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3978NRS Aged Care Nursing & Journal of Nursing Management

Explore the scholarly literature, published between 2011- 2017 inclusive, to critically analyse the impact of ageism in healthcare. Your critical analysis must include the impact of a registered nurse’s ageist behaviour on the older patient, the impact on the nursing care of the older patient and the impact on colleagues in the health care team.

In this task you are required to do the following:

1)Define ageism and contextualise it to the health care of an older person.

2)Discuss theories and principles that are relevant to ageism, nursing care and the health care environment.

3)Critically analyse the impact of a registered nurse’s ageist behaviour on

  • an older patient in their care
  • the safety and quality of the nursing care of an older patient in their care
  • colleagues from the health care team

4)Identify, explain and justify two strategies that are effective in addressing ageism in the health care environment.

5)Support your critical analysis with a minimum of 15 scholarly articles.

  • Ensure that you use scholarly literature[ Scholarly or peer-reviewed journal articles are written by scholars or professionals who are experts in their fields, as opposed to literature such as magazine articles, which reflect the tastes of the general public and are often meant as entertainment.] (digitised readings, research articles, relevant Government reports and text books) that have been published in 2011 to 2017.
  • Provide a clear introduction and conclusion to your paper.
  • Please do not use headings in this assignment task.

Answer:

According to Butler, 1969, ageism refers to the smug attitude and the discrimination act against the aged people. In the lifespan of a person, ageism would be the last kind of discrimination would suffer and it is unlike the other stereotypes as it is mandatory that every living creature must or may be subjected to as long as they live for long. Ageism manifests through different ways, which include the ageist humor, viewing aged people as a burden to the young, energetic people and treating the older person with total disdain (Makris, et al., 2015). Based on the Australian Bureau of Statistics, 2009, which has put a prediction that in the year 2056, twenty-four percent of the Australians would get aged sixty-five years and above as opposed to the thirteen percent in the year 2007. Such statistical prediction shows that the ageism figures reported from the older Australians would increase in the future. Current studies and statistical research findings have shown that eighty percent of the Australian population aged sixty years and above have already reported going through ageism.

In the healthcare setting for the older person, there has been adequate evidence illustrating and showing that most of the healthcare professionals are discriminating the more elderly patients they assigned to offer nursing care. Ageism in the health care place emerges when the medical professionals are unwilling and unenthusiastic to assist the older person (Maclntyre, et al., 2016). The nursing professionals do view the older adult as dormant, rigid, economically counterproductive and always looking dull. In most instances, the nursing professionals do distance themselves from the older person whom they view that shall pass on shortly, or they are not in a position to offer any help. Furthermore, the negative attitude and the pessimistic perspective that the nursing care providers have towards the older people do affect the health status or condition of the aged person profoundly (O'Lounghlin & Kendig, 2017). Several factors show why there is a progressive failure in providing quality care to the older people.

It has come to be known that most of the healthcare professionals do rigorously and thorough research in unearthing the problems affecting the younger patients than they study for the older patients. Besides, most older people are always on several medications than the younger individuals with similar clinical manifestations. Such a perception makes the healthcare providers feel and view the older people as weak and cunningly pretenders, hence, the health care professionals start ignoring them (de Sao Jose & Amado, 2017). Also, some of the nursing care professionals do make referral decisions based on merely the patient’s age rather than what is ailing or the kind of care needed by the patient. Such decisions are not informed but rather get necessitated by the stereotyping and preference by some nurses to care for only the young patients. Lastly, an older person who develops disability such as hearing or visual impairment as a result of old age is most likely to miss being rehabilitated, given equipment and necessary training for his/her daily survival management.

A good number of theories have got advanced by different theorists. The philosophers' ideas are quite relevant to the ageism, nursing care, and the healthcare setting. The disengagement theory, which refers to the process that is unavoidable in which several of the relationships involving an older person and his/her societal members get eroded and those which continue to be inexistent get changed concerning quality (Stumpers, Cohen, Pooley, & Mander, 2015). The theory is advanced to claim that either the older person initiates the withdrawal of the relationship with the other society members or the community just deteriorates the relationship. The withdrawal can be partial or entirely withdrawn. The theory upholds that the aged person is less concerned about life, unlike that time he was a young adult.

