Health Promotion of The Elderly

Promoting Health and
Wellness of the Older

Person
Health promotion has been defined as an
approach to any health-related interaction
or activity that is characterized by holism,
equity, participation, collaboration,
individualization, negotiation, facilitation,
and support.

This characterization is in
contrast to the management of acute
illness, which is typified by a prescriptive,
authoritative approach.
In order to help older adults engage in
health promoting activities, interpersonal
skills such as active listening, responding
to cues, reinforcement, and open
questioning should be used. In light of the
incidence of disease in the old-old age
group, the pros and cons of screening
should be addressed with these
individuals, and the older adult helped to
make educated decisions about
participating in health behaviors to
prevent disease.

While mammography is generally
recommended as an important screening
measure for the older adult, it is possible
that after the age of 85 years, the risks
and discomforts of mammography may
outweigh the benefits.

Similarly, the
recommendations for Pap smears are
inconsistent and suggest guidelines
ranging from screening every 3 years to
no screening after the age of 65 years.
Moreover, recommendations for
screening should be based on specific
risk factors such as whether the woman is
sexually active and/or if she had adequate
screening with normal results prior to the
age of 65 years. These factors need to be
discussed with the older woman to
appropriately determine the need for
screening and the risks/benefits of this
procedure.

Likewise, aggressive, automatic attempts
to control cholesterol in asymptomatic
adults over the age of 75 years may not
be appropriate. However, monitoring the
diet to maintain a reasonable weight is
important to help maintain functional
status and avoid exacerbation of
degenerative joint disease.

Exercise can certainly be viewed as a
source of primary prevention, and
consistently has been noted to benefit the
older adult. There is increasing evidence
to suggest that habitual aerobic exercise,
such as walking, cycling, circuit weight
training, swimming, and jogging, can
improve strength and aerobic capacity.

Regular alcohol use, at least 1 ounce of
alcohol daily, is not uncommon in older
adults, particularly those in continuing
care retirement communities. Moderate
alcohol use has been reported to have a
protective effect on heart disease,
increase high-density lipoprotein
cholesterol, decrease platelet
aggregation, and offer social activities to
older adults. The reported cardiovascular
risk reduction was especially true for
adults above the age of 50 years.

While identification of alcohol abuse and
the associated risk of drug-drug
interactions, falls, and fractures with
alcohol intake are important to consider
when caring for older adults, the positive
benefits of moderate alcohol use must
also be recognized. Healthcare providers
should discuss the pros and cons of
alcohol use with older patients and help
them decide whether to consume alcohol
and/or how much to consume.

While the long-term benefits of strict
adherence to dietary guidelines for older
adults are unclear, these individuals
should be encouraged to eat a well-
balanced diet and maintain their body
weight within 10% of their age-adjusted
normal weight. In particular, older adults
should optimize their intake of fiber,
calcium, and vitamin D. Ideally, these
individuals should try to eat 24 grams of
fiber and take 1500 mg of calcium and
800 IU of vitamin D daily.

Mental Health, Wellness
and Stressors Impacting
the Health of the
Older Person
Stress is the wear and tear on the body
caused by constant adjustment to an
individual's changing environment.
Anything that causes change in our life
causes stress. There are many changes
going on in the lives of the elderly.

Stress can be either short-term (acute) or long-term
(chronic). Acute stress is the reaction to an
immediate threat. This is commonly known as the
"fight or flight" response. The threat can be any
situation that is experienced, even subconsciously,
as a danger. Under stress, a person's heart rate
and breathing increase. His or her muscles become
tense. A person's stress level increases when there
are multiple stressors present. A person's body
needs relief from stress to reestablish balance. As
people age, the ability to achieve a relaxation
response after a stressful event becomes more
difficult. Aging may simply wear out the systems in
the brain that respond to stress.

Moving into a skilled nursing facility or
extended care facility is one of the top
stressors for elderly people. It can mean
many types of losses. A person may no
longer be able to keep personal
belongings. He or she may lose privacy
and control over daily life, as well. Losing
a life that is familiar and facing an unsure
new environment may make the elder
may feel abandoned. The stress from
relocating to a care facility often leads to
depression.

The loss of a spouse is seen as the single
greatest loss an individual can
experience. It results in the loss of
security and companionship. The nuclear
family unit has weakened in the past 20
years. Elderly people may not have family
close by. Adult children may be busy with
their own lives and family and not
available to help an aging parent.
Sometimes, elderly people can find
companionship from animals. Research
has shown that having a pet can reduce
blood pressure and stress in the elderly.

Long-term stress increases the risk for
heart disease, high blood pressure,
stroke, digestive problems, and sleep
disorders. An older person is already at
greater risk for these conditions. Many
times, there are multiple stressors, such
as illness, and the loss of a spouse.
These multiple stressors may be too
much for a person to deal with. This may
lead to depression, and the need to seek
help from their health care provider or
specialist.

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Health Promotion of The Elderly

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Promoting Health and

Wellness of the Older

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