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Question:

Write an essay on Aging.

 

Answer:

Aging is a natural phenomenon and a part of healthy life leading. It is the process of becoming older which is observed in all the living beings, including human being, animals and plants. With aging the body functioning changes significantly. In human aging, it represents a number of behavioral, physical, social and psychological changes. In addition to the changing fact, it is also true that aging enhance the risk of injury and disease. Therefore, it can be said that aging makes people vulnerable to be harmed (Reed & Carstensen, 2012). At that moment, the aged care services provide assistance for enhancing their independence.

 

In this assignment, the case is focused upon the 79 years old female Merindah. She is a retired community registered nurse by profession. She has been shown to be an active participant in volunteer work with older indigenous people after her retirement from the local hospital as the registered nurse. Three months ago she had a hip replacement operation and she has not recovered as quickly as she hoped which affected her autonomy and independence. Her family lives near her home and they are happy to assist her, but Merindah needs to be independent in her ADLs, cooking and other activities. Recently she showed bruises on her legs and arms which included significant pain, thereby limiting her mobility. This assignment would focus upon the analysis of the experience of aging and its relation with the psychological and social theories of aging. In addition, the role of community nurse and appropriate nursing interventions for increasing independence of Merindah would also be discussed.

Relation within the Merindah’s experience and social and psychological theories of aging

The psychological theories of aging support the healthy aging process of human being, where the aged people would remain healthy and active throughout the aging process. According to the activity theory, the successful aging occurs when aged people remain active and keep their social interaction throughout their aging process. The theory proposes that the social involvement delays aging and increase activity ( Ciorba et al., 2012). This theory is supported by the case study. Here, Merindah has been  shown to be active with community work after her retirement, it showed healthy aging process and social work made her active through a long period. On the other hand, the disagreement theory proposes that, it natural for the aging process that the aged people would withdraw their involvement from society as a significant phenomenon of the aging process (Strihler, 2012).

According to this theory, with age the physical and psychological deterioration is expected. In the case study of Medindah, it has been seen that after her hip replacement surgery she is experiencing lack independence and difficulties in ADLs thereby deteriorating her physical and psychological status along with reduced social interaction. The continuity theory depicts that the older adults would try to continue their normal life leading styles as they did in the young life stage. It is related to activity theory that depicts that aging process should be healthy. According to the case study, Merindah tried to remain active socially and physically through the aging process. However, after hip replacement surgery she is losing her self esteem and confidence.

There are a number of social theories related to aging and its impact upon people and society. The functionalism perspective is related to the earliest theory of aging. The theorist argued that society should address the roles for older people consistent with advanced aged and they depicted that the physical decline at aging would disrupt society supporting the disagreement theory. Therefore, according to this theory, society should withdraw the aged persons from their responsibilities aligning with the deterioration of their abilities and interactions (Kausler, 2012). The case study of Medindah supported the functionalism theory as it has been seen that as Merindah started to become old, she retired from her role of community registered nurse in the hospital. On the other hand, after retirement she tried to maintain her community and social role by completing her volunteer work with indigenous people. With the progress in aging process, she experienced more deterioration in her physical and psychological activities, thus withdrawing her active role from the social interaction and activities.

 

Communication theories underpinning the way of interacting with the Merindah

As a nurse, communication is a very important aspect of communicating with the patient. It is because based on the communication skills of the nursing staff, a positive and trustworthy relationship can be established within nurse and the patient. In this context, the communication theories can guide and direct the nurse to adopt the correct communication skills that would be specific for the patient and the health care context where the care is being provided. In the case study, the client Merindah is a 79 years old female, therefore, addressing her physical and psychological needs through an effective communication strategy and skills are necessary. Therefore, the communication theories suitable for communicating with the older adults can be helpful for enhancing her independence through positive interaction with the nurse and patient (Moberg, 2012).

One communication theory related to aging is the communication accommodation theory perspective. This theory depicts how to communicate with an older adult from a nursing perspective. The theory was established by Howard Giles depicting that, people should adjust their speech, vocal patterns and the gestures while interacting with older adults for accommodating with people (Horn, 2012).

In this context, extending the thought, if the people are a geriatric or older adult and the communication is progressing in the health care context for health and welfare of the older adult, the communication skills and the behavioral aspects become more specific and important for meeting their special needs. In this context, the registered nurse would attempt to communication with Merindah in a low peach of voice which could be understood by Merindah. A positivity is facial expression is another important point which should be consisted by the nurse. Therefore, it has been analyzed that both verbal and non verbal communication skills are important for communicating with Merindah. While communicating with the patient the nurse would show polite behavior for asking about her health issues she was facing from last few years. According to the theory, there are two major accommodation processes depicted by the theory including convergence and divergence (Wahl, Iwarsson & Oswald, 2012). The convergence refers to the communication strategy where both the communicators adapt each other’s communication behaviors for reducing social and communication barriers. In contrast, the divergence theory depicts that the speech and non verbal differences within the communicators can diverge their interaction.

