A common condition refers to a health issue or disease that is frequently seen or diagnosed in a particular population or demographic group. It is one that is widespread and affects a significant number of people. Common conditions are often well-studied and well-understood, and may have a range of effective treatment options available.
Some common conditions in aged care include:
- Dementia/Alzheimer's
- Arthritis
- Parkinson's disease
- Osteoporosis
- Hypertension
- Heart disease
- Diabetes
- Incontinence
- Depression/Anxiety
- Chronic pain
By the end of this chapter, you will understand:
- Common conditions impacting ageing individuals
- How to recoginse change in a persons health status and condition
- How to promote health and wellbeing
- Managing pain and discomfort
Common diseases that impact body system functioning include:
| Dementia/Alzheimer's | Alzheimer's disease is the most common cause of dementia and typically affects older individuals. It is a progressive disease that can lead to complete dependence on caregivers for daily activities. |
|---|---|
| Arthritis | Arthritis is a term used to describe inflammation in one or more joints. It is a common condition that affects people of all ages and can cause pain, stiffness, and difficulty moving the affected joint. |
| Parkinson's disease | Parkinson's disease is a neurodegenerative disorder that affects movement and coordination. It is caused by a loss of dopamine-producing brain cells, leading to symptoms such as tremors, stiffness, slow movement, and difficulty with balance. |
| Hypertension | Hypertension, also known as high blood pressure, is a condition in which the force of blood against the walls of the arteries is consistently too high. It is a common condition that affects many people and can lead to serious health problems if left untreated, including heart disease, stroke, and kidney disease. |
| Heart disease | Heart disease, also known as cardiovascular disease, refers to a range of conditions that affect the heart and blood vessels, including coronary artery disease, heart attack, heart failure, and arrhythmia. |
| Diabetes | Diabetes is a chronic condition in which the body has an impaired ability to produce or use insulin, a hormone that regulates the level of glucose in the blood. |
| Incontinence | Incontinence refers to the loss of control over bladder or bowel function, resulting in the unintentional release of urine or feces. It is a common condition, especially among older adults, and can be caused by a variety of factors including weak pelvic muscles, nerve damage, and certain medical conditions. |
| Chronic pain | Chronic pain is defined as pain that persists for longer than three months and extends beyond the normal healing process. |
| Physical disability | A physical disability is a condition that affects a person's ability to move or perform tasks related to mobility. This can include conditions that affect the musculoskeletal system, such as arthritis, multiple sclerosis, spinal cord injuries, cerebral palsy, and amputations. It can also include conditions that affect the nervous system, such as Parkinson's disease and muscular dystrophy. |
| Cognitive disability | A cognitive disability is a condition that affects a person's ability to think, learn, and process information. It includes a wide range of conditions that can affect a person's cognitive abilities, such as intellectual disability, learning disabilities, and acquired brain injuries. |
| Intellectual disability | Intellectual disability is a condition characterised by significant limitations in cognitive functioning and adaptive behaviors, such as communication, self-care, and social interaction. |
| Psychosocial disability | A psychosocial disability is a condition that affects a person's mental health and emotional well-being. It includes a wide range of conditions such as mental illness, personality disorders, and emotional disorders. |
| Sensory disability | A sensory disability is a condition that affects a person's ability to see, hear, touch, taste, or smell. It includes a wide range of conditions such as blindness, deafness, and other vision or hearing impairments, as well as conditions that affect the sense of touch, taste, or smell. |
Watch
Watch this YouTube video on common conditions impacting our aging population.
Indicators of change
Indicators that a persons health status or physical condition has changed depend on the individual but also their condition. It is important that individuals are closely monitored to quickly identify and report any changes in their health to their case manager or primary carer. Changes to look for where the individual has not verbally communicated a change with you that may be physically visible or identifiable by mood:
- Changes in mobility and physical functioning
- Changes in mood or behavior
- Changes in appetite or weight
- Changes in sleep patterns
- Changes in cognitive functioning
- Changes in memory such as decreased ability to recall events or names
- Changes in vital signs such as blood pressure, heart rate, and respiration rate
- Increased or persistent pain, or changes in the type or location of pain, can indicate a change in health status.
Whilst some of the common conditions mentioned previously may further develop and have impacts on the individual health there are some impacts that are directly associated with ageing and disability regardless of any additional conditions or diseases one person has. The impacts of aging and disability can be physical, social, and economic in nature. Some common impacts include:
- Physical decline: Ageing and disability can lead to decreased mobility, increased susceptibility to illness and injury, and a decline in physical functioning.
