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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.

After reviewing the healthy people 2020, “their goal is to Improve the health, function and quality of life of the older adults” (HealthyPeople2020). I feel that the most important objective for the older adults are to decrease the rate of emergency department visit due to falls. As adults increase in age they become more at risk for falls which can lower their quality of life or lead to death. Falls usually occur for one of these reasons chronic illnesses, impaired vision, environmental hazards and medications. “Every year, 3 million older people are treated in the emergency department for fall injuries” (CDC, 2017).  We can prevent falls by increasing awareness of falls and educating patients and their families about ways to prevent falls. There are ways to prevent falls such as having your doctor review your medication, have an eye exam once a year and participating in activity for strength and balance. Also make your home safer by making sure your home has adequate lighting and getting rid of things that will cause falls.

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Understanding the health care system at the local level is important when planning an EBP implementation because the health care systems may differ depending on the location. One must take into account the demographics, such as region, population, access to resources, etc. One must also take into account the socioeconomic status of the population being treated. For example, some places may have more access to resources to other places, such as urban areas compared to rural areas. In regards to population one must take into account the age groups, their ethnicity, culture and spiritual beliefs, and values. All of those factors play a significant role in determining if the EBP implementation is effective or not.

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Health care systems in various countries have different accountabilities. One cannot just bring change by implementing any Evidence-Based Research Project directly without having understood the implications of the health care system. It is imperative to carry thorough studies to gain knowledge about the extent to which health care systems have developed and what level of changes and advancements that are needed in this regard. For proper implementation of evidence-based practice, it is essential to examine care related to individuals and how the local staff is performing from monetary and technological resources provided to the organization (Stokke, 2017). The flow of information at the hospital also has to be analyzed depending upon which are a more considerable part of the practical implementation. The medical caretakers have the heavy responsibility of implementing and devising strategies to eliminate healthcare-associated risks, answer the clinical inquiries and work on them if they are needed for the betterment of the healthcare system. One should focus on giving knowledge on the importance of EBP to the whole staff and make them aware of evidence-based practices. All individuals including medical attendants should be taught to take an essential role in the implementation.

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The two most essential change theories, in my opinion, are Lewin’s model and Social Learning theory. Lewin’s model has remained very useful in explaining the role of power in advancement or no advancement and implication of change. Change can only take place if the joined quality of one constraint becomes noteworthy than the consolidated quality of the restricting arrangement of powers. The social cognitive theory which was initially known as social learning theory considers that the change in behavior has been primarily impacted by individual variables and some properties of behavior. In comparison to both models, Lewin is more valid and reasonable. It disregards all components related to individuals that affect change. In contrast to this, the social cognitive theory is more influenced by what flows are drawn naturally and focuses on individual components. Lewin model is also more preferred because it takes into consideration, the outer and inner ecological conditions (Moses, 2015).

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The two most commonly recognized change theories are Lewin’s and  Lippitt’s change models. The two are both very similar to one another in that they both look to evaluate when change in needed, initiated, and ultimately evaluated. The differences with each  are  how the creator ultimately expands further with these three stages.  

Lewin’s Model consists of three stages: unfreezing, moving, and refreezing. The unfreezing stage ultimately looks at status quo, and increase driving forces for change; moving stage is the action stage in which the changes are implemented and involve people; and the final stage refreezing establishes the change as the new way of doing things with the reward of desired outcomes (Mitchell, 2013). Though Lewin’s model is simple and straight forward, as we all know now, change does not just happen as simple,  st raight  to the point stages. This is where Lippitt’s change model may work better not only for changes but changes to be done within the nursing field.  

Lippitt’s model directly reflects change in a way  nurses  already know how. This is true because the language used to establish the model mimics that of the nursing process (Mitchell, 2013). Lippitt’s model is broken down into 7 phases, as follows: diagnose the problem (phase 1), a ssess motivation and capacity for  change ( phase 2), assess change agent’s motivation and resources (phase 3), select progressive change objective (phase 4), choose appropriate role of the change agent (phase 5), maintain change (phase 6), and terminate the helping relationship (phase 7) (Mitchell, 2013). Use of Lippitt’s model though it may not be as direct can help create a  clearer  and outlined  way of implementing change within the health care system. This is primarily why I would more likely use Lippitt’s model because  it  acknowledges more specific areas where change can either be a halted because oversight.  

