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Week 10 Discussion 1: Elder-Specific Discussion Topics Week 10 Discussion 1 Elder-Specific Discussion Topics Week 10 Discussion 1: Elder-Specific Discussion Topics Value: 100 points Due: Create your initial post by Day 3, and reply to your peers by Day 7. Grading Category: Discussions As our elderly population is living longer, patients are living with a multitude of chronic comorbidities. The American Academy of Family Physicians (AAFP) predicts that “by 2030, the population older than 65 years will double to 72 million” (Tatum et al., 2018). With this significant rise, elderly patients will represent a considerable percentage of our patient population. As this population is vulnerable to disability and poor quality of life, well elder evaluations are used to identify the needs of older adults and promote well-being. Well elder assessments evaluate medical, physical, social-emotional, and environmental influences on health and well-being. Components of a well elder examine include functional capacity, fall risk, cognition, mood, pain, polypharmacy, social support, finances, goals of care, advanced care planning, nutrition, continence, sexual function, vision/hearing, dentition, living situation, spirituality, and driving (Lapierre, n.d.). Assessing each of these elements looks beyond just the disease process and focuses on patient’s functionality, preferences, and individualized interventions to improve overall well-being (Seematter-Bagnoud & Büla, 2018). Advanced Practice Registered Nurses (APRN) in the primary care setting should be applying cognition assessments and screening tools. Because a comprehensive geriatric assessments (CGA) are extensive and time consuming, the AAFP recommends primary care givers to utilize a “rolling” assessment throughout multiple visits (Tatum et al., 2018). The rolling assessment focuses on one or two screenings a visit and once there is a an area of concern a CGA should be completed. An example of this would be the yearly “Wellness” visit offered for those who have had Medicare Part B for longer than 12 months (Medicare, n.d.). This is a great resource for APRNs and patients to create a personalized prevention plan based on their health and specific risk factors. References: LaPierre, K. (n.d.) The Well Elder Part 1- Demographics Overview [Video]. Regis College. https://myonline.regiscollege.edu/mod/page/view.php?id=405126 Medicare. (n.d). Yearly “Wellness” visits. U.S. Centers for Medicare and Medicaid Services. https://www.medicare.gov/coverage/yearly-wellness-visits Seematter-Bagnoud, L., & Büla, C. (2018). Brief assessments and screening for geriatric conditions in older primary care patients: a pragmatic approach. Public health reviews, 39, 8. https://doi.org/10.1186/s40985-018-0086-7 Tatum, P. E., Talebreza, S., & Ross, J. S. (2018, June 15). Geriatric Assessment: An Office-Based Approach. American Academy of Family Physicians (AAFP), 97(12), 776-784. https://www.aafp.org/afp/2018/0615/p776.html Initial Post Please choose one of the following topics and respond to the thread corresponding to the question you select. Please include at least three scholarly sources within your initial post. Note: As you are choosing a topic, please try to make sure that all topics are chosen at least by one person. You can see this by noting if anyone has posted to the topic within the corresponding threads. Dementia in the elderly. Discuss ways in which the cost associated with dementia can be curtailed along with maintaining the individual’s quality of life. Dementia is not only Alzheimer’s disease, so please consider multiple types of dementia within your answers (types of dementia include Alzheimer’s disease, vascular dementia, dementia with Lewy bodies [DLB], mixed dementia, Parkinson’s disease, frontotemporal dementia, Creutzfeldt-Jakob disease, and normal pressure hydrocephalus). Elder abuse. Include physical, emotional, sexual, etc. How, as an APRN, can you screen for and address elder abuse? What types of health promotion concepts can be used to help advocate for the personal safety of our elders? Are there screening tools available? In what unconventional locations within your community might an elder screening be performed? Fall prevention. What are specific geriatric risk factors that create an increase in fall risks? What can be done from a health promotion standpoint to decrease falls in the elderly? Define fall risk and what types of assessments are available in the outpatient and inpatient settings. Financials, levels of neglect in the elders. Consider financial risk, scams, family, and other pitfalls the elderly may find themselves in relating to their finances. Provide examples and ways to advocate for our patients and our communities as an advanced practice nurse. Components of a well elder evaluation. Define a well elder evaluation. Make sure you address components that pertain to the home environment and the communities in which they live. How can an APRN assist in these evaluations and promote different aspects within your community. Functional status. Consider ADLs and IADLs. What is the difference? What types of assessment can be done and by whom to determine if an elder is capable of caring for themself at home? In addition, what types of services are available to help promote overall elder health not only in their homes but when living with family or in assisted living and nursing homes? What types of supportive services are available to assist the elderly