By Dalton Smith, ATC, 1st Year SPT
College of Nursing and Health Professions 
Arkansas State University

 

In 2015 the world population of adults over the age of 60 was at 900 million but by 2050 that number is projected to be at 2 billion¹! With this we should expect our patient population demographics to shift towards these older adults, and with it our treatment strategies. The World Health Organization defines health as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity”².  Older adults are plagued with added stressors that accompany aging such as losing mental capacities and a decrease in functional ability. This leads to isolation, loneliness or even psychological distress and then add chronic illness or acute injuries and you’ve got the formula for a health disaster.

Healthy people 2020 objectives identify multiple areas to improve older adult health as a priority. But are we doing the best we can to help? Over the next few decades we will see these cases more and more. According to the CDC, Arkansans 50 years and over are among the leaders in the nation who report they rarely or never receive the social support they need³. So, the question is how can our healthcare professionals have a positive impact on health in our older patient population?

The first thing that can be done to help is to listen to our patients. Many of us know already that our patients want to talk about their lives, but did you know that adequate emotional and social support is associated with a reduced risk of mental illness, physical illness and mortality⁴? So talk to your patients, actually listen and support them. This is a very easy, yet effective, way to have a positive influence on your patients.

Another way to help is to offer encouragement! Encourage them to eat healthy diets, get involved in their community and get at least 30 minutes of physical activity a day. Studies have shown that having better physical health has a large effect on mental health and having better mental health has a stronger effect on current physical health⁵. Therefore encouraging older adults and providing resources about the importance of physical health will have a positive effect on their overall health.

Sometimes a little education is all that is needed. Many patients aren’t aware of the resources they have access to. Here are some things you can educate them about:

• For patients interested in becoming more physically active, there are many locations that offer Silver Sneaker⁶ programs throughout the state.
• Maybe they want to become more involved in the community but don’t know how. There are many opportunities to be found on volunteerar.org⁷ that they could explore or you could recommend based on their interests.
• If transportation is an issue, there are services throughout the state that could help get them to and from healthcare visits.
• Using ChooseMyPlate.org⁹ or referring to a registered dietitian, you would be able to give them the information they need to start them on a path toward a healthy diet. And AGEC offers a diabetes empowerment education program¹⁰ that is extremely beneficial to older patients living with diabetes.
• There is an abundant amount of resources available to older adults in Arkansas ranging from abuse hotlines to foster grandparent programs. They can be found on humanservices.arkansas.gov¹¹ or even on the AGEC website under free community programs¹⁰.

At the end of the day it’s about finding ways to help people. Sure, we can inform them that eating well, participating in regular physical activity and not using tobacco will increase their well-being, but through listening we offer the support our patients need and can direct them to additional resources.

 

1. WHO (2019). Mental health of older adults. Available at: https://www.who.int/news-room/fact-sheets/detail/mental-health-of-older-adults .
2. World Health Organization (1948). Constitution of the World Health Organization. Available at: http://www.who.int/governance/eb/who_constitution_en.pdf (Accessed 17 Jul. 2019).
3. Centers for Disease Control and Prevention and National Association of Chronic Disease Directors. The State of Mental Health and Aging in America Issue Brief 1: What Do the Data Tell Us? Atlanta, GA: National Association of Chronic Disease Directors; 2008.
4. Strine TW, Chapman DP, Balluz L, Mokdad AH (2008). Health-related quality of life and health behaviors by social and emotional support: Their relevance to psychiatry and medicine. Soc Psychiatry Psychiatr Epidemiol 43:151-159.
5. Ohrnberger J, Fichera E, Sutton M. The dynamics of physical and mental health in the older population. J Econ Ageing. 2017;9:52–62. doi:10.1016/j.jeoa.2016.07.002
6. https://tools.silversneakers.com/LocationSearch
7. https://www.volunteerar.org/organization
8. https://www.care.com/c/stories/5841/arkansas-transportation-resources/
9. https://www.choosemyplate.gov/older-adults
10. https://agec.uams.edu/communityprograms/
11. https://humanservices.arkansas.gov/programs-services/services-by-group/senior

By Alex Henry, BS-CD & Hannah Speer, OTD/S
College of Nursing and Health Professions
Arkansas State University

 

