Olga Ciudin

1. The needs of the older person

In the past century, there has been a significant rise in life expectancy in almost all
regions of the world, contributing to an increasingly elderly population. With the
improvement of the medical condition, the mortality is descending, which means that more
people are living into old age.
The island of Ireland already has one million people aged 60 years or older. By 2031,
it is expected that Northern Ireland’s percentage of people aged 60 or older will increase to
28 per cent, it will take until 2041 to reach a similar level in the Republic of Ireland. There is
a also major increase in the oldest old. By 2041 the number of people aged 85 years or older
will rise almost five hold, from 74,000 to 356,000 with the number of centenaries predicted to
top 8,500 by 2041. (Ageing statistics in Ireland, 2012)
These projected increases present significant health, social and economic challenges
for policy and planning, with implications for the resourcing of services for older people and
for targeted forward planning in order to meet future demands. The need for long-term care,
which includes home-based nursing, community, residential and hospital-based care, is also
increasing.
There are a number of aspects that are involved in taking care of elderly or aged
people. Having a good amount of awareness about various needs and requirements of the
elders, is extremely important for those people who have the responsibility of taking care of
their aged family members like, their parents or relatives.
Around the world, people go about doing the same things in very different ways.
Although the behaviours of races and cultures are different, the basic needs they are
satisfying are very similar. Abraham Maslow is one psychologist who studied these needs.
Maslow found that all human beings have five levels of needs to be satisfied and Self-
fulfilled people constantly get all five of these needs met. (theneurotypical.com, 2018)
The first and most basic of all needs are those to do with physical survival. This is the
need for food, drink, shelter, sleep and oxygen. If a person cannot satisfy this basic survival
need it dominates their interest and concern. A person who is cold, sick or hungry will not be
very interested in socialising, learning or working.
 Nutrition
Older people abiliy to cook or to
feed for themselves may be
affected by restricted mobility or
frailty.
Mobility
The ability to walk and have the
range of movements necesarry to
carry out everyday activities may be
limited.
Medical care
Mnay older person need medical
care to manage conditios
associated with ageing, for example
heart disease, type 2 diabetis or
arthritis

Exercise
Personal hygiene Due to limited mobility,because of
different conditions, taking part in
The ability to wash, bath or shower
the most forms of exercise may be
may be limited due to poor mobility
difficult, and more, older people are
or frailty
prone to slips, trips and falls within
their home and local environment.

Physical needs of the older person

Social needs
Social needs are important basic human needs. When social needs are not satisfied,
this can lead to mental and physical health problems. With a growing population of older
adults and the need for them to stay healthy and community-dwelling, satisfying social needs
is important.

Social needs
Relationships with family
and friends
Communication
Social interaction outside It may be difficult for some
Some conditions such as the family. older to maintain existing or
stroke can prevent older form new friendships as
people communicating as Due to physical or mental
health problems, an older opportunities to meet others
they did previously, leading person may miss put the may be limited due to poor
them feeling frustrated, opportunity to interact with mobility or the sensory
isolated and unable to voice others problems prevalent in olfer
their opinions people
Being connected socially is very important to all people, but for the elderly it becomes a key
quality of life concern. Due to health issues or lack of ability to get out, the aging often find
their social opportunities shrinking and they spend more of their time alone. The elderly need
opportunities to become involved socially with family, friends and the community. Attending
functions at the local senior centres, volunteering or connecting through social media can
help the elderly feel like a contributing member to society. (www.homeaidhealthcare.com,
2013)
Emotional needs
Sense of autonomy Physical problems may make it difficult for
older people to carry everyday tasks without
assistance, and this is why it is important to
encourage older people to remain as
independent as possible
Sense of belonging Older people may lose their sense of
belonging in society especially if unable to
continue in their jobs, go out with friends
and family or attend social activities.
Feeling cared for Older people often feel anxious and
uncertain about what the future holds so
they need someone to listen to their worries
and concerns in order to feel cared for.

