Among the older population there are many who we consider ‘vulnerable’ individuals. Frailty, chronic illnesses, co-morbidities, polypharmacy. living alone, and social isolation are all reasons why many of those within the older population are vulnerable. These health outcomes are routed to the individual's life history and how early life experiences, choices and environments later influence the health of the individual later in life. This approach is referred to as the life course perspective (Elder,1994). Using the life course perspective allows health care professionals to better understand the individual and population health of older adults. The video below provides examples of real life experiences that some face throughout the life course that influence their health outcomes later in life.
It is important in my role in home and community care, as well as my study of interest in gerontology, to use the life-course perspective in understanding the health outcomes of older adults. This is why I find it fitting to utilize the ecological approach as it addresses the life course of individuals, families and communities. I found a very thorough resource developed by a professor from the School of Public Health at the University of California, Berkeley that explains the ecological model in the context of aging populations. Satariano (2010) demonstrates the ecological approach in action through reviewing walkability in neighborhoods for older adults and emphasizes the importance of enforcing environmental policies and programs to enhance health and mobility of older adults and community at large.
In regard to home and community care there is a need for stronger policies toward supporting older adults not just to live in their homes longer, but continue to remain a part of the community in ways that are meaningful to them while maintaining their health. That being said, in understanding multiple levels of influence on health in older adults we must move away from treating each disease independently and work toward a more integrated and interdisciplinary approach to help prevent older adults from becoming care dependent.
This video supports that the health of older adults is a product of various internal and external factors and suggests that the health care system take a more integrated approach in caring for older adults. Meaning that providing care for older adults doesn’t just end after the doctors appointment. Older adults need to be provided the proper resources, beyond medication, to enable them to live successfully within their own homes and communities.
Aging is not a disease, but an integral part of the human condition. To maximize the health and well-being of older Canadians, and ensure their continued functionality and independence for as long as possible, CMA believes that the health care system, governments and society should work with older Canadians to promote healthy aging, provide quality patient-centered health care and support services, and build communities that value Canadians of all ages (CMA, 2013, p.10)
The Canadian Medical Association (CMA) supports optimizing the health outcomes for older adults through promoting healthy ageing and creating age-friendly environments and a community. This document evaluates different levels of influence of health and determinants of health on older adults and makes recommendations for health service delivery and physicians to apply to their practices.
Potempa et al., (2010) define and explain the Healthy Ageing Model that supports health promotion in older adults . As identified in the figure below, the Healthy Ageing Model uses a client-centered approach which refers to the importance of listening to clients/patients stories in a judgment free and empathetic way. I believe that this model encourages professionals to provide a more interpersonal approach to care in addition to considering that health outcomes are a result of various determinants of health that one often cannot control. Though the Healthy Ageing models is more oriented toward clinicians if followed accordingly this allows for the individual to be set up for success while living in their home and community. For example, if a clinician follows the model by (1) providing client centered care (2) providing reachable and attainable goals(3) enforces coaching to support behavior change and (4) understanding the levels of influence of health or one’s ‘Personal Health System’, the older adult is more likely to have healthy outcomes and remain living independently.
Lastly, the Assembly of First Nations (2009) created a research paper that thoroughly identifies many spheres of influence on health of older Canadian’s, in particular, aboriginal Canadians such as environment, community and culture. Food quality, water quality, air quality, housing, extreme temperatures have the ability to cause poor health outcomes for any individual, however, older adults are more susceptible to being negatively affected by these factors due to vulnerability due to frailty, chronic illnesses, co-morbidities, polypharmacy. living alone and or in addition to social isolation. The Assembly of First Nations utilize the wholistic policy and planning model which incorporates the medicine wheel, lifespan, First Nations self-government, health determinants and social capital. I have included an image of the model below.
For the second portion of this units requirements I will be reviewing the ecological model in respect to older adults living in the community as well as the further discuss my role in in health care in regard to the model.
Please see all my resources for this unit here.
References
Environmental Health Older Adults and Seniors (Elders): Assembly of First Nations. (2009, March).
Elder, G. H., Jr. (1994). Time, Human Agency, and Social Change: Perspectives on the Life Course. Social Psychology Quarterly, 57(1), 4. doi:10.2307/2786971
Health and Health Care for an Aging Population [Policy Summary of The Canadian Medical Association]. (2013, December).
Potempa, K. M., Butterworth, S. W., Flaherty-Robb, M. K., & Gaynor, W. L. (2010). The Healthy Ageing Model: Health behaviour change for older adults. Collegian, 17(2), 51-55. doi:10.1016/j.colegn.2010.04.008
Satariano, W. (2010, November 23). The Ecological Model in the Contexte of Aging Populations: A Portfolio of Interventions. Lecture presented in School of Public Health at the University of California, Berkeley.
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