Each year, 1.5 million Americans are diagnosed with diabetes (American Diabetes Association, 2019). If left untreated, diabetic patients are at risk for several alterations, including heart disease, stroke, kidney failure, neuropathy, and blindness. There are various methods for treating diabetes, many of which include some form of drug therapy. The type of diabetes as well as the patient’s behavior factors will impact treatment recommendations.

For this Discussion, you compare types of diabetes, including drug treatments for type 1, type 2, gestational, and juvenile diabetes.

Reference: American Diabetes Association. (2019). Statistics about diabetes. Retrieved from http://diabetes.org/diabetes-basics/statistics/

To Prepare

• Review the Resources for this module and reflect on differences between types of diabetes, including type 1, type 2, gestational, and juvenile diabetes.
• Select one type of diabetes to focus on for this Discussion.
• Consider one type of drug used to treat the type of diabetes you selected, including proper preparation and administration of this drug. Then, reflect on dietary considerations related to treatment.
• Think about the short-term and long-term impact of the diabetes you selected on patients, including effects of drug treatments.

Post a brief explanation of the differences between the types of diabetes, including type 1, type 2, gestational, and juvenile diabetes. Describe one type of drug used to treat the type of diabetes you selected, including proper preparation and administration of this drug. Be sure to include dietary considerations related to treatment. Then, explain the short-term and long-term impact of this type of diabetes on patients. including effects of drug treatments. Be specific and provide examples.

4 references.

Week 4 Project

Locating Resources

Locate a minimum of three community or national resources for your illness group chosen in Week 1( see attached), preferably in your community. Study these resources and write a report about them in a 4- to 5-page Microsoft Word document. Include in your response all the information the patient should know about them (the specific services they offer, fee schedules, if and when appropriate, criteria for eligibility, and any other important information). Discuss potential advantages and disadvantages for vulnerable populations in seeking these resources.

Support your responses with examples.

On a separate references page, cite all sources using APA format.

The need to improve the nutrition of the elderly living in residential long term care is well recognized. This assignment involves a research review, formulation of questions for your observation of elderly meal times and a final response. 

A. Watch video A holistic approach, when working with people with dementia, leads to an improved quality of life. Eating and Drinking well: supporting people living with dementia (Links to an external site.)Links to an external site.

1. Questions: Food and Drink availability concerns – Food is associated with many activities and events. To improve good nutrition:
   • What was done to help make nutritious foods available to the patient?
   • How is the possibility of dehydration addressed? What is the fluid volume recommended?
   • What are special tools suggested to improve eating?
   • Preferences may change with age. What is done to help improve eating?
   • How does the environment affect eating?
2. Questions: Food and Drink through activity (min 11:30 – 12:00, 14:36)

•  How does knowing the story of the patient help improve overall nutrition?

1. Questions: Communication and relationships (min 20:47 – end)

•  How does good communication with staff improve nutrition?

B. Reading: “Best Practices for Nutrition, Food Service and Dining in Long Term Care Homes.” (http://www.dietitians.ca/Downloads/Public/2013-Best-Practices-for-Nutrition,-Food-Service-an.aspx (Links to an external site.)Links to an external site.)

1. What would you do to ensure texture changes are adequate for dysphagia?
2. How would you reduce polypharmacy regarding laxative use?
3. How would you induce a positive dining experience?
4. What are some tips you would enact to train your servers?

C. Reading: “Effectiveness of mealtime interventions on nutritional outcomes for the elderly living in residential care: A systematic review and meta-analysis“, R. A. Abbott

• Write five observation questions you would focus on based on the reading. Some suggestions are ‘mode of food presentation’ and ‘dining environment.’ Collaborate with the your group to finalize observation questions. 

Observation: You have two choices. Either visit on-site: Extra credit point for observing at Woodland Country Manor, Sommerville Road (Breakfast 7 am, lunch 11:30 am, dinner 4:30 pm) OR find one additional video showing elderly eating at meals. 

Final Response requirements. 

1. What are some of the most important steps needed to improve and/or maintain good nutrition?
2. What assessments/interventions would be important to conduct?
3. What  did you observe either in person or from the additional video? (Summarize your observations and reference the video.)
4. How did your observations compare with the information you gathered in the literature?