Frailty in Aged People
Frailty is a crucial aspect of health science, which is most commonly found among the elderly. A study conducted by Dury et al. (2016) has demonstrated the increase in the risk of frailty as people grow older. The rapidly aging population often faces chronic illnesses as their quality of life decreases. To improve their condition, healthcare experts must step in and improvise the healthcare services to provide them with “a good frail life”. Healthcare professionals are expected to understand the status of the frailty of their patients in order to design appropriate intervention techniques (Lin et al., 2017). Chen, Gan & How (2018) suggested that old patients in aged care settings should be screened and their health status is required to be identified. It helps nurses to determine the degree of the frailty of the elderly, according to which intervention techniques are required to be implemented. Lin et al. (2017) suggested constant monitoring of their physical conditions by nurses, in aged care homes, to avoid any accidents or mishaps, in conditions of frailty.
The government of Australia has emphasized aged care through its aged care policies and legislation like Aged Care Act (1997) and Aged Care Quality and Safety Commission Act (2018). These policies have defined aged people as Australians who are aged 65 years and above. According to the Charter of Aged Care Rights under the Aged Care Act of 1997, older people have been represented as those who are independent, can make independent life choices and decisions, and are aware of their rights and limitations. With respect to healthcare settings, they are defined as those who are aware of the type of services provided regarding aged care and possess the right to access quality healthcare services. Government policies have empowered them to raise their voices against ill-treatment, abuse, and neglect, as they possess the right to be listened to and understood by healthcare professionals and their carers. Hence, they are sufficiently empowered by legislation.
The phrase “patient-centered care” refers to healthcare services that focus on a patient’s needs and requirements while providing appropriate treatment and interventions for his/her illnesses. Ebhrahimi et al. (2021) have defined patient-centered care as a multi-dimensional model that emphasizes several aspects like communication between patients and healthcare experts, shared decision-making, and planning personalized care for patients. It aims to improve the quality of healthcare, thus, contributing to increased patient health outcomes. It is designed for the elderly to support them in taking on their own responsibilities. The authors also defined patient-centered care in the hospital as well as out-of-hospital settings. According to Ebhrahimi et al. (2021), patient-centered care can become effective if the concerned person is considered a part of the healthcare team, that is, he should be involved actively in his recovery process. This can be done by imparting proper knowledge and education about the health status of the individual and explaining to him/her the entire recovery procedure. The healthcare experts are required to build a relationship of trust and faith with their patients and allow them to make their own decisions regarding healthcare services. They should be allowed to remain independent and their decisions should be listened to and respected. These measures enable them to take care of themselves. Nilsen et al. (2021) have also supported the above-mentioned theories that help improve their capabilities of taking their own responsibilities. The authors have added another aspect that can improve their degree of involvement in taking care of their own selves. Healthcare professionals should take into account the characteristics of the person and determine their areas of strengths and weaknesses. This is required to be done in order to support them in their areas of weaknesses and encourage them to take action, in the course of recovery, in their areas of strengths.
Aged Care Policies and Legislation
A current philosophical issue involving aged people is the problem of ageism, which has been identified as an issue around the globe. In recent years, Canada has emerged as the hub where aged people are facing this problem. Spence (2019) has defined ageism as stereotyping or stigmatizing or discriminating against a person on the basis of their age. The term “ageism” is mostly used in a negative sense and can be compared to terms like “racism” and “sexism” which have negative implications. The article by Spencer (2019) pointed out that the elderly is considered a blemish of society, in recent years. As their efficacy decreases in their professional arena as compared to the young generation, they are thought to be worn out and a burden to society. Hrvatin (2022) has also exposed the problems of ageism in Canada. As they are considered a burden by most people, they receive treatment but they are not given adequate attention and care, in case of any healthcare issues. Hence, the government should step in to make improvements to the conditions of the elderly. According to the author, the Canadian government should invest more in the senior community care units and old age homes to improve their conditions. Government interventions may change this outlook toward older people. Other aspects of ageism that have negative impacts on the health of the elderly are the lack of opportunities for employment, unavailability of social protection, reduced life expectancy, poor health conditions, negligence, and social isolation. Loss of employment occurs due to the negative outlook of employers that people of old age have undergone loss of productivity, though it is not true. The unavailability of a particular law in the country for the elderly makes them socially vulnerable. Negligence and older abuse are a matter of concern in recent years. Swift & Chasteen (2021) explained the problems of ageism during the covid-19 pandemic. Barrett et al. (2020) have described peoples’ negative mindsets while suggesting the lives of the elderly in order to reduce economic costs during the pandemic. All of these causes demotivate them to survive longer. Ageism comes with several co-morbidities like cardiovascular problems, arthritis, and diabetes. Hence, Hrvatin et al. (2022) noted that most people ignore the responsibility of spending on the healthcare of elderly people, thus, increasing their risks of mortality. These act as demoralizing factors contributing to mental health illnesses in the elderly (Ayalon & Tesch-Romer, 2018).
