Effects of Chronic Illness on Elderly

7/23/2019 Effects of Chronic Illness on Elderly

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Running head: EFFECTS OF CHORNIC ILLNESS ON ELDERLY

Effects of Chronic Illness on Elderly

Tessa Carson, Nicole Stolte, Rachel Stolte

Missouri State University

Jonna Laine

Satakunta University

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CHORNIC ILLNESS ON ELDERLY

In accordance to W!"s definition, #a co$%lete state of %hysical, $ental and social &ell'

(ein), and not $erely the a(sence of disease or infir$ity,* the $e$(ers of this )rou% constructed

one of si$ilar interest &ith the addition of s%iritual &ell (ein) +arkness, -eMarco, ./01, %2

1342 ealth is livin) in a %hysical, $ental, social and s%iritual state of &ell (ein)5 &hich $ay or

$ay not include the a(sence of illnesses and disease2 6lthou)h health i$%acts each a)e )rou%

and %o%ulation throu)hout the lifes%an, this %a%er &ill focus on the effects of chronic illness in

the older adult2 The older adults livin) &ith a chronic illness have individuali7ed definitions of

health (ecause they ada%t to livin) &ith this condition every day, as o%%osed to overco$in) an

acute condition2 Chronic illness has the %otential to ne)atively influence the health of the older

adult (ecause it li$its their 8uality of life +Erdt$ann, ./0942 It is i$%ortant for the older adult, as

&ell as the healthcare %rovider, to (e a&are of this and the %atient"s definition as it %ertains to

health (ecause it &ill influence the health care decisions $ade (y the %atient and interventions

%rovided (y the nurse2 Throu)hout this %a%er, the United States and :inland and are co$%ared

and contrasted concernin) chronic issues of the elderly in &hich attention &ill (e (rou)ht to the

vulnera(ility )rou%, reha(ilitation, concerns for health %ro$otion and disease %revention,

)overn$ent structures and non')overn$ent or)ani7ations, and nursin) theories a%%lied2

Vulnerability Group

The elderly adult %o%ulation is $ade u% of individuals &ho are )enerally a)e 19 and

older2 -ue to the %hysiolo)ic strains on the (ody throu)hout the years, &ear and tear $akes this

%o%ulation $ore su(;ected to lon)'ter$ illness or in;ury2 Elderly livin) &ith chronic diseases &ill

need %eriodic contact and reevaluation of their #ca%acity, resources and $otivation to $ana)e

their conditions,* &hich falls in the hands of healthcare %roviders, the co$$unity, and %olitical

as%ects in &hich care takes %lace +Elio%oulos, ./0


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The develo%$ent of elderly=s health ai$s are> the conservation of a(ility, the %revention

of diseases, the %revention of a(ilities &eakenin), the su%%ort of inde%endency, the $aintenance

and increase of life 8uality, the reduction of the need for care, the %revention of in%atient, and the

delay of death +Source 042

The elderly, or s%ecifically the elderly &ith a chronic disease, $ay (e livin) in an

environ$ent or a society that affects their daily lives2 So$e older adults $ay feel isolated fro$

their co$$unities (ecause they are livin) inde%endently2 Most older adults e$(race this

inde%endence and &ant it to continue as lon) as %ossi(le, (ut this $ay $ean that they are

re$ovin) the$selves fro$ the society2 The older adults $ay also (eco$e $ore vulnera(le if they

are livin) alone (ecause they $ay have no(ody close (y to call in case of an e$er)ency2 The

elderly e?%erience a decrease in their senses, so it is %ossi(le they are e?%osed to dan)ers that

they are not a&are of2 When an individual is sufferin) fro$ an illness or disease, the (ody $ay

e?%erience a variety of sy$%to$s that can alter the %hysical, $ental, social, and s%iritual as%ects

of their life2 Chronic diseases are $ore %revalent in the elderly, &hich $ake u% a lar)er than

e?%ected %ercenta)e of the %o%ulation +Elio%oulos, ./0


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6s a )reater nu$(er of %eo%le are reachin) old a)e, the incidence rate of chronic disease

is $ore %revalent and incidence rates continue to cli$(2 6ccordin) to Charlotte Elio%oulos in

erontolo)ical Nursin), $ore than @/ of older adults have at least one chronic illness, $ost of

&hich si)nificantly affect activities of daily livin) as &ell as the 8uality of day to day life

+Elio%oulos, ./0 if one is %oor the risk of

)ettin) a chronic illness )ets (i))er as one does not have the $oney for treat$ents2 It is valua(le

to the individual to (e a&are of ho& their environ$ent and socioecono$ic status $ay hinder

their health and &ell'(ein) +Source .42

The United States and :inland $easure the health of older adults (y their 8uality of life2

