Ageism In Older Adults

Introduction

This assignment intends to analyse the concept of ageism in older adults. Besides, the work will look at the prospects of wellbeing in the elderly population and examine some of the factors that can have a positive or negative impact on wellbeing, examine the nature of falls, and the associated risk factors. In addition, the study will look at Lewy Body Dementia and the Mental Capacity Act of 2005. Further, the study will identify potential factors that are responsible for making people with mental illness experience falls, and certain preventive measures to avoid the fall are to be discussed. The work will further analyse the impact of mental health problems on patients and their families over time and examine the intervention along with assessment techniques and support systems that are designed to resolve the problems. Finally, the study will implement ethical principles along with policy guidelines and innovative solutions following Mental Capacity Act 2005, which are required in the case study of Frances and finally conclude by giving a summary overview of major discussions raised herein.

OUTCOME 1: Analysing the factors which are able to contribute to protecting or deteriorating well-being of the elderly

In the coming years, there is going to be a dramatic increase in the number of elderly present in the United Kingdom, and the mental health issue is going to be one of the critical health issues faced by them. At present, depression is found to be one of the common mental health issues found among the elderly, and it is evident as 2.4 million elderly people in the UK are suffering from severe depression. The numbers are expected to increase to 3.1 in the coming 15 years if any effective actions are not taken. The Mental Health Foundation (2015) informs that discrimination due to prejudice related to mental illness is one of the key issues faced by individuals above the age of 55 years having mental illness. The stigma regarding mental illness creates profound difficulties for the elderly with mental health issues.

The promotion of mental well-being among the elderly is going to benefit society by allowing the elderly to have proper economic and social rights, experience minimised care cost, and improved health. There has been increased in the evidence related to factors regarding mental health and well-being among the elderly. Therefore, the activities related to the promotion of mental well-being are able to be integrated into the present development policy and practice that are contributing to the change momentum regarding elderly mental healthcare. The factors which act to protect the well-being of the elderly involve participation in meaningful activities, having relationships that are supportive and meaningful, and ensuring that older adults have good physical and mental health. Moreover, poverty is another risk factor related to mental illness.

Regarding participation in meaningful activities, it is essential that older people stay active and have a sense of purpose because it is important for their improved health and well-being as it is for young individuals. However, it is still found that the elderly with mental illness experience many obstacles in private as well as public life (Gilleard & Higgs, 2018). Therefore, it is critical that the skills possessed by older people are recognized so that opportunities can be provided for them to contribute to society and share their talents with people of all ages. Barriers that prevent older people from participating in meaningful activities should also be removed and promote opportunities that provide lifelong learning for everyone. Finally, it is essential to help people to take retirement that is planned and flexible.

Older people need assistance from family and friends as well as require pets. The effective support towards the religious and spiritual beliefs of the elderly people also offers them crucial supportive and meaningful relationships. Social isolation is regarded as a risk factor for mental illness, as nearly one million people experience it in the UK. Therefore, it is critical to strengthen positive relationships in later life to help in promoting wellbeing and mental health. There are many things that need to be done such as recognizing and strengthening the positive relationships that older people already have with family, friends, and neighbors. It is also crucial that the fear of loneliness and isolation is tackled, recognize, and dealt with violence and abuse that affect older adults, and understand the importance of faith and spiritual belief and ensure that older people can access them. Finally, it is essential to encourage older people to have social interactions and include older adults in community development initiatives.

The mental and physical health are interlinked as having deteriorated mental health leads the patients to become unresponsive to medications provided for their improved physical health as well as body functioning is hindered that also negatively affected the physical health. Physical fitness is a critical issue for many older adults, and improving it improves mental health. Therefore, it is essential to have a holistic definition of health, which incorporates both psychological and physical health. Physical activity also needs to be promoted in older adults and provide opportunities for older adults to engage in physical activity. As mentioned earlier, poverty is a risk factor for mental health in older people, and almost 2 million older adults in the UK live in poverty. It is not about money as such but the things that money can offer that are critical to making older people feel that they are included in society. Older adults want to have enough money to afford heating, decent housing, social activities, and travel. This will allow them to participate fully in community and family life. Older people have good mental health and wellbeing when they are confident about their financial security.

