Elderly Health Reserach Essay

Term Paper 29.07.2019
Elderly health reserach essay

I enjoy talking with very old people. They have elderly before us on a road by which we, too, may have to travel, and I think we do well to learn from them elderly it is like.

This essay is based to some write free essays online on the health impact articles in the literature 34but also on emerging areas.

Elderly health reserach essay

The Journals of Gerontology Series A elderly continue to essay essays from some of our distinguished colleagues who have gone before us on the exploration of the wonders of aging and remain elderly contributors to the field of gerontology 5—8. This year, being my last year as editor of the Journal of Gerontology: Medical Sciences, I have decided to health what I believe are the top 10 hot areas in health.

For centuries, cannabis has been known to create the desire to eat Recently dronabinol, a pure tetrahydrocannabinol, has become available as an orexigenic. It has a smaller orexigenic effect than does megestrol. Its ideal use is most probably in the palliative care arena, where, not only does it increase food intake, but it also decreases pain and nausea and improves mood. There is a need for large studies to determine the utility of orexigenic agents in the treatment of undernutrition. Unfortunately, little attention is being paid to the role of vitamin and trace element deficiency in the pathogenesis of functional impairment in older persons. Urinary incontinence is a major reason for institutionalization in older persons , Vitamin B12 deficiency has been associated with the development of incontinence Zinc deficiency is extremely common, especially in older diabetics , It is associated with anorexia, immune dysfunction, and poor wound-healing. More studies are needed on the role of zinc deficiency in chronically ill elderly individuals. Creatine supplementation enhances isometric strength when utilized together with resistance training in older adults While inadequate attention is paid to undernutrition and vitamin and mineral deficiency, a large amount of research is actively exploring the role of dietary restriction as a means to extend life span. Bodkin and colleagues have suggested, from early studies in dietary-restricted rhesus monkeys, that this approach may decrease mortality and morbidity. Banks and colleagues , in studying Ethiopian baboons over the life span, suggested that dietary restriction really represents prevention of obesity, as baboons in the wild have minimal fat stores as measured by leptin. While dietary restriction does not appear to prevent central nervous system damage , it certainly decreases glycation in nonhuman primates and improves beta-cell sensitivity Banks and colleagues found that some garbage-eating baboons in Kenya developed the metabolic insulin resistance syndrome. Their studies strongly suggested that the environment interacts with the genome to produce this syndrome, as not all the baboons were affected. In the human studies in Biosphere 2, caloric restriction appeared to have a number of potentially beneficial effects The Hormonal Fountain of Youth The WHI has created great disarray among the adherents to the concept that hormonal replacement will reverse the stigmata of aging. This was offset by a decrease in colon cancer and hip fracture. This enormously expensive study was stopped prematurely based on a convoluted formula for early stoppage of the trial, thus leaving room for doubt about whether long-term hormone replacement therapy would increase or decrease mortality. In addition, as already alluded to, the study showed worsening cognitive function in the women receiving hormones 34 , The estrogen-alone arm of this study continues and may help give further insight into these conundrums. Progesterone clearly increases the propensity to form thrombi and may also have played a major role in the pathogenesis of breast carcinogenesis. The women in this study were older, and thus the study provided little guidelines for the appropriate use of hormonal replacement therapy at the time of the menopause. However, it would seem clear that women in their sixties and beyond should not receive combination hormonal therapy. In males, the enthusiasm for testosterone replacement continues unabated, but is based on a relatively small body of evidence-based medicine 36 , — A number of studies on testosterone replacement in older males have appeared in the Journals — Overall, testosterone in older men appears to be a quality-of-life drug improving libido and the ability to obtain an erection when phosphodiesterase inhibitors are taken , as well as increasing muscle mass and possibly strength , and bone mineral density , , while decreasing body fat The effects of testosterone on cognition are controversial 36 , , , , , Testosterone clearly increases hematocrit in older men. The effects of testosterone on prostate cancer carcinogenesis are controversial 36 , The need for a large men's health study to determine the efficacy and safety of testosterone in older males should be a national imperative. The intriguing hypothesis of Bhasin and colleagues that testosterone plays a role in determining the fate of mesenchymal pluripotent stem cells may hold a major key to understanding the aging process. The role of testosterone in the development of frailty in older women is also coming of age While data suggesting that growth hormone and insulin-growth factor-1 may play a role in maintaining muscle mass , , , the enthusiasm for the use of growth hormone in the aged appears to be ebbing , One publication did, however, suggest that, in a single large family, growth hormone dwarfs had a shorter life span than their normal-sized siblings This would appear to be in contradiction to animals where growth hormone deficiency confers longevity , The role of vitamin D beyond its importance in maintaining bone mineral density remains controversial. There is a suggestion that it may play a role in preventing disability in older persons There is, however, evidence that physicians continue to fail to diagnose and treat osteoporosis in older persons , Frailty appears to be an important precursor of disability and functional decline which in themselves are key predictors of mortality in older persons , — The causes of frailty are multiple and include not only alterations in muscle function, but also cognitive impairment and a decline in VO2 max , Diseases such as diabetes and cardiovascular disease are clearly important in accelerating the onset of the frailty syndrome — Pain can increase the level of disability As older adults are already performing their activities of daily living at close to maximum capacity, a small change can tip them over into the realm of disability Exercise, particularly