Every day 10,000 people turn 65 years old (Heimlich & Heimlich, 2014). Because of this, the elderly adult population is increasing rapidly. Of this elderly population, 40% will need some form of long term care whether it be an assisted living facility or a nursing home (Mezuk, Lohman, Leslie, & Powell, 2015). The rapid growth of this cohort makes one percent of elderly adults who commit suicide extremely alarming (Mills, Gallimore, Watts, & Hemphill, 2016). Adults 65 years and older, specifically men, have a suicide rate of 30 per 100,000 (Mezuk, Lohman, Leslie, & Powell, 2015). Forma et al. (2017) found that of elderly adults who committed suicide, 70% had been admitted to the hospital within the last two years. Of the 70% who committed suicide, 36.8% had been discharged from the hospital within the previous month. There are many factors to consider in looking at suicide in the elderly population. The elements can be as personal as social isolation, feeling like a burden to the family, depression as well as facility issues such as high staff turnover and the number of beds (Mezuk, Lohman, Leslie, & Powell, 2015). This significant number of factors coincides with an alarming rate of suicide in the elderly population. These factors should be taken into consideration by the facility staff both in the hospital and in long term care facilities. Staff, especially nurses, should be educated to identify risk factors of depression and suicide and to monitor the mental health of the patients.

A research study conducted by Mospan, Hess, Blackwelder, Grover, & Dula (2017) recognized the role of the primary care provider in taking properly monitoring patients at risk for suicide. The researchers found that nurses rarely used their knowledge of suicide prevention (p. 537). They suggested an educational intervention which provided a variety of online, live, and asynchronous learning activities (for example) to help bridge the gap. Cheryl et al. (2013) conducted a study involving the competencies for educating advanced practice and general psychiatric mental health nurses. The researchers found that there are no standard competencies for teaching or assessing suicide risk.  However, the American Psychiatric Nurses Association’s position on this topic is that it is the individual nurse’s responsibility to complete research for his or her evidence-based practice to treat patients with mental illness (Cheryl et al., 2013). Based on these studies, student nurses and nurses already in the field should both be able to detect signs of suicide in their elderly patients and to learn about suicide prevention. All facility staff, nurses especially, should take the initiative in developing their skills to understand the risk of suicide in their patients better.

 

 

 

References

Mospan, C., Hess, R., Blackwelder, R., Grover, S., & Dula, C. (2017). A two-year review of suicide ideation assessments among medical, nursing, and pharmacy students. Journal of Interprofessional Care, 31(4), 537-539.  doi: 10.1080/13561820.2017.1301900

Cheryl, P., Janet, Y., Barbara, L., Pamela, G., Eric, A., & Deborah, H. (2013). Competency-based training for PMH nurse generalists: Inpatient intervention and prevention of suicide. Journal of the American Psychiatric Nurses Association, (4), 205. Retrieved from https://doi.org/10.1177/1078390313496275

Heimlich, R., & Heimlich, R. (2014, February 07). Baby boomers retire. Retrieved from http://www.pewresearch.org/fact-tank/2010/12/29/baby-boomers-retire/

Forma, L., Aaltonen, M., Pulkki, J., Raitanen, J., Rissanen, P., & Jylha, M. (2017). Care service use in 2 years preceding suicide among older adults: Comparison with those who died a natural death and those who lived longer. European Journal of Ageing, 2, 143. Retrieved from https://doi.org/10.1007/s10433-016-0397-9

Mills, P. D., Gallimore, B. I., Watts, B. V., & Hemphill, R. R. (2016). Suicide attempts and completions in Veterans Affairs nursing home care units and long-term care facilities: a review of root-cause analysis reports. International Journal of Geriatric Psychiatry, 31(5), 518. Retrieved from https://ezproxy.library.astate.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=edb&AN=114190206&site=eds-live&scope=site

Mezuk, B., Lohman, M., Leslie, M., & Powell, V. (2015). Suicide risk in nursing homes and assisted living facilities: 2003-2011. American Journal of Public Health, 105(7), 1495–1502. https://doi.org/10.2105/AJPH.2015.302573

World Health Organization. (2014). Preventing suicide: A global imperative. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/131056/9789241564779_eng.pdf;jsessionid=61FB77728ABF43079DC58810EFB7F8B0?sequence=1

By Jessica Camp, MSN, APRN, AGCNS-BC
College of Nursing & Health Professions, Arkansas State University

 

It appears that more older adults are using technology in their daily lives (Davis, 2019). According to a study by AARP, mobile devices and computers are the primary technology used by this population (Anderson, 2017, p. 3). To a lesser extent, older adults reported managing their healthcare and learning with this technology. Another study by PEW Research Center Older Adults and Technology Use (Smith, 2014) found that:

• Six in ten seniors now go online
• Just under half are broadband adopters
• Younger, higher-income, and more highly educated seniors use the internet and broadband at rates approaching—or even exceeding—the general population
• Internet use and broadband adoption each drop off dramatically around age 75
•  27% of older adults use social networking sites such as Facebook, but these users socialize more frequently with others compared with non-SNS users
• E-readers are as popular as smartphones

Sadly, however, Davis (2019) points out that the design of technology used by older adults rarely focuses on them. This article aims to shed a bit of light on some of the technology that may be useful or even helpful for older adults and technology that is actually designed for the older adult.