- Social isolation: Older adults and people with disabilities may experience social isolation due to limited mobility and difficulty engaging in activities they once enjoyed.
- Economic burden: The cost of healthcare and assistance can place a significant financial burden on individuals and families affected by aging and disability.
- Decreased independence: Older adults and people with disabilities may require assistance with daily activities, leading to a decrease in their independence and autonomy.
- Changes in roles and relationships: Ageing and disability can result in changes in the roles and relationships of older adults and individuals with disabilities, including those within families and communities.
- Health disparities: Older adults and individuals with disabilities may experience health disparities due to limited access to healthcare and other resources.
It's important to note that aging and disability can also bring opportunities for personal growth, increased wisdom, and a deeper appreciation for life. As we age, our bodies go through changes that can lead to physical decline, including decreased mobility, increased susceptibility to illness and injury, and a decline in physical functioning. These changes can impact an individual's sense of self, their ability to engage in activities they once enjoyed, and their overall physical well-being.Older adults may face financial challenges as they age, including declining income, increasing healthcare costs, and the need for long-term care. These financial concerns can contribute to feelings of stress and anxiety, and can impact an individual's overall well-being.It's important to note that while aging can have a direct impact on well-being, it can also bring opportunities for personal growth, increased wisdom, and a deeper appreciation for life. Additionally, well-being can be influenced by a variety of factors, including health, social support, and personal circumstances.
| Indiicator of body system issue | Impacts of ageing and disability | Procedure for reporting issues | |
|---|---|---|---|
| Continence | Loss of bladder or bowel control; urgency; lack of realisation that incontinence has occurred |
Loss of muscle control Loss of sphincter awareness and control Loss of sensation |
Refer for investigation to ensure no medical reasons for issues (such as UTI, tumour or prostate issues) Manage with pads or potential for catheter placement (urine only) |
| Malnutrition | Weakness; fatigue; minimal appetite; skin changes; sunken eyes; confused and disorientated |
Often reduced appetite due to decreased activity and metabolism slows. Loss of sense of taste and smell. |
Review to rule out anything medical *May require supplemental feeding; potential placements of IG tube and IV to rectify |
| Dehydration | Weakness; fatigue, headache; poor skin turgor; concentrated urine |
Loss of thirst sensation Often overdress for the weather Increased sleep leading to dehydration |
Review for medical reasons (such as infection). Manage with increased oral fluids; fluid balance chart; possible IV |
| Weight regulation |
Changes in weight Clothes fitting differently |
Activity changes Metabolism changes Loss of muscle mass Fluid retention |
Review for medical reasons (ie. Diabetes; bowel or stomach; cardiac issues) |
| Oral health |
Loss of teeth Gum disease Pain |
Loss of gum tissue Loss of calcium |
Review for medical reasons Dentures or treatment as required |
| Appetite regulation |
Appetite regulation Appetite changes and varies |
Hormones Metabolic changes Medication |
Review for medical reasons |
| Dysphagia | Difficulty in swallowing fluids or chewing and swallowing solids |
Loss of muscle control CVA (Stroke) Nerve damage |
Review for medical reasons Rule out CVA Manage with assisted feeding, alternate meal types or IG tube placement |
| Bowel health issues |
Constipation Diarrhoea Changes in normal bowel habits Pain or bleeding Increase in gas production |
Metabolic changes Medication Diet changes Intolerances Disease |
Review for medical reasons |
| Bone health issues |
Pain, swelling or tenderness Weakness Changes in mobility and strength |
Loss of calcium Loss of bone density Inability to absorb calcium |
Review for medical reasons |
| Food tolerance |
Signs of gut, or bowel discomfort or being unwell after consumption Allergy signs and symptoms |
Metabolic changes Medication Diet changes |
Review for medical reasons |
| Skin integrity issues including wounds |
Skin integrity issues including wounds and pressure point injuries Breakdown in skin integrity Waxy look and feel to areas Open wounds, bruising, paper like skin (thin and easily damaged) Infection and slow healing |
Hydration status Disease Medication Loss of elasticity and collagen Vitamin and mineral deficiency |
Review for medical reasons |
| Dementia |
Multiple signs Confusion, disorientation, forgetfulness, irritability, inability to perform tasks |
Cerebral changes Calcification of brain sections Disease Injury |
Review for medical reasons |
| Cognitive changes |
Confusion, dysphasia, word issues; inability to complete tasks or failure to remember how to |
Cerebral changes Calcification of brain sections Disease Injury |
Review for medical reasons |
| Mental Health |
Multiple presentations depending on issue Depression, anxiety, personality and mood changes; alternate reality experiences |
Changes to lifestyle Loss of S/O Cerebral changes |
Review for medical reasons |
Reporting changes
In your role you are not only responsible for identifying changes you are also required to report any changes to an individual's health status, and physical and mental well-being. Reporting changes should happen promptly to ensure they are supported as quickly as possible. Here are some guidelines for when and how to report changes:
- Identify the appropriate person or organisation to report to: Depending on the situation, the appropriate person or organisation to report to may be a supervisor, family member, doctor or healthcare provider, a caregiver.