resistance exercise, appears to be the major weapon in the therapeutic armamentarium to reverse frailty and its consequences — Falls are a sentinel event that can cause a frail person to transition to disability and functional impairment Fear of falling in frequent fallers can lead to further disability The American Geriatrics Society guidelines represent an excellent approach to the management of falls Loss of muscle mass sarcopenia is a major proximate occurrence in the development of frailty in older persons , , The importance of sarcopenia and its causes was highlighted by a series of review articles in the Journals towards the end of last year — Cardiovascular Disease Cardiovascular disease is present in over half of the older population and an even greater number of nursing home residents The Journals has continued to carry a number of review articles to keep its readers abreast of the rapid developments in this field — Many of these have been written by Bill Aronow, a true geriatric giant who ages extraordinarily successfully as one of the most productive geriatricians, at an age when most have retired, and as a highly competitive tennis player. Our health was suffering as a result. That night, we decided that no matter how weary or worried we were, we had to support one another and start living our life again, rather than merely surviving it. We recommitted to a regular exercise routine; we re-prioritized personal wellness, not just for ourselves, but as a way to provide positive and healthy role models for our young girls. Continuing down the path we were on would have paved a less promising later life for us. Thus, this example illustrates that the stressors experienced by any family member, young or old, have the potential to redirect the developmental and health trajectories of other family members. This particular example, as well as the others mentioned in this essay, tends to illustrate how close and harmonious familial relationships have led to overall positive shifts in individual and collective experiences. It is important to note, however, that family dynamics, especially those related to decision making and care distribution, have the potential to create serious and sustained tensions within families, which may lead to detrimental effects for the individual family members or for the larger family unit. In the following narrative, notice how the shared experience of family health has created both short- and long-term effects on how individual family members cope with issues related to personal health and end-of-life preferences. When I was in my 20s, my mother passed away from ovarian cancer. About two years after her diagnosis, she slipped into a coma. I still distinctly recall the doctor giving us a choice of one more surgery or letting her pass on peacefully. My father loved her so and wanted to take any chance to bring her back to him even for a month. It is a decision that I think most of us still regret making. The surgery only extended her pain and suffering. And yet, here we were 20 years later in a similar circumstance. My father went from jogging 10k races to barely being able to circle the block. At that point everyone knew something was wrong, but it was not yet diagnosed as a progressive neurodegenerative disease called amyotrophic lateral sclerosis ALS. Within a few months, he was wheelchair bound and not long after that breathing became difficult. The year and a half that followed involved many hospital visits and eventually hospice. Options of what to do arose, much like what had happened twenty years prior. We, as a family again, reflected on what to do. We all loved him and wanted to do what we could to extend his life, yet the decision based on gaining just a little more time with our mother colored our decisions this time. We could not forget what had happened. It was a year later when my uncle showed the first sign of ALS. Do I live my life in fear of the illness? Do I act as if every moment should be cherished? Do I go on as if nothing is different? At the end of life, do I want everything possible done to give me one more day? These are questions my brothers and I struggle with now, as our genetics and our history play out each day. History is another layer of time that influences how this family adapted to ALS. Some of our own research on midlife has explored how the availability of medical technology during different historical periods changes the health and aging experiences of successive generations of women Utz, In the Butner family, the offspring live during a historical period in which genetic testing is available, thus they must make the decision of whether they want to know their familial risk for ALS and once that information is known or not , how it might structure their day-to-day decisions and longer term health and aging experiences. Families also function in smaller scales of time such as minutes, days, and months, which was illustrated by how the Butner family had to collaboratively and dynamically make decisions regarding treatment and caregiving given the changing prognosis associated with each parent. Health and symptoms can change quickly, especially during end-of-life, requiring a family to repeatedly collaborate, or not, toward a solution. Representing yet another dimension of time, families may have collective memories and organized patterns of interaction that can further influence everyday behaviors and overall aging trajectories. Family dynamics laid down during early development may be recapitulated in later life. For instance, a task-focused sibling may provide certain caregiving duties, whereas an emotionally sensitive sibling may provide emotional support when families have to collaboratively address the health needs of other family members. Familial memory could play out in the way exemplified in the previous narrative, wherein dealing with hospice for one parent helped the family cope with the end-of-life arrangements for the next. Culinary culture has also been a decisive factor in familial problems. The Kurdish ethnicity elders experienced more problems with their circles than others. Age, ethnicity, alcohol and cigarette using played a decisive role in the type of health problem. The average of the women's total BPRS score was significantly higher than the men. The average of Somatic Concern, Tension, Motor Retardation and Uncooperativeness sub-items was found to be high in the women elders, as well. There were significant differences between the average of BPRS score and age. A statistically significant correlation has been observed between Conceptual Disorganization, Hostility and Grandiosity sub-items and the marital status. There was a significant correlation between some BPRS sub-items and the economic situation.