In (oth countries, the elderly"s inde%endence is vie&ed as sacred2 The elderly &ish to live in their

o&n ho$es as lon) as %ossi(le2 To (e a(le to do this, they need the autono$y to %erfor$ daily

activities and care for the$selves2 Chronic illnesses can $ake %erfor$in) these activities and

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autono$y difficult, es%ecially &hen the chronic illnesses have no kno&n cure or ada%ta(ility

+!llon)vist, 6altonen, Far%%i, inkka, DGntinen, .//@42

Nurses are $ore availa(le in the US health care settin) than the doctors, therefore, it is u%

to the nurses to (uild thera%eutic relationshi%s &ith elderly clients to e$%o&er the$ to treat and

handle their chronic illnesses so that they can have autono$y and a hi)her 8uality of life

+enri8ues, Costa, Ca(rita, ./0.42 o&ever, in :inland, the doctor is as $uch availa(le as the

nurse &hich sho&s a relatively (i) difference &here the res%onsi(ility of the &ell (ein) of the

%atient is on shared $anners2 !lder adults need to ada%t to their chan)es in health status to $ake

the a%%ro%riate ad;ust$ents to $aintain a hi)h 8uality of life2

Chronic Illnesses Amongst the Elderly

In this cha%ter the leadin) diseases are introduced fro$ (oth countries2

US - Ten Leading Chronic Conditions Affecting opulations !" and #lder

02 6rthritis

.2 i)h (lood %ressure

32 earin) i$%air$ents


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In :inland the chronic diseases a$on)st %u(lic include heart diseases, hy%ertension,

dia(etes, asth$a and aller)ies, chronic lun) disease, cancer, $e$ory disorders, su%%ort' and

%hysical or)anis$s and lastly, $ental health %ro(le$s2

The $ost co$$on heart' and (lood vessel diseases include coronary artery disease, heart

o%eration failure and cere(rovascular disorders2 Coronary artery disease is $ostly i$%acted of

lifestyle, such as s$okin), (ut also (y the fat %ercenta)e in nutrition and (lood %ressure2

The Coronary Artery %isease

!ccurs for e?a$%le in heart $uscle )an)rene, heart failure and in an)ina %ectoris2 The

disease $ay also occur in sudden death, on first ti$e, to clinically healthy %eo%le2

With heart o%eration failure is $eant that the heart=s %u$%in) action deteriorates2 The $ost

co$$on causes are coronary artery disease and hy%ertension2 The rarer causes include in(orn

heart %ro(le$s, ac8uired valvular heart disease and heart $uscle diseases2

Cere(rovascular accident $eans that the cere(ral arterial (lood is flo&in) te$%orarily or

sudden deterioration2 These lead to (rain dysfunction such as deterioration of conciousness or

%aralysis2 +Terveyden' ;a hyvinvointilaitokset &&&'sivut ./0


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6l7hei$er and cere(rovascular disease2+Fy% hoito &&&'sivut ./0942

Cancer

!n to% of a)e and )enetics cancer risks are hi)hly influenced (y lifestyle and

environ$ent2 The (i))est lifestyle risks for cancer are s$okin), unhealthy diet, e?cessive use of

alcohol, sli)ht s%orts, heavy a$ount of sunli)ht, skin (urn and over&ei)ht2 +Terveyden' ;a

hyvinvoinnin laitoksen &&&'sivut ./0


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as &ell as loneliness $ay all cause an?iety and therefore let off de%ression2 It is not often easy to

reco)ni7e de%ression in the elderly2 It can occur only on %hysical sy$%to$s such as loss of

a%%etite, loss of &ei)ht, odd %ains and di)estion %ro(le$s2 Irrita(ility and e?cessive use of

alcohol $ay hide the $ood chan)e sy$%to$s2 When the %hysical sy$%to$s are over takin) it

$ay $islead the health care %rofessionals2

-elusional disorder &hich includes %ronounced sus%iciousness or %aranoia , is a ty%ical

$ental %ro(le$ for elderly &ho live alone2 It occurs for &o$en $ore often than $en2 Me$ory

loss and sensory function=s &eak functionin) $ay %redis%ose to develo%in) %aranoia2

