions regarding his past and current health while simultaneously asking him to be honest and open. The GP will then always refer to the recorded information in the future when attending to Pradip. Having one GP reduces instances of the doctor having to rush through Pradip’s records only during visits which increases the chances of settling at uninformed decisions (Logan, 2016). Meaningful relationships are also established by having only one GP and pharmacist to attend to him.

Challenges Faced By Seniors In Maintaining Physical Activity

By having one GP and pharmacist, Pradip will also be involved in shared decision making with them. The GP will always give him the opportunity to select the best treatment approach that he will be most comfortable with based on his goals and wishes. The GP will also have the opportunity and foundation of recommending treatment approaches based on previous approaches that the GP will have a clear record of; including any complications that could have resulted from certain approaches. Having one pharmacist attending to Pradip will give the Pharmacist the opportunity to develop follow-up on prescribed drugs (Donald, et al., 2017). Pradip will also have the opportunity to express any kind of adverse drug reaction that he may encounter. Consequently, the pharmacist will know the right kind of medicine to prescribe and those to avoid.

Chronic pain will have a direct impact on almost every aspect of Arlinda’s life. To begin with, the pain will be a significant cause of functional impairment of the affected organ. The pain is also likely to disturb her sleep in various ways. By having to endure pain throughout the day, she could find herself having difficulties falling asleep (Patel, Guralnik, Dansie, & Turk, 2013). While in bed, the normal turning may result in pain in her leg and subsequently result to frequent awakenings that will lower the quality of her sleep. Additionally, reduced pain threshold may occur due to reduced quality of sleep as well as sleep deprivation. Consequently, Arlinda will have a reduced ability to cope with chronic pain. There are also high possibilities that she is going to experience depression.

She is also likely to get distressed because of inability to perform even some of the basic things she previously did for herself. This is known as dependence for activities of daily living (Gibson & Lussier, 2012). Although she might be able to adapt to the pain and may not show signs of distress on a daily basis, long-term effects may prevail in her and manifest in form of depression. If her chronic pain gets intense with time, Arlinda is most likely to develop cognitive malfunction. Additionally, chronic pain in her leg will result in immobility. Consequently, she is also likely to be a victim of social isolation. It is likely that she will not be able to access some of the social places and people that previously revolved in her life.

Conclusion

Due to her advanced age, Arlinda is most likely to experience slow wound healing. First, her skin elasticity has reduced due to her age. This is due to the degradation of the collagen fibers located in the outer dermal layer as well as dilapidation of elastic tissues (Sgonc & Gruber, 2012). Physical Activity Is The Medicine For Older Adults Discussion Paper Both the two are essential in flexibility and strength provision as well as in aiding tissues in the recovery of their original states. Subsequently, Arlinda will have slow healing of her wound and increased chances of scarring from the wound. Slower collagen replacement is another factor that will slow her wound healing process. With reduced elasticity, the amount of collagen found in her body will also lower. Collagen fibers are vital for cellular development and for regeneration of tissue in all layers of the dermis. With low amounts of the crucial fibers, her wound is bound to heal slowly. Age-related diseases are also potential causals of slow wound healing for Arlinda (Advanced-Tissue, 2014). Certain diseases such as diabetes and cardiovascular disease amongst other diseases that affect the flow of blood are more common in older adults. If Arlinda happens to be suffering or to be diagnosed with any of them, they are likely to be detrimental to the entire healing process. This is because the wound area will not receive blood in sufficient quantities and subsequently, it will be low in oxygen and malnourished.

