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Over the last decades, significant changes in the demographic picture have been observed worldwide. The average age of human life is increasing in both developed and developing countries. In the USA, the problem of care and treatment of old individuals is one of the most relevant issues. This research paper studies the key features of aged people and the peculiarities of their treatment, which are grounded in evidence-based practice. The study explores the demographic data pertaining to the issue, the factors contributing to a person belonging to this group, the main dangers faced by old people, and the treatment that is to be provided to this vulnerable group.
Nowadays, world population is facing ageing. To illustrate, experts compared the average life expectancy of individuals in five leading countries - the USA, the UK, France, Hungary, Italy, Japan, and China in 1975 and 2000. According to the statistics, France, the UK and the USA had the biggest number of aged people in 1975. This category of people aged 80 and more constituted above 2% in these countries. In 2000, the state of affairs has somewhat changed establishing new leaders - Italy and the UK. The rate of elderly people in these states was equal to 4%. According to forecasts, Japan will have become the top leader by 2030. The amount of elderly people in this country is expected to exceed 10%.
There is a gender gap in life expectancy worldwide. For example, “in 2000 in the USA, one in every eight American is over the age of 65 and three out of five of these individuals were women”. Female life expectancy exceeds that of the males by up to seven per cent. After losing their husbands or life partners, old women prefer living alone.
In the USA, the chronological age is the leading factor of including individuals into the elderly group. This category comprises people whose age exceeds 65 years. There is inner subdivision that includes three groups: young old, old-old, and the oldest-old people. Individuals aged from 65 to 75 years belong to the first group. People aged from 65 to 75 years comprise the second one. Older people whose age exceeds 85 years are in the third group. Nevertheless, biological, psychological, and social factors are extremely important in the definition of individual’s age. They often do not coincide with the passport age of a person.
Challenges Elderly People Face
Gunnar Akner distinguishes three major challenges faced by elderly people. They are multimorbidity, consequences of injuries, and side effects of medicine and medical procedures. Multimorbidity is referred to as “the co-existence of two or more chronic conditions, where one is not necessarily more central than the others”. These conditions include both medical and psychiatric illnesses. Except for traditional disorders, multimorbidity includes “chronic bursitis of the hip, rotator cuff problems, dyspepsia, migraines, sleep disturbances, functional bowel syndrome or constipation, disability, falls, hearing impairment, and sarcopenia”. Multimorbidity decreases the quality of life and incapacities people to move and work. It is the cause of elderly handicap and mortality. Approximately 50% of individuals belonging to the elderly group suffer from three or more chronic conditions. The most widespread illnesses are osteoporosis, osteoarthritis, diabetes mellitus, hypertension, and chronic obstructive pulmonary disease.
Elderly people often develop such neurodegenerative disorders as dementia, Alzheimer’s disease, and Parkinson’s disease. They may develop psychosis, such as in the case of schizophrenia. The amount of psychiatric diseases constitutes from 0.2 up to 4.7% of total illnesses. Elderly people misinterpret events occurring in the surrounding world. They cannot speak and behave in a normal way. Sometimes delusions and hallucinations occur. The above-mentioned illnesses require urgent treatment, both pharmacological and non-pharmacological. Relatives have to be extremely careful in order to recognize the symptoms and urgently deliver the suffering person to a doctor.
Schizophrenia is the most typical disease among representatives of the elderly group. In fact, patients can belong to two categories. Some of them suffer from schizophrenia early, while others develop the disease in the older age.
Alzheimer’s disease takes the seventh position among the top lethal causes in the United States. According to the statistics, “the prevelance of psychosis in people with Alzheimer’s disease ranges between 30% and 50%”. Four key types, such as the Capgras type, the phantom boarder symptom, the mirror sign, and the TV sign, represent the disease. Patients with the Capgras type disease think that surrounding people deceive them. Elderly people claim that they live among impersonators. Individuals with the phantom boarder symptom are sure that somebody else lives in their house. Elderly people with the mirror sign do not recognize their own reflection. Finally, patients with the TV signs see TV heroes as the real people existing in the fantastic space.
Parkinson’s disease takes the third place among neurodegenerative disorders. The symptoms of this disease are very extraordinary. Nevertheless, there are negative consequence of medical treatment. Patients often see hallucinations. Elderly people suffering from psychotic symptoms make up to 60% of patients with Parkinson’s disease.
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Stroke is the next danger faced by old people. In many cases, it may cause the patient’s death. Unfortunately, many individuals do not pay due attention to the first symptoms of this illness. At severe stage, consulting doctors does not contribute to the significant improvement of their patients’ health.
Elderly people often suffer from total physical weakness. They need observation and support of other people. When left alone, old individuals experience injuries, such as burns, cuts, and fractures. These issues in combination with negative consequences of their medical treatment cause numerous dangers, including the possibility of death.