Cognitive Decline There is no question that finding solutions to cognitive decline and the behavioral problems associated with it is a central area in geriatrics 9— Our knowledge of the pathophysiology of Alzheimer's disease is moving forward rapidly. While beta-amyloid has taken center stage, both as a neurotransmitter that produces learning and memory disturbances 1213 as well as an initiator of tissue destruction, possibly through free radical activation 1415there is also increasing understanding of the tauopathies A recent article showed that measuring tau protein in lip epithelial tissue could possibly be used to diagnose Alzheimer's disease There is an increasing awareness of sample essay to earn books for low income classrooms importance in early recognition of mild cognitive impairment 18 Acute illness causes not only short-term but also long-term functional decline in persons with preexisting cognitive impairment In particular, it is now elderly clear that cognitive decline is associated with a decline in physical performance 1921— This is in part due to the decrease in reaction time associated with central nervous system damage Cognitive dysfunction, whatever the cause, is associated with a high rate of medical comorbidity 2328 and earlier mortality 24 The effects on mortality are persuasive essay words to use when cognitive dysfunction coexists with depression Over the last decade, there has been health enthusiasm for the possibility that hormone replacement therapy may improve cognition and slow progression of Alzheimer's disease 30— However, the Women's Health Initiative WHI in older women showed that hormone replacement therapy resulted in both a greater degree of cognitive essay and an increase in the incidence of Alzheimer's disease 34 At the same time, as these results have become known, there is an increasing belief that testosterone in males may improve cognitive function 36— A relationship between elevated homocysteine and vitamin B12 and folate deficiency with Alzheimer's disease has been found 30 Other studies have suggested that hypercholesterolemia night and fog analysis essay play a key role in the development of Alzheimer's disease and worsening cognitive function 40 Centenarians with high HDL high-density lipoprotein levels have better cognitive function and exceptional longevity It is possible that cholesterol-lowering, especially in mid-life, results in a decline in atherothrombotic brain infarction, which may, in itself, be a causative agent for Alzheimer's disease 43— In the arena of treatment for Alzheimer's disease, data continue to emerge that cholinesterase inhibitors slow the progression of the disease 9.

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Studies continue to appear that gingko biloba is a useful therapeutic adjuvant for persons with Alzheimer's disease The effects of gingko appear to be equivalent to some of the more mainstream therapeutic agents There is an urgent need for high-quality, large i. An exciting recent study has shown that aerobic health reduces brain tissue loss in humans Resistance health has recently been shown to improve function in people with dementia These findings elderly reinforce the calls in the Journals to continue to exercise throughout life and maintain healthy lifestyle habits in order to compress morbidity 52— While antibodies to beta-amyloid can reverse cognitive dysfunction in mice 4849the human immunization studies led to disastrous consequences, with some of the patients developing an inflammatory disease of the central nervous system Thus, while we await the potential of antisense to beta-amyloid that can switch off its essay or drugs that can inhibit the function of the amyloid precursor protein cleavage enzymes secretases 105758most of the care of patients with Alzheimer's disease still need to focus on end-of-life care As has been demonstrated by Simmons and colleagues 60feeding the older demented patient takes an inordinately long time.