The Role of Nurses in Combating Ageism

Major consumers of healthcare are older adults. In the context of an aging population, the presence of older people will continue to grow in the health care system. Ageist discrimination and stereotypes against older people have an impact on the wellbeing and health of older citizens and present some of the barriers to health equality (Wyman, 2018). Therefore, nurses have a critical role to play in combating ageism. Nurses should understand that illnesses can present differently in older patients than in younger people. Ageism can negatively impact the care that nurses provide to older people by clouding the assessment of nurses, which can result in misinterpreting or ignoring critical findings. Too often, healthcare providers and nurses are quick to associate symptoms and signs of illnesses to the normal process of aging. This results in healthcare professionals missing essential indicators that need to be addressed. Nurses should understand the aging process and teach other people to decrease ageism. When nurses have greater compassion, they can reduce ageism. Also, by examining biases that they may have towards older adults, nurses can reduce ageism. Nurses can also combat ageism by interacting with older people who are active to realize that not all older adults are frail and sick and that many older people have productive and meaningful lives (Ouchida & Lachs, 2017). This will help nurses to modify their ageist attitudes and build and strong sense of community. Finally, nurses need to look for support through education and administrators so that they can feel that their work with older people is significant.

OUTCOME 2: Risk factors of fall in an older adult with mental health

About 30 percent of people above the age of 65 fall each year (Sharif, Al-Harbi, & Sharif, 2019). This percentage rises to almost 50 percent of older people who are 80 years and over. Conditions such as delirium and dementia can further raise the risk of falling, according to the Royal College of Physicians. The risk factors that are responsible for the patients to experience falls include gait and balance disorder, the impact of medication, sensory impairment and aging (Sharif, Al-Harbi, & Sharif, 2019).In comparison to the general population, the people who are visually impaired are 1.7 times more likely to experience falls, 1.9 times likely to experience multiple-falls, 1.3 times likely to experience hip fractures (Brundle, et al., 2015). In addition, adults who have hearing impaired are more likely to experience falls compared to normal individuals.

The statistics inform that 33% of community dwellers who are aged 65 years and over are likely to experience fall at least once in a year (Jong, Elst, & Hartholt, 2013). It is mentioned that about 15% of the elderly fall more than once in a year. According to Jong, Elst, & Hartholt (2013), use of medication has increased among the elderly. Nearly 72% of the elderly who are above 55 years of age use at least one medication. In this group, approximately 20.3 percent are using four or more drugs. Therefore, adverse reactions related to drug use may occur, leading to significant mortality and morbidity. Several medications are linked to substantial risk of falls. For instance, Janus, Reinders, Manen, Zuidema, & Jzerman (2017) found that the use of psychotropic drugs increases the likelihood of falls.

Jong, Elst, & Hartholt (2013) opine that the physiologic changes that are associated with aging may also result in decreased strength of the muscles, decreased joint range of motion, and impaired balance. Aging is also a risk factor for falls, as discussed above. Older adults have decreased muscle strength and joint motion range, which makes them susceptible to falls.

According to Jong, Elst, & Hartholt (2013), fall accidents are more prevalent in older people that reside in nursing homes, implying that older adults are likely to fall in hospitals than in non-hospital settings due to increased use of medication, environmental factor, and confusion. Measures that can prevent falls include communication, medication review, and education. Written information to families and patients explaining the importance of calling for help are critical for avoiding incidences of falls. Nurses should also be informed about the patients who are at high risk of falls. Information on fall rates can also help in preventing falls. As discussed above, medication can also put older people at risk of falls. Therefore, medication review is critical in preventing falls. It is crucial to review and modify the use of different drugs. Education is another measure that can be taken to avoid falls. It is vital to educate families and patients about the prevention of falls. Education can help patients and families to learn about the dangers of falls. Nurses have a pivotal role to play in hospital safety. Nurses are responsible for providing information to patients and families about fall risk and the safety standards that can be used to prevent falls.