Representatives of the elderly group are extremely sensitive to drugs and medical procedures. Therefore, such treatment often causes numerous side effects that may lead to disability. Elderly people may experience both physical and psychological complications, such as problems with eating, loss of weight, and significant mood swings.
The treatment for elderly people is to be provided taking into account the needed scientific experience. Physicians must not be biased by ageism when aged peoples are not treated as carefully as representatives of younger generations. The US care programs that deal with the elderly have several issues, such as “comprehensive assessment, development of a comprehensive care plan that incorporates evidence-based protocols, implementation of the plan over time, proactive monitoring of the patient’s clinical status and adherence to the care plan”. Elderly individuals should enjoy both primary and specialty treatment. They can turn to hospitals and emergency units that will provide them with professional medical support. Charity programs suggest humanitarian help as well as the transportation of disabled individuals. Adult day care groups and exercise clubs exist arranging assistance for the above-mentioned vulnerable category.
Despite the state’s help to elderly people, family and friends play crucial roles in their support. Relatives and friends that accompany aged people should control their activities and follow doctors’ prescriptions. Elderly people need extreme psychological help that can come both form their families and clinicians. Realizing their physical weakness, the elderly suffer from depression. Moreover, the level of suicides among old people exceeds that of any other age group. According to the statistics, the amount of suicides in young old and old-old groups is about 45% among men and nearly 5% among women. The percentage of suicides in the oldest-old group exceeds the overall national level by approximately two times. The greater majority of old people committing suicides lives far from their families.
Doctors pay due attention to treating psychotic disorders among the representatives of the elderly group. They prescribe antipsychotic treatments to the patients suffering from schizophrenia. However, medicaments usually help to decrease symptoms of the disease. Haloperidol, trifluoperazine, and thioridazine are taken during the curing period. Currently, doctors prefer prescribing atypical antipsychotics to patients with schizophrenia. Clozapine, risperidone, olanzapine, and quetiapine are among the most popular drugs. Nevertheless, duecareful attention should be paid to observing possible negative effects of these drugs in order to stop their intake in the case of danger.
Elderly people with Alzheimer’s symptoms take antipsychotics. Doctors prescribe memantine to individuals who suffer from Alzheimer’s disease in its moderate and severe forms. Unfortunately, this psychotic disorder is incurable. Individuals suffering from Alzheimer’s disease cannot obtain their former memory and physical capacities. Drugs may only improve the patient’s health to a certain degree and cause negative consequences in the form of high blood pressure, shortness of breath, and problems with lungs.
Individuals suffering from Parkinson’s disease take levadopa, dopamine, and monoamine inhibitors. Nevertheless, these prescription medicaments cause numerous negative psychotic effects. What is more, treating the acute phase of stroke often leads to negative effects. To improve patients’ health, doctors prescribe amphetamine. Proper physical exercises are required to prevent the aggravation of the illness.
Taking into account the peculiarities of the elderly aged group, their relatives are expected to take active part both in medical and psychological support. In the cases of suicidal attempts, they are to show the person to the specialist who can provide cognitive therapy and medical treatment. Caine, Lyness, and Conwell studied the cases who had committed suicide. The researchers noted that 47 individuals suffered from psychiatric diseases. Nevertheless, only 19 of them received the needed medical treatment.
In fact, doctors have developed significant evidence-based practice concerning gerontological counseling by evaluating “longevity, life circumstances, social supports and resources”. Prevention and early intervention are the key steps.
Cooke, Oliver, & Burns develop several recommendations for treating elderly people. Firstly, old people are to undergo structured medication reviews. Physicians proscribe medical treatment in the cases where it is needed. Secondly, testing of urinary tract infections can be misleading because of age peculiarities of patients. Therefore, a urine dip is to be implemented only in rare cases. Thirdly, aged individuals are not to undergo catheterization on the habitual ground. Urinary retention is the only cause for this medical procedure. Finally, old people are to face their last minutes of life at home, if there are no special reasons to stay in the hospital.
Nowadays, there is a growing the number of old people all over the world. This category of individuals is extremely vulnerable. It requires urgent attention and special treatment, both medical and psychological. The passport age of a person is considered the key factor that influences the belonging of an individual to the elderly group, which includes young old, old-old, and oldest-old types. Nevertheless, biological age as well as social and psychological factors are extremely important for proper evaluation of cases and prescription of due treatment.
People in the elderly group suffer from multimorbidity, consequences of injuries, and side effects of medical procedures and drugs. When prescribing medication, physicians must be extremely attentive in their actions. Nevertheless, emotional factor is extremely important. The rate of suicide among elderly people exceeds this rate of all the other age groups. Therefore, the psychological support is extremely important for this vulnerable category. Family and friends are to arrange assistance for elderly people by accompanying them to psychiatrists for the necessary control. Lastly, one must remember that cultural health of a nation is evaluated by its attitude to older generations. Therefore, the care for old people has to be one of the priorities of the society.