Interestingly enough, these are not the only technology-based items, nor services, available to older adults. Currently, there is a multitude of technological products marketed specifically for older adults. Nextavenue contributing write Patricia Corrigan shared an overview on several tech items that can help older adults who serve to maintain their independence, such as:

• Wearable battery-operated emergency alert systems (such as Philips Lifeline), which detect falls and summon help
• The Apple watch (Series 4), which monitors your heart rhythm and detects falls
• Some cell phones (such as GreatCalla), which offer emergency response buttons
• Voice-controlled devices (such as LifePod), which work with “smart” speakers to remind you when to take your medication or head to a medical appointment
• Cameras, microphones and motion sensors (Evermind makes one version), which monitor your regular activity — or signal a lack of it to your caregiver (2018, para. 2)Surprising to this author, there is a company offering transportation normally available through the use of technology to older adults. One company provides transportation for older adults by turning traditional on-demand transportation systems (like Uber, for example) already in place into senior-friendly transportation. Older adults can call an eight-hundred-number and press a few buttons once registered, to obtain a ride, and even return home all the while sharing information with the family about their activity through messaging communication. This service charges twenty-seven cents per minute currently in addition to the service rate charged by the transportation company for the travel. Unfortunately, it is not yet available in all parts of Arkansas. However, the zip code 72002 for Little Rock provided the following rates (from their website):
• Not surprising, there is more than one company that markets cell phones, including smartphones, to our older adults. One such company touts that they are the home of the “original easy-to-use cell phone” (Greatcall, 2019a, para. 1). They also offer a family caregiving device that includes a wearable communicator designed for two-way communication, fall detection, and GPS locating features that are reportedly waterproof. Further, they offer a version of this that tracks fitness and looks similar to the traditional wearable device providing the same features (Greatcall, 2019b). Another company offers more conventional cell phones with some additional services designed for urgent and emergent communication around the clock (Snapfon, 2019, para. 1-3).

Ride Fare:
$3.60 base fare + $0.76 per mile + $0.15 per minute (with a minimum fare of $7.60)

and
Concierge Fee:
$0.27 per minute

* Please note that during periods of high demand, our vendors may include a surge charge (gogograndparent.com, 2018)

Despite older adults still reporting skepticism regarding technology, the trend is up on use for most aspects. This article shows that there is no shortage of new ways technology is being garnered to help out older adults. Let this article encourage you to learn more about how technology can assist your older adult patients, your family or even yourself.

 

 

 

Smith, (2014). PEW report. Older Adults and Technology Use. PEW Research Center. Retrieved on January 14^th, 2019 from http://www.pewinternet.org/2014/04/03/older-adults-and-technology-use/

Anderson, M., & Perrin, A. (2017). PEW Report. Technology Use Among Seniors. PEW Research Center. Retrieved on January 14^th, 2019 from http://www.pewinternet.org/2017/05/17/technology-use-among-seniors/

Abrahms, S. (2015). 3 Must-have cell phones for seniors. Retrieved on January 17^th, 2019 from https://www.forbes.com/sites/nextavenue/2015/06/17/3-must-have-cell-phones-for-seniors/#238490ce6cce

Greatcall. (2019a). About us. Retrieved on January 17^th, 2019 from https://www.greatcall.com/about-us

Greatcall. (2019b). Feel safer on the go. Retrieved on January 17, 2019 from https://www.greatcall.com/devices/lively-mobile-medical-alert-system

Snapfon & Excellcious Communications LLC. (2019). Easy to use features. Retrieved on January 17, 2019 from https://www.snapfon.com/big-button-cell-phone/

Snapfon & Excellus Communications LLC. (2019). sosPlus mobile emergency management services. Retrieved on January 17, 2019 from https://www.snapfon.com/sos-plus/

GoGoGrandparent. (2018). How it works. Retrieved on January 17, 2019 from https://gogograndparent.com/

Corrigan, P. (2017). Technology can help us age in place, if we let it. Nextavenue: Where Grown-ups Keep Growing. Retrieved on January 14^th, 2019 from   https://www.nextavenue.org/technology-age-in-place/

