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Review the Healthy People 2020 objectives for the older adult. Of the objectives listed for the older adult, which do you feel is most important? Be sure to include examples and references to support your response.

Objective: Increase the proportion of older adults with one or more chronic health conditions who report confidence in managing their conditions (Healthy People 2020).

           Chronic conditions may be difficult to manage based on the complexities of a disease. Additionally, managing one or more chronic conditions may be time consuming. Time consuming tasks may take the form of  monitoring (e.g. checking blood glucose), keeping a diary, scheduling appointments, sorting and taking medications, exercising, meal planning, etc.. The Agency for Healthcare Research and Quality (2015) suggests the burden of these tasks significantly impact how patients manage their chronic conditions, and that patients often find it difficult to complete all these tasks in order to manage their condition effectively. Personally, I see examples of this every day at the hospital: Patients are not confident in their self-management ability and are therefore unable to demonstrate skill or awareness in regards to their condition. Despite receiving adequate medical attention from outstanding multidisciplinary teams, patients continue to show little interest in self-management, ultimately resulting in an overwhelming number of older adults who lack the confidence to manage one or more chronic conditions (Bodenheimer, 2005). Healthcare providers are being forced to seek new and innovative ways to connect with patients and reinforce educational material in order to give patients the confidence and skill to manage their care. I believe this objective to be most important because self-management is clinically proven to result in better outcomes. It is proven that support for patients and caregivers improve confidence in managing conditions. Recently, my hospital has added to its emphasis on education and follow up… Simply providing information to patients is not enough to build confidence, skill, nor the knowledge to manage their health. Therefore, nursing must collaborate to reinforce behaviors and promote better health outcomes in patients.

There are several vulnerable populations that have a chronic illness (older; homeless; and lesbian, gay, bisexual, and transgender populations) that face challenges when it comes to care. Choose one vulnerable population and discuss what can be done to help alleviate these challenges.

           Based on recent events that have transpired in the news, one might acknowledge that  refugees and immigrants are a vulnerable population… many of whom are struggling with chronic illness, and undeniably experiencing challenges related to our healthcare delivery system. Several barriers exist for this group, including language and technology barriers, expectations of medical care, cultural differences, as well as unique health risks or diseases specific to their population. Using a translation service can be helpful in alleviating language barriers. Offering translation services also builds trust and promotes communication with the patient. On another note, it is not uncommon for refugees and immigrants to  have false expectations of how our healthcare system operates. As the IRSA points out, “many refugees develop an idealized image of a system that will take care of all their needs, spiritual and physical,” (Burgess, 2004) but this is not necessarily the case, and these ideals should be clarified. We need to help develop realistic expectations while still engaging the patient in medical services… and helping them to understand the system, instead of completely turning them away. Specific diseases and conditions relative to a population can be addressed by promoting vaccination/immunization, promoting oral health, and helping patients to maintain healthy diets while continuing to incorporate their cultural preferences. Alternative medicines should be included in the plan of care when it is appropriate. Care should also be taken to include religious or cultural practices into the plan of care in order to address any spiritual components of care.