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Vulnerable Population

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Vulnerable Population

Aspects of a Chosen Population

The elderly are among the most vulnerable population based on health and healthcare access. The World Health Organization (2018) highlights that from 2015 to 2050 the population of the elderly in the world will rise from 12 to more than 20%. Currently, the pace of population aging is significantly growing than in the past. The shift in the distribution of the global aging population is more prevalent in high-income countries such as China, Japan, and the United States. A longer life expectancy implies that the proportion of the elderly compared to the younger generation is growing tremendously, raising concerns over global strategies to address health and healthcare for the elderly.

From the biological aspect, aging results in changes in molecular and cellular changes that may predispose an individual to infection and chronic illnesses. The changes during the aging result in decreased physical and mental capacity which affect their health perception. Beyond the biological aspect, changes such as transitions involving retirement and relocation may also affect the health status of the elderly (Shlisky et al., 2017). Of note, most elderly individuals are abandoned by their family members are remain lonely at home. The lack of social support and financial constraints of this population results in their vulnerability to conditions and poor-quality care.

Why the Group is Considered Vulnerable

This group is considered vulnerable due to socioeconomic determinants of health that render them at high risk of infections and chronic conditions. One of the risk factors includes transition during retirement and change in preferences and patterns for the elderly. Physical functioning, social wellbeing, and psychological issues that face them render them exposed to infections and poor access to care. Regarding physical functioning, the elderly suffer mobility issues and illness due to their age (Robinson, 2018). Of note, some of the characteristics of physical limitations among the elderly include their inability to walk or commute which challenges their access to care. Reduced physical functioning can result in reduced engagement in activities of daily living such as bathing, dressing and an increased risk of falls. Sensory impairment is another characteristic of physical functioning which affects the population's perception of care. Older adults experience declines in hearing and vision which necessitate policy formulation to address their concerns.

Psychological wellbeing and social wellness also affect the elderly’s health status. The older population’s capacity to grow and adapt to the environment evolves as they age and render them more susceptible. Low social support, physical activity, and spirituality are also observed among the elderly. Due to poor social support, the elderly are more predisposed to stress, depression, and anxiety which affects their quality of life (Robinson, 2018). Socially, the elderly are usually abandoned at home by their families as they are considered a burden and liability. Poor social integration with other individuals in the society, less social contribution, and poor social coherence within the society may predispose them to emotional distress and other mental health issues. As adults age, their social networks and social roles change detracting them from social wellness.

Communicable Diseases in the Population

Nosocomial infections, urinary tract infections, and respiratory tract infections are some of the communicable diseases that are more prevalent among the elderly. Most older adults are frequently hospitalized and readmitted which increases their risk of contracting hospital-acquired infections as they interact with the care providers, other patients, and the hospital environment. Although limited empirical data demonstrate the association between age and urinary tract infections, older patients suffer from urinary tract-related infections which affect their quality of life and render them vulnerable (Esme et al., 2019). The frequency of urinary tract infections among the elderly living in community settings is higher and this raises concerns over measures to mitigate community transmissions. The common urinary tract infections for the population include chronic pyelonephritis, urethritis, and chronic kidney disease. Asymptomatic bacteriuria, common among the elderly can be exacerbated by poor hygiene.

Another type of communicable infection includes respiratory tract infections including influenzas, pneumonia, and tuberculosis. The underlying high risk of increased mortality of respiratory infections may be due to poor implementations of self-care practices and health promotional activities among the elderly. The respiratory syncytial virus is another common infection among the elderly and the symptoms resemble those of acute respiratory infections caused by influenza. Bacterial pneumonia among the elderly is also common especially among those institutionalized (Lee et al., 2020). The risk for bacterial pneumonia may be the due aspiration of nasal secretions that contain bacteria colonizing the respiratory system.

Barriers to Healthcare Access

The elderly are unable to control some of the socioeconomic determinants of care that affect their access to care. Even though the majority of older adults are covered by insurance coverage such as Medicare, the elderly face disparities in healthcare access due to income, education, and rural residence. Studies have established that financial constraints are a core factor in the elderly populations’ access to care services. Surviving on insurance coverage and other financial constraints due to abandonment by their families places the elderly at risk of limited access to care (Robinson, 2018). Wrong perceptions regarding health are also common among the elderly due to declining cognitive function which implies they have low health literacy levels. The elderly’s perception of physician’s lack of responsiveness is a great concern to seeking care. Rising healthcare costs, the lack of health information, and the lack of social support may also deter the elderly from accessing care.