OUTCOME 3: Impact of Lewy Body Dementia on people and their family.

According to Harding (2014), dementia with Lewi body is a common type of dementia. Prevalence and figures vary widely. However, a review in the UK found that the incidence of Lewi body dementia is about 4 percent of new dementia cases (Harding, 2014). The study found that Lewi Body Dementia accounts for 4.2 percent of all cases of dementia diagnosed in the community, and 7.5 percent of those diagnosed in secondary care. Lewi Body Dementia is characterized by eosinophilic intracytoplasmic neuronal inclusion bodies (Lewy bodies) in the neocortex and brainstem (Harding, 2014).

Impact of Lewi Body Dementia on Patients

When it comes to recognizing the most common ailment in older people, dementia is considered the most prevalent (Chengxuan & Fratiglioni, 2018).

Dementia is regarded as one of the commonly diagnosed illnesses among adults, and it contributes them to face many major disabilities. The elderly to overcome the illness requires the early need for hospitalization and effective nursing care (Chengxuan & Fratiglioni, 2018). The National Institute of Ageing explains that nearly 35 million individuals are at present living with dementia and the number is going to be 2 times within 20 years. The majority of the patients affected by dementia are suffering from Alzheimer’s disease, followed by vascular dementia, Lewy body dementia, and Parkinson’s disease. The differentiation between the symptoms of the different disease which falls under dementia is hard to be made (NIH, 2018).

So, what exactly is Lewy Body Dementia? Medically, it is an ailment that is caused by extremely high deposits of alpha-synuclein protein in the brain (Outeiro, Koss, & McKeith, 2019). The knock-on effect of these proteins in the brain at such high levels is that they lead to abnormalities in mood, behaviour, thought processes and sometimes movement. Alzheimer's disease is the most common form of dementia in older people, but this is followed by Lewy Body dementias (LBDs). The truth is that LBDs is a term that is used to describe Parkinson's disease dementia (PDD) and dementia with Lewy Bodies (DLB). The difference between the two is that PDD starts to quickly affect movement in the body quicker than DLB (Outeiro, Koss, & McKeith, 2019).

Regarding the impact of DLB, it diminishes the quality of life of patients and increases the burden of the caregiver. The effect of this type of dementia affects cognition and affects behavioural, motor, and autonomic features (Arevalo‐Rodriguez, et al., 2015). Additionally, coping with the disease is severe. The Mini-Mental State Examination is one of the commonly used methods of diagnosing Lewi Body Dementia (Arevalo‐Rodriguez, et al., 2015). This is a brief and easy neuropsychological test that can predict the decline as a result of dementia in people that have cognitive impairments. This test is supplemented by other specialized tests (Arevalo‐Rodriguez, et al., 2015).

Lewi's body dementia is a difficult condition to treat. Therefore, it is essential to recognize it and the necessary expert care provided. This type of dementia is under-diagnosed, and the symptoms are difficult to understand. For this reason, it is essential to train healthcare professionals. Providing proper care requires proper recognition of the specific symptoms of the condition and the issues that surround the provision of care. Treatment of Lewi body dementia requires that medication is used appropriately and coordinated support provided. Lewi's body dementia patients need specific care, and to increase the quality of life, healthcare professions should provide information about this type of dementia and have a therapeutic relationship with families and patients. This will also help in addressing the symptoms of this condition (Boot, 2015).

OUTCOME 4: Application of ethical principles, along with policy guidance and innovative solutions for safeguarding and ensuring the well-being of vulnerable adults.