Anderson, G.O. (2017). Technology Use and Attitudes Among Mid-life and Older Adults. AARP Research.  Retrieved on January 14^th, 2019 from https://www.aarp.org/content/dam/aarp/research/surveys_statistics/technology/info-2018/atom-nov-2017-tech-module.doi.10.26419%252Fres.00210.001.pdf

 

by Jessica E. Camp, MSN, APRN, AGCNS; Addie N. Fleming, MNSc, RN, CCRN; Valerie Fielder, BS, CDP, and Samantha M. Hollis, BSN, RN, CDP
Edited by Dr. Susan Hanrahan and Dr. Linda Tate
Arkansas State University, UAMS Center on Aging Northeast & Schmieding Home Caregvier Training Program, St. Bernards Medical Center

 

The committee designed a health screening event for older adults, their caregivers, and professionals that provide care to older adults.  Northeast Arkansas has a large number of elderly, care givers, and a large variety of professional services. The event was designed to bring everyone together. It was planned for November to increase attendance by avoiding other area events and in conjunction with National Family Caregiver Month. The Fair gathered more than 200 patients and 90 vendors from the community. This article shares the successes of the event and the opportunities for next year.

Advisory Panel
The Center on Aging had a vision for the event. The mission and vision were shared with the team during recruitment and revisited at the initial meeting.  An advisory panel consisted of the many health professionals, community members, university faculty and leaders from services for older adults in the area was invited to participate.

Health Screenings
The local university, ASU, provided a great foundation for creating a health screening event.

The physical therapy department provided “timed up and go” (TUG) screenings aimed at identifying balance issues and risk for falling. Social work faculty provided anxiety and depression screenings. Communication Disorders students provided hearing screens in a private room.  Nursing students provided blood pressure checks, height, and weight and body mass index screenings.  Dietary Approaches to Stop Hypertension (DASH) diet education was given verbally and in writing to persons at risk for or currently experiencing hypertension. Exercise, weight loss and the DASH diet can help control chronic illnesses, such as heart disease and diabetes, making it important information to share with older adults and their caregivers (Cash & Glass, 2015, p. 1047).

The Arkansas Department of Health provided vaccinations based on the Center for Disease Control and Prevention (CDC) recommendations for adults and older adults (Cash & Glass, 2015, pp.18-21). Hilltop Eye Care and Southern Eye Associates provided vision screenings and education on cataracts and glaucoma. St. Bernard’s Imaging Center conducted bone density screenings as well as total cholesterol, anemia, and glucose laboratory screenings. Higginbotham Family Dental provided dental screenings. Additional professionals were invited and provided services or information about services.

Transportation
Transportation for the public was not available to the event. This was noted by some persons unable to attend as a barrier.  Requests to public transportation and local churches to enlist transportation assistance were not met.  For the 2018 event, negotiations are in process.

Communication
Some screening groups left before the event ended which participants complained about.  Critical conversations with the voluntary service professional groups will need to take place early in the planning of the 2018 event to ensure the professionals stay for the whole event, which could include shortening the event.

A secondary communication issue was not being able to hear announcements made at the event stage. With exciting activities such as the mayor’s appearance and a physician’s panel, it was difficult for the audience to hear anywhere past the first row of vendors. This is an opportunity that can be corrected for the 2018 Senior Expo (Larsen, 2018).

Professionals
Health professionals, caregivers, and patients were targeted to receive education during the event. Several vendors voiced a desire to attend the planned educational sessions, but were unable because they were also manning a booth at the event. In post-event discussions, it was decided that a separate educational event targeting health professionals could be a solution.

Vendors
While the volume of local vendors involved in the first annual event surpassed the goal, there were still challenges. Discussions with leaders of another local annual health fair shared tactics that prevented vendors from leaving their event early, such as imposing fines or not inviting them to future events.

In summary, these services met the needs of many older adults. Senior Health Fairs bring value to the intended audience. Targeted health fairs, such as this one, provide more opportunities for older adults to interact with health professionals in the community. With the success of the first event, the 2^nd Annual UAMS Center on Aging Northeast’s Senior Expo is scheduled for November 9, 2018.

 

References:

Cash, J. C. & Glass, C. A. (2016). Adult-gerontology practice guidelines. New York: Springer Publishing Company.

Larsen, P. (2018). Lubkin’s chronic illness: Impact and illness. Burlington, MA: Jones & Bartlett Publishing.

Rhoads, J. & Peterson, P. S. (2018). Advanced health assessment and diagnostic reasoning (3^rd ed.). Burlington, MA: Jones & Bartlett Publishers.