Healthy Aging Promotion in Australia

Question: Discuss about the Healthy Aging Promotion in Australia. Answer: Introduction: The essay is about the increase in proportion of ageing population in Australia and its influence on nursing practice. The statistics on ageing in Australia demonstrate how and why Australia's population is ageing. The data on the increase in life expectancy among Australian citizens in the past and their comparison with present statistics reveal how life expectancy has increased, and people are living for longer time. It analyzes the factors that have lead to ageing of population in Australia. It reveals that technological advancement in surgery technological interventions, improved housing, better workplace environment and improved sanitation has helped to reduce mortality rate and fertility rate. Besides this migration of baby boomers generation has further increased the expected duration of life of individuals. The number of people above 65 years of age is continuously increasing in Australia. The ultimate impact of this trend will be that demand for health and geriatric service will increase in the future. In the event of this change, it will be vital for nurses to understand the skills required for assessment of older people. Proper holistic care will be possible with effective assessment of older population. This essay further emphasized the role of strength based approach in nursing older adults and how this approach could help in improving health status in individual. According to Australian Government, people above 65 years are considered to be ageing. However, this figure differs for indigenous Australians because of their vulnerability to chronic disease. The ageing trend is seen mostly in the baby boomer generation. Baby boomers were born in 1947, and this group of people will move to the old old' category of elderly population-those aged above 85 years (Buckley et al., 2013). Today's older Australians are living healthier and longer than previous generations. In 1960 the life expectancy at birth was 74 years for girls and 67 for boys, but now girls are expected to live longer till 84 years and men till 80 years ("About ageing in Australia (AIHW)", 2016). In Australians, life expectancy for people above 64 years in 2012 was 84.1 for males and 87.4 for females (CDU Library eGateway Login, 2016). The number and proportion of older population in Australia are growing steadily. It is evident from the fact that about 15% of Australian were above th e age of 65 years in 2014 while in 1964 it was just 8%. The proportion of individuals above 65 years is expected to double in the next thirty years ("About ageing in Australia (AIHW)", 2016). The increase in ageing population has occurred because of changes in population's fertility, mortality and migration. The mortality rate has decreased because of invention of antibiotic, vaccination, improvement in housing. The major death due to childbirth has decreased significantly. The fertility rate has declined over the years leading to fewer birth every year and increase in proportion of aged people. Sanitation, workplace health and safety, and development in pharmacological interventions have helped in reducing death due to chronic disease. Technological advances in surgery, decrease in infection rate and better understanding about progression of illness has helped a lot in improving health status (Mathers et al., 2015). Secondly, stability in mortality rate is another reason for population ageing in Australia. Aged people are now living for a much longer age time compared to those in the past. Earlier 74% people expected to reach the age of 65 years and then this group expec ted to live till 79 years (CDU Library eGateway Login, 2016). The Australian Bureau of Statistics reveals that about 23% people will be above 65 years, and 5% will be above 85 years by 2064 ("About ageing in Australia (AIHW)", 2016). Thirdly ageing population has increased due to the effect of migration. The influx of migratory people who are member of postwar Baby Boom cohort has further added to the ageing population Australia. They will continue to have an impact on the size of the population (Martel et al., 2013). The ultimate consequences of the ageing population will be that it will have an impact on health care services. The reliability of medical service will increase among the older population. The demand for living independently at home and managing things on their own will increase, and increase number of aged care service will be required (Lewin et al., 2014). Therefore the major impact will be on government health and welfare expenditure. They will have to invest more in aged care and disability services to provide residential care from their home or hostels. With the increase in ageing population, the healthcare staff will require holistic skills on assessment of older people. Often they confuse between normal changes associated with ageing and the disease process. Therefore better understanding is needed about the mechanism of ageing and symptoms of chronic diseases among this age group. The leading disease mostly prevalent in older age group is arthritis, dementia, cardiovascular disease, cancer, respiratory illness, diabetes, osteoporosis and many others. The assessment of older adults includes assessment in different levels of chronic disease care, acute care, and primary care. The major focus should be on person-centered care to understand patients perspective of problem. A health care staff must have the skills to identify patients strength and weakness to provide them appropriate care. They need to have clear ideas about