in staying in their own homes? Cognition. Describe how cognitive functioning may change as we age. What are neuropsychological examinations, and when should these be requested? Describe what this type of testing can accomplish and how, as a provider, you would use these results. Discuss ways in which we can improve and maintain our cognitive health (for example, diet, exercise). Provide specifics. Polypharmacy. Consider medication compliance, risk of adverse effects, creatinine clearance <50ml/min. As an Advanced Practice Nurse, how can you address this growing problem? What type of surveillance will you put into place within your own practice, and how can you advocate to help address this concern within your own community? Pain assessment and treatment. Discuss specifics regarding pain within the elder population: perception of pain, pain assessment scales, etc. In addition, provide evidence-based cited information relating to the opioid epidemic within your state and what percentage of addicted individuals are elderly. What type of resources are available in your community to help those with substance abuse problems? Are there any services specific to the elderly? Reply Posts Respond to ONE of your peers who chose a different topic and discuss two separate resources they did not mention. One resource should be aimed at patient education and the second resource should be written for the health professional. Replies to your peers must be on two separate days (minimum) and must utilize at least two scholarly references per peer post. Please refer to the Grading Rubric for details on how this activity will be graded. You will receive points as if you submitted two peer posts as mentioned in the rubric, despite only one being required this week. Alexandra, Week 10 Discussion 1 Elder-Specific Discussion Topics Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS:Week 10 Discussion 1: Elder-Specific Discussion Topics Thank you for highlighting the essential components of a well elder assessment. I agree in that it should encompass all aspects of their life such as the physical, social-emotional and environmental influences on their health. The following are resources and examples related to elder evaluation and assessments available for patients and healthcare professionals. The National Council on Aging (2021) is a nonprofit advocacy and service organization dedicated to improving lives of older adults. On their website, you are able to access helpful information and resources and articles related to health insurance, programs that can help pay for food and medicine, as well as crucial points for elderly regarding preventative measures against falls. There are program locators able to help assess the residence of an elderly person’s home and ensure a safe environment. For example in my home state of California, you are able to search different programs through the website www.stopfallscalifornia.org to locate a program near you to help learn about fall prevention and efforts in the community. The NCOA website and main contact line is a valuable tool in that helps families and caregivers alike access best practices, tools, and advocacy initiatives to ensure all persons can age with health and financial security. Rosen et al. (2018) discuss interventions that can help in the screening and evaluation of elders with regards to potential mistreatment, through something called the Vulnerable Elder Protection Team (VEPT). It is a multi-disciplinary emergency department-based team modeled after hospital-based intervention teams created in the past for child abuse victims and intimate partner violence. As APRNs, we have the opportunity to improve the quality of care to vulnerable populations such as the elderly by placing great care in recognizing the signs of such mistreatment. The process would start with identifying high risk patients and refer to the VEPT team, who would conduct additional screening and interviews via social workers. They would then contact the on-call medical provider to collaboratively discuss the next steps should the situation necessitate. The VEPT team focusses on also acquiring history from family, friends, caregivers, or other outpatient health providers involved with the elder’s care. Though not all healthcare facilities may have a program like this, as healthcare professionals we should be champions for implementing strategies and policies that align with this type of approach to help adequately assess the elderly we serve. References National Council on Aging. (2021). We Are NCOA.  https://www.ncoa.org/page/about-us Rosen, T., Mehta-Naik, N., Elman, A., Mulcare, M. R., Stern, M. E., Clark, S., Sharma, R., LoFaso, V. M., Breckman, R., Lachs, M. & Needell, N. (2018). Improving quality of care in hospitals for victims of elder mistreatment: development of the vulnerable elder protection team. Joint Commission Journal on Quality and Patient Safety, 44(3), 164–171. https://doi.org/10.1016/j.jcjq.2017.08.010 Posting to the Discussion Forum Select the appropriate Thread. Select Reply. Create your post. Select Post to Forum. Discussion Question Rubric Note: Scholarly resources are defined as evidence-based practice, peer-reviewed journals; textbook (do not rely solely on your textbook as a reference); and National Standard Guidelines. Review assignment instructions, as this will provide any additional requirements that are not specifically listed on the rubric. Note: The value of each of the criterion on this rubric represents a point range. (example: 17-0 points) Discussion Question Rubric – 100 Points Criteria Exemplary Exceeds Expectations Advanced Meets Expectations Intermediate Needs Improvement Novice Inadequate Total Points Quality of Initial Post Provides clear examples supported by course content and references. Cites three or more references, using at least one new scholarly resource that was not provided in the course materials. All instruction requirements noted. 