Health Promotion & Disease Prevention in Older Adults

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Chapter 8

Health Promotion and Illness/Disability Prevention

Health promotion: the science and art of helping people change their lifestyle to move toward a state of optimum health

Primary prevention: seeking out services and education in order to prevent disease

Secondary prevention: detecting early disease and seeking care before the disease progresses or symptoms become apparent

Terminology (1 of 2)

Tertiary prevention: the care of established disease; attempts to restore the person to their highest function, minimize the negative effects of disease, and prevent disease-related complications

Quaternary prevention: limiting disability while maintaining functional ability or reducing loss of function through adaptation

Terminology (2 of 2)

Transtheoretical model—progression through 6 stages of behavioral changes—precontemplation, contemplation, preparation, action, maintenance, and termination

Health belief model—determines certain behaviors that attributed to and prevented participation in preventive measures

Health promotion model—presumes an active role by the participant in developing and deciding the context in which health behaviors will be modified

Models of Health Promotion

Patient barriers unrelated to health beliefs include: lack of transportation, financial limitations, lack of insurance coverage, lack of availability, language barriers, and health illiteracy

Older Adults’ Barriers to Health Promotion

Primary preventive measures

Yearly well visits

Immunizations

Smoking cessation

Alcohol consumption

Polypharmacy

Bone health

Disease Prevention (1 of 2)

Secondary preventive measures

Annual screening recommendations for older adults should be made on an individual basis with the use of the guidelines and evidence-based recommendations from USPSTF.

Tertiary preventive measures

Aims to prevent or reduce long-term effects of a disease by helping patients manage their conditions and chronic symptoms such as-stroke, cardiopulmonary disease, chronic pain, and cancers

Disease Prevention (2 of 2)

Which of the following are secondary health prevention measures? (Select all that apply.)

A. Mammogram

B. Cardiac rehab

C. Smoking cessation class

D. Stroke rehab

E. Colonoscopy

F. Annual flu shot

Quick Quiz!

ANS: A, E

Answer to Quick Quiz

Look for potential health hazards and contributing risk factors

Utilize Gordon’s typology of 11 functional health patterns

Subjective and objective assessment of each pattern

Within each pattern, identify the aging adult’s knowledge of health promotion, ability to manage health-promoting activities, and value given to activities of health promotion.

Assessment for Health Promotion and Disease Prevention

Self-perception/self-concept pattern

Encompasses a sense of personal identity; body language, attitudes, and view of self in cognitive, physical, and affective realms; and expressions of sense of worth and emotional state

Roles/relationships pattern

Encompasses the achievement of expected developmental tasks

Health perception/health management pattern

Encompasses the perceived level of health and current management of any health problems

Gordon’s Typology (1 of 4)

Nutritional/metabolic pattern

Encompasses evaluation of dietary and other nutrition-related indicators

Coping/stress-tolerance pattern

Encompasses the client’s reserve and capacity to resist challenges to self-integrity and his or her ability to manage difficult situations

Cognitive/perceptual pattern

Encompasses self-management of pain, the presence of communication difficulties, and deficits in sensory function

Gordon’s Typology (2 of 4)

Value/belief pattern

Encompasses elements of spiritual well-being that the older adult perceives as important for a satisfactory daily living experience and the philosophic system that helps him or her function within society

Activity/exercise pattern

Encompasses information related to health promotion that encourages the older adult to achieve the recommended 30 minutes daily of physical activity on most days of the week

Gordon’s Typology (3 of 4)

Rest/sleep pattern

Encompasses the sleep and rest patterns over a 24-hour period and their effect on function

Sexuality/reproductive pattern

Encompasses the older adult’s behavioral expressions of sexual identity

Elimination pattern

Encompasses bowel and bladder excretory functions

Gordon’s Typology (4 of 4)

Involves exploring the older adult’s ideas and beliefs concerning health care needs

Reading current literature to keep abreast of the latest specific health promotion recommendations

Understanding of behavior change and behavior change theories such as the theory of self-efficacy

Planning in Health Promotion and Disease Prevention

Adopt proactive stance toward an action plan for health promotion of the older individual

Seeking activities, locations, and means for disseminating health promotion information to a group of older adults is an example of implementing a proactive stance.

Evaluation

Determining the effectiveness of care plan

Implementation and Evaluation in Health Promotion and Disease Prevention

Nurses can provide a bridge between the theory of health promotion and the implementation of health promotion, health protection, and preventive services.

Use an individualized approach.

Focus on providing appropriate education both formally in health promotion classes and informally during health care visits.

Provide current recommendations for health promotion activities and help older clients decide what health behaviors they want to engage in.

Supporting Geriatric Empowerment