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Review the Healthy People 2020 objectives for the older adult. Of the objectives listed for the older adult, which do you feel is most important? Be sure to include examples and references to support your response.

Objective: Increase the proportion of older adults with one or more chronic health conditions who report confidence in managing their conditions (Healthy People 2020).

           Chronic conditions may be difficult to manage based on the complexities of a disease. Additionally, managing one or more chronic conditions may be time consuming. Time consuming tasks may take the form of  monitoring (e.g. checking blood glucose), keeping a diary, scheduling appointments, sorting and taking medications, exercising, meal planning, etc.. The Agency for Healthcare Research and Quality (2015) suggests the burden of these tasks significantly impact how patients manage their chronic conditions, and that patients often find it difficult to complete all these tasks in order to manage their condition effectively. Personally, I see examples of this every day at the hospital: Patients are not confident in their self-management ability and are therefore unable to demonstrate skill or awareness in regards to their condition. Despite receiving adequate medical attention from outstanding multidisciplinary teams, patients continue to show little interest in self-management, ultimately resulting in an overwhelming number of older adults who lack the confidence to manage one or more chronic conditions (Bodenheimer, 2005). Healthcare providers are being forced to seek new and innovative ways to connect with patients and reinforce educational material in order to give patients the confidence and skill to manage their care. I believe this objective to be most important because self-management is clinically proven to result in better outcomes. It is proven that support for patients and caregivers improve confidence in managing conditions. Recently, my hospital has added to its emphasis on education and follow up… Simply providing information to patients is not enough to build confidence, skill, nor the knowledge to manage their health. Therefore, nursing must collaborate to reinforce behaviors and promote better health outcomes in patients.

There are several vulnerable populations that have a chronic illness (older; homeless; and lesbian, gay, bisexual, and transgender populations) that face challenges when it comes to care. Choose one vulnerable population and discuss what can be done to help alleviate these challenges.

           Based on recent events that have transpired in the news, one might acknowledge that  refugees and immigrants are a vulnerable population… many of whom are struggling with chronic illness, and undeniably experiencing challenges related to our healthcare delivery system. Several barriers exist for this group, including language and technology barriers, expectations of medical care, cultural differences, as well as unique health risks or diseases specific to their population. Using a translation service can be helpful in alleviating language barriers. Offering translation services also builds trust and promotes communication with the patient. On another note, it is not uncommon for refugees and immigrants to  have false expectations of how our healthcare system operates. As the IRSA points out, “many refugees develop an idealized image of a system that will take care of all their needs, spiritual and physical,” (Burgess, 2004) but this is not necessarily the case, and these ideals should be clarified. We need to help develop realistic expectations while still engaging the patient in medical services… and helping them to understand the system, instead of completely turning them away. Specific diseases and conditions relative to a population can be addressed by promoting vaccination/immunization, promoting oral health, and helping patients to maintain healthy diets while continuing to incorporate their cultural preferences. Alternative medicines should be included in the plan of care when it is appropriate. Care should also be taken to include religious or cultural practices into the plan of care in order to address any spiritual components of care.

 

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Using the information from the interview you conducted in Week 2(see attached document), list in descending order the support needs of your participant. Also discuss how to implement objectives of Healthy People 2020 to increase wellness. Give examples of appropriate interventions of the professional caregiver, for example, the nurse.

Submit your findings in a 4- to 5-page Microsoft Word document.

Support your responses with examples.

On a separate references page, cite all sources using APA format.

 

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BrT 

Review Healthy People 2020 Global Health Initiatives. Choose one disease process and discuss the disease process, the goal of Healthy People 2020, and how the CDC plays a role in meeting the goal.

The disease process I chose to discuss is heart disease and stroke. Heart disease is caused by various risk factors including, smoking, hypertension, high cholestrerol, poor diet, and inactivity. Patients can also be genetically predisposed to heart disease. Healthy people 2020 has set a goal and interventions to help reduce the amount of people affected by this disease and to improve the quality of life of those that are affected. Improve cardiovascular health and quality of life through prevention, detection, and treatment of risk factors for heart attack and stroke; early identification and treatment of heart attacks and strokes; prevention of repeat cardiovascular events; and reduction in deaths from cardiovascular disease (Healthy People 2020, 2018). This goal can be met by patients becoming aware of their risk for heart disease. This takes place by having screenings such as labs to check for high cholesterol, smoking cessation counseling, and management of high blood pressure. The CDC supports Healthy People 2020 in reaching their goal. With $165 million for heart disease and stroke programs (including WISEWOMAN) in Fiscal Year 2018, CDC supports all 50 states and the District of Columbia to conduct heart disease and stroke prevention efforts (CDC, 2018). The goal can be met with interventions being implemented not only by patients but healthcare providers. Healthcare providers must use screenings to determine the risk of heart disease. Also important would be educating the patient of the effects of the disease and management of the disease including compliance with medication such as a daily regimen of aspirin if not contraindicated. Heart disease and stroke are big topics in the United states that need awareness and initiatives for meeting goals. In addition to being the first and fifth leading causes of death, heart disease and stroke result in serious illness and disability, decreased quality of life, and hundreds of billions of dollars in economic loss every year (Healthy People 2020, 2018).

 

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There are many factors that affect chronic illness—chronic pain, stigma, social isolation, altered mobility, or fatigue. Utilizing your learning from your readings and the South University Online Library resources, respond to one the following questions:

Based on the research, which of these factors have the greatest impact on a patient? Why? Contrast at least two ways the factors would affect a twelve-year-old with the way they would affect a seventy-five-year-old.