In the case of interaction with Merindah, the nurse would attempt to promote a positive communication environment for enhancing her independence. According to the theory, knowing the patient is very important. From the case study it has been revealed that Merindah is an active woman throughout her entire life, however, due to age related changes, she is losing her independence. Therefore, she needs a supportive environment which would restrict the deterioration of her self-dependency through positive communication (Shultz & Adams, 2012).

 

Age related changes related to the Merindah

Merindah has been shown to deteriorate physically as well as from the psychological perspective of well being through her age. In this context, identifying and assessing the age related changes within the patient is very important for the nursing staff to plan the specific and holistic nursing intervention for the patient. From the case study it has been revealed that Merindah used to be independent and active women throughout her life. She has successfully played her role as the community registered nurse by providing patients excellent care services. She is 79 years old now and experiencing some age related changes and disabilities related to these issues. She showed psychological changes related to the physical disabilities also (Pammolli, Riccaboni & Magazzini, 2012).

The age related changes include the deterioration of some basic functional factors of body. There are eight main areas of age related physical changes shown in people progressing towards aging process. The first one is memory a brain functioning, second one is changes or deterioration of bones and joints, eyes and ears, problematic metabolic and digestive system, urogenital problem, dental problem related to loss of teeth, gingivitis, periodontitis, wrinkled skin with enhanced rate of dead skin cells, functional disabilities. In addition to these physical changes, the psychological, social and emotional changes are related, rather, these physical changes affect negatively upon the mental, social and emotional well being of aged people, thereby reducing the functioning of these particular domains (Anderzhon, 2012). With progressive age, people usually tend to lose near and dear ones throughout their course of life which provides them the experience of grief and loss which sometimes includes depression and anxiety related changes.

In the case of Merindah, she has been gone through hip replacement surgery and she did not recovered as efficiently as she hoped. Therefore, this age related change is characterized under the bones and joints changes. With age women tend to loss calcium from bone, thereby enhancing the chance of bone fracture and mobility related disabilities. In addition, with age the recovery process also slows down which has been happened with Merindah. She is experiencing dull skin due to the aging of skin. At this age, skin becomes unable to regulate with rapid weather changes. Recently she has been diagnosed with bruise in arm and legs; it is due to reduced resistance of skin towards environmental harm. Due to reduced autonomy her psychological well being is also affecting, as she is getting depressed. One reason behind the recent bruise is inability to maintain personal hygiene which enhanced the risk of fall and injury. She is also getting difficulties in mobility, thereby using wheelie walker, but unable to cook also. All of these are affecting her health and well being as a whole (Burns, 2012).

Assessment needed to be undertaken for the Merindah

Assessment

Rationale

Pain assessment

Pain assessment is necessary for analyzing the level of pain she is experiencing cu3rrently according to which particular intervention would be undertaken by the community nurse for reducing pain and enhancing autonomy

Eye sight assessment

As she has been diagnosed with bruise on arm and legs, her eye sight should be assessed for reducing the chance of fall and further injury

Risk factors assessment

The assessment of risk factors and hazardous materials surrounding Merindah enhances the chance of her fall and injury. Therefore, the assessment of risky materials and removal of these substances from the surrounding area should be done. For example, bathing is a risky event for her and the event should be reduced by eliminating harmful structures from bathroom and making that place safe for her use without assistance (Hull, Saunders & Martin, 2012).

Psychological assessment

 

Mobility assessment

Mobility assessment is necessary for enhancing her independence. She uses wheelie chair and feel tired during long time standing, so the assessment can provide information about the areas where the nursing intervention can enhance her mobility

Medication assessment

The medication assessment is also important for un understanding the patient’s current status, both physical and psychological status and which are the areas of concern for the patient, thereby helping the nursing staff to plan intervention for improving her condition

Review of medication

Medicine

Use

Adverse effect

Digoxin

It is provided to patients experiencing heart failure and electrolyte imbalance. Therefore, it can be said that Merindah has experienced cardiovascular issues

Nausea, vomiting, appetite loss, blurred vision, hallucination, unusual behavior, feeling dizzy, anxiety, headache

Celebrex

It is a nonsteroidal anti-inflammatory drug which acts by decreasing inflammation and pain causing hormone secretion. Thus, it is used for the patients experiencing arthritis or other causes which includes pain (Miller, 2012). It is administered to Merindah for reducing her pain

Skin rash, breathing shortness, liver problems, anemia, kidney problem. Swelling, dizziness, stomach pain. Severe skin reaction

Pannadeine forte

It is the medication related to pain reduction which consists of codeine phosphate and paracetamol.