In order to combat such concerns and make the lives of aged people better, Pillemer, Burnes & MacNeil (2021) investigated some techniques. According to the authors, intergenerational contact is required to counter shallow mindsets among the younger generation of people. Nurses may help promote education and awareness about aging and its effects on the elderly. Healthcare staff must be trained properly so that they can treat them better in aged care settings. They also suggest the implementation of appropriate laws and policies against maltreatment and elder abuse. Nurses must change their own outlook, that is, they should not see elders as a burden. They should take their responsibility and treat them well. They should understand the difference between care and treatment. Treatment is given to patients who are ill, either physically or mentally or both, but care ca be given to everyone in need. Nurses and carers of elderly must help in keeping them motivated and active, and assist them in recovery in cases of illness. In the case of any form of elder abuse or neglect, they should inform the local authority, dealing in elder issues, and provide them support to overcome their issues.
References
Australian Government. (2022). Charter of Aged Care Rights. Aged Care Quality and Safety Commission. Retrieved 12 April 2022, from https://www.agedcarequality.gov.au/consumers/consumer-rights.
Australian Government. (2022). Legislation and policies. Aged Care Quality and Safety Commission. Retrieved 12 April 2022, from https://www.agedcarequality.gov.au/consumers/consumer-rights.
Ayalon, L., & Tesch-Römer, C. (2018). Contemporary perspectives on ageism. Springer Nature. https://doi.org/10.1007/978-3-319-73820-8
Chen, C. Y., Gan, P., & How, C. H. (2018). Approach to frailty in the elderly in primary care and the community. Singapore medical journal, 59(5), 240. doi: 10.11622/smedj.2018052
Duppen Rn, D., Machielse, A., Verté Rn, D., Dury, S., De Donder, L., & Consortium, D. S. (2019). Meaning in life for socially frail older adults. Journal of Community Health Nursing, 36(2), 65-77. https://doi.org/10.1080/07370016.2019.1582160
Ebrahimi, Z., Patel, H., Wijk, H., Ekman, I., & Olaya-Contreras, P. (2021). A systematic review on implementation of person-centered care interventions for older people in out-of-hospital settings. Geriatric Nursing, 42(1), 213-224. https://doi.org/10.1016/j.gerinurse.2020.08.004
Hrvatin, V. (2022). We have a ways to go in how we support aging Canadians, but for many, getting older can be a great experience. National Post. Retrieved 4 February 2022, from https://www.healthing.ca/wellness/aging/aging-isnt-a-great-experience-in-canada/.
Lin, Y. C., Chang, J. C., Chen, Y. M., Li, C. M., & Huang, L. H. (2017). Health related quality of life among frail and pre-frail older adults in Taiwan. International Journal of Gerontology, 11(4), 249-252. https://doi.org/10.1016/j.ijge.2017.01.003
Nilsen, E. R., Hollister, B., Söderhamn, U., & Dale, B. (2022). What matters to older adults? Exploring person?centred care during and after transitions between hospital and home. Journal of Clinical Nursing, 31(5-6), 569-581. https://doi.org/10.1111/jocn.15914
Pillemer, K., Burnes, D., & MacNeil, A. (2021). Investigating the connection between ageism and elder mistreatment. Nature Aging, 1(2), 159-164. https://www.nature.com/articles/s43587-021-00032-8
Shé, É. N., McCarthy, M., O’Donnell, D., Collins, O., Hughes, G., Salter, N., … & Cooney, M. T. (2018). The systematic approach to improving care for Frail Older Patients (SAFE) study: A protocol for co-designing a frail older person’s pathway. HRB Open Research, 1. doi: 10.12688/hrbopenres.12804.2
Spence, H. (2019). The (old) elephant in the room: value of older workers ignored. Toronto Star. Retrieved 4 February 2022, from https://www.thestar.com/opinion/contributors/2019/11/20/the-old-elephant-in-the-room-value-of-older-workers-ignored.html.
Swift, H. J., & Chasteen, A. L. (2021). Ageism in the time of COVID-19. Group Processes & Intergroup Relations, 24(2), 246-252. https://doi.org/10.1177/1368430220983452
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