Ageing Bias

Ageing Bias

Impact of Personal Experience to Nursing Practice

Communication process

As a nurse cultural competence is an important aspect that is meant to ensure effective communication between the nurse and the patient. The diversity in terms of culture, age, gender and living conditions should not be a factor determining the communication process of the patient and nurse. As a nurse one is required to portray competence through the behaviors and acts to reflect the right application and attitudes in the communication process. Dealing with different gender groups have impacts on the nursing practice applied to each group. In most cases, the manner in which the men communicate aims to provide a direct report while the women in most cases communication in a way that they can establish a rapport. The manner of dealing with the two gender demands a different nursing practice for each group. Communication with men acts as a chance to exchange information and therefore easier to gather data. Women on the other hand communicate in a way of creating a connection with the nurse. This means as a nurse, I have to establish a rapport with the women for them to be open to the communication process. Communicating with different racial members requires me as a nurse to be careful to avoid evoking the feeling of discrimination. The blacks and the Hispanics have faced this problem of discrimination and it is thus the communication avoids the stereotypes and any of discrimination. Age certainly determines the manner in which I go about my nursing practice. The young aged group of patients may not be able to fully express how they are feeling and this determines the manner in which they are treated. The senior patients are prone to memory loss and thus require a clear communication process to ensure that they follow instruction promptly.

Old Age

The old aged in the United States from the age of 65years and above are most likely to require long-term care. These old aged group of patients is at a higher risk of becoming disabled thereby requiring more specialized treatment plans. This age group has been known to have higher health services requirements. There more likely to experience complications such as delirium, functional decline; pressure related illness, and fall-related hospitalization. From my community, it is can be identified that the two majorly applied care systems for the old aged include home & community-based care and the nursing home care. These two systems have direct impacts to the nursing practice. 

Dealing with patients in home based care requires preventive home visits is essential to maintain or improve the  health status as well as reduce their need to be catered for  institutional care services. During these home visits, as a nurse, I aim to skew may practice to identifying an health problems or risk, offer professional advice, as well as link them up with other professional community services. The homes visit follows the following predetermined practice; diagnosis, planning of activities, effecting the practices and evaluation of the results (Bouman, et al. 2004).

Institutionalization is one of the other common manner ways of treating the old aged in the community. The nursing decisions made have been known to affect the level and type of care provided to these old aged patients in nursing homes. As a nurse, I have identified the need to create a good nurse-patient relationship with these patients to offer as much assistance to them as possible. Being in an institution there is pressure that arises due to the great number of patients that are to be attended. This calls for effective time management and the adherence to competence standards (Wildey & O’Brian, 2010).

Ageing biases

The Medicare Healthcare Insurance was established in 1965 as a way of providing the old aged over 65 years and access to the health care services that they require. While this scheme assures the access of the required healthcare service, it does not offer any guarantee over the same. The older citizens often find themselves being discriminating in receiving the healthcare services.

One form of ageism biasness involves the implicit bias in the healthcare processes (Blair, et al, 2011). In one case, a white male clinician was visited by an elderly African-American who has been for some time put on antihypertensive medications but the blood pressure remains uncontrollable. The clinician instantly perceived this patient as an uncooperative and one who was unlikely to adhere to the intensive drug regimen. Despite the fact that the patient’s hypertension had not been managed by earlier prescriptions, the clinician decided to prescribe a more intensive treatment regimen.

It has been observed that most aged patients over the age of 65 years were found to have hearing impairments severe enough to negatively affect their potential of working, driving, listening to music, and enjoying other forms of communication. Despite this, these patients were not being treated for or assessed for the hearing loss. Very few of these patient categories was found to be provided with hearing aids or subjected to other treatments programs such as use of antibiotics to deal with the ear infections that would be helpful in elevating the hearing capabilities of many.

The Geriatricians have observed that there are limited definitions of the expected lab results for the older people. The older patients aged over 65 years are left out in many preventive treatment including vaccines and other screening tests. The normal practice has seen the older group being put under very many medications which are bound to interact with each other. Sometimes this group of patients does not receive the right medication due to lack of standards and even risk of acquiring other invasive procedures. At times, the old aged patients are denied an opportunity of being subjected to a life-saving surgery due to the prejudiced concern that their age puts them out for certain procedures (Simkins, 2008).