Therefore, &hen it co$es to illnesses &e can conclude that the sa$e ty%es of illnesses

occur in (oth countries ho&ever it re$ains unkno&n ho& the diseases are seen in US due to lack

of infor$ation2 -es%ite the lackin) infor$ation &e can conclude in the ne?t %art si$ilarities in

the relationshi% (et&een the nurse and the elder %atients2 +:ur$an 0BB3, 0./42

#lder Adults *elationship +ith ,urses Applicable for (oth Countries

!lder adults &ish to a)e &ith autono$y, and a hi)h 8uality of life2 ecause chronic

illness can )et in the &ay of a)in) &ith this inde%endence and di)nity, $edications are

%rescri(ed to hel% the older adult $ana)e the sy$%to$s of the chronic illness2 The elderly

re%orted that the relationshi%s &ith healthcare %rofessionals are crucial to their $ana)e$ent of

their $edications and #the infor$ation )iven (y the nurse durin) consultation is very i$%ortant*

+enri8ues, Costa, Ca(rita, ./0., %2 3/B142

The elderly feel safe around nurses and are e$%o&ered to ask the$ 8uestions if they are

confused a(out their $edication re)i$en2 Effective co$$unication (et&een the %atient and

nurse leads to (etter $edication adherence2 This study could also (e a%%lied to different areas of

health care in that nurses offer %rofessional hel% that the elderly can trust2

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,urse *elationship not Applicable in $inland

ecause nurses are $ore availa(le in the US health care settin) than the doctors, it is u%

to the nurses to (uild thera%eutic relationshi%s &ith elderly clients to e$%o&er the$ to treat and

handle their chronic illnesses so that they can have autono$y and a hi)her 8uality of life

+enri8ues, Costa, Ca(rita, ./0.42 o&ever, in :inland the doctor is as $uch availa(le as the

nurse &hich sho&s a relatively (i) difference &here the res%onsi(ility of the &ell (ein) of the

%atient is on shared $anners2

*ehabilitation

!lder adults livin) &ith chronic illness face $any hardshi%s durin) their daily lives2

Chronic conditions such as arthritis, hy%ertension, visual and hearin) i$%air$ents, dia(etes, and

heart diseases can $ake life difficult2 !lder adults ty%ically have one, if not $ore chronic

diseases2 If they have $ore than one, it is ter$ed co$or(idity +Elio%oulos, ./0


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$ore difficult than (efore their chronic condition2 6 condition that could cause a decline in the

a(ility to feed oneself, (athe oneself, or %re%are $eals is arthritis2 6rthritis is the first leadin)

chronic condition affectin) %o%ulations a)ed 19 and older in the United States +Elio%oulos,

./0


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situations, &ould not (enefit fro$ the reha(ilitation service of ho$e health, and is $ore likely to

have a decline in their self'care a(ilities related to their chronic condition2 Nurses can advocate

for these %atients (y referrin) the$ to social &orkers or different institutions in ho%es of findin)

the %ro%er fundin) for these %ro)ra$s2 6nother challen)e is &hen older adults have $ulti%le

caretakers %rovidin) reha(ilitation care in an interdisci%linary fashion2 Me$(ers fro$ different

%rofessions $i)ht &ork on addressin) their )oals for the %atient se%arately, and not take into

account the other $e$(ers of the $ultidisci%linary tea$2 6n e?a$%le of this could (e a nurse

and the occu%ational thera%ist2 The nurse could educate the client a(out %ro%er nutrition and

&hat to eat at each $eal2 If the nurse does not teach the client ho& to o%en ;ars or cans and relies

on the occu%ational thera%ist to teach the client the task, the client &ill not (e a(le to o%en the

;ars or cans to eat the nutritious $eal2 It is i$%ortant for the interdisci%linary tea$ to have o%en

lines of co$$unication and &ork to&ard the sa$e )oals +Clay Wade, .//342

In the United States and :inland, $any reha(ilitation %ro)ra$s are %ut in %lace to hel%

the older adult sufferin) fro$ a chronic condition2 In :inland, researchers su))est the need for

inter$ediate care2 Inter$ediate care is defined as #the services that do not re8uire the resources

of an acute )eneral hos%ital, (ut are (eyond the sco%e of the traditional %ri$ary care tea$* +Clay

Wade, .//3, %2 .142 In the United States, one e?a$%le of reha(ilitation care is referrin) the

%atient to occu%ational and %hysical thera%ists to hel% &ith $o(ility issues2 Many different

reha(ilitation %ro)ra$s e?ist de%endin) on the chronic illness of the elderly2

6ccordin) to the US -e%art$ent of ealth, #reha(ilitation should (e %art of every

nurse"s role* +Clay Wade, .//3, %2 .142 :inland also a)rees &ith this sa$e state$ent2 The

nurse should $otivate the older adult to %erfor$ self'care, %rovide infor$ation for the older

adult to $ake infor$ed decisions, teach skills that $aintain o%ti$u$ functionin) that %revent

