Powerless: The Role Of Powerlessness In Older Adults

Individual factors were found to be a predictor of functional limitation and frailty in older adults. Several studies showed that personal characteristics, such as ethnicity, female gender and age (Espinoza & Hazuda, 2015), gene (Interleukin-18 gene) (Mekli, Marshall, Nazroo, Vanhoutte, & Pendleton, 2015), education and health status, demonstrated an association with frailty (Chang et al., 2015; Chen et al., 2014; Fried et al., 2001; Mitnitski et al., 2015; Tocchi, 2015). Furthermore, it is clear that comorbidities such as diabetes mellitus (DM), stroke, hip fracture, history of coronary heart disease (CHD) and arthritis significantly increase the risk of frailty (Ambrose, Cruz, & Paul, 2015; Zaslavsky et al., 2013).

The Government outlined their aim to fulfil their responsibility to provide care and protection for those who through their illness or disability are genuinely unable to express needs and wants or exercise control. However, they made clear that the right to self-determination would be at the heart of a reformed system only constrained by the realities of finite resources and levels of protection, which should be responsible but not risk averse. This section demonstrates a future vision for the safeguarding of vulnerable adults and discusses protection but also the importance of not being risk averse similar to what is outlined in the Human rights Act 1998 which discusses the right to independence which involves a degree of naturally occurring risk.

But this approach can also be negative and this is because someone can feel that they are having a lot of pressure put on them if they have to make a decision and it could lead to them getting stressed out and sometimes people might refuse to make a decisions if care professionals are expecting a decision from the person being asked. But as I have said before everyone takes things differently. This would be applied as well if Frieda was getting care from careers, Frieda could experience the positive effects or she could experience the negative effects depending on how she feels after the fall. Another way to support the independence of a person it let them have control of the things they can in their lives. So this can be from letting someone control their money, letting someone choose what they want to buy when they do food shopping. Another way to support independence is to maintain the person’s dignity, so this can be done like if someone wants to a care professional to go to the toilet with them the care professional could go with them but the maintain their dignity they might not look at the person while they are using the toilet unless they need any help. This approach can be effective because it gives people a sense of control and it gives a person a sense of having control of their life and their ageing. If someone does feel that they are in control of their life they might cooperate with care professionals more and they might even become more involved

As people get older they lose independence, they become less mobile and aren’t able to do everything for themselves any more. It is important to ensure that they keep as active as they can to ensure they keep their independence for longer.

This type of symptom is very common in people who have suffered from a right-hemisphere stroke. Since the frontal lobe is also responsible for the ability to sequence tasks successfully, damage to this lobe has caused the patient with difficulty to execute constructional tasks. For example, Mr. Fix-it may have difficulty in things such as building a bike or putting pieces of a puzzle together, in which the patient can possibly now have constructional apraxia due to the stroke taking place in the right hemisphere.

Like demonstrated in chapter four of the book, they lose all sense of independence and privacy, and are forced to get dressed, take their medicine or do activities when told to instead of being able to decide for themselves. With the idea of assisted living, Keren Wilson will allow her mother to “be Jesse again, a person living in a apartment instead of a patient in a bed.”(Gawande, 2014, p. 89). I feel it is important to treat those with serious infirmities, like physical or mental weakness, with respect and independence because many of them don’t have a say or voice on where they are placed. They are unable to live on their own so they are forced to be put in nursing homes, where they become sheltered, abandoned, and sadly sometimes forgotten. This is why showing them respect, dignity, and giving them some independence will go a long way.

Exercises and physical activity have been associated with numerous health benefits including reducing incidences of falls and injuries among the elderly and the geriatric population. Appropriately exercise programs and cardiovascular fitness in older people improve strength and balance. The interventions included strengthening, endurance, balance, flexibility exercises, Tai Chi, stand up/step down procedure and walking exercises. In the first research, the findings were that program targeting balance, leg strength, and freezing gait were only effective in people with milder illnesses, as opposed to more serious disorders like Parkinson’s disease. The study was done for a period of 2 years. In the second research, the findings showed that a multi-component enhanced physical performance of the community indwelling adults but did not translate to psychological outcomes or reduced rates of falling.

More and more people will need care in old age, and if they are disabled. Millions of Americans suffer from a chronic illness, or some kind of disability, and many of these people will have limits in their daily activities. Some people experience

In addition to supporting the needs of those with impaired cognitive function, it is also important to be aware of the challenges a decline in physical function can bring. According to Dong et. al (2010) an increased risk for self-neglect was found in older adults who scored poorly on a test of physical performance. The same relationship was found among those who self-reported reduced physical function (Dong et al., 2010). Abnormal physical performance testing was identified in 76.3% of elder self-neglect cases referred by social services agencies (Dong et al., 2010). It has also been found that elderly adults reported to social services for elder self-neglect had an impairment in the ability to perform instrumental activities of daily living (Naik, Burnett, Pickens-Pace, & Dyer, 2008).

Allen, J.D., Robbins, J.L., VanBruggen, M.D., Credeur, D.P., Johannsen, N.M., Earnest, C.P.,…Welsch, M.A. (2013). Unlocking the barriers to improved functional capacity in the elderly: rationale and design for the “fit for life trial”. Contemporary Clinical Trials. 36(1), 266-275.

When I think of my patients who are totally dependent on us health care workers, I also think about myself when I am in that situation. It is unsettling to think that someday I would depend on someone to perform simple daily living activities that I have always done on my own. Fonda’s speech explains that we could find advantages to aging that only seen when we are at that stage. I still fear having to end up in a state of total dependence on someone else. However, as Fonda stated, it is how we approach those changes that will determine the quality of life that we would lead in old age (Fonda, 2012).

Ms.D. is independent and lives alone in her home, however, she reports difficulty remembering to carry out or terminate activities. She reports that she has forgotten to turn off the sink twice this year and flooded her apartment both times. The Functional Activities Questionnaire was chosen to inquire about her safety and the other activities in her life. Next, the Berg Balance Scale was used to highlight Ms. D.’s risk of falling noted by her “furniture-walking”, foot drop, and failed hip replacement. She carries a cane with her but often walks in the senior center without using it. Also, Ms. D. reports difficulty walking in the community and states that she needs a break every five steps due to fatigue. Lastly, the Modified Mini-Mental State Exam was chosen to determine Ms. D.’s cognitive impairment level, if any, and to rule-out Alzheimer’s Disease. As her chief complaint, Ms. D. reports often forgetting the names of people, places, and things. As mentioned before, she has forgotten to turn off her sink and flooded her apartment

As people grow older, they develop dental problems which lead to nutritional intake issues. Cognitive function declines affecting memory, decision making, conversing, and problem solving. In addition, falls can occur with mental status disturbances. Lack of social interaction, depression, and anxiety also crop up in the elderly. Sleep patterns are altered by restless legs, snoring, and disrupted breathing sequences. At times, pain can be constant from arthritis, osteoarthritis, or other medical issues (Tabloski, 2014).

As people age they develop many special needs related to the later period of life. Many elderly people have specific physical needs where adaptations to their home are necessary or where they need specific equipment for self care. 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. Health needs also negatively affect the elderly and cause multiple physical problems. Every elderly person experiences needs that are related to each of these areas.

As the life expectancy in the United States rises, the number of elderly in the population has also expanded. These increases have led to the oldest-old (people aged 90 and older) to become the fastest growing age group in the country. The oldest-old face many unique challenges because of their age, one of which is disability. Disability in the elderly has major impact upon society 1 and will continue will be a growing burden in years to come.