Prevention Services in An Elderly Patient Discussion Paper

The patients advanced age, and multiple chronic problems are major factors influencing individualized preventive services. Disease preventive services are treatment initiatives made to prevent the occurrence of a disease or worsening. Disease prevention measures are therefore critical among independent patients with minimal or no chronic diseases. There are three different forms of preventive service, which include primary, secondary, and tertiary prevention. Prevention Services in An Elderly Patient Discussion Paper

Primary Prevention

Primary prevention is an initiative undertaken to stop the occurrence of a disease and works by either lowering or eliminating risk factors. According to Visconti and Neiterman (2021), focusing on primary prevention can help patients maintain their health for longer while limiting the burden of disease on the healthcare system. These services include activities that limit risk exposure or enhance the immunity of individuals at risk to prevent the disease from progressing in a susceptible individual to subclinical disease. For this patient, examples of primary prevention services include vaccinations and lifestyle changes. According to Lionis and Midlöv (2017), the elderly are vulnerable to infectious diseases due to their multiple chronic medical conditions and compromised immune systems, which are factors that reinforce the need for vaccination among patients. Other primary prevention measures include regular physical activity, eating a healthy diet, weight management, and regular checkups. Prevention Services in An Elderly Patient Discussion Paper

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Secondary Prevention

Secondary prevention focuses on early disease detection. These services seek to detect and treat disease or its complications at an early stage before the occurrence of major symptoms and, in so doing, lower morbidity and mortality. For Mrs. Reimer, the secondary prevention strategies that can be adopted include regular blood sugar and blood pressure monitoring, regular bone density cans, and screening for other chronic diseases. In their study, Jepma et al. (2021) noted that lifestyle-related secondary prevention among older patients is related to benefits in functional status, cardiovascular risk, and mortality.

Tertiary Prevention

Tertiary prevention measures target the clinical and outcome stages of the disease. These services are implemented in symptomatic patients and seek to lower the severity of diseases as well as the related sequelae. The aim of tertiary prevention is to lower the effects of the disease after it has been established in a patient. In this patient, tertiary prevention will be undertaken to appropriately reduce the chances of further functional loss. The patient’s disease management will include the use of disease-specific care management, chronic care clinics, and referral to specialists. Managing the patients’ chronic conditions requires an appropriate plan to ensure that medications are taken as prescribed, a healthy diet is necessary, exercise routine, and going for regular medical checkups. The patient may further benefit from rehabilitation services to assist her in recovery from her falls or other forms. These rehabilitation services can enhance her strength, balance, and coordination. Due to her advanced age and chronic disease, it is important to place the patient in a support group for individuals with chronic conditions. The support groups offer essential information, resources, and emotional support. According to Campbell et al. (2021), community-based support helps patients improve their physical functioning, maintain social connections, and access healthcare services. Human social support is essential in enhancing user engagement to pursue the targeted behavior change. Improving the patient’s motivation to adopt the prevention measures prescribed is important. In their study, Van Acker et al. (2023) advocated for the use of mhealth services to provide preventive measures and ensure long-term use engagement. Prevention Services in An Elderly Patient Discussion Paper

References

Campbell, M., Stewart, T., Brunkert, T., Campbell-Enns, H., Gruneir, A., Halas, G., … & Doupe, M. (2021). Prioritizing supports and services to help older adults age in place: A Delphi study comparing the perspectives of family/friend care partners and healthcare stakeholders. Plos one, 16(11), e0259387.

Jepma, P., Snaterse, M., Du Puy, S., Peters, R. J., & op Reimer, W. J. S. (2021). Older patients’ perspectives toward lifestyle-related secondary cardiovascular prevention after a hospital admission—a qualitative study. Age and Ageing, 50(3), 936–943. https://doi.org/10.1093/ageing/afaa283

Lionis, C., & Midlöv, P. (2017). Prevention in the elderly: a necessary priority for general practitioners. European Journal of General Practice, 23(1), 203-208. 10.1080/13814788.2017.1350646

Van Acker, J., Maenhout, L., & Compernolle, S. (2023). Older Adults’ User Engagement With Mobile Health: A Systematic Review of Qualitative and Mixed-Methods Studies. Innovation in Aging, 7(2), igad007.

Visconti, C., & Neiterman, E. (2021). Shifting to primary prevention for an aging population: A scoping review of health promotion initiatives for community-dwelling older adults in Canada. Cureus, 13(8). https://doi.org/10.1093/geroni/igad007 Prevention Services in An Elderly Patient Discussion Paper

Mrs. Reimer is a 91-year-old widowed female who lives alone in a well-organized single-family home on one level. She has a daughter and son-in-law who check on her about twice weekly. Neighbors also look out for her and are available if needed. Mrs. Reimer’s medical problems include type 2 diabetes, hypertension, osteoarthritis with back pain, osteoporosis, and a history of deep vein thrombosis (DVT). Her current medications include Dipyridamole to prevent DVT, Simvastatin, Olmesartan, Pioglitazone, ASA 81 mg, and weekly Fosamax (Alendronate). She has peripheral neuropathy in her lower extremities, which contributes to her weakness and imbalance. Mrs. Reimer uses a walker for ambulation and has fallen in the past. Mrs. Reimer manages all activities of daily living (ADLs) independently and states that she bathes at the sink. Most instrumental activities of daily living (IADLs), including shopping, cleaning, and bill payment, are handled by her family. She states that she is happy and very satisfied with her life.

Because of her advanced age and multiple chronic problems, individualized preventive services are important. Discuss primary, secondary, and tertiary preventive services to meet Mrs. Reimer’s health promotion needs. Prevention Services in An Elderly Patient Discussion Paper