- Observe changes carefully: Pay close attention to changes in an older person's behavior, mood, physical functioning, and overall well-being, and keep track of any changes you observe.
- Provide detailed information: When reporting changes, provide as much detailed information as possible, including specific symptoms, changes in behavior, and any relevant background information.
- Follow up: After reporting changes, follow up with the appropriate person or organisation to ensure that the situation is being addressed and that the person is receiving the appropriate care and support.
It's important to note that in some cases, changes in a person's health status may be indicative of a more serious condition that requires immediate attention. In such cases, it may be necessary to seek emergency medical care or to contact emergency services.
Working with others to implement plans
There are instances where you will need to work with multi-disciplinary health teams to implement individualised plans and escalate concerns. Each organisation will have its own procedure for undertaking this work however it may include:
- Communication: Establish open and effective communication with the multidisciplinary health team, including regular meetings and check-ins, to ensure that all members are aware of the individual's health status and care needs.
- Collaboration: Work closely with other members of the health team to ensure that the individualised care plan is integrated, effective, and responsive to changes in the individual's health status.
- Documentation: Maintain accurate and up-to-date documentation of the individual's health status, including any changes in their condition, and make sure that this information is shared with all relevant members of the health team.
- Escalation process: Have a clear escalation process in place for reporting and addressing any concerns or changes in the individual's health status. This should include who to contact, when to contact them, and what information to provide.
- Interdisciplinary meetings: Participate in interdisciplinary meetings to discuss the older adult's care and well-being, and to ensure that everyone is on the same page in terms of their goals and objectives.
- Continuing education: Stay informed and up-to-date on best practices in care for older adults, and share this information with other members of the health team to ensure that everyone is providing the best possible care.
It's important to remember that the health and well-being of older adults is a shared responsibility, and that effective care requires a collaborative, interdisciplinary approach. By working closely with a multidisciplinary health team and following established procedures, aged care workers can help ensure that older adults receive the best possible care and support.
Promoting health and well-being is important when working with the elderly for several reasons:
- Improved quality of life: By promoting health and well-being, older adults can experience a higher quality of life, including improved physical and mental health, increased social engagement, and a greater sense of purpose and fulfillment.
- Increased independence: By supporting older adults to maintain their health and well-being, they may be able to maintain their independence and autonomy for longer, reducing the need for more intensive forms of care.
- Reduced healthcare costs: By promoting health and well-being, older adults may be able to manage chronic conditions and avoid the development of new health problems, reducing the overall cost of healthcare.
- Improved social connections: By promoting social engagement and connections, older adults can experience improved mental health and a greater sense of community, reducing the risk of social isolation and loneliness.
- Enhanced dignity and respect: By promoting health and well-being, older adults can experience greater dignity and respect, and be better able to contribute to society and to their communities.
It's important to note that promoting health and well-being for older adults requires a holistic approach, including physical, social, and emotional support. Effective promotion of health and well-being also requires the involvement of family members, healthcare providers, and community organisations.
There is a range of strategies that can be used to promote and maintain health and wellbeing:
- Ensuring that older adults receive a balanced and nutritious diet can help maintain their health and well-being. This may involve providing healthy meals and snacks, assisting with meal preparation and feeding, and encouraging hydration.
- Encourage hydration by providing access to water and other hydrating drinks, and by monitoring fluid intake. Encouraging regular movement and exercise can help maintain physical health and well-being in older adults. This can include simple exercises and activities, such as walking or chair exercises, or more structured programs like physical therapy.