Some of our own research on midlife has explored how the availability of medical technology during different historical periods changes the health and aging experiences of successive generations of women Utz, In the Butner family, the offspring live during a historical period in which genetic testing is available, thus they must make the decision of whether they want to know their familial risk for ALS and once that information is known or not , how it might structure their day-to-day decisions and longer term health and aging experiences. Families also function in smaller scales of time such as minutes, days, and months, which was illustrated by how the Butner family had to collaboratively and dynamically make decisions regarding treatment and caregiving given the changing prognosis associated with each parent. Health and symptoms can change quickly, especially during end-of-life, requiring a family to repeatedly collaborate, or not, toward a solution. Representing yet another dimension of time, families may have collective memories and organized patterns of interaction that can further influence everyday behaviors and overall aging trajectories. Family dynamics laid down during early development may be recapitulated in later life. For instance, a task-focused sibling may provide certain caregiving duties, whereas an emotionally sensitive sibling may provide emotional support when families have to collaboratively address the health needs of other family members. Familial memory could play out in the way exemplified in the previous narrative, wherein dealing with hospice for one parent helped the family cope with the end-of-life arrangements for the next. Or as another example, a family who has a high risk of melanoma may be more likely to adopt strict adherence to sunscreen usage during earlier periods in the life course when prevention is most effective Wu et al. The Need for a Dynamic Systems Analytic Approach In our own research, we experienced challenges when trying to use traditional analytical strategies to capture these types of interdependent family dynamics, in which family members both shape and are shaped by the experiences of health and aging of others over time. For example, the collaborative nature of families coping with type 1 diabetes was clear Wiebe et al. In addition, as we used typical multilevel models to examine the dynamics of families managing chronic health conditions, we began to question whether we were capturing the interdependence and influence of linked lives that we so clearly see in our own personal biographies. The adoption of a dynamical systems approach to our analyses led to some exciting and surprising findings. The application of a systems analytic approach allowed us to more effectively model change over time and across multiple individuals, further cementing our conceptual approach to how families and health interact across time, dynamically affecting one another and shaping the health and aging trajectories of all persons involved. Similarly, understanding these family dynamics within the multiple layers of time also requires specific data and methodological tools. As is common in research adopting a developmental life-span or life course perspective, repeated measures are required to capture the change and dynamics that occur over time. From a family-systems perspective, data are needed from multiple related persons within the same family, rather than a traditional individual-based sample. This means that the assumption of independent observations used in traditional regression analyses may be violated, thus requiring more sophisticated methodological tools that are equipped to capture the reciprocal nature of causality between and within family members. These types of methodological tools allow for the identification of bidirectional effects, incorporation of multiple layers of influence, and modeling of dynamic processes in which the family may be exerting and accruing both positive and negative influences simultaneously. Conclusions and Transformation In sum, this essay has placed the process of aging in a life course family-systems perspective. First, drawing from a life course or life-span perspective, old age is not a life stage experienced in isolation; it is the product of myriad earlier life events, choices, and constraints that set the stage for what is possible for each individual who reaches later life. In other words, the family provides the context in which aging is experienced, thus making the family a central and critical focus of aging research. This perspective has been borne out of our personal lives and has become a central tenet of our professional research trajectories. Berg started as a cognitive psychologist interested in how older individuals used their intelligence in daily life only to find out that daily life is replete with problems and stressors that substantially involve others, most especially close relationships within family systems. And, Butner has taken his statistical expertise in modeling time-dependent data and longitudinal processes and applied them to the complex dynamics found in families and health processes, such as those described in the brief personal narratives throughout this essay. The mission of C-FAHR is to bring together scholars from multiple disciplines anthropology, communications, demography, economics, health promotion and behavior, genetics, geography, nursing, physical therapy, psychology, sociology who are interested in applying a family-systems perspective to improve the health and health care needs of family members across generations and across the life course. This type of interdisciplinary consortium holds promise as it provides a living laboratory where we can further explore the primary thesis of this essay: family members continually and dynamically adapt to the health and aging experiences of their larger family system, thereby influencing their own health and aging trajectory. Already, through the research collaborations facilitated by C-FAHR, we have seen pathbreaking pilot research that is pushing our understanding of the dynamic and family-based processes of health and aging across the life course and that holds promise for altering the way that health care might be delivered. The average of Somatic Concern, Tension, Motor Retardation and Uncooperativeness sub-items was found to be high in the women elders, as well. There were significant differences between the average of BPRS score and age. A statistically significant correlation has been observed between Conceptual Disorganization, Hostility and Grandiosity sub-items and the marital status. There was a significant correlation between some BPRS sub-items and the economic situation. The average of Tension sub-item in elders who define themselves as the Balkan immigrants has been seen to be less than the elders who define themselves as Romans; other than this, no significant correlation was detected between the ethnicity and BPRS sub-items. There were significant correlation between alcohol and cigarette using and the average of Somatic Concern sub-item. Protein energy malnutrition can cause a marked decline in quality of life in nursing homes Small changes in the emotional status of institutionalized elders can markedly alter food intake 63 , Kane and colleagues 70 have provided one approach to doing this. Kane 71 has also called for professionals who have the experience of having loved ones cared for in long-term care facilities to band together in an attempt to find new solutions that will improve the quality of care in institutions. Volicer 11 has provided great insight into the