Elderly individuals are considered as high-risk population because of their changing physiology. When talking about the cardiovascular system, the aging population experiences decreased ability to maintain the stability of the body’s hemodynamics. Some of the tissues of the vascular and cardiac muscles are also replaced by stiff and fibrotic material which reduces the elasticity of the vessels. These changes lead to reduction in the cardiac output and rise of vascular resistance which contributes to the dependence of the heart to the volume of the blood. Additionally, the responsiveness of the autonomic nervous system and the hepatic blood flow are also decreased. For the respiratory system, impaired exchange of gas has been observed which lead to reduction of the lung’s vital capacity and even slower expiratory flow rate. In terms of renal function, a decreased rate for glomerular filtration is evident. The reduction of the renal function may lead to serious health problems like accumulation of various toxic substances like drugs and its metabolites. There has also been an evident decrease in bone mass which leads to osteoporosis. The aging population also experiences loss of skin tone and elasticity due to skin atrophies and changes in the collagen and elastin component of the skin. Moreover, the lean body mass of aging population also decreases as a consequence of muscle cell atrophy (Boss, 1981; Hallingbye, et al., 2011; Lewis, n.d.). These changes especially the decreased renal, cardiac, and respiratory functions of the elderly are considered as challenges in providing quality care for older adults because it affects their body’s ability to receive drugs and treatments. Since elderly individuals are at-risk for different diseases, the treatment for a particular disease would be complicated since other diseases are also occurring.
According to studies, it has been estimated that 80% of elderly are in need for care due to atleast one chronic condition, 50% due to multiple chronic conditions, and 60% are currently taking more than three prescriptions or medications. Due to increased risk of developing chronic diseases, elderly individuals are in need of a range of health care services to be able to address prevention of illnesses and reduction of health care costs. The limited studies on the effective and efficient approaches involved in elderly care is considered as a barrier in the improvement of health care services for the older population. Another barrier is the limited access of elderly individuals to quality health care services. Since the older population does not have enough strength and resources to visit health care institutions and organizations, they do not usually receive treatment for various diseases (Thorpe, et al., 2011). Another identified barrier include limited number of professionals who are specialized to provide quality care to elderly individuals. Since there is a current shortage of nurses specializing in geriatric-focused care, it would be beneficial if there would be an increase in the number of recruitments of nurses who are knowledgeable on gerontological nursing. Other barriers include financial constraints and cultural differences which affects the choices of the elderly (Bennett and Flaherty-Robb, 2003).
Some of the evidence-based practices that aim to facilitate optimal quality care and improvement for older adults include care coordination, increase of awareness, race and ethnicity specialized interventions, and improved access to health care. Care coordination involves cooperation of different health organizations and professionals to ensure that all of the health care needs and preferences of the patient are met. Studies have shown that care coordination has been known to improve health outcomes and cost savings for patients. Increased awareness is also necessary to improve patient outcomes due to various differences when it comes to ethnicity and cultural values. Another evidence-based practice to facilitate optimal quality care is the widening of insurance coverage of elderly individuals which has been a part of a comprehensive strategy that aims to minimize inequities in health care (Mayberry, et al., 2006; American Nurses Association, 2012).
References
American Nurses Association. (2012). The Value of Nursing Care Coordination. American Nurses Association. Retrieved from http://www.nursingworld.org/carecoordinationwhitepaper [Accessed on 18 Feb 2016].
Bennett, J.A., and Flaherty-Robb, M.K. (2003). Issues Affecting the Health of Older Citizens: Meeting the Challenge. OJIN: Online Journal of Issues in Nursing 8(2).
Boss, G.R. (1981). Age-Related Physiological Changes and Their Clinical Significance. Western Journal of Medicine 135(6):434-440.
Hallingbye, T., Martin, J., and Viscomi, C. (2011). Acute Postoperative Pain Management in the Older Patient. Aging Health 7(6): 813-828.
Mayberry, R.M., Nicewander, D.A., Qin, H., and Ballard, D.J. (2006). Improving quality and reducing inequities: a challenge in achieving best care. Baylor University Medical Center Proceedings 19(2):103-118.
Lewis, M.C. (n.d.). Theme 1: Physiologic Changes in the Elderly. University of Miami. Retrieved from https://www.pogoe.org/sites/default/files/gsr/2_Physiologic_Changes_In_The_Elderly.pdf [Accessed on 18 Feb 2016].
Thorpe, J.M., Thorpe, C.T., Kennelty, K.A., Pandhi, N. (2011). Patterns of perceived barriers to medical care in older adults: a latent class analysis. BMC Health Services Research 11 (181).