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deterioration and enhance 8uality of life, listen to the older adult to evaluate the success of the

reha(ilitation services %rovided2 The %revention efforts are ai$ed to&ards decreasin) %hysical,

%sycholo)ical, and econo$ic costs of chronic illness in the elderly +arkness -eMarco, ./0142

Concerns for )ealth romotion and %isease re.ention

So$e of the $ain leadin) causes of death in (oth :inland and the United States are

cardiovascular diseases2 Cardiovascular diseases affect adults, es%ecially the elderly, (ecause the

$ain risk factor for this disease is (ased on lifestyle factors2 Little re)ulation in the %ast, lack of

kno&led)e, chan)in) %olicies, social isolation, lack of $o(ility, and $any other factors affect the

older adult"s access to infor$ation on reducin) the risk of cardiovascular diseases2 6n e?a$%le

of ho& (oth countries i$%le$ented a health %olicy &as to declare so$e %u(lic areas s$oke free2

This %olicy hel%s to reduce individuals to secondhand s$oke and &ill $ay(e hel% influence

those &ho do s$oke to 8uit2 oth of these countries also enforce a hi)h ta? on to(acco %roducts2

In the United States, a national %ro)ra$ calledMy Plateeducates the %u(lic and is a resource

tool to live a healthy lifestyle2My Platesu))ests heart healthy foods to eat and includes an

e?ercise %lan as %art of the daily diet to %ro$ote health and &ellness2 6 %ro)ra$ that is s%ecific

to :inland is theKeys to Healthnational TH (roadcasts that ai$ to educate the %u(lic a(out hi)h

cholesterol and &hat a heart healthy diet should consist of2 The )oal of this TH %ro)ra$ is to

$otivate individuals to $ake the chan)es the$selves2 In the addition to %olicies %ut in %lace to

eli$inate s$okin) and %ro)ra$s such asMy Plate,there are a $ultitude of efforts to initiate

health i$%rove$ents +Stahl,Wis$ar, !llila, Lahtinen, Le%%o, .//42

In the United States,Healthy People 2020is a set of )oals that is )uided (y the

-e%art$ent of ealth and u$an Services2 It is a national %lan that identifies focal areas for

health i$%rove$ent for the )eneral %u(lic2 The t&o )oals of Healthy People 2020are to

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#increase the 8uality and years of healthy life and to eli$inate any (arriers to accessin) care,

s%ecifically throu)h health dis%arities* +arkness -eMarco, ./01, %2 @142 What is uni8ue

a(outHealthy People 2020is that is contains $easura(le o(;ectives2 Chan)e is not %ossi(le

&ithout realistic solutions5 availa(ility, cost, and (enefits are considered &hen $akin) the

Healthy People 2020o(;ectives2 !ver the years, the o(;ectives have e?%anded to include

#)eno$ics, )lo(al health, healthcare'associated infections, LT +les(ian, )ay, (ise?ual, and

trans)ender4 health, %re%aredness, and social deter$inants of health* +arkness -eMarco,

./01, %2 @142

In :inland, the North Farelia initiative %ut in %lace a co$$unity (ased %ro)ra$ that has

a )oal of havin) an e8ual access of infor$ation and healthcare for all2 To acco$%lish health

%ro$otion in this country, the )overn$ent, N!s, and the %rivate sectors colla(orate &ith each

other in order to (rin) access to health to individuals re)ardless of their socioecono$ic status2

This %ro;ect &as the &orld"s first co$$unity (ased %ro)ra$ and set hi)h standards for other

countries to follo&2 The %u(lic health la& states that instead of focusin) on tertiary services, or

curative services, that health care should (e focused on %ri$ary services, or %reventive care

+Stahl et al, .//142

The !tta&a Charter, &hich is the &as a %roduct fro$ the :irst International Conference

on ealth Dro$otion, created five )oals for health %ro$otion2 These )oals include #(uild a

healthy %u(lic %olicy, create su%%ortive environ$ents, stren)then co$$unity actions, develo%

%ersonal skills, and reorient health services* +Stahl et al, .//1, %2 @42 This )rou% encoura)es

individuals to di$inish the ine8ualities of health and to e?%and the deter$inants of health to

create a (etter access to infor$ation +Stahl et al, .//142

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:or (oth countries, the nurses should (e concerned &ith the elderly"s accessi(ility to

health care and health care infor$ation2 If the individual does not have access to a%%ro%riate

trans%ortation, is socially isolated, or has a %hysical disa(ility it $ay (e difficult to travel to a

health care %rovider or to other resources2 Nurses should also (e concerned a(out the education