Public Health Nursing

Discrimination is one of the issues the elderly face regarding community nursing. While a majority of the elderly population uses medical care from the physician's office, minorities use government-sponsored clinics. However, even with medical insurance, the elderly face racial disparities in care access. The quality of clinical care among the elderly is unequal due to racial segregation where African American populations are largely disadvantaged. Essentially, stigma and discrimination have a profound effect on how people perceive their mental health, especially the elderly (Osborn et al., 2017). With cognitive decline, the elderly are at higher risk of developing mental health conditions. However, there is an underutilization of mental health care among the elderly. Imperatively, mental health is transferable and while it affects the elderly, the patient’s families may also be at risk of developing the conditions.

Public health nursing also relates to access to care which is limited among the elderly. Of note, the older population lives with frailty, advanced illnesses, and diminished ability to manage their basic activities such as preparing meals, bathing, and managing their medications. Public health nursing has been beneficial to the elderly population, including their access to care through insurance coverage. However, the results of Medicare and Medicaid expansion in improving care among the vulnerable population has not benefitted the as earlier perceived (Robinson, 2018). While the central focus has been on individual care, there is a need to address public health through health education and health promotional activities.

Evidence-Based Practice to Improve Health Outcomes

Nutritional considerations and social support are some of the evidence-based practices that can be implemented to improve health outcomes among the elderly. Nutritional problems and increased risk of malnutrition and obesity are common among the elderly which predispose them to biological and sociologic issues. Dietary recommendations and changing family dynamics should be addressed because the elderly experience less support while facing substantial challenges in health and healthcare. Most older people experience changes in taste and smell, loss of appetite, dental and chewing problems, and issues with mobility which influence their nutritional patterns (Shlisky et al., 2017). Aging-related changes in absorption and utilization of daily recommended nutrients imply that the elderly consume below recommendations for intake. For severe malnutrition, dietary supplements may be used to address nutrient deficiencies or when the medications interfere with nutrient absorption.

Enrolling the elderly for social support may be an effective strategy to address their vulnerability. Changing society’s perception of aging and health can be important in addressing the loneliness and social isolation that the elderly face. Despite being considered less valuable to society, local communities should be educated on the value of the elderly population and be trained on the skills to apply when caring for the elderly. Health perception and concerns differ as people age; therefore, the younger members of society can be educated on how to care for the elderly (Fakoya et al., 2020). Of note, distinguishing the different concepts of isolation and loneliness among the elderly should be addressed to determine the appropriate goals for interventions to be implemented.

Resources to Improve Health Outcomes

Various resources can be used to improve health outcomes for the elderly. Because health literacy is a vital concept and a key determinant of health and healthcare access, effective health education strategies should be encouraged for the elderly (Doetsch et al., 2017). Websites and brochures are some of the resources which can be used to improve their health outcomes. Also, the integration and collaboration of primary and hospital care should be enhanced to mitigate preventable admissions commonly observed among the elderly.

References

Doetsch, J., Pilot, E., Santana, P., & Krafft, T. (2017). Potential barriers in healthcare access of the elderly population influenced by the economic crisis and the troika agreement: a qualitative case study in Lisbon, Portugal. International journal for equity in health, 16(1), 1-17.

Esme, M., Topeli, A., Yavuz, B. B., & Akova, M. (2019). Infections in the elderly critically-Ill patients. Frontiers in medicine, 6, 118.

Fakoya, O. A., McCorry, N. K., & Donnelly, M. (2020). Loneliness and social isolation interventions for older adults: a scoping review of reviews. BMC public health, 20(1), 1-14.

Lee, M. H., Lee, G. A., Lee, S. H., & Park, Y. H. (2020). A systematic review on the causes of the transmission and control measures of outbreaks in long-term care facilities: back to basics of infection control. PLoS One, 15(3), e0229911.

Osborn, R., Doty, M. M., Moulds, D., Sarnak, D. O., & Shah, A. (2017). Older Americans were sicker and faced more financial barriers to health care than their counterparts in other countries. Health Affairs, 36(12), 2123-2132.

Robinson, S. M. (2018). Improving nutrition to support healthy aging: what are the opportunities for intervention?. Proceedings of the Nutrition Society, 77(3), 257-264.

Shlisky, J., Bloom, D. E., Beaudreault, A. R., Tucker, K. L., Keller, H. H., Freund-Levi, Y., ... & Meydani, S. N. (2017). Nutritional considerations for healthy aging and reduction in age-related chronic disease. Advances in nutrition, 8(1), 17.

World Health Organization. (2018, February 5). Aging and health. WHO | World Health Organization. https://www.who.int/news-room/fact-sheets/detail/ageing-and-health