The older person just views life as priceless and only wishes when shall his/her Lord take her/his life to rest. The theory argues that there is total stereotyping and discrimination of older people. For example, the caregivers, family members, and the healthcare providers do distance themselves from an older person and try as much as possible to create newer links with young adults in the society (Swift, Abrams, Drury, & Lamont, 2016). Such actions result to the loneliness, inferiority, senility, dementing and developing of negative feelings by the old person. Community members view the old people as burdens, disabled, sexless and rigid. The theory has been conflicted by some critics who argue that it fails to put into consideration of the larger of older people who do not withdraw from the society. The critics of the theory state that some older people do assist in decision making on certain community matters, educating the young people on the ways of life and culture, presiding over certain cultural practices such as rituals and succession rites.

Another theory put forward is the activity theory. The theory was advanced to show that still the older people have other roles to perform after retiring. An older person regardless of the discrimination and prejudice perspective by the younger people actively participates in the family roles such as acting as the head of the family or family advisor, active role in the community functions such as offering blessings at marriage occasions among many others (Hanson, 2014). The nursing care fraternity should not prioritize the working class in service delivery but should be aware of the active roles played by the retired older people.

Healthcare providers do assume that the aged have got no role to play in the society. Hence, they try to ignore and become hesitant in providing the necessary nursing care. In most instances, one realizes that at the health care setting wards for the aged are less technologically equipped since the medical management has a perception that only the younger and working people have a need to access technological equipment while in the wards (Sloane, et al., 2014). For us to maintain a positive sense for the aged people, new roles should get assigned to the elderly, and give theirs to the younger people.

Additionally, the neuroendocrine theory which was a proposal by Prof. Vladimir Dilman and the Ward Dean MD. The theory focuses and elaborates on the wearing away of the older person’s neuroendocrine system. The two argued that the system comprises of biochemical that control the release of the hormones from hormonal glands which get altered by the hypothalamus part of the brain (Mckenzie & Brown, 2014). Due to the older age, the theory argues that the hormonal secretion and control in system declines and the hormone's effectiveness get reduced due to the poor reception.

The theory further holds that due to the old age, the hypothalamus fails to offer effective regulation on the hormonal secretion and the older person’s receptors are less sensitive to the hormonal uptake. The theory tries to explain and show that the caregivers do discriminate the aged without putting into consideration of the biological processes involved (Ben-Harsh, et al., 2013). Most societal members and the nursing professionals perceive the aged as inactive and sexless not taking into account of the hormonal regulation and reception in the biological activity of the neuroendocrine activity of the older person.

The Australian Nurses Standards for practice have outlined principles that direct the nurses to offer and provide quality nursing care to all patients regardless of the age. The principles hold that the patient’s need should get catered for by the nurse on duty. The nursing professional should record information from the old patient, come up with an informed decision on the necessary care and how to offer it to client satisfaction (Kagan & Melendez-Torres, 2015). The Standards of Practice also reminds the nurse to keep the patient’s information in safe custody and confidential. The health care professional must follow the standards in the provision of nursing care to the older people despite the perception and stereotype developed towards the aged.

Most health care settings have developed mission statements that welcome everyone to seek medication and get quality services regardless of the age. Also, most nursing homes or centers have also welcoming missions or slogans that are encouraging the older people to seek refuge there for the satisfaction of their needs (Kydd & Flemming, 2015). Such principles outlined in the Australian Nurse Standards of Practice and the Mission Statements have created a conducive environment for the aged to seek and get the required nursing care.

There have been reports that some registered nurses engage in ageist behaviors which negatively impacts their relationships with the older patients. A registered nurse who engages ageist behavior perceives the older patient as of a less value and not worthy living unlike the positive the registered nurse has towards younger patients. Due to the ageist behavior, the registered nurse would view the older patient as naïve, confused, and dormant (Parsons, Macdonald, Hajek, & Moody, 2015).

Furthermore, the nurse’s negative perception would result into the endangering of the older patient’s life through prescribing drugs aimed at causing harm to the patient or his/her death approach. Also, due to the stereotype behavior, the nurse would offer inadequate and substandard nursing care service to the older patient. The nursing care service from the ageist nurse would be of poor quality since the nurse does not concentrate on the patients complains and undertakes no research to investigate the problems raised by the older patient. Finally, the registered nurse’s behavior would result in strained and poor relationships with the other healthcare team members due to the wrong perception.

The following strategies are effective in the address for ageism; policy level is working and the human rights law enactment by WHO. At the health care environment, policies should get formulated and implemented which shall regulate the behavior of nursing professionals and the quality of care they provide to both the older and younger patients (Hurtado, Berkman, Buxton, & Okechukwu, 2016). Also, the right to better medical and nursing care services to all people should be followed strictly as per the requirement of the WHO enactment. Through these two strategies, the health care providers would be forced to act and offer nursing care service to all patients without partiality regardless of the age, thus, leading to the address and end of ageism.