- Promote social interaction through activities like group outings, recreational programs, and visiting programs.
The relationship between nutrition and hygiene in aged care is important because both factors play a critical role in maintaining the health and wellbeing of older adults. Good nutrition is essential for maintaining good health, especially for older adults who may have difficulty absorbing nutrients and are more susceptible to illness and infections. Proper nutrition helps to maintain strong immune systems, support wound healing, and improve overall physical function.
Hygiene, on the other hand, is critical for preventing the spread of disease and infection, as older adults are more susceptible to illnesses and have weaker immune systems. Good hygiene practices include regular hand washing, maintaining the cleanliness of living spaces and clothing, and following safe food preparation and handling procedures. Poor oral hygiene can have a significant impact on nutrition, especially for older adults. Oral health problems, such as gum disease, tooth decay, and oral infections, can make it difficult or painful to chew and swallow food, leading to poor nutrition.
Exercise and movement
Exercise and movement play a critical role in maintaining physical and mental health, especially for older adults who are prone to age-related physical and cognitive declines. However, restrictions on daily life can limit the ability of older adults to engage in physical activity and movement, leading to negative impacts. Impact of Restrictions on Daily Life:
- Decreased Physical Function: Physical inactivity can lead to decreased muscle strength, flexibility, and balance, making it more difficult for older adults to perform daily activities and increasing their risk of falls and injury.
- Reduced Mobility: Restrictions on daily life can limit the ability of older adults to move around freely, leading to reduced mobility and independence.
- Decreased Cardiovascular Health: Regular physical activity is important for maintaining good cardiovascular health, but restrictions can limit the ability of older adults to engage in regular physical activity, leading to an increased risk of heart disease and stroke.
- Decreased Mental Health: Exercise and movement can have a positive impact on mental health by reducing stress, improving mood, and increasing feelings of well-being.
Restrictions can limit the ability of older adults to engage in physical activity and movement, leading to decreased mental health. Therefore, it is important for aged care providers to promote exercise and movement for older adults, and to provide resources and support to help overcome restrictions and barriers to physical activity and movement. By ensuring that older adults have access to regular physical activity and movement, aged care providers can help maintain their physical and mental health and support their overall health and well-being.
Pain and discomfort can have a significant impact on an older person's quality of life, and it is important for aged care providers to understand how to respond to and manage pain.
Responses from people in pain:
- Verbal cues: People in pain may express discomfort through verbal cues such as crying, yelling, or expressing frustration.
- Body language: People in pain may also exhibit physical symptoms such as grimacing, clutching at the affected area, or avoiding certain movements.
- Changes in behavior: People in pain may exhibit changes in behavior, such as withdrawing from social interaction, having difficulty sleeping, or changes in appetite.
Pain Scales
Pain scales are used to assess and measure the intensity of an individual's pain. They provide a standardised and objective method of evaluating pain, and help health care providers to determine the best course of treatment. Pain scales can be used in a variety of settings, including hospitals, clinics, and aged care facilities, to assess pain in individuals with a range of health conditions, including chronic pain, post-operative pain, and acute pain. There are several types of pain scales, including numeric rating scales, visual analog scales, and verbal rating scales. Each type of pain scale has its own set of advantages and disadvantages, and healthcare providers may choose the scale that is most appropriate for the individual and their particular situation. The use of pain scales can help to improve communication between the individual and their healthcare provider, and can also help to track changes in the individual's pain over time. This information can be used to determine the effectiveness of treatments and make any necessary adjustments to the individual's care plan.
- Numeric Rating Scale: The numeric rating scale is a simple tool where the individual rates their pain on a scale of 0 to 10.
- Visual Analog Scale: The visual analog scale is a line with the two ends labeled as "no pain" and "worst pain imaginable". The individual marks the point that best represents their current pain level.
- Verbal Rating Scale: The verbal rating scale is a tool where the individual uses words to describe their pain, such as "mild", "moderate", or "severe".
Watch
Watch this YouTube video on How to assess pain.
Watch
Watch this YouTube video on How to manage pain.
Use the following questions to check your knowledge.
- Give three examples of common conditions you have had experience with.
- Describe the two ways in which you could identify there has been a change in a person's health status.
- Explain how you would encourage an individual to exercise when they have been withdrawing from others.
- Explain the difference between the numeric scale and the visual analog pain scales.