Recreational needs
The leisure and recreation needs of the elderly are obviously not as comprehensive
as those who are younger and more active. If the elderly are living in a situation
where they are sharing accommodation their leisure activities would come from
having group meals together, bingo, card games or organised outings in their community.
Leisure activities might occur every day for them as they are not physically exhausting.
The elderly may be influenced by some of these leisure and recreational activities due
to fitness level, health or how old they have got. Health especially would be a factor
for the elderly as they are more susceptible to illness and injury.
Depending on the older person’s financial situation this may affect them in the
amount of recreational activities they participate in. Those elderly people who live on their
own and don’t have any family members to look after them may also be very isolated and not
get involved in any leisure or recreational activities within their community.
All these things are major influences in enabling the participation of leisure and recreation.
The elderly who live in remote areas without great facilities and support would have limited
use of recreational facilities. For example small country towns don't have the use of a
swimming pool which is a great activity for the elderly. It is a low impact activity which
benefits all levels of fitness. Their financial situation mixed with isolation will also play a big
part in them being able to attend daily outings and mixing in their community. (lifestyle, 2018)
Financial needs
If elderly individuals happen to be living on their own, i.e., without anyone's support,
it is but natural that they will have a certain amount of financial needs. They will need to fend
for themselves for everything such as food, groceries, medicines, etc. Pensioners would have
the benefit of a steady source of monthly income (whatever be the amount trickling in).
However, those senior citizens who do not have any pension facilities or any other sources of
income, would have to live entirely on the basis of their savings or through special senior
citizen government finance schemes.
Elderly people need familiar surroundings and people around them and hence prefer
staying at home in old age. Being a familiar living place, the home can be modified according
to their changing needs. Another advantage would be of having a safe and helpful
neighbourhood in case of any emergency. Transportation is easy and quick when older people
are residing in a familiar area. However, if due to some reasons, they do not have a house of
their own, there are government housing schemes designed specifically for older people.
Also, there are certain private nursing homes that work for old people and take care of their
health and other basic necessities. (wellnesskeen.com, 2018)
Spiritual needs
Several studies suggest that the exercise of spiritual activities can influence through
positive emotions such as hope, forgiveness, self-esteem and love which may be important
for mental health through psycho neuro immunological and psycho physiological
mechanisms of action. The spirituality also has an important influence on longevity
confrontation with death and life satisfaction there is deep faith in older adults and practice of
religiosity that gives them a sense of belonging and vital satisfaction; the elderly have less
fear of death and have support in the disease. (Guerrero-Castañeda, 2017)
 2. Investigation into conditions affecting older person
In this chapter I will relate about a cognitive condition, and physical condition that
affects older people nowadays. These conditions are arthritis and depression. I will describe
in detail the symptoms and signs of these diseases, as well how living with these conditions
affects the life of the older person.
Arthritis
Arthritis is one of the common physical conditions that affects older people
nowadays. Arthritis is a name for a group of conditions affecting the joints. These conditions
cause damage to the joints, usually resulting in pain and stiffness. Arthritis can affect many
different parts of the body of the joints and almost all the joints in the human body.
There are over 100 types of arthritis, but most commonly affecting individuals are
osteoarthritis and rheumatoid arthritis. Osteoarthritis may produce inflammatory symptoms as
well, but primarily destroys joint cartilage over time. Rheumatoid arthritis is an autoimmune
disorder that produces inflammatory joint symptoms all over the human body. Often,
rheumatoid arthritis symptoms are confused with osteoarthritis symptoms. Arthritis is more
commonly seen in adults over 65 years of age, but it can also develop in children, teens and
younger adults. Arthritis is more common in women than in men and in people who are
overweight. Also known as degenerative joint disease or osteoarthrosis, osteoarthritis is the
most common arthritic disease.