ageing and disease process (Fillenbaum, 2013). For example, the symptoms of dementia and ageing are very similar. Often people ignore the symptoms of dementia as they consider it to be a normal ageing process. The assessment in older adults is complicated. The nurse must adopt holistic approach to care. In normal aging, mental flexibility is lost, and memory changes occur while in dementia, mental decline is severe enough to disrupt daily life activities. It affects the core functions of the brain like memory, language, visuospatial function and ability to focus on any task (Lpez-Otn et al., 2013). Health staff mu st have the skills to differentiate between dementia and normal aging process to plan effective intervention for aged population. They must have the clinical judgment to enable older adults to cope with their problems (Gold, 2012). Stress, loneliness, and negativity also affect older adults a lot. They also have obscure manifestations of disease which is difficult to detect and by the time the actual problem is detected, major complications take place in older people. The knowledge about cognitive assessment in older people is essential for nurses and health care staff. It would help clarify the presence of one or more symptoms of dementia or depression. Firstly close observation of patients is necessary to determine whether symptoms represent dementia, delirium or depression. Often this condition is caused by the effect of taking certain drugs. So medication review will be extremely important part of older people assessment. They complete health checkup should involve monitoring their nutritional status, signs of chronic diseases, vital signs observation, physical and neurological examination (Klepin et al., 2013). Assessment of older people will require physicians and nurses to have broad knowledge about physical, biological, psychosocial, functional and psychological assessment of individuals. The patient's social network, religious and occupational pursuits are also important. The restorative approach should be taken to maximize independence and functional ability of older adults. This can be achieved by the focus on rehabilitation that enhances older people's independence in daily activities. Before dealing with any patients, they must always be aware of their current health status (Zarit Zarit, 2012).The first level of assessment looks at functional activities, and patients care, the second level of assessment monitors patients independence in life activities like self-medications, routine activities, shopping and other. The final level of evaluation will look after advance activities of life such as occupational and recreational activities. The goal should be to maximize life potential, prevent disease symptoms and stress due to it and promote maintenance of health by improving personal hygiene, nutrition, mobility and motivation level in patients (Curtis et al., 2013). Strength-based approach to nursing older adult is a process that values the capacity, skills, knowledge and potential of individual. It encourages practice that focuses on people potential and strength rather than their limitations. In strength-based approaches, older adults strength are used as building blocks to plan major interventions. Secondly, it works to make sure that required assets and resources are available to enhance patient health outcome. It relies more on capacity and intention of older adults to recover. To implement this approach, nurses acknowledge contribution of patients and focuses on personal relationship. It is a method to invite meaningful participation, providing opportunities for skill-building and concentrating on potential of older adults (Moyle et al., 2014). Strength based approach is beneficial in helping older adult do things themselves and improving retention in treatment regimen. It also develops social networks and enhances well being of person. With the increase in older adults populations, self-management of disease will be essential to resolve their problems and deliver long-term therapeutic care. Deployment of personal strengths aids recovery and empower patients self-esteem and motivation in life. It will also minimize the burden of health services as it focuses on prevention of disease and independence (Hirst et al., 2013). As reported above, Australian demographics showed gradual increase in geriatric population in Australia. The consequences are more demand for health care and residential care to treat older population. Disability and mental health disorders will be a major factor influencing aged person quality of life. Different strength based assessment tool useful in nursing older adults are the Behavioral and Emotional Rating Scale (BERS) and Care Receiver Efficacy scale (CRES). The BERS scale is used to measure strength of older adults and rate their improvement with time (Wetherell et al., 2013). The CRES tool assesses the self-efficacy in older patients and it is structured to improve their self-efficacy in receiving care. In this case, nurse may monitor their ability to cope with diseases and tries to know their perception of independence (Alves et al., 2016). For example strength based approach can be used to improve cognitive impairment in older adults with dementia. It may involve sessions on interacting with patients and teaching them ways to improve their cognitive skills. Greater ability to cope with illness and managing medications themselves will increase satisfaction level of older people and promote speedy recovery. For persons coping with dementia, nurses can work to teach them new skills and enhance their existing strengths. The programs will