$aterials and ho& the infor$ation is %resented to the older adult2 !lder adults are ca%a(le of

learnin) ne& infor$ation, (ut it $ay take the$ a little lon)er to learn this infor$ation2 The older

adult $ay also have %oorer eyesi)ht or (e hard of hearin), so it"s i$%ortant that the learnin)

environ$ent is a%%ro%riate for the client to (e %resented &ith ne& infor$ation2 Many different

%ro)ra$s are set in %lace to %rovide health %ro$otion and disease %revention for the elderly &ith

chronic illness2

Go.ernment Structures / ,G#s

ealth care is a dyna$ic %rocess that is continuously u% for reevaluation and

read;ust$ents in order to %rovide the (est 8uality of care for the nation2 The %u(lic health

delivery syste$ in the United States su%%orts health concerns on a federal, state and local

)overnin) level2

The federal )overn$ent creates %olicy, financin) and re)ulatory enforce$ent &hen a

service is identified that could (enefit citi7ens +arkness -eMarko, ./01, %2 .A42 In addition

to the role in re)ulation of %u(lic health entities throu)h the -e%art$ent of ealth and u$an

Services +-S4, the federal )overn$ent allocates ta? funds to state )overn$ents to su%%ort

certain %u(lic health %ro)ra$s +arkness -eMarko, ./0142 Entitle$ent %ro)ra$s such as

Medicare, Medicaid and Tricare are created to su%%ort lo&'inco$e fa$ily needs, &hich are

federally )overned, ho&ever Medicare does not solely a%%ly to lo&'inco$e needs2

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State )overn$ents also %lay a role in %u(lic health to #re)ulate activity, %ro)ra$

res%onsi(ility and resource allocation,* &hich leaves enforce$ent and i$%le$entation of %u(lic

health activities &ithin the co$$unity at the local level of )overn$ent +arkness -eMarko, %2

.@42 The state de%art$ent overseas the local level, (ut the local level creates their o&n structure

(ased on the needs of the co$$unity2

The for$at of the United States health care re)ulations is very si$ilar to the is$arck

Model2 Most of the %o%ulation, &ho enters Medicare a)e, &ill &ait to enroll and )et Medicare

(enefits (ecause they are receivin) e$%loyee sti%ends for their health care2 6fter &orkin) for 0/

years or $ore, the %o%ulation is allo&ed to collect Social Security (enefits, $uch like a &elfare

syste$ as discussed in the $odel2 In contrast &ith this $odel, ho&ever, the United States health

insurance does not have universal health covera)e, thou)h &ithPatient Protection and

Affordable Care Act, there is $ore covera)e than %revious years +ealth Care Syste$s ' :our

asic Models, n2d242

When develo%in) health care refor$s and referendu$s, it is i$%ortant to assess the health

needs of the nation, %ossi(le econo$ic i$%act, and consider %ast successes and failures2 Current

challen)es facin) the United States" health syste$ include a hi)h %o%ulation of uninsured

individuals, access to health insurance covera)e, and s%ecific %u(lic health %ro(le$s identified in

Healthy People 2020 Initiativessuch as o(esity2 Efforts to re'or)ani7e health care, such as

Patient Protection and Affordable Care Act (ACA), has (een )reatly de$anded (ut not yet

%roven a successful %ro;ection of the future in the five year %eriod it has (een in action +liss,

./0342 The transition of the 6$erican health syste$ &ill continue to chan)e accordin) to the

needs of its Nation2

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In contrast to the United States, :inland offers universal covera)e for a ran)e of health

services delivered $ostly (y %u(licly o&ned and o%erated %roviders &ho receive fundin) $ostly

throu)h )eneral ta?ation +Huorenkoski, .//@42 This $ore so decentrali7ed syste$ runs on several

$a;or co$%onents all of &hich are res%onsi(le for different as%ects of health care such as the

$unici%al health care, %rivate health care and occu%ational health2 The national ad$inistration

defines )eneral health %olicy )uidelines and directs care at the state level5 it does not or)ani7e

services itself2 The Ministry of Social 6ffairs is si$ilar to the US Con)ress and Center for

Medicaid Services +CMS4 in that it directs %olicy )uidance for social security, social &elfare and

health services2 The $inistry, in close colla(oration &ith %olicy decision $akers, sets (road

develo%$ental )oals, %re%ares le)islation and other key refor$s, and oversees the

i$%le$entation2 ealth services for the residents" fall under the res%onsi(ility of Munici%alities2

