Health Promotion and Well-Being in Older Adults (8)

Cognitive Changes & Memory in Older Adults

• Older adults may require more time to recall information, yet the content of their memories tends to be more accurate (e.g., detailed recollection of a wedding from decades earlier).

• Memory‐enhancing strategies:

  • Remain socially engaged (conversation, group activities, volunteering).

  • Maintain mental stimulation through puzzles, reading, gardening, cooking, or other hobbies.

  • Use of external aids (calendars, reminder apps, labeled containers) to support recall.

Foundations of Health Promotion

• Core premise: individuals exert considerable control over their own health status.

• Determinants of health highlighted in the text:

  • Environment & housing conditions.

  • Social patterns (family, community involvement).

  • Diet and nutritional quality.

  • Regular exercise and physical activity.

  • Personal habits (smoking, alcohol, sleep hygiene, medication adherence).

• Misconceptions about aging need clarification; healthy choices confer benefits at every age, including the later years.

Benefits of Exercise (Health Promotion Box)

• Physiological and psychosocial advantages specifically documented for older adults:

  • Maintains or improves cardiovascular fitness.

  • Prevents or lessens the severity of chronic illnesses (coronary artery disease, congestive heart failure, hypertension, osteoarthritis, osteoporosis, diabetes, obesity, chronic obstructive pulmonary disease).

  • Prevents many falls and fractures.

  • Improves muscle strength, flexibility, and balance.

  • Enhances self-care capacity, thereby supporting independent living.

  • Promotes social interaction (group classes, walking clubs).

  • Decreases anxiety, depression, and insomnia.

• Exercise prescription principles:

  • Favor evenly-paced, satisfying activity over exhaustive workouts.

  • Always schedule a rest period afterward to allow full physiologic recovery.

Immunizations

• Annual vaccinations recommended:

  • Pneumococcal vaccine.

  • Influenza vaccine.

• Contraindications / precautions:

  • Compromised immune system.

  • Allergy to eggs or egg products.

  • Prior severe reaction to a similar vaccine.

  • In such cases, physician consultation is mandatory before immunization.

Nutrition & Dietary Considerations

• Adequate nutrition underpins health maintenance and quality of life.

• Functional tasks tied to nutrition (often supported by family caregivers):

  • Transportation to purchase groceries.

  • Meal planning that addresses nutrient needs and cultural preferences.

  • Meal preparation and safe food storage.

• Older adults generally need foods of higher nutrient density and lower caloric density because they:

  • Are typically less physically active.

  • Possess greater adipose tissue and reduced lean body mass.

• Dietary recommendations:

  • Lower saturated fats and simple carbohydrates.

  • Higher fiber content.

• Common threats to dietary adequacy:

  • Poor oral health (ill-fitting dentures, dental pain).

  • Diminished appetite or altered taste sensation.

  • Food intolerances and gastrointestinal issues (e.g., constipation).

• Nutritional assessment/counseling must consider long-standing habits and cultural influences to ensure realistic and acceptable changes.

Psychosocial Influences on Nutrition

• Economic constraints affect the ability to purchase nutrient-dense foods.

• Loneliness or isolation often reduces motivation to shop for, prepare, or consume balanced meals.

• Functional limitations in shopping and cooking further jeopardize diet quality.

• Fluid requirement: encourage a minimum intake of 1500\,\text{mL/day} despite:

  • Decreased thirst perception.

  • Fear of urinary incontinence.

Physical Activity Guidelines

• Evenly paced exercise supports:

  • Cardiovascular efficiency (lower blood pressure, improved oxygen utilization).

  • Joint mobility maintenance.

• Do NOT exercise to the point of exhaustion; follow with an intentional rest phase to restore maximal functioning.

Sleep Patterns & Nighttime Safety

• Older adults require longer overall rest but less actual sleep time.

• Nighttime awakenings elevate accident risk; mitigation strategies:

  • Install night-lights in hallways and bathrooms.

  • Remove excess furniture/clutter that may create tripping hazards.

• Factors disrupting sleep:

  • Prescription and over-the-counter medications.

  • Alcohol or caffeine consumption late in the day.

  • Psychological stress.

  • Environmental noise and temperature extremes.

Accident Prevention & Environmental Safety

• Most accidents are preventable through awareness and environment modification.

• Age-related contributors to fall risk:

  • Diminished vision (acuity, depth perception, contrast sensitivity).

  • Altered posture or balance mechanisms.

• Consequences: a single fall can precipitate long-term immobilization, threatening independence and self-esteem.

Safety Alert — Practical Tips for the Older Adult

• Minimize clutter and excess furniture in rooms and hallways.

• Remove scatter rugs (or secure them with non-slip backing).

• Install and use handrails on all staircases.

• Place grab bars in showers and near toilets.

• Use night-lights to illuminate pathways.

• Rise slowly from a supine position to prevent dizziness.

• Exercise caution when transitioning between well-lit and dark areas.

• When self-medicating, employ pill organizers or dispensing aids to avoid dosage errors.

• Wear properly fitting shoes and clothing to maximize stability.

• Allow adequate time for all activities; avoid rushing to reduce fall likelihood.