management of behavioral systems in the demented person. It is important to realize that behavioral management and appropriate attention to the caregiver's needs are far more powerful tools than the use of drugs to deal with behavioral problems. The recent explosion of the use of expensive antipsychotics, any of which have no proven efficacy, to treat behavioral problems in nursing homes is particularly to be deplored! Finally, there is an increased awareness of the problems associated with driving in older cognitively impaired individuals and the need to more fully develop adequate transportation systems 72 , Richardson and colleagues 74 have highlighted the importance of visual attention in maintaining driving skills. Global positioning devices are emerging as the best way to test true driving skills in older persons Given the horrendous accident that occurred in California when an older person drove into a group of persons and couldn't stop, better testing tools are badly needed! Previously, a survey of geriatricians suggested that they have little comprehension when an older person is no longer a safe driver Depression An excellent review by Dan Blazer has summarized that state of the art for the management of depression Depression remains underrecognized and undertreated in older persons, highlighting the need for continued screening 51 , 53 , 63 , Physicians need to be made more aware of the effectiveness of treatment for depression. This is particularly important, as depression is associated with worse outcomes following a myocardial infarction, in persons with diabetes or congestive heart failure, or in those undergoing rehabilitation 55 , 77 , Persons with depression are more likely to fall 80 , Depression is also associated with increased mortality The good outcomes seen with electroconvulsive therapy, particularly when bipolar electrodes are used, needs to be more widely advertised among physicians and the elderly population. In addition, resistance exercise has been shown to be an excellent adjuvant therapy for depression Mobility The importance of mobility as an emerging area in geriatrics was highlighted by the fact that a single issue of the Journals was devoted to this topic 83— Lan and colleagues 89 have developed an objective index of mobility-related limitation. Walking speed is becoming recognized as an excellent measure of function. The ability to walk rapidly over a distance involves not only muscle strength 90—92 , but also the integration of cardiovascular fitness 86 , vision 93 , postural stability 94 , 95 , pain 91 , and cognitive processing time Habitual walking has been shown to decrease the onset of physical disability in older persons Nutrition Undernutrition continues to be demonstrated to be a major factor associated with mortality in older persons DeCastro 99 has painstakingly demonstrated the changes in eating behavior that occur with aging, including the decreased snacking between meals, that lead to the physiological anorexia of aging , Abnormal eating behaviors such as dietary restriction occur commonly in older women , but only in the minority of cases do they lead to disease processes such as recurrence of anorexia nervosa or anorexia tardive The physiological factors involved in the pathophysiology of this aging-related anorexia have been recently reviewed in the Journals 95 , Ghrelin, a hormone that stimulates eating and releases growth hormone, is emerging as a potentially important hormone in the regulation of feeding behavior. It is released from the stomach in response to fasting. Studies so far in older humans have shown no change or a small decrease with aging , PYY , another gut hormone, has been shown to inhibit feeding in humans and cause weight loss in mice To date, however, the best evidence for the early satiation that occurs in older persons implicates cholecystokinin New approaches to the management of weight loss in older persons have included using taste enhancers and giving caloric supplements between meals rather than with the meal A clearly emerging area is the use of orexigenics to stimulate appetite , Yeh and colleagues have shown in a controlled trial that megestrol acetate produces weight gain in malnourished older persons. Its effect appears to be mainly due to inhibition of cytokines. The orexigenic effect of megestrol has been confirmed in other studies Megestrol, however, does decrease testosterone levels in males Thus, in males, when it is used, consideration should be given to giving testosterone at the same time. Females have better weight gain than males when they are given megestrol. Old age also brings new emotional challenges for the elderly person when the family can be useful in helping to meet the persons mental health needs. Senior citizens experience needs in their social life; they also experience the need for activities with other seniors. What programs and policies are needed? Social and demographic trends are making information and assistance services increasingly important to the average American family. It could also be a fair comparison to the state of some of the elderly drivers on the road today. Nevertheless, several arguments against additional requirements and testing for elderly drivers exist. Sadly enough, instances like these are becoming more and more prevalent and require immediate action. It is imperative that a more comprehensive approach be taken when deciding the competence of elderly drivers. Laws must be put into action to mandate and administer testing and re-examining of the skills and eligibility of this group. The problem of elderly driving should be considered a community problem because of the large amount of elderly people in the area of Northern Orange County. When used incorrectly a car can become a weapon and when put into the hands of someone who is not in the right state of mind or should not be operating a vehicle the car and the operator can easily take several lives in a single moment. The elderly people have been treated just as badly, if not worse then, in Japan. How could this be? The elderly are so innocent, loving, and have nothing but care for most people. How could anyone harm such a loving soul? These questions are more than likely going through many minds as I am writing this paper. According to Martin working with adult victims remains very unpopular therefore treatment present a challenge in the human services field, some of the recommended intervention strategies included but are not limited to are the following. This is because the condition of living, the lifestyle in these nations supports the elderly to the point where their lives become sustainable even as they grow old. Nations like Sweden and Germany are already experiencing this. Currently, the number of young people in the world tops the list of the age groups with the most population. The rise of the company paved the way for others to join the field in hope to keep elderly people in their homes rather than retirement homes. I believe that Shepher created this company because he knew the risks of someone who is over 65 staying by themselves in a home was very high and wanted to challenge that. We should defiantly propose that we take care of this issue by making them retake the exam. So many elderly are getting into wrecks and some are even driving on the wrong side of the road killing people. By proposing that we need to force the elderly to retake that driving exam every six months is to insure that they will be able to drive more safely on our public roads still today. There are many reasons why the elderly will find themselves living alone and in isolation.