Other biases are being perpetrated to the aged patients in some of the following manner. The older patients are in most cases prescribed with less aggressive medical plan as compared to other younger patients with the same symptoms. A report that had been filled to the congress identified that majority of the Medicare beneficiaries that had been diagnosed with diabetes where left out in the receiving the recommended blood tests, examinations, as well as other important screening services meant to keep the disease in check. Older patients have also been undertreated in the areas of mental health, preventive care, rehabilitative care, and primary care (Blair et al., 2011).

Statistics indicate that one in every four people who are in the prescription drugs or the OTC happens to be over the age of 65 years. However, very few of the aged adults are involved in the clinical trial for most of these drugs. Even they are engaged, they are largely underrepresented from these trials and yet they aim to assess the safety and efficacy of the drugs and treatments. This underrepresentation has contributed to adverse drug reactions, inappropriate dosages and a fallacy that older people cannot cope or benefit from new drugs or treatment plans.

A community education plan to address ageing bias

The process of ageing is bound to affect every aspect of human life including biological, social, and even psychological. Advancements in medical technology cannot alone deal with challenge of increase the life expectancy, aging or death. There is a need to create a paradigm shift in the cultural attitudes that have been fueling ageing bias in the community. The older aged patients need protection from the stereotyping and discrimination of these groups that leads to the doubting of their abilities. The older patients by default get physically weak and become dependent unto their care providers which put them at a risk of abuse. 

The community education plan is therefore required to help eradicate the issue. The plan will assist in raising awareness that the aging population is increasing and thus a crucial to learn how to handle this category of citizens with care and passion. The plan will bring out the fact that the aging population is becoming more diverse and therefore the need to expand the care plans that had been earlier applied to help cope with the cultural diversity. The community needs to be made aware of the expected increase in costs of taking care of the aged, thereby enhance their readiness in financing their care plans (Estebsari at al., 2014).

The community education plan will make use of the Aging in Place tool. This tool helps communities in the preparations and planning of the care plans for their aging individuals. The Aging in Place tool will be comprised of a series of programs and zoning practice that offers more solutions to the older groups of citizens living in the community. The tool aims at helping the aging adults remain as productive members of the neighborhood. It will address the issue of enhancing the personal dignity and improving the functional dependence among this category of the population. The program will not only help satisfy the desire of the older people to remain in their known environment but will also help the community, government and individuals in reducing the cost burden of the intensive care services that  would have been adopted (Ball, 2004). The social, civic, and economic contributions of these senior adults will be maintained and sustained.  The program will focus on three critical areas; healthcare plan, environment and planning and zoning of the community.

In creating a community education plan to address ageing bias, it will be important to address the following issues. The plan will seek to offer alternative choice with regard to healthcare and housing from where the aging population can make choice on, while considering all the income category groups. The choices of services offered should be flexible enough to allow their adjustment to an individual’s lifestyle. The program will be developed in light of not just the challenging posed by the aging population but will also address the opportunities that can be accrued from the aging population from diverse backgrounds (Ball, 2004).

References

Ball, S. (2004). Aging in Place: A ToolKit for Local Governments .

Blair, I., Steiner, J., & Havranek, E. (2011). Unconscious (Implicit) Bias and Health Disparities. The Permanente Journal , 71-78.

Bousman, A., Rossum, E., Kempen, G., & Knipschild, P. (2004). Effects of Home Visits by Home Nurses to Elderly People with Health Problems. BioMed Central Health Services Research, 35.

Estebsari, F., Taghdisi, M. F., & Ardebili, H. S. (2014). An Educational Program based on the Successful Aging Approach on Health-promoting Behaviors in the Elderly. Iranian Red Cresent Medical Journal .

Kathleen, W., & O’Brian, L. (2010). Nursing Care of Older Patients in Hospital: Implications for Clinical Leadership. Australian Journal of Advanced Nursing, Volume 28 Number 2.

Simkins, C. (2008). Ageism’s Influence on Health Care Delivery and Nurisng Practice. Journa of Student Nursing Research, Vol 1, Issue 1.