In conclusion, ageism results to the adverse implications in the older patients. The negative definitions given to the older patients makes them feel as unworthy and do not deserve living anymore, brings seclusion from the society activities and renders them inferior. Such negative definitions for older people include; being inactive, resistive to change and not ready to learn new things, economically burdens, disabled and sexless. Furthermore, the definitions result to the feeling of loneliness, valueless and poor living creatures. Some principles have been proposed or advanced to act in defense of the older person such as the neuroendocrine theory which argues that the insensitive or inactive nature is a biological factor which cannot get avoided by anyone in the aging process. Other approaches include the disengagement theory and the activity theory. The separation theory holds that in some instances the old people withdrawal from the society involvement relationships. On the other hand, the theory claims that in most cases it is the younger members of the community that withdraws from the relationship between them and the aged people. This occurs because the aged are too dependent, inactive and do not add any value in the society progress. The ageist behavior of a registered nurse is detrimental to the relationships between the nurse, older patient and other health care team. Also, the ageist behavior results to the provision of poor quality nursing services which may have dire consequences on the older patient’s health. Work level policies and the right to quality nursing care strategies should be implemented to counter ageism.

References

Makris, U. E., Higashi, R. T., Marks, E. G., Fraenkel, L., Sale, J. E., Gill, T. M., & Reid, M. C. (2015). Ageism, negative attitudes, and competing co-morbidities–why older adults may not seek care for restricting back pain: a qualitative study. BMC geriatrics, 15(1), 39.

MacIntyre, C. R., Menzies, R., Kpozehouen, E., Chapman, M., Travaglia, J., Woodward, M., ... & Adair, T. (2016). Equity in disease prevention: Vaccines for the older adults–a national workshop, Australia 2014. Vaccine, 34(46), 5463-5469.

O’Loughlin, K., & Kendig, H. (2017). Attitudes to Ageing. In Ageing in Australia (pp. 29-45). Springer New York.

de São José, J. M. S., & Amado, C. A. F. (2017). On studying ageism in long-term care: a systematic review of the literature. International Psychogeriatrics, 29(3), 373-387.

Stumpers, S. A., Cohen, L., Pooley, J. A., & Mander, D. J. (2015). The social construction of ageing: Australian and Welsh perspectives. Australian Community Psychologist, 27(1), 53-72.

Swift, H. J., Abrams, D., Drury, L., & Lamont, R. A. (2016). The perception of ageing and age discrimination. Growing older in the UK. London: British Medical Association. Retrieved from htt p://www. bgs. org. uk/pdfs/2016bma_growing_older_in_uk. pdf.

Sloane, P. D., Warshaw, G. A., Potter, J. F., Flaherty, E., Ham, R. J., & Disengagement, A. V. (2014). Principles of Primary Care of Older Adults. Ham's Primary Care Geriatrics: A Case-Based Approach, 3.

Hanson, R. M. (2014). 'Is elderly care affected by nurse attitudes?'A systematic review. British Journal of Nursing, 23(4).

McKenzie, E. L., & Brown, P. M. (2014). Nursing Students' Intentions to Work in Dementia Care: Influence of Age, Ageism, and Perceived Barriers. Educational Gerontology, 40(8), 618-633.

Ben-Harush, A., Shiovitz-Ezra, S., Doron, I., Alon, S., Leibovitz, A., Golander, H., ... & Ayalon, L. (2016). Ageism among physicians, nurses, and social workers: findings from a qualitative study. European Journal of Ageing, 1-10.

Liu, Y. E., Norman, I. J., & While, A. E. (2013). Nurses’ attitudes towards older people: A systematic review. International Journal of Nursing Studies, 50(9), 1271-1282.

Kagan, S. H., & Melendez?Torres, G. J. (2015). Ageism in nursing. Journal of nursing management, 23(5), 644-650.

Parsons, K., MacDonald, S., Hajek, A., & Moody, J. (2015). Increasing attitudes and interest in caring for older adults in first year nursing students using innovative teaching and learning strategies. Journal of Nursing Education and Practice, 5(9), 63.

Hurtado, D. A., Berkman, L. F., Buxton, O. M., & Okechukwu, C. A. (2016). Schedule control and nursing home quality exploratory evidence of a psychosocial predictor of resident care. Journal of Applied Gerontology, 35(2), 244-253.

Kydd, A., & Fleming, A. (2015). Ageism and age discrimination in health care: Fact or fiction? A narrative review of the literature. Maturitas, 81(4), 432-438.


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