All over the world, the aging population is growing, and it is estimated that in the near future, the older populace in many nations will outnumber that of the young generation and thus the importance of focusing on this group in the provision of improved health care. This is because the projected growth of the old population is expected to put a considerable constraint on health care as well as supporting services. For that reason, meeting the nutrition requirements for the older population is essential for the maintenance of health, improving the quality of health as well as ensuring functional independence (Leslie & Hankey, 2015). While many healthy adults in the older population have maintained proper eating habits, those with poor health have over time had difficulties to meet their nutritional requirements. According to the World Health Organization (2018), the older population is particularly vulnerable to malnutrition. In addition to this, the attempts to ensure that they receive proper nutritional requirements, have been met with a wide range of practical problems. For instance, their dietary needs are not quite well defined because factors like the lean body mass as well as Basal Metabolic Rate tend to decline as a person ages. Nutritional vulnerability has the potential of contributing to even more medical complications, increased chances of nursing home admission as well as longer hospital stays, and for this reason, it is essential to consider the nursing requirements for these people and evaluate the implications of nursing care in accordance to the changes in the environment.
As already pointed out, with the increasing numbers of the elderly in the population, it is increasingly becoming paramount to consider health care requirements for these individuals. Since this population is projected to rise above that of the younger generation in many countries, health care providers have been concerned that there would be a potential constraint in health care provision as well as related services in the future for the older adults group. One health risk to consider in this case among the elderly is malnutrition (Star, McDonald & Bales, 2015). Many of the diseases that are experienced by the old are associated with dietary factors. The factors are mainly compounded by the changes which occur naturally when a person is aging. Nutrition vulnerability can be defined as the occurrence of risk factors for malnutrition. While the physiological changes which accompany the aging process are crucial risk factors, there are still many social, economic, psychological as well as physical factors which also determine how much an older adult consumes (Hewitt, Ismail & Draper, 2006). The resultant consequences of these risk factors are interwoven in the overall web of nutrition vulnerability.
There are many reasons that explain why the elderly are susceptible to malnutrition or have poor nutritional statuses. The first factor is poor mobility. Whether this is caused by decreasing physical ability or poor energy levels, it could seriously have a significant impact on the on an elderly’s nutrition. A simple activity such as going to the grocery store could prove extremely problematic for weak and old individuals. For that reason, the hindrance to mobility could lead to malnutrition if there is no one to help them. The second factor that could lead to malnutrition for this group is poor mental health. Cognitive disorders, failing memory, as well as depression, could have a significant impact on dietary intake. For instance, poor memory, as well as cognition, can lead to a person forgetting to eat or drink thus putting themselves in the risk for malnutrition, weight loss and dehydration (Hopkins, Shaver & Weinstock, 2016). In addition, depression has the potential of reducing the motivation to shop for food, cook and eat leading to the same risk factors. Another factor contributing to nutrition vulnerability among the adults is trouble swallowing (Chury, 2014). Dysphagia could be due to age-related decline in the swallowing functionality, dementia, stroke or radiation to the neck or head. All these factors among others such as decreased hunger and thirst sensations, money worries and chronic illnesses as well as medication are factors that could lead to nutrition vulnerability among the elderly.
Since malnutrition in older adults could lead to serious health-related problems, it is essential to come up with reliable risk reduction methods. There is a wide range of recommendations that are advised for this purpose. First, it is vital to encourage the consumption of healthier food among this group (Familydoctor.org, 2017). The best foods for this purpose are those that are full of nutrition such as vegetables, fruits, whole grains as well as lean meats among others. Second, snacking on the healthy food options is a superb way of gaining some extra calories in between meals and is primarily for the older adults that reach satiety early during main meals. Encouraging exercise among the elderly is another recommendation that could be adopted for reducing the risk of malnutrition. When an old person is fit and has enough energy, they have the physical ability to shop, cook well-prepared meals and eat without problems (Mlinac & Feng, 2016). Finally, planning social activities with the elderly could help ensure they get out to the sun, forget about anything that might worry them and prevent them from eating
When the above recommendations are not practiced, the risk of malnutrition in the older patients is quite high compared to younger individuals. When a person has already been identified as malnourished, it does not mean that that is the end of their lives. This is because of the treatments remedies for malnutrition. The type of treatment to be administered depends on the severity of the condition as well as the presence of any other underlying factors. The standard form of treatment, however, involves the health care provider preparing a target care plan that has specific goals for the treatment process. For instance, a feeding program that has a specified diet plan. In addition, nutritional supplements are an essential part of a patient’s recovery process. For the individuals with severe nutrients absorption issues, they could require artificial dietary support such as a tube or feeding intravenously. Finally, the patient is to be monitored closely while reviewing their treatment progress.
Nurses are an essential part of identifying the patients with nutritional risks. As a matter of fact, it is the nurses who perform the first analysis for pinpointing elderly patients that are in need of nutritional assessment as well as evaluation. The first requirement for them is the ability to properly utilize nutrition screening tools (Sauer et al. 2016). When this nutrition screening is performed within the first hour by the nurses, it sets a stage for ensuring quality care. The second nursing requirement in this aspect is the ability of the nurse to identify the severity of the situation at hand and be able to refer a patient to a registered dietitian nutritionist. Another requirement is the ability of a nurse to introduce practice changes that could have a positive impact on the nutritional care of the elderly (Ahmed & Haboubi, 2010). In addition, the nurses should be in a position to utilize literature to develop practices as well as improved standards of care in these facilities (Seifert & Hickman, 2010). It is also recommended that nurses to be in a capacity of creating processes which ensure that the patients have assistance with feeding when the time comes. Nurses should also discharge teachings that involve specific nutritional instructions which can be incorporated into the home setting readily. Ensuring a smooth transition could help prevent readmission.