40 points Components are accurate and thoroughly represented, with explanations and application of knowledge to include evidence-based practice, ethics, theory, and/or role. Synthesizes course content using course materials and scholarly resources to support importantpoints. Meets all requirements within the discussion instructions. Cites two references. 35 points Components are accurate and mostly represented primarily with definitions and summarization. Ideas may be overstated, with minimal contribution to the subject matter. Minimal application to evidence-based practice, theory, or role development. Synthesis of course content is present but missing depth and/or development. Is missing one component/requirement of the discussion instructions. Cites one reference, or references do not clearly support content. Most instruction requirements are noted. 31 points Absent application to evidence-based practice, theory, or role development. Synthesis of course content is superficial. Demonstrates incomplete understanding of content and/or inadequate preparation. No references cited. Missing several instruction requirements. Submits post late. 27 points 40 Peer Response Post Offers both supportive and alternative viewpoints to the discussion, using two or more scholarly references per peer post. Post provides additional value to the conversation. All instruction requirements noted. 40 points Evidence of further synthesis of course content. Provides clarification and new information or insight related to the content of the peer’s post. Response is supported by course content and a minimum of one scholarly reference per each peer post. All instruction requirements noted. 35 points Lacks clarification or new information. Scholarly reference supports the content in the peer post without adding new information or insight. Missing reference from one peer post. Partially followed instructions regarding number of reply posts. Most instruction requirements are noted. 31 points Post is primarily a summation of peer’s post without further synthesis of course content. Demonstrates incomplete understanding of content and/or inadequate preparation. Did not follow instructions regarding number of reply posts. Missing reference from peer posts. Missing several instruction requirements. Submits post late. 27 points 40 Frequency of Distribution Initial post and peer post(s) made on multiple separate days. All instruction requirements noted. 10 points Initial post and peer post(s) made on multiple separate days. 8 points Minimum of two post options (initial and/or peer) made on separate days. 7 points All posts made on same day. Submission demonstrates inadequate preparation. No post submitted. 6 points 10 Organization Well-organized content with a clear and complex purpose statement and content argument. Writing is concise with a logical flow of ideas. 5 points Organized content with an informative purpose statement, supportive content, and summary statement. Argument content is developed with minimal issues in content flow. 4 points Poor organization and flow of ideas distract from content. Narrative is difficult to follow and frequently causes reader to reread work. Purpose statement is noted. 3 points Illogical flow of ideas. Prose rambles. Purpose statement is unclear or missing. Demonstrates incomplete understanding of content and/or inadequate preparation. No purpose statement. Submits assignment late. 2 points 5 APA, Grammar, and Spelling Correct APA formatting with no errors. The writer correctly identifies reading audience, as demonstrated by appropriate language (avoids jargon and simplifies complex concepts appropriately). Writing is concise, in active voice, and avoids awkward transitions and overuse of conjunctions. There are no spelling, punctuation, or word-usage errors. 5 points Correct and consistent APA formatting of references and cites all references used. No more than two unique APA errors. The writer demonstrates correct usage of formal English language in sentence construction. Variation in sentence structure and word usage promotes readability. There are minimal to no grammar, punctuation, or word-usage errors. 4 points Three to four unique APA formatting errors. The writer occasionally uses awkward sentence construction or overuses/inappropriately uses complex sentence structure. Problems with word usage (evidence of incorrect use of thesaurus) and punctuation persist, often causing some difficulties with grammar. Some words, transitional phrases, and conjunctions are overused. Multiple grammar, punctuation, or word usage errors. 3 points Five or more unique formatting errors or no attempt to format in APA. The writer demonstrates limited understanding of formal written language use; writing is colloquial (conforms to spoken language). The writer struggles with limited vocabulary and has difficulty conveying meaning such that only the broadest, most general messages are presented. Grammar and punctuation are consistently incorrect. Spelling errors are numerous. Submits assignment late. 2 points 5 Total Points 100 Order Now