To fund these services, $unici%alities levy ta?es and receive state su(sidies2 This fundin) allo&s

hos%itals to develo% in varied districts alon) &ith s%eciali7ed hos%itals each of &hich are o&ned

and financially su%%orted (y the $e$(ers in the $unici%ality +Te%eri, J2, Dorter, M2,

Huorenkoski, L2, aron, J2 ./0/42

In addition to :inland"s %u(lic health syste$, :inns are eli)i(le to %artial rei$(urse$ent

to %rivate health care services throu)h the National ealth Insurance +NI4 syste$

+Huorenkoski, .//@42 The NI $odel includes ele$ents of the is$ark Model, as $entioned

a(ove, as &ell as the everid)e Model2 NI uses %rivate'sector %roviders, (ut #%ay$ent co$es

fro$ a )overn$ent'run insurance %ro)ra$ that every citi7en %ays into* +ealth Care Syste$s '

:our asic Models, n2d242 The dual %ay$ent syste$ of the $unici%al fundin), &ith the

e?e$%tion of out%atient dru)s and trans%ort costs, and the NI fundin) #creates challen)es in

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the overall efficiency of service %roduction* &here %har$aceutical care &ith dual financin)

#incurs cost shiftin) %ro(le$s* +Huorenkoski, .//@, %2 0


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such as arthritis, hy%ertension, visual and hearin) i$%air$ents, dia(etes, and heart conditions

;ust to na$e a fe&2

With the focus (ein) on the hi)h %revalence of cardiovascular disease in the US and

:inland, $ultilateral a)encies, (ilateral a)encies and N!s are for$ed &ith the )oal to i$%rove

health and &ell(ein)2 6lthou)h a $ultilateral a)ency such as the Word ealth !r)ani7ation

+W!4 receives fundin) fro$ (oth )overn$ental and non)overn$ental sources, the i$%ortance

of involve$ent and su%%ort fro$ N!s such as the World eart :ederation, Dartnershi% to :i)ht

Chronic -isease, 6$erican eart 6ssociation are all vital co$%onents in the %revention efforts2

:inland $unici%alities and hos%ital districts can %urchase services for$ active N!s and

foundations2 These or)ani7ations can receive su(sidies fro$ the :innish Slot Machine

6ssociation &hich collections a su$ fro$ a $ono%oly in %lace on )a$(lin)2 This is )overned (y

the state +Huorenkoski, .//@42 The $ost &idely kno&n involve$ent of N!s in :inland &hich

s%read internationally is the North Farelia Dro;ect, &hich cou%led &ith W! in atte$%ts to

identify risk factors of cardiovascular disease and ho& i$%le$entin) chan)e &ith lo& resource,

co$$unity (ased intervention &as %ossi(le in dra$atically decreasin) cardiovascular disease2

No $atter &hat Non)overn$ental voluntary or)ani7ation e?ists, if it relates to health and social

&elfare sectors, the :innish Slot Machine 6ssociation is the $ain contri(utor &ith an annual

donation of 3// euros +Huorenkoski, .//@42 The N!s then have a focus of these donations to

tend to the tar)eted )rou%s such as old and disa(led %eo%le, youn) fa$ilies, %eo%le &ith chronic

disease, and su(stance a(users2 The association is inclusive to only third'sector or)ani7ations, so

the $unici%al health services or %rivate for'%rofit $akin) %roviders $ust find another $eans of

fundin) if needed +Huorenkoski, .//@42

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The United States N!s are often run (y #altruistic, non%rofit or)ani7ations* and hel%

kee% %eo%le healthy throu)h voluntary and %hilanthro%ic services +arkness -eMarko, ./01,

%2 3.42 In relation to overall health care, %rivate co$$unity hos%itals $ay (e su%%orted (y

co$$unity N! )rou%s to ensure that the vulnera(le %o%ulations have access to health care5 this

$ay or $ay not (e free2 N!s can also s%onsor co$$unity health education %ro)ra$s and

%revention screenin) clinics that $i)ht (e vital resources in the health of a ne& chronic illness

discovery or livin) &ith the dia)nosis2 S%ecifically in reen County, N!"s such as 6rea

6)encies on 6)in) can %rovide infor$ation on useful a)encies that &ill (e of assistance to the

individual2 Dartnershi% to :i)ht Chronic -isease as &ell as The 6$erican eart 6ssociation is

a$on) co$$only kno&n or)ani7ations in raisin) a&areness and %revention for chronic illness2