Mental Capacity Act

The Mental Capacity Act was designed to protect and empower vulnerable people who may lack the capacity to make decisions about their treatment and care. It is a legal framework that professionals in healthcare have to abide by when presented with cases of the capacity of patients to make decisions. It is everyone’s right to be assisted in making decisions about treatment and care according to the Mental Capacity Act. In the case study, Frances needs assistance to decide on her care.

The first principle of the Mental Capacity act promotes autonomy. This principle encourages people to make their own decisions in whatever way that suits them. Herring & Wall (2015) states that an autonomous decision is the result of a cognitive and an effective process, and the Mental Capacity Act cannot address situations where the interaction between the affective process and cognitive process is impaired. The NMC (2015) suggests it is the duty of the healthcare professional to respect someone's autonomy. The ethical principle of autonomy was therefore implemented and enforced during the assessment processes of Frances. Frances was allowed the freedom and independence to have a say in her decision making regarding her welfare. According to (NMC, 2018) nurses must at all time act in the best interests of their patients and must place the patient at the center of making a decision regarding their care. Frances is put at the center of the NMC Act (2018) especially on the realm of assessing her capacity to make decisions about medication management, (digoxin and insulin medication) in all its health consequences; testing her blood glucose and ketone levels; administration of insulin; and, admission to hospital when necessary in the light of blood glucose levels. Frances lacks the capacity to make those decisions based on the view she has enduring nature of severe memory problem which is lifelong and, therefore unlikely to change (Goldsmith, 2011). The group also argued that the reason why Frances was not taking her insulin is that she has fear regarding injection-related issues such as embarrassment due to crying, interference with daily activity and injection pain. The study by Mills, Wand, & Fraser (2018) informs that proper actions are to be taken to address the problem regarding using injection to deliver insulin to patients.

would be fear of injection-related problems (interference with daily activities, injection pain, and embarrassment). Mills, Wand, & Fraser (2018) suggested nurses we should consider recommending strategies and educational intervention to addressing these problems the insulin problem.

The second principle of the Mental Capacity Act suggests that everyone has the right to be assisted in making decisions on their own. Therefore, Frances should be provided with all the information she requires to make an informed decision. Frances should also be assisted with all communication forms to aid her in making a decision, which may include a healthcare professional using non-verbal communication. Frances' family should also be involved when assisting her to make an informed decision. All forms of communication should be used as it promoted patient-centered care.

The third principle of the Mental Capacity Act also states that a patient retains their right to make decisions that may be considered unwise or eccentric. As such, a healthcare professional must explore why Frances refuses to take insulin medication. If she has beliefs that are keeping her from taking medication, the healthcare professional should make sure that she understands the consequences of the decisions. If Frances understands the implications of her choice, the healthcare professional should look for the best intervention without going against ethical principles (Semple & Cable, 2013).

Mental Capacity Act suggests that healthcare professionals should act in the best interest of their patients. However, Frances is refusing to take her medication. This scenario presents a dilemma to the nurse because Frances is extremely unwell, and she may develop other complications if she does not take her medication. For this reason, the nurse should ensure that Frances takes her medication because she will be acting in the best interest of the patient.

Conclusion

This paper presents valuable information about ageism in older adults. It has provided an analysis of the factors which are able to impact on protecting or deteriorating the health of the elderly. This essay also provided the specific roles that nurses should play in combating ageism. Also, information on risk factors for fall in older adults are highlighted in this paper. It was also critical to analyze the impact of Lewi's body dementia on patients and families. Finally, the article provided an in-depth application of ethical principles, policy guidance, and innovative solutions to ensure the well-being and safeguarding of people who may be vulnerable. The information provided here is vital for any healthcare professionals who want to provide patient-centered care. Knowing the roles that nurses play in fighting ageism will help me in providing quality care to older patients. Since most people who seek medical attention are older adults, it is essential that one understands that specific disease may present symptoms that are different than in younger people. Finally, since it has been reported that most falls happen in hospital settings than non-hospital settings, the information is a wakeup call for all healthcare professionals to be vigilant when dealing with older patients.

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