ACTIVITIES OF DAILY LIVING: As we age the need for assistance with activities of daily living will rise especially older adults greater than 80years old with chronic diseases. There are needs to increase institionalized cost and financial incentives to families to care for their older love one at home.Some health problems and hospitalization has resulted in period of vulnerability and dependency on others.There are needs for adequate support and good quality of care at home.
SOCIAL SECURITY SERVICES : So many elderly people discovered when it is too late that their social security is too small for them to depend on because with age, so many elders need prescription drugs to maintain and survive.It is important for the nurses to understand that part of their job is education of patients and families. Assisting the vulnerable elderly to be aware of their options if they are financially handicap.
BLACKS AND OTHER MINORITY: So many black people without college education do not have enough money to take care of themselves as they aged.They have been disadvantaged in Education and income throughout out their lives and are therefore poor in old age.Social security is not enough since they struggled throughout when they were actively working. However Social Security are reliable atleast one is sure to receive a certain amount of money every month guaranteed. Rheumatoid arthritis and Osteoarthritis with the wear and tear can create deformities and stiffness making it difficult to perform activities like climbing the stairs, twist and opening up a container.
STRUCTURE AND POSTURE :Every 20years 1.2centimeter of height is lost. The vertebral disk due to dehydration will become thin which causes a shortening of the trunk.The aged individuals then develop a stooped forward- bent posture. With the knee and hip flexed, the arms bent at the elbows. Some elders are more compromised than the others.
DECREASED CARDIAC OUTPUT :
There are reduced efficiency and contracting of the heart as we age.This diminished Cardiac output will be more noticeable when the individual is physically or mentally challenged with illness, stress, worries,anxiety or excitement. The heart rate in an elderly will be very slow to return to its baseline. The heart of an elderly with CHF or Hypertension cannot be enlarged when everything is shrinking down.As a nurse follow the doctor orders and your hospital policy and procedures. Be knowledgeable, caring and compassionate. HEARING IMPAIRMENT among the elders: Over 22millions people have hearing impairment .Over 50% of people over the age of 65years have hearing impairment and greater than 90% of institutionalized elders have hearing impairments. Changes in the middle ear and the inner ear worsen with age making it very difficult to hear and difficult to function.
MACULAR DEGENERATION: Aged eyes admits less light to the retina and intervention for the elders with limited resources are relegated to the background. Some elders go through getting loss, stumbling and falls, and difficulty seeing in the dark.Many changes are affected by a decrease in blood supply because of natural deposits of calcium and fats in the vessel intima.
WEAR. AND TEAR: This is due to life long time abuse of the body from accidents, athletic injuries, and physical trauma. A sunken appearance of the eyes due to the disappearance of fat deposits around the orbit of the eyes. This is more common among the sick elders and malnourished.
THE KIDNEY: There are evidence of age-related glomerular sclerosis in elders population greater than 85years.Abnormal glomeluri increase by about 40% by the age of 90years.
WIDOWS: A fragile elderly widow woman might be having difficulty with ADL and will need family support, resources and community support. Sometimes family members might not be willing to help or not in the position to help.So the vulnerable elderly will rely on the community for help.
OLDER HOMOSEXUAL: Some older homosexual might have difficulty in the community that they found themselves because health care providers are insensitive and lack information on how to take of older fragile elder homosexuals.
POVERTY AMONG ELDERS:Some couples have bonds, stocks, homes, vehicles, real estate. They might decide to sell their home and move to a smaller home and are able to have required help needed for ADLs .Some couples will decide to stay in their house until death with reverse mortgage plan in place. They occupy their homes for life and apply reverse mortgage instead.The revenue shared approach mortgage(RSAM)is used.But poor couples have no such opportunity no retirement plans,savings, bonds, real estate and vehicles. It is good for older adults and everyone to have things needed to maintain themselves,their body and souls such as outdoor air,exercise, nutritious meals and favorite events. ” Physical fragility of the older adults are clinically recognizable state of increased vulnerability to stress poor health outcomes such as disability, falls,institutionalization and death .It is often defined as a medical syndrome that results from age-associated decline across multiple physiology system. Healthcare providers and researchers need a standardized method that is consistent and accurate measurement to identify endangered fragile elders”.The Johns Hopkins Frailty Assessment Calculator.