include a guided session to educate patient about dementia and aid in recognizing emotions and behaviors (Geldmacher Kerwin, 2013). A solution focused therapy could be done on patients to identify the issues faced by older populations and guide them to manage situation. It starts by asking relevant question like problems that trouble them in life and then tries to identify the patient response to understand their strength and weakness. This therapy helps to separate problems from patients and aids them in following a solution focused pathway on improving health outcome. This approach is used in mental health setting to guide patients to deal with challenges they face due to cognitive and mental disorders. It may help in identifying depressive symptoms in patients and engage them in activities that relax and relieves them from their illness (Gingerich Peterson, 2013). From the essay of ageing in Australia, it can be concluded that appropriate preparedness of health care department is required to tackle and treat older population in the futures. The demographics and statistics on ageing population into Australia bring into focus the alarming rate at which Australia is moving towards an ageing population. The increase in Proportion of an ageing population will mean introducing greater competency and frequency in health care access. Geriatric care would be essential then to tackle health issues of ageing population. The assessments of older people demonstrated what are the skills required by a nurse to undergo complete assessment. It stresses on the need to differentiate between normal ageing process and chronic disease process. Certain symptoms of disease like dementia, delirium and ageing are often confused by nurses. So having accurate competent in assessing all necessary details of patients helps in planning effective intervention plans. Finally, the essay demonstrated how the use of strength-based approach could be beneficial in nursing older adults and increase independence in their life. Reference Alves, S., Teixeira, L., Azevedo, M. J., Duarte, M., Pal, C. (2016). Effectiveness of a psychoeducational programme for informal caregivers of older adults.Scandinavian journal of caring sciences,30(1), 65-73. Buckley, J., Tucker, G., Hugo, G., Wittert, G., Adams, R. J., Wilson, D. H. (2013). The Australian baby boomer populationFactors influencing changes to health-related quality of life over time.Journal of aging and health,25(1), 29-55. Curtis, J. R., Back, A. L., Ford, D. W., Downey, L., Shannon, S. E., Doorenbos, A. Z., ... Arnold, R. W. (2013). Effect of communication skills training for residents and nurse practitioners on quality of communication with patients with serious illness: a randomized trial.Jama,310(21), 2271-2281. Fillenbaum, G. G. (2013).Multidimensional functional assessment of older adults: The Duke older Americans resources and services procedures. Psychology Press. Geldmacher, D. S., Kerwin, D. R. (2013). Practical diagnosis and management of dementia due to Alzheimers disease in the primary care setting: an evidence-based approach.Prim Care Companion CNS Disord,15(4), 1-14. Gingerich, W. J., Peterson, L. T. (2013). Effectiveness of Solution-Focused Brief Therapy A Systematic Qualitative Review of Controlled Outcome Studies.Research on Social Work Practice,23(3), 266-283. Gold, D. A. (2012). An examination of instrumental activities of daily living assessment in older adults and mild cognitive impairment.Journal of clinical and experimental neuropsychology,34(1), 11-34. Hirst, S. P., Lane, A., Stares, R. (2013). Health promotion with older adults experiencing mental health challenges: A literature review of strength-based approaches.Clinical Gerontologist,36(4), 329-355. Klepin, H. D., Geiger, A. M., Tooze, J. A., Kritchevsky, S. B., Williamson, J. D., Pardee, T. S., ... Powell, B. L. (2013). Geriatric assessment predicts survival for older adults receiving induction chemotherapy for acute myelogenous leukemia.Blood,121(21), 4287-4294. Lewin, G., Allan, J., Patterson, C., Knuiman, M., Boldy, D., Hendrie, D. (2014). A comparison of the homeà ¢Ã¢â€š ¬Ã‚ care and healthcare service use and costs of older Australians randomised to receive a restorative or a conventional homeà ¢Ã¢â€š ¬Ã‚ care service.Health social care in the community,22(3), 328-336. Lpez-Otn, C., Blasco, M. A., Partridge, L., Serrano, M., Kroemer, G. (2013). The hallmarks of aging.Cell,153(6), 1194-1217. Martel, C., Carson, D., Taylor, A. (2013). Changing patterns of migration to Australia's Northern Territory: Evidence of new forms of escalator migration to frontier regions?.Migration Letters,10(1), 101. Mathers, C. D., Stevens, G. A., Boerma, T., White, R. A., Tobias, M. I. (2015). Causes of international increases in older age life expectancy.The Lancet,385(9967), 540-548. Moyle, W., Parker, D., Bramble, M. (2014).Care of Older Adults: A Strengths-Based Approach. Cambridge University Press. Wetherell, J. L., Petkus, A. J., White, K. S., Nguyen, H., Kornblith, S., Andreescu, C., ... Lenze, E. J. (2013). Antidepressant medication augmented with cognitive-behavioral therapy for generalized anxiety disorder in older adults.American Journal of Psychiatry,170(7), 782-789. Zarit, S. H., Zarit, J. M. (2012).Mental disorders in older adults: Fundamentals of assessment and treatment. Guilford Press. About ageing in Australia (AIHW). (2016).Aihw.gov.au. Retrieved 18 August 2016, from https://www.aihw.gov.au/ageing/about/ CDU Library eGateway Login. (2016).Search.informit.com.au.ezproxy.cdu.edu.au. Retrieved 18 August 2016, https://search.informit.com.au.ezproxy.cdu.edu.au/fullText;dn=395422637064551;res=IELAPA