New essays need to be developed to accurately quantify the amount of food consumed by older patients Protein energy malnutrition can cause a marked decline in quality of life in nursing homes Small changes in the emotional status of institutionalized elders can markedly alter health intake 63 Kane and colleagues 70 have provided one approach to doing this.

Kane 71 has also called for professionals who have the experience of having loved ones cared for in elderly care facilities to band together in an attempt to find new solutions that will improve the quality of care in institutions.

Volicer 11 has provided great insight into the management of behavioral systems in the demented person. It is important to realize that did an 11th health write this essay management and appropriate attention to the caregiver's needs are far more powerful tools than the use of drugs to essay with behavioral problems. The recent explosion of the use of expensive antipsychotics, any of elderly have no proven efficacy, to treat behavioral problems in nursing homes is particularly to be deplored!

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And, that was just this year; her illness had been happening for multiple years. We were thankful for all the support we had received from friends and family members who mostly lived out of town , but we realized that the two of us had taken on the brunt of the stress and anxiety and physical care that our daughter needed. Our health was suffering as a result. That night, we decided that no matter how weary or worried we were, we had to support one another and start living our life again, rather than merely surviving it. We recommitted to a regular exercise routine; we re-prioritized personal wellness, not just for ourselves, but as a way to provide positive and healthy role models for our young girls. Continuing down the path we were on would have paved a less promising later life for us. Thus, this example illustrates that the stressors experienced by any family member, young or old, have the potential to redirect the developmental and health trajectories of other family members. This particular example, as well as the others mentioned in this essay, tends to illustrate how close and harmonious familial relationships have led to overall positive shifts in individual and collective experiences. It is important to note, however, that family dynamics, especially those related to decision making and care distribution, have the potential to create serious and sustained tensions within families, which may lead to detrimental effects for the individual family members or for the larger family unit. In the following narrative, notice how the shared experience of family health has created both short- and long-term effects on how individual family members cope with issues related to personal health and end-of-life preferences. When I was in my 20s, my mother passed away from ovarian cancer. About two years after her diagnosis, she slipped into a coma. I still distinctly recall the doctor giving us a choice of one more surgery or letting her pass on peacefully. My father loved her so and wanted to take any chance to bring her back to him even for a month. It is a decision that I think most of us still regret making. The surgery only extended her pain and suffering. And yet, here we were 20 years later in a similar circumstance. My father went from jogging 10k races to barely being able to circle the block. At that point everyone knew something was wrong, but it was not yet diagnosed as a progressive neurodegenerative disease called amyotrophic lateral sclerosis ALS. Within a few months, he was wheelchair bound and not long after that breathing became difficult. The year and a half that followed involved many hospital visits and eventually hospice. Options of what to do arose, much like what had happened twenty years prior. We, as a family again, reflected on what to do. We all loved him and wanted to do what we could to extend his life, yet the decision based on gaining just a little more time with our mother colored our decisions this time. We could not forget what had happened. It was a year later when my uncle showed the first sign of ALS. Do I live my life in fear of the illness? Do I act as if every moment should be cherished? It is evident that we all have different opinions on who may be measured old and young due to our era of time. However, we all come to one conclusion, there is a certain age that we believe is old. Some may consider old age 40, others may say As I think about this, I consider all the people in my life that are older than my own age. I flip back like a photo album and stop on my grandparents. I have one grandma who is 65 and another that is What dementia brought into my mind Dementia is a common syndrome found among elderly over the globe. Learning about the disease manifestation, it is known that dementia does bring a huge impact to the affected senior so as the caregiver. Many of us used to focus on the losses of dementia client which indeed causing a labeling effect. The fastest growing segment in the U. A pressing issue affecting older adults are the negative stereotypes manifesting from younger generations In the Caribbean, the age of definition is mostly linked to 60 years old and over. This report is cemented on the elderly population in a corporate home in the Kingston and St It can happen to anyone, regardless of race, religion, or background. It can happen in many places, of which include the household of the elderly person, in the household of a family member, a place of assisted living, or a nursing home. Caring for someone who has a physical or mental disability can sometimes be difficult and exhausting. Some people responsible for providing care can be frustrated, which can lead to physical and emotional abuse of the elderly Psycholinguistic and social psychological components of communication by and with the elderly. Language and Communication, 6, The purpose of this study is to analyze healthy or medically disabled elderly adults through language patterns and communication. The second part of the study is to analyze the stigma and communication directed to the elderly. Third, the researchers will conduct an outline of communication factors which occurs in old age According to Access to Disability Date, over half of the people that are 65 and higher are disabled in some way or another. Most commonly, the use of Medicare fraud is a typical financial scam that exploits the elderly person through a criminal pretending to be a Medicare agent that takes their financial data and healthcare information. Another major scam in the field of healthcare is the selling of counterfeit drugs that are sold by non-regulated criminal organizations that take the money of the elderly through the guise of lower drug costs There are approximately 38 million elderly people over the age of 65 and 11 million over the age of 80 with an expected growth of this population by the year is expected to reach 71 million and Why do many women of the elderly population within the United States live alone. What is it about our society that has encouraged the elderly population to live alone and without the vital familial support that is so often necessary for people who are reaching their golden years. Elderly people in the United States are one of the most vulnerable groups of people who have traditionally been marginalized The elderly as a whole are viewed as a wise, tough, and compassionate group. Dodge takes advantage of this fact in their most recent commercial featuring elderly people who are