The adverse effects include nausea, vomiting, liver toxicity

Mylanta

The particular medication is used for treating heartburn, acid indigestion, stomach upset. It works by upon the existing acid in stomach and thereby reducing the level of acid at stomach and reduce the rate of toxicity

Side effects include constipation, headache, diarrhea, vomiting

Coloxyl with senna

This medication contains active ingredients docusate sodium sennosides. These medications are used for treating different types of constipation from mild to severe

Common side effects of this medication include abdominal cramps, diarrhea, hypersensitivity

Nursing intervention and rationales

Issues

Intervention

Justification

Reduced autonomy and independence

Regular exercise, physiotherapy, gardening

Regular exercise would be helpful for enhancing her independence. On the other hand, a structured physiotherapy by a physiotherapist can help the patient to enhance her mobility which would enhance her self confidence and thereby enhancing independence and autonomy towards daily activities (Moats & Hoglund, 2012). 

Reduced self esteem

Behavioral communication stimulation, person centered counseling

The behavioral communication stimulation would be helpful for enhancing her self esteem. Through the stimulation process, her cognitive stimulation would promote her understanding about the natural process of age related changes. In the person centered counseling, the counselor would attempt to make her understand that at this age she should take some assistance and that does not reduce her autonomy, instead of that it reduces the her risk of injury

Risk of fall and injury

Hazard management, alarm in wheelchair

Hazard management is the immediate action after the hazard assessment. As she has been diagnosed with bruise on arm and legs, it can be interpreted that it might be the result of fall. The case study also highlighted that the shower is over the bath which enhance her risk of fall and she faces difficulties to reach her medication over the cupboard. Therefore, these substances enhance her risk of fall. Therefore, after assessing her eyesight hazard management is the initial priority of her intervention (Resnick & Resnick, 2012). 

 

Conclusion

In conclusion, it can be said that aging includes lowered functioning of immune system and makes people vulnerable to some age related disorders including dementia, Alzheimer disease and cognitive impairment. In most of the cases, aged people experiences mobility issues along with the problem in completing their ADLs independently. Therefore, proper care, support and assistance are required by the aged people for promoting healthy aging. In this context, this report highlighted the special case of 79 years old female Merindah who was very active but losing her abilities with time. Therefore, this report discussed about the aging realated psychological and social theories on the basis of the case study, then the communication theories related to the required role of registered nurse to interact with the patient has been discussed. After discussing her age related changes, necessary assessment and review of medication, necessary nursing intervention has been discussed based on her health needs with holistic approach.

 

Reference List

Anderzhon, J. (2012). Design for aging. Hoboken, N.J.: John Wiley & Sons.

Burns, Y. (2012). Navigating residential aged care. [Ringwood, Vic.]: Yvonne Burns.

Ciorba, A., Bianchini, C., Pelucchi, S., & Pastore, A. (2012). The impact of hearing loss on the quality of life of elderly adults. Clin Interv Aging, 7(6), 159-163.

Horn, J. L. (2012). The Theory of Fluid and Crystallized Intelligence in Relation to Concepts of Cognitive Psychology and Aging in. Aging and cognitive processes, 8, 237.

Hull, R., Saunders, G., & Martin, D. (2012) Hearing and aging.

Kausler, D. H. (2012). Experimental psychology, cognition, and human aging. Springer Science & Business Media.

Miller, C. (2012). Nursing for wellness in older adults. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins.

Moats, S. & Hoglund, J. (2012). Nutrition and Healthy Aging in the Community. Washington, D.C.: National Academies Press.

Moberg, D. O. (2012). Aging and spirituality: Spiritual dimensions of aging theory, research, practice, and policy. Routledge.

Pammolli, F., Riccaboni, M., & Magazzini, L. (2012). The sustainability of European health care systems: beyond income and aging. The European Journal of Health Economics, 13(5), 623-634.

Reed, A. E., & Carstensen, L. L. (2012). The theory behind the age-related positivity effect. Journal of Aging, 1(2), 213-242

Resnick, B. & Resnick, B. (2012). Restorative care nursing for older adults. New York: Springer.

Shultz, K. S., & Adams, G. A. (2012). Aging and work in the 21st century. Psychology Press.

Strihler, B. (2012). Times, Cells, and Aging. Elsevier.

Wahl, H. W., Iwarsson, S., & Oswald, F. (2012). Aging well and the environment: Toward an integrative model and research agenda for the future. The Gerontologist, gnr154.
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