BY: KRIS LYN L.

TEJEREO
Compressed Morbidity
 FOCUS OF HEALTH CARE CHANGING
FOCUS OF
Preventing disease and promoting health
Walter (1998), “ the best preventive care consist
of a combination of office based services, patient

HEALTH
education, lifestyle counselling, clinical vigilance
through routine check-ups and the administration
of timely screening”
CARE
Broad-based focus on preventive health care will
cost of screening and diagnostic test money will

CHANGING
be saved eventually when there are fewer
complications and less need for acute and long
term care, both of were extremely expensive.
Ten Tips for Healthy Aging

Ten Tips for Healthy Aging

Health promotion
Measure to prevent an illness or
disease from occurring
Encouragement of healthy habits
and lifestyle known to maximize one’s
quality of health.
Public Health efforts to educate the
community on the benefits of
practices such as low-fat diet, regular
exercise and accident prevention.
Primary Prevention provides an
opportunity to decrease risky
behaviours to avoid to avoid
unnecessary disability and promote
independence
 Early detection and
treatment of the disease
 Refers to methods and
procedures to diagnose the
presence of the disease in
the early stage
 Health screening is one
weapon in the battle for the
practice of preventive
medicine
Return the client to an
optimum level of
health and wellness
despite of the disease
condition
Screening Test
•

Health
is usually relatively simple, non-invasive and
economical
• performed by health care provider
• frequency depends upon the client’s family history

Screening
and high risk status and discussion between the
physician and the patient
• test do not provide a specific diagnosis but
instead indicate that further testing is needed to
determine a definite diagnosis.
Leading Cause of Death in
Persons Age 65 and Older
♦ Heart Disease
♦ Malignant neoplasm
♦ Cerebrovascular disease
♦ COPD
♦ Pneumonia and Influenza
 Recommended Screening Tests for the General Population of People Age 65 and Older

Test Frequency
Blood Pressure Every visit or at least yearly
Pulse Every visit or atleast yearly
Electrocardiogram Clinician’s Judgement
Cholesterol Yearly if High Risk
Blood Sugar Clinician’s Judgement
Urinalysis Yearly as appropriate
Clinical breast exam Every after age 40
Mammogram Every after age 50
Papanicolaou Test Every 1-3 years based on risk
Pelvic Exam Every Year
Fecal Occult Blood Test Every Year after age 50
Digital rectal exam Every after age 40
Sigmoidoscopy Every 3-5 years after age 50
Vision Exams Every year after age 65
Hearing Periodic after age 65
Bone mineral density At least once after menopause
Prostate Specific Antigen Every year after age 50
Sites for Screening Test
Physicians office
Hospitals
Assisted Living facilities
Nursing facilities
Community Clinics
Mobile Screening units
Health fairs at malls or other businesses
such as pharmacies or grocery stores
Churches
 *The sponsoring organization and/or has
the legal responsibility for ensuring that correct
procedures are followed, personnel are trained,
the equipment is safe and follow-up reporting is
accurate.
 PROVIDERS
Health care providers
- are beginning to place more
emphasis on wellness by discussing
nutrition, exercise and the dangers of
smoking with their clients

Gerontological Nurse Practitioner

- who may be in independent
practice or work with a physician group,
focus on health education and
promoting health as well as assessing
and treating certain health problems.
 Principal Findings of the US
Preventive Task Force
 Interventions that address clients personal
health practice are vitally important
 The clinician and client should share decision
making
 Clinicians should be selective in ordering tests
and providing preventive services
 Clinicians should take every opportunity to
deliver preventive services, especially to
person with limited access to care
 For some problems, community level
intervention may be more effective than
clinical preventive services
Criteria to Justify Screening for a Disease
 The disease must have a significant effect on quality of
life
 Acceptance methods of treatment must be available
 The disease must have an asymptomatic period during
which detection and treatment significantly reduce
morbidity and/or mortality
 Treatment in the asymptomatic phase must yield a
therapeutic result superior to that obtained by delaying
treatment until symptoms appear.
 The incidence of the condition must be sufficient to
justify the cost of screening
SELF- MONITORING TEST