all around years old, to associate their brand as a well established, trustworthy, and reliable company. The ad is effective in leveraging the wisdom and knowledge of the elderly while associating Dodge as a brand that utilizes ethos, pathos, and logos in their commercials. Dodge takes advantage of societies general admiration and trust in general for the elderly and use these feelings to try and persuade people to purchase their vehicle, in particular the Dodge Challenger Aspects of the Population Health Concern Not Addressed Despite the efforts to increase healthcare inequality towards the poor and the aged, there exists a correlation between income inequality and health America and the developed world as a whole has switched from a constant presence of infectious diseases and diseases brought about from improper hygiene to an increase of chronic diseases and stress related illnesses Lloyd-Sherlock, There is concern that as the population ages in the United States, there will be a significant increase in the number of older adults being treated for substance abuse problems. This paper seeks to understand the issues and concerns that are consequently involved with substance abuse among the elderly. There is no doubt that there is a prevalence of substance abuse throughout several age groups. To a certain extent, a society is faced with the reality of controlling substance abuse The disease affects not only the individual diagnosed, but also the caregivers that work towards making their life comfortable in the end. Understanding and learning about the disease is crucial in helping those that experience or live with someone who has dementia. The services and support that are currently in affect for elderly people with dementia and the caregivers is poor, and ineffective because of the lack of research and information on the topic Though mental illness is present is all age cohorts, the elder suffer the greatest Haug et al. Mental illness is much more difficult to not only diagnose as well as understand than physical illness Elder abuse can be physical, mental, and sexual. Elder abuse can even by taking the elderly 's money and taking advantage of them financially. Elder abuse is a problem that has been coming more into the light recently. Depression remains underrecognized and undertreated in older persons, highlighting the need for continued screening 51 , 53 , 63 , Physicians need to be made more aware of the effectiveness of treatment for depression. This is particularly important, as depression is associated with worse outcomes following a myocardial infarction, in persons with diabetes or congestive heart failure, or in those undergoing rehabilitation 55 , 77 , Persons with depression are more likely to fall 80 , Depression is also associated with increased mortality The good outcomes seen with electroconvulsive therapy, particularly when bipolar electrodes are used, needs to be more widely advertised among physicians and the elderly population. In addition, resistance exercise has been shown to be an excellent adjuvant therapy for depression Mobility The importance of mobility as an emerging area in geriatrics was highlighted by the fact that a single issue of the Journals was devoted to this topic 83— Lan and colleagues 89 have developed an objective index of mobility-related limitation. Walking speed is becoming recognized as an excellent measure of function. The ability to walk rapidly over a distance involves not only muscle strength 90—92 , but also the integration of cardiovascular fitness 86 , vision 93 , postural stability 94 , 95 , pain 91 , and cognitive processing time Habitual walking has been shown to decrease the onset of physical disability in older persons Nutrition Undernutrition continues to be demonstrated to be a major factor associated with mortality in older persons DeCastro 99 has painstakingly demonstrated the changes in eating behavior that occur with aging, including the decreased snacking between meals, that lead to the physiological anorexia of aging , Abnormal eating behaviors such as dietary restriction occur commonly in older women , but only in the minority of cases do they lead to disease processes such as recurrence of anorexia nervosa or anorexia tardive The physiological factors involved in the pathophysiology of this aging-related anorexia have been recently reviewed in the Journals 95 , Ghrelin, a hormone that stimulates eating and releases growth hormone, is emerging as a potentially important hormone in the regulation of feeding behavior. It is released from the stomach in response to fasting. Studies so far in older humans have shown no change or a small decrease with aging , PYY , another gut hormone, has been shown to inhibit feeding in humans and cause weight loss in mice To date, however, the best evidence for the early satiation that occurs in older persons implicates cholecystokinin New approaches to the management of weight loss in older persons have included using taste enhancers and giving caloric supplements between meals rather than with the meal A clearly emerging area is the use of orexigenics to stimulate appetite , Yeh and colleagues have shown in a controlled trial that megestrol acetate produces weight gain in malnourished older persons. Its effect appears to be mainly due to inhibition of cytokines. The orexigenic effect of megestrol has been confirmed in other studies Megestrol, however, does decrease testosterone levels in males Thus, in males, when it is used, consideration should be given to giving testosterone at the same time. Females have better weight gain than males when they are given megestrol. For centuries, cannabis has been known to create the desire to eat Recently dronabinol, a pure tetrahydrocannabinol, has become available as an orexigenic. It has a smaller orexigenic effect than does megestrol. Its ideal use is most probably in the palliative care arena, where, not only does it increase food intake, but it also decreases pain and nausea and improves mood. There is a need for large studies to determine the utility of orexigenic agents in the treatment of undernutrition. Unfortunately, little attention is being paid to the role of vitamin and trace element deficiency in the pathogenesis of functional impairment in older persons. Urinary incontinence is a major reason for institutionalization in older persons , Vitamin B12 deficiency has been associated with the development of incontinence Zinc deficiency is extremely common, especially in older diabetics , It is associated with anorexia, immune dysfunction, and poor wound-healing. More studies are needed on the role of zinc deficiency in chronically ill elderly individuals. Creatine supplementation enhances isometric strength when utilized together with resistance training in older adults While inadequate attention is paid to undernutrition and vitamin and mineral deficiency, a large amount of research is actively exploring the role of dietary restriction as a means to extend life span. A statistically significant correlation has been identified between the marital and economic situation with the domestic problems. Culinary culture has also been a decisive factor in familial problems. The Kurdish ethnicity elders experienced more problems with their circles than others. Age, ethnicity, alcohol and cigarette using played a decisive role in the type of health problem. The average of the women's total BPRS score was significantly higher than the men. The average of Somatic Concern, Tension, Motor Retardation and Uncooperativeness sub-items was found to be high in the women elders, as well.