Monty being 80 years of age, there are changes that have occurred or are occurring in his lungs and greatly increase his chances of contracting pneumonia. Advancement in age results to remodeling of lung matrices. As a result, alteration in the turnover and structure of collagen and elastin occurs accompanied by a reduction in lung elastic recoil (Kim, Heise, Reynolds, & Pidaparti , 2017). Cross-sectional diameter in distal airspaces homogenously increases accompanied by loss of the surface area for alveolar gaseous exchange, as well as a decrease in the number of capillaries in each alveolus. Small airways decrease in diameter as a result of decreased tethering. Subsequently, the airways develop a tendency to close more freely at a certain lung volume. This brings about a reduction in expiratory flow rates as gases get trapped in the airways that close during respiration. This causes an upsurge in residual capacity at the cost of vital volume. Monty could also experience a progressive decline in chest wall compliance due to changes in lung elasticity (Medline-Plus, 2018). Reduced mobility of the costovertebral joints, narrowing of spaces between intervertebral disks, gradual appearance of varying degrees of kyphoscoliosis and calcification of intercostal cartilages are also factors known of contributing in the reduction of the chest wall. Performance of the respiratory muscles also lowers whereby; there is a reduction in the maximal diaphragmatic force and a loss of cross-sectional area by the respiratory intercostal muscles. A combination of all the aforementioned greatly predisposes Monty at higher risk of getting pneumonia due to changes in the lungs functioning.

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Incidental exercises are activities built up in small amounts throughout the day with no specific goals. Such exercises will be of great help to 80 years old Monty and should be recommended by the RN for various reasons. First, by engaging himself in these exercises, Monty will evade himself from the risk of health complications that are attributable to sedentary behavior. Examples of such complications are; high cholesterol, cardiovascular disease, hypertension and type II diabetes. Incidental exercises should also be recommended as they will maintain Monty’s physical fitness (Keppo, 2017). If Monty’s day is dominated by sedentary behavior, he may experience stiffness in some parts of his body; more so his legs. Such stiffness can be easily eliminated and subsequently avoided through incidental exercises.

At his age, Monty is also likely to have constricted blood vessels. This condition could restrict blood flow to vital body organs and result in complications such as heart attacks. Incidental exercises will play a big role in facilitating blood flow throughout his body. Additionally, they will aid in preventing the reduction of muscle strength and bulk due to inactivity (Taylor, 2013). There are various incidental activities that a patient could indulge in when in an acute ward. First, a patient could frequently walk themselves to the washrooms. Pedometers could also be used in promotion of physical activity. Accelerometers are other devices that could be used to monitor and promote ambulatory activities. Patients could also be recommended to feed themselves during mealtime to exercise the muscles of the hands.

References

Advanced-Tissue. (2014, Nov 06). Age and Its Effect on Wound Healing. ADVANCED TISSUE. Retrieved August 21, 2018, from https://advancedtissue.com/2014/11/age-effect-wound-healing/

Davies, E. A., & O’Mahony, M. S. (2015, May 22). Adverse drug reactions in special populations – the elderly. British Journal of Clinical Pharmacology, 80(4). doi:10.1111/bcp.12596

Dening, T., & Thomas, A. (2013). Oxford Textbook of Old Age Psychiatry (illustrated ed.). OUP Oxford.

Donald, M., King-Shier, K., Tsuyuki, R. T., Al-Hamarneh, Y. N., Jones, C. A., Manns, B., . . . Hemmelgarn, B. (2017, March 6). Patient, family physician and community pharmacist perspectives on expanded pharmacy scope of practice: a qualitative study. CMAJ Open, 5(1). doi:10.9778/cmajo.20160135

Gibson, S. J., & Lussier, D. (2012, April 1). Prevalence and Relevance of Pain in Older Persons. Pain Medicine, 13(2). Retrieved August 21, 2018, from https://academic.oup.com/painmedicine/article/13/suppl_2/S23/1847844

Keppo, S. (2017, July 31). WHY IS INCIDENTAL PHYSICAL ACTIVITY IMPORTANT? OPTIMUM Health solutions. Retrieved August 21, 2018, from https://www.opt.net.au/incidental-physical-activity-important/

Kim, J., Heise, R. L., Reynolds, A. M., & Pidaparti , R. M. (2017, August 28). Aging effects on airflow dynamics and lung function in human bronchioles. PLOS ONE. Retrieved August 21, 2018, from https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0183654

Logan, W. C. (2016, January 18). Importance of Having a Primary Care Physician. ALL ABOUT SENIORS. Retrieved August 21, 2018, from https://www.allaboutseniors.org/importance-of-having-a-primary-care-physician

Medline-Plus. (2018, August 14). Aging changes in the lungs. MEDLINE PLUS. Retrieved August 21, 2018, from https://medlineplus.gov/ency/article/004011.htm

Physical Activity Is The Medicine For Older Adults Discussion Paper