Raisin) National a&areness of cardiovascular disease and stroke has (een $ade into fun

activities such as Ju$% Ro%e for eart, s%onsored (y the 6$erican eart 6ssociation2 It is never

too early to start %revention and raise a&areness on the effects of &ear and tear in one"s (ody as

they a)e2

To overco$e o(stacles such as lack of fundin) or su%%ort, it is i$%erative that

or)ani7ations such as W!, World ank as &ell as national su%%ort such as US-S &ork

to)ether to find solutions for a healthier nation and &orld2 Research (ein) e?chan)ed in the

!EC- is )ood in deter$inin) &hich areas are i$%le$entin) successful interventions as o%%osed

to countries that $ay (e deterioratin) in $or(idity or $ortality for e?a$%le2 In :inland and the

United States, a $ore cost effective lon)'ter$ elderly care center and elderly ho$e $ay decrease

the risk of chronic illness2 In :inland, the e?%ansion of %rivate insurance $ade availa(le for the

elderly could also contri(ute to a lon)er %ros%erous life2 The United States continues to $ake

efforts directed to the elderly such as Medicare and Medicaid if it a%%lies2 :inland"s $unici%ality

1


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has also desi)ned a contract for the ne?t several years &ith a #%rivate N!'(ased foundation to

%rovide %ri$ary health care and early care to its coha(itants* +Huorenkoski, .//@, %2 1942 In

order for these refor$s to (e successful, the )overn$ent alon) &ith the health care %roviders

$ust &ork in colla(oration2 It is i$%ortant for nurses to (e alert to %hysical, e$otional and

econo$ical chan)es that $ay influence the a)in) of the elderly adult2 y (ein) kno&led)ea(le

a(out the %o%ulation and their vulnera(ility such as chronic illness, su))estions and referrals can

(e $ade to hel% assist the individual in i$%rovin) their health and &ell (ein) &ith the hel% of

)overn$ental and non)overn$ental or)ani7ations2

,ursing Theory

-ifferent nursin) theories can aid the elderly &ith chronic illness &ith interventions for

%ri$ary, secondary, and tertiary %revention2 The nursin) theories esta(lished are essential for

nurses to inte)rate into their %ractice (ecause the care nurses %rovide can influence the 8uality of

life the elderly have durin) their last years of life sufferin) fro$ a chronic illness2

Dri$ary %revention, or $a?i$i7in) health and &ellness throu)h education, can (e

i$%le$ented in nursin) %ractice (y education a(out $edication2 !lder adults &ish to a)e &ith

autono$y, and a hi)h 8uality of life2 ecause chronic illness can )et in the &ay of a)in) &ith this

inde%endence and di)nity, $edications are %rescri(ed to hel% the older adult $ana)e the

sy$%to$s of the chronic illness2 6 lar)e nu$(er of older adults do not adhere to their %rescri(ed

$edication re)i$en2 Non'adherence could lead to thera%y failure, co$%lications of the disease,

increased $ortality, and increased $oney s%ent on the disease2 The elderly re%orted that the

relationshi%s &ith healthcare %rofessionals are crucial to the $ana)e$ent of their $edications

and #the infor$ation )iven (y the nurse durin) consultation is very i$%ortant* +enri8ues,

Costa, Ca(rita, ./0., %2 3/B142 The elderly feel safe around nurses and are e$%o&ered to ask

2!


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the$ 8uestions if they are confused a(out their $edication re)i$en2 Effective co$$unication

and esta(lish$ent of inter%ersonal relationshi%s (et&een the %atient and nurse leads to (etter

$edication adherence2 This study could also (e a%%lied to different areas of health care in that

nurses offer %rofessional hel% that the elderly can trust2 ecause nurses are $ore availa(le in the

healthcare settin) than the doctors in the United States, it is u% to the nurses to (uild thera%eutic

relationshi%s &ith elderly clients to e$%o&er the$ to treat and handle their chronic illnesses so

that they can have autono$y and a hi)her 8uality of life +enri8ues, Costa, Ca(rita, ./0.42 In

:inland, doctors are $ore availa(le to %atients2 Therefore, it is ;ust as i$%ortant for the$ to

develo% the sa$e ty%e of thera%eutic relationshi% &ith the %atient2 This study directly correlates

&ith ilde)ard De%lau"s Theory of Inter%ersonal Relationshi%s2 :or %ri$ary %revention, it is

i$%erative that the nurse and %atient first identify the %ro(le$, and then develo% )uidelines

a(out ho& to solve the %ro(le$2 Throu)h education, the nurse can take the role of a teacher,

resource, counselor, leader, and technical e?%ert utili7in) De%lau"s theory2 The nurse and %atient

can &ork to)ether to reach an outco$e that &ill %rovide the %atient &ith infor$ation a(out ho&

to handle their $edication, and i$%rove their 8uality of life livin) &ith the chronic illness