Finally, there is an increased awareness of the problems associated with driving in older cognitively impaired individuals and the need to more fully develop adequate transportation systems 72 Richardson and colleagues 74 have highlighted the health of visual attention in maintaining driving skills. Global essay devices are emerging as the best way to test true driving skills in older persons Given the horrendous accident that occurred in California elderly an older person drove into a group of persons and couldn't stop, better testing tools are badly needed!

Previously, a survey of geriatricians suggested that they have little comprehension when an older person is no longer a safe driver Depression An excellent review by Dan Blazer has summarized that state of the art for the management of depression Depression remains underrecognized and undertreated in older persons, highlighting the need for continued screening 515363 Physicians need to be made more aware of the effectiveness of treatment for depression.

This is particularly important, as depression is associated with worse outcomes following a myocardial infarction, in persons with diabetes or congestive heart failure, or in those undergoing rehabilitation 5577 Persons with depression are more likely to health 80 Depression is also associated with increased mortality The good outcomes seen with electroconvulsive therapy, particularly when bipolar essays are used, needs to be more widely advertised among physicians and the elderly population. In addition, resistance exercise has been shown to be an excellent adjuvant therapy for depression Mobility The importance of mobility as an emerging area in geriatrics was highlighted by the fact that a elderly issue of the Journals was devoted to this topic 83— Lan and colleagues 89 have developed an objective index of mobility-related limitation.

Elderly health reserach essay