SELF-MONITORING
TEST
Blood Glucose Monitoring
SELF- MONITORING TEST

Blood Pressure and Pulse

Blood Glucose Monitoring

Barriers to
Health
Promotion
 Barriers to the Practice of
Health Promotion/ Disease
Promotion
 Inadequate reimbursement for
preventive medicine practices
 Fragmentation of health care delivery
system
 Insufficient time spent with clients
 Confusion resulting from conflicting
recommendations by the various
health experts/panels
 Health providers’ concerns over risk
versus benefit of screening procedures
 Health provider’ concern about the
cost effectiveness of preventive efforts
 Prejudices toward client populations
 Medical school focus on illness and
disease
 Potentials Factors
Affecting patient
Adherence
 Health seeking behaviour
 Belief in the efficacy of
screening
 Cost of screening program
 Anticipated feelings of
anger, fear, and shame
 Availability of
transportation
 Availability of companion
 Lack of regular physician
 Ageism

Cultural

Financial
 Attitudes
and
Assertiveness
Many are very independent, despite multiple obstacles
such as poverty, personal losses, and presence of
acute or chronic illnesses.
Some would rather live and die in an old home
needing repair in a neighborhood with increasing
criminal activity tan ask for a accept help.
People may not have access to primary prevention or,
because of a lack of formal education and finances,
not be aware of what prevention strategies are
available.
Independent Practice Association (IPSs), multiple-
physician groups, hospital mergers, and managed care
insurance plans, older clients need t be more assertive
to be sure that they and their family members receive
the quality care that they need and deserve.
 SUGGESTIONS FOR TEACHING FOR OLDER ADULTS ABOUT INDIVIDUAL RESPOSIBILTY AND ASSERTIVENESS FOR MAINTAINING
WELLNESS
 Learn to do some of the simple health checks yourself  Select Physicians and hospitals that have the specific
(Pulse, BP, Breast Exam). Ask your physician or nurse to special services, staff and equipment to give quality care to
teach you how. older adults. A quality to look for in a physician and nurse is
the ability to listen well
 Stop Smoking  When in a hospital, clinic or physician’s office ask if the
nurse caring for you is a registered nurse. A registered nurse
must wear a name tag with the label RN
 Keep active, both mentally and physically. Reduce  Do not let anyone tell you that symptoms or problems are
Stress. due to age. Aging is not a disease. It is normal to be
physically and mentally healthy into the 100s. Problem
should be diagnosed and treated.
 Take as few medicines as possible, but do not stop  Be assertive in seeking quality health care for yourself and
taking any without discussing it with your physician. your family.
Discuss the possible need for vitamin, mineral and
calcium supplement with your physician.
 Prepare for all physicians’ office visits by writing down  Take responsibility for your own health and that of your
all of your questions and concerns a few days before family and insist on quality care
the visit and do not leave until your questions from the
physician and/ or nurse. Ask at least one question of
your physician even if you think you know the answer.
 Keep your own written records of the dates of  Do not change your health insurance unless you can obtain
physician visits, immunizations and blood pressure better benefit at the same or lowest cost. Be sure you
readings. understand exactly what the benefits are. Ask questions
 ATTITUDES AND
SUGGESTIONS FOR ASSERTIVENESS
THE OLDER ADULTS TO USE WHENcont…
COMMUNICATING WITH THE
PRIMARY CARE PROVIDER
 Bring all medications with you for the PCP to review. Make an effort to know all of
your medications Selection of and Health Care
Appeals and
Individual
Physical Complains
Responsibility
Resource
names and dosages why they were prescribed. Include any
vitamin or mineral supplements Providers
and any herbs or other similar substances you
are taking

to Essential components of
 Make notes of any symptoms or concerns you have had since your last visit. Try
If be
older adults
as specific do not
as possible believe
with details that
of timing, they
associations with food or
Nurses can provide older client, family, and
wellness are good nutrition,
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and
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iscare
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process. members
to consider risks benefits for yourself and decide what is right for
you. You are not obligated to agree with everything and should feel comfortable to
ask for time or further information.
 Ask for final instructions to be written for you. It is not reasonable be expect
someone to remember everything discussed months later.
 Role
of
Nurses
 Health education
 Advocacy
 Referral Process
 Topics for Health Education Programs for Older Adults
• Arthritis
• Alternative therapies (herbs, acupuncture, music)
• Cancer (breast, prostate, lung, colon)
• Dementia (including Alzheimer’s disease)
• Health maintenance organizations
• Heart disease
• Hypertension
• Immunization
• Medicare and Medicare Supplement Insurance (Medigap)
• Medications
• Mental health (especially depression)
• Normal aging (ageism and myths)
• Nutrition
• Osteoporosis and fractures
• Sexuality
• Skin problems
• Vision problems (cataracts, glaucoma, and macular degeneration)