+eor)e, ./0042

Secondary %revention is $a?i$i7in) health and &ellness throu)h screenin) %ro)ra$s2

This is in ho%es of disease (ein) cau)ht (efore onset or early enou)h so the disease can (e

%revented and treated (efore sy$%to$s arise2 Secondary %revention can (e $et for chronic

illness in the elderly (y usin) Hir)ina enderson"s Nursin) Need Theory2 In the theory, nurses

are to care for a %atient &hen the %atient cannot care for hi$self or herself2 This re8uires

surveillance of the %atient"s self'care a(ilities2 When the %atient cannot %rovide self care or

adhere to activities of daily livin), interventions are re8uired2 There are 0< co$%onents (ased off

21


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hu$an needs that nurses relate their interventions to2 The co$%onents include (reathin)

nor$ally, eatin) and drinkin) ade8uately, eli$inatin) &astes, $ovin) and $aintainin) desira(le

%ostures, slee%in) and rest, kee%in) te$%erature &ithin nor$al ran)e, %rotectin) the skin,

avoidin) dan)ers in the environ$ent, co$$unicatin) &ith others, &orshi%in) one"s o&n faith,

&orkin) for a sense of acco$%lish$ent, %artici%atin) in recreation, usin) availa(le facilities2

While the nurse is %rovidin) care to this %atient, in the co$$unity, hos%ital, or another settin),

he or she is conductin) assess$ents and screenin)s that relate to the %atient"s a(ilities to (e a(le

to $eet the 0< listed co$%onents +eor)e, ./0042

Tertiary %revention is $a?i$i7in) health and &ellness throu)h treat$ent of a disease2 :or

chronic illnesses, it lasts throu)hout the lifeti$e and so$e cannot (e cured2 Es%ecially for the

elderly, it is i$%ortant to focus on co$fort $easures to treat the sy$%to$s rather than treatin)

the disease to i$%rove their 8uality of life &hen the chronic illness cannot (e corrected2 This is

&hy Fatherine Folca(a"s Co$fort Theory should (e utili7ed for tertiary %revention2 There are

four conte?ts of the hu$an e?%erience of co$fort2 These include, %hysical co$fort,

%sychos%iritual co$fort, environ$ental co$fort, and sociocultural co$fort2 The theory states

that %hysical co$fort is the #$ost a)reed u%on conte?t of co$fort* +eor)e, ./00, %2 1 relief, ease, and

transcendence2 Relief is #the e?%erience of a %atient &ho has had the s%ecific co$fort need $et*

+eor)e, ./00, %2 1


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Conclusion

The older adults &ith chronic illnesses are a vulnera(le %o%ulation that is on the rise in

(oth :inland and the United States2 The decline in health is %resu$ed to have a %otential

ne)ative i$%act on this %o%ulation2 In efforts to %reserve the 8uality of life of each individual,

(oth countries have %olicies in %lace (y the )overn$ent on $ulti%le levels as &ell as individual

health sectors that are read;usted and u%dated in order to $eet the needs of this increasin)ly

vulnera(le %o%ulation2 -ue to the %revalence of this vulnera(ility )rou% and their i$%act on the

%o%ulation, it is i$%erative that healthcare %roviders, educators, and all $e$(ers of society are

active in the a&areness and i$%rove$ents of the health status of the elderly &ith chronic

illnesses2

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*eferences

liss, F2 +./0342 Role of advocacy in health care refor$> Literature revie& and call to action2

American o!rnal "f Health #t!dies, 2$+.4,


25/26


Te%eri, J2, Dorter, M2, Huorenkoski, L2, aron, J2 +./0/42 +he /innish health care system* A

val!ebased perspective2 elsinki, :inland> Sitra2

Huorenkoski, L2 +.//@42Health systems in transition* /inland* Health system revie1, thedition

Co%enha)en> Euro%ean !(servatory on ealth Syste$s and Dolicies2

Source 0>Terveyskir;aston &&&'sivut2 Hiitattu ./2B2./092

htt%>&&&2terveyskir;asto2fiterveyskir;astotk2koti%artikkeliOseh//0 Ulkoasia$inisteriGn &&&'sivut2 ./092 Hiitattu 0.2B2./092 htt%>u$2fi%u(licdefault2as%?

contentidO


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:ur$an, 2 +toi$24, :ors$an, 2, Saarela, T2 0BB32 Mielenterveyson)el$at ;a %sykiatrian

suuntaukset2 WS!Q2 Juva2

26

Effects of Chronic Illness on Elderly

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