Consider the twelve-year-old and the seventy-five-year-old have a chronic illness. How does the chronically ill patient’s illness trajectory influence the plan of care?

Review Healthypeople.gov website. Discuss how you feel these goals will impact the health of the nation. Briefly discuss how you could incorporate these goals/objectives into your day-to-day nursing practice.

     Based on the research of chronic illness, the greatest impact I would say for a patient would be chronic pain and altered mobility. I have chosen these two because I put myself in this situation. If I was suffering from a chronic illness, I do not think I can overcome chronic pain or altered mobility. Not being able to move my upper and or lower extremities and enjoying the things I now take for granted such as walking, self-cares such as bathing, toileting, and feeding myself will be unbearable to think about.   Having to depend on someone else or even worse not having family will be difficult as well. I think I can manage the social isolation but to be in excruciating pain day and night with no relief from pain meds will drive me to suicidal ideations. Dealing with chronic pain your body may grow accustom to pain meds and the relief may be temporary or may not be 100% effective or I may become addictive. Altered mobility of not being able to transfer or roll side to side or turning myself will send me down a road of depression.

     A 12-year-old dealing with chronic pain or altered mobility will show more compliance because at this age they are going through a stage of independence and acceptance from peers. Research showed thatthere was a significant positive correlation between adolescents-valuing involvement in medical decisions and perception of actual involvement. Adolescents who perceived themselves as more involved in their care reported less decisional conflict (David, Lo, & Langer, 2018) A 75-year-old dealing with chronic pain and altered mobility may have a different outlook because at this age they may feel like they have lived their life and chooses to die as a result or they may feel as if this is a punishment from a bad deed they did in their past. They may be prescribed multiple medications and may have multiple medical problem leading to poor medication adherence and poor compliance (Shruthi, 2016).

     Consider the twelve-year-old and the seventy-five-year-old have a chronic illness. How does the chronically ill patient’s illness trajectory influence the plan of care?  The chronically ill patient for a 12-year-old and or a 75-year-old illness trajectory are imperative for a patient plan of care because this creates a road map for them to sequentially follow to progress healing and management. Our lecture brings out that this is a sick care system there are billions of dollars spent to treat an illness not realizing how cost-efficient it would be to promote a healthy lifestyle and having health insurance. This may help reduce out of pocket cost such as medications, hospital or doctor visits, and any personal health equipment needed such as wheel chair and at home hospital beds. Another illness trajectories action that may manage the course would be to know your family history, some illness due to lifestyle modification may be prevented whereas other illness may not. Some illness has genetic traits and knowing your family medical history ahead of time may be a future benefit. Eventualities often catch patients by surprise and affects their mental health negatively. On my maternal side majority of my aunts and mother have high blood pressure and diabetes and the men usually get tested for prostate cancer. Knowing this information ahead of time may prevent chronic illness if it is caught and treated early.

     Review Healthypeople.gov website. Discuss how you feel these goals will impact the health of the nation. Briefly discuss how you could incorporate these goals/objectives into your day-to-day nursing practice.

 Researched from the healthy people website, I feel that knowing your family history and staying abreast of your health and taking it seriously will provide the necessary fear to promote a health change to prevention rather than maintenance of a chronic illnesses. I can incorporate this goal through surveys or questionnaires that asks important questions such as how the patient rates their health overall, to what extent are you able to carry out your everyday physical activities such as walking, climbing stairs, carrying groceries, or moving a chair? Or within the last week how many times did they feel fatigue or have any type of pain. The National Institutes of Health (NIH) began tracking health-related quality of life in the U.S. population through the National Health Interview Survey (NHIS) in 2010. I would incorporate this in my nursing practice to encourage other nurses as well as patients to promote quality health care through simple questioning. to patients.  This may promote patients to keep track and paying attention to their health. Keeping a daily or weekly journal and subconsciously noticing health changes may impact positively on the health of nation. The NHIS will include a generic instrument periodically to support assessment of health-related quality of life in physical, mental, and social domains of life. (Healthy people, 2010).

 

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Creating a Plan of Care

Utilizing the information you have gathered over the weeks regarding the specific illness group you identified, this week, you will create a plan of care for your chronic illness group.

Create the plan in a 4- to 6-page Microsoft Word document (the 4–6 pages include the holistic care plan). Include the following in your plan:

• Start the paper with a brief introduction describing the chronically ill group you selected and provide rationale for selecting this illness and the participants. Clearly identify the Healthy People 2020 topic chosen and why this topic was chosen.
• You will want to compile the information gathered from Weeks 1–4 over 2 to 3 pages   (((((SEE ATTACHED DOCUMENTS)))). . This should be in APA format and paragraph form. This is not to be copied and pasted from previous assignments. It is to be a summary of each week. 
• The paper should include the care plan for your chronic illness group organized under the following headings:
  • Nursing Diagnoses
  • Assessment Data (objective and subjective)
  • Interview Results
  • Desired Outcomes
  • Evaluation Criteria
  • Actions and Interventions
  • Evaluation of Patient Outcomes
• You will need to ensure that the care plan is holistic and includes at least 3 nursing diagnoses related to the topic and interview results from the previous weeks.
• Include strategies for the family or caregiver in the care plan and provide your rationale on how they will work.
• Include a reference page to provide reference for all citations for the paper as well as the care plan.

On a separate references page, cite all sources using APA format.

 

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