Caring for older people especially those with malnutrition problems can be a daunting task for many people. However, nurses are required to be equipped with the right set of skills that would come in handy for ensuring that the patients are well take care of and they are treated and discharged. As it has been established, nutritional vulnerability is common among the old and therefore one of the most appropriate nursing requirements for this is to be equipped with the necessary skills for caring as well as treating the patients. The knowledge which is required to be in a capacity to understand and handle the interdependency of the social, biological and psychological needs of the older individuals is diverse. For this reason, it is recommended that during staffing, specialized skill and expertise must be sought to ensure that nurses with the necessary skill set are brought on board. Dealing with older patients could also be annoying due to the fact that they are slower that the average normal human, they forget quickly and might look down on a person. To avoid discouragement which might impact performance, it is advised that nurses practice to be patient with their patients and be friendly and social as possible to ensure smooth handling of operations.
The environmental determinants of health, as well as diseases, are pervasive as well as integral towards assessment, intervention, diagnosis, evaluation and planning of components for the nursing practice (Applebaum et al., 2010). When the environmental implications of nursing care are missed, there is a lost opportunity for future preventions, and thus the public is less well served. It is for this reason that it is essential to evaluate the implication of nursing care as pertaining to the changes in the environment (National Academy of Sciences, 2010). During nursing care, the nurses tend to overlook their environment and do whatever it is they are supposed to be doing. The natural environment of the nurses could be unappealing to many people who are not of the profession, and that is why nurses are specialized and skilled individuals that are trained to carry out these undertakings. If a nurse is uncomfortable with the natural surroundings, then it could have a negative impact on nursing care (Kieft et al., 2013).
The change in the natural environment could be a positive factor or negative depending with how one looks at the issue. For instance, when the natural environment is altered, some nurses might have already been used to the way in which they do things as a common standard. This standard could have been helpful in the provision of healthcare and related services. In this case, when the environment is changed, it alters the manner in which these nurses operate and thus create a negative impact, if the good way of service delivery is changed. On the other hand, the change could also bring about positive results. For instance, if there are quality improvements that need to be done in the delivery of services as well as instances when there are skill upgrades, it is important that nurses learn and adopt better and improved ways of doing their work. For that reason, a change in the natural environment could help improve the delivery of service.
A change in the social environment could have an effect on health care since increased social support at the workplace is paramount for improved nursing care (Salmond & Echevarria, 2017). Sometimes, nurses need to work together, consult each other on a wide range of issues and support each other in their duties. For this reason, the social context within which a nurse operates is especially crucial for determining how they perform. In addition to this, some nurses might have a certain acknowledgement of a certain social surrounding and changing this could have an adverse effect in the manner in which they provide services. Apart from the manner in which the nurses depend on each other, the social environment could also involve the interaction of nurses with their patients and in this case the elderly. As it has been pointed out before, it could be a great challenge to care for an elderly person due to many factors that have been suggested. For this reason, the nurses should be in a position to understand how to better handle these patients. One way that would create a great difference is being in a position to better interact with the patients. This comes down the manner in which the nurses socializes with the patients and creating a sense of trustworthiness and environment that encourages the older patients to open up and share their feeling with the nurses. The change in the social environment could therefore have a positive impact if it is geared towards creating a connection between the nurses and the patient which could improve the quality of nursing care significantly.
Finally, the change in the government could bring about both positive and negative impacts on nursing care. A change in the government could bring about various health reforms that are important in carrying out nursing care. For instance, affordable health care plans dedicated to the elderly to ensure quality of life for them due to improved healthcare. If the government is changed and such reforms implemented, it could ensure that the old people rest easy and ensure that they are not worried about the burden of health care. That means that they would now be able to afford a wide range of medication as well as services as opposed to before the change. This would go a long way in providing smooth services for them in the hospitals and in the end encouraging improved nursing care because they would not be stressed about medical bills and give healthcare providers a hard time and also because the reforms are bound to ensure to ensure that they do not avoidable the hospitals and therefore improve quality of life for them. However, the change in government could also have a negative impact on nursing care. For example, if a government comes into power and introduces high tax levies in the healthcare sector or come up with health insurance policies that are far-fetched for the common citizens, the this government could create a crisis in the area. People would not be in a capacity to afford health care easily and hospitals would struggle thus delivering poor services to the people that are in desperate need of it
Conclusion
Since Nutritional vulnerability has the potential of contributing to even more medical complications, increased chances of nursing home admission as well as longer hospital stays, and for this reason, it is essential to consider the nursing requirements for these people and evaluate the implications of nursing care in accordance to the changes in the environment. The changes could be political, social or natural and all these have implications on nursing care. It is the duty of nurses to take care of their patients and ensure that they all get specialized care in accordance to their health needs. For this reason, there are many recommendations that have been offered to help reduce any risks associated with malnutrition as well as the possible treatment procedures that are necessary. In addition, the nursing requirements of patients have been detailed indicating the best nursing practices for the malnourished older population
References
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Chury, K. (2014, October 16). 10 Reasons for Elderly Malnutrition and What You Can Do to Help. Retrieved September 13, 2018, from ThinkyBites: https://www.thinkybites.com/content/2014/10/16/10-reasons-for-elderly-malnutrition-and-what-you-can-do-to-help
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