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Mabuchi, T., Hosomi, K., Yokoyama, S., & Takada, M. (2020). Polypharmacy in elderly patients in Japan: Analysis of Japanese real‐world databases. Journal of Clinical Pharmacy and Therapeutics, 45(5), 991–996.  

Post 3:

The aging process is characterized by the accumulation of several molecular and cellular damage over the years which leads to a gradual decrease in both physical and mental ability, the risk of having diseases increases and death can happen eventually. Individuals experience this differently (World Health Organization, 2021). As the elderly person's health health declines, and are more isolated socially, he or she tends to rely on the person taking care of him or her. If the person is physically frail, the caregiver may neglect him or her, or even engage in physical abuse. Some of these victims are aware that they are being abused, but the fear of being neglected prevents them from reporting the case or even mention it. But for those who have memory loss, they may not remember things that happened (National Institute of Justice, 2013).

Nurses should put certain things into consideration when assessing older adults as compared to middle-aged adults. The nurse should be aware that older adults may have geriatric syndromes- a term used to refer to common health problems that older adults may have, they may not be organ-specific, and have multifactorial causes like frailty, cognitive impairment, etc. Sometimes, these problems are often unrecognizable or not addressed properly. Identifying the specific problems to aging is important so that interventions can be directed to meet the specific needs of the patients. Older adults should also be assessed for all kinds of abuse as this age makes them vulnerable. Unlike the middle-aged adults whose assignments are mainly organ related (Spirgien and Brent, 2018).

National Institute of Justice, (2013). Causes and characteristics of elder abuse. 

Spirgien L. and Brent L., (2018). Comprehensive geriatric assessment from nursing perspective. https://www.ncbi.nlm.gov/books/NBK543827/

World Health Organization, (2021). Aging and health.

Post 4:

As one gets older there are some changes associated with old aging. aging characteristics are said to be progressive, intrinsic and universal. Some of the changes that occur in old age include, physical, psychological and physiological. Some of these changes are considered as normal aging process, E, g., wrinkles and gray hair. aging affects the teeth, heart and sexuality (Mayo Clinic). Characteristics of aging process includes Cardiovascular system-there is stiffening of the blood vessels and arteries, causing the heart to work harder to pump blood, predisposing to high-blood pressure and other cardiovascular problems. Memory and Thinking Skills-the brain undergoes changes that may have minor effects on memory or thinking skills. Eyes and Ears-aging may cause the eye to have difficulty with focusing on objects, sensitivity to glare, trouble adapting to different levels of light, aging can also affect the lens causing clouded vision or cataracts. There may be hard hearing or high frequencies following a conversation in a crowded room. Mouth–the gums may pull back from the teeth, teeth may start falling off, dry mouth. teeth and gum may become vulnerable to infection. Skin-there is thinning of skin, loss of elasticity and more fragile, easily bruised. decreased production of oil causing dry skin. wrinkles, spots and skin tags. Bladder and Urinary tract-bladder becomes less elastic, weakness of bladder and pelvic floor muscles, enlarged of inflamed prostate in males, leading to incontinence. Digestive system- structural changes in large intestine, lack of exercise, low fiber diet and dehydration causes constipation in old age. Bones, Joints and muscles-Bones shrink in size and density, loss of calcium causes bone weakness subsequently fracture. shorter in height. loss of muscle strength, endurance and flexibility, also, coordination, stability and balance (Mayo Clinic).

Functional dependence/disability, Poor Physical health, Cognitive impairment, Poor mental health and low income are aging characteristics that can lead to elder abuse (WHO). Memory issue le. g., Alzheimer causes vulnerability to elder abuse like, Physical abuse, Neglect and Financial abuse, depending on the nature of relationship between the abuser and the victim. abusers are family members, sometimes, offspring of the victim, long term dependent of victim. due to health or financial issues will be abusing the victim. Financial exploitation due to unrecognized cognitive impairment {NIJ}.

The nurse should have a good knowledge about geriatric and aging process. Health assessment of elderly is the same strategy of head-toe assessment, but assessment of elderly may take more time, especially if they are confused. A comprehensive health assessment including interviews to obtain important information, like, mental status, family health history, social history-alcohol or substance usage including smoking. allergies, medication. past medical history. Nurse should observe the appearance of the skin- cleanliness, dehydration, scars and injuries. Eyes- vision, if there is need for glasses or change of available one. any issues like cataract or glaucoma. Mouth-teeth and gum disease. Ears -check for hearing difficulty, or if there need for hearing aide. Check for frailty and balance. Check the medication, elderly is at risk for polypharmacy, that is multiple medications which can cause drug reactions. Ask questions about the living environment to prevent falls.

References:

WHOs Global Strategy and Actions plan on ageing and Health and the UN Decade of Healthy Agency (2021-2030). 

NIJ National Institute of Justice, Strengthen Science. Advance Justice.

Aging: What to expect-Mayo clinic-https://www.mayoclinic.org-aging