It could look this way if you had a competent doctor with 100% recovery protocols. Your doctor would have had to immediately recognize post medical school that stroke rehab was a shitshow and put together the leadership that would solve stroke. But that's not the doctor you have, you have a status quo doctor who did absolutely NOTHING about getting stroke solved. It sucks to have a stroke right now because failures in stroke have continued for decades and will continue ad infinitum!
Healthy Aging: What Will Your Future Look Like?
Approximately 55.8 million adults aged 65 years and older live in the United States, making up 16.8% of the population. The proportion of seniors is projected to grow to 22% by 2040. Proactive planning for healthy aging is a priority of the World Health Organization and can promote a healthy aging process, one that geriatric NPs are well-positioned to lead, according to research presented at the Gerontological Advanced Practice Nurses Association (GAPNA) annual meeting held September 27 to 30, 2023, in New Orleans, Louisiana.
As a gerontologic and palliative care nurse practitioner, Erica Frechman, PhD, AGPCNP-BC, ACHPN, NEA-BC, FPCN, lead author of the study, was inspired to pursue PAF from her conversations with patients and family members about aging and end of life questions. A common reason for a lack of planning for this stage in life relates, in many instances, to fear. Older adults fear a loss of autonomy and of physical decline and dependency on others, Dr Frechman said. She termed it a “fatalistic stance.” However, anticipatory planning can be used to counter that feeling.
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The study, PLAN: Preparing and Living for Aging Now, intended to discover what older adults’ perceptions are of PAF and then to identify if there could be any potential facilitators or barriers for them in the planning process. The authors identified the 5 domains of Planning for Aging and Frailty (PAF):
- Communication and socialization
- Environmental (encompassing living arrangements and transportation methods)
- Financial
- Physical care (describing physical dependencies and caregivers)
- Cognitive status
The researchers recruited 252 volunteers aged 50 to 80 years from the website ResearchMatch.org, a senior center, and 2 YMCA sites in North Carolina. Participants were surveyed to gauge their perceptions of the 5 domains and their own stages of readiness to change within those areas. The surveys included questions on the individuals’ functional and health statuses, demographics, current level of frailty, social supports, and personal experience with aging and frailty (either their own or with others). Twenty volunteers were also recruited for semi-structured phone interviews.
Of the 252 respondents, 180 reported being relatively healthy (71.8%), 28 (11.2%) were vulnerable, and 24 (9.5%) reported being frail, needing high level of support. The survey results found that respondents were most concerned about their future financial health; 68.7% of respondents reported that they either were actively working towards a plan or already had a plan in place. On the opposite end of the scale, cognitive status and memory issues received the least responses, with only 28.2% of older adults having made plans for those eventualities. Additional findings included:
- 46.1% had plans for their living arrangement
- 38.5% for transportation
- 40.5% for physical care (dependence)
- 44.8% physical care (caregiver)
Having plans either in place or in progress appeared dependent on several factors, most notably the age of the respondent — the older the adult, the more planning had been done. Marital status, increasing vulnerability, current living situations, and whether they had social support networks also influenced responses. Of note, having personal experience with aging and frailty increased the chances that older adults were open to or already actively planning for their own futures. This was most evident in people 70 years and older.
Gerontologic NPs are in a unique position to provide first-hand knowledge and guide the planning process for aging and frailty with their patients. Planning for aging and frailty is another part of patient-centered care and healthy aging.
Visit Clinical Advisor’s meetings section for more coverage of GAPNA 2023
Source
Frechman E, Buck H, Dietrich M, Rhoten B, Maxwell C. PLAN: Preparing and Living for Aging Now, a multi-methods study investigating older adults’ readiness to plan for aging and frailty. Poster presented at: GAPNA 2023; September 27-30, 2023; New Orleans, LA.
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