Sourse: www.everydayhalth.com, 2018

 The majority of Irish people over the age of 55 have evidence of osteoarthritis at some
joint in their body. Around 40,000 people have the severe inflammatory auto-immune
condition called rheumatoid arthritis (RA) where the body is said to attack itself. 70% of
these rheumatoid arthritis patients are women. Every year in Ireland, around 400,000 people
consult their doctor with symptoms related to arthritis, according to Prof Barry Bresnihan,
consultant rheumatologist and Chairman of Arthritis Ireland.
Prof Bresnihan said almost one-third of women and one-quarter of men will complain
of arthritis or joint pain to their GP, and the condition is more common in older people.
(Hunter, 2018)
Common symptoms of arthritis.
The symptoms of arthritis develop gradually. First symptoms are felt in small joints,
finger and toes, shoulder and knees. Muscle stiffness can be prominent early feature. One of
the main characteristics of the arthritis is the flare up, which means the symptoms that come
and go, but will intensify with time and will become more severe Most of the flare ups often
occur in the morning or after sitting a while without have any activity. Stiffness, warmth and
redness are other symptoms of arthritis. The lining of affected joint becomes inflamed,
causing joints to become swollen, hot, tender to touch and painful.

Sourse: www.sepalika.2017

Investigating arthritis impact in the life of the older person.

 Arthritis affects people in different ways, and there are no right or wrong ways to feel.
It can make someone feel pain, stiffness, tiredness or frustration. Frequently they can
experience several of these symptoms at once. The problem with the pain of arthritis is the
fact that it goes on day in, day out. If asked to put with it for a few hours, most people would
cope. Most people will get some relief from their pain once they start treatment. People with
arthritis often find getting out and about difficult. Many rely on cars – either driving
themselves or getting lifts – or public transport to get around.

Sourse: www.betterfamilyheath.org, 2018

Living with a condition for which there is no cure can have a devastating effect on a
older person. The impact can extend to social, economic, psychological, physical, cognitive
and cultural aspects of a person’s life. All of these factors can have a profound impact on a
person’s well-being and self-esteem. It is normal for people to experience a wide range of
feelings and emotions. They may be tearful, or angry, or upset among other emotions. Not
surprisingly, therefore, arthritis can cause serious levels of depression and social isolation
According to research conducted by Arthritis Ireland, 3 in 10 people with arthritis say they
are sad and depressed, and 4 in 10 admit that they sometimes find it hard to keep going and
their disease is a constant worry for them. (www.arthrisisireland.ie, 2019)
 Depression
Depression is a common problem among older adults, but it is not a normal part of
aging. In fact, studies show that older adults feel satisfied with their lives, despite having
more illnesses or physical problems. However, important life changes that happen as we get
older may cause feelings of uneasiness, stress, and sadness. For instance, the death of a loved
one, moving from work into retirement, or dealing with a serious illness can leave people
feeling sad or anxious. After a period of adjustment, many older adults can regain their
emotional balance, but others do not and may develop depression. (nia.org, 2017)
Irish population has the highest rates of depression in western World, new data
reveals. According to the OCED, Ireland ranks second on the list just behind Iceland. The
Organisation for Economic Co-operation and Development (OECD) conducted the survey
and the data collected suggested that women are more likely to report the condition than men.
Those surveyed were between the ages of 25 and 64-years-old and the study found that 12%
of Irish people who took part reported having depression
Depression is common among older adults in Ireland, with 10% of the population
reporting clinically significant depressive symptoms with a further 18% reporting sub-
threshold levels of anxiety. There is evidence of under-diagnosis and hence under-treatment
of depression and anxiety. Of older adults with objective evidence of depression, 78% do not
report a doctor’s diagnosis of depression.
Depression is associated with disability. Nearly two-thirds of older adults with
depression have a longstanding illness or disability compared to one-third of people who are
depression free. Depression is associated with increased medication use. Of people aged 75
and over with depression, 56%are taking five or more medications compared to 36% of
adults without depression.
Older people in Ireland, who are diagnosed with depression, have extremely low rates
of labour force participation. Of adults aged 50-64 without depression, 60% are in
employment compared to 30% of older adults with depression. As well, health service is
increased in utilisation of people with depression. Depressed adults aged 75 and over have an
average of 7 visits to their GP in the past year compared to an average of 4 visits among the
non-depressed older population. (TILDA, 2011)
Common symptoms of depression:

 Feeling sad or down a lot of the time, even when there’s no reason.

 Feelings of despair that you can’t escape.

 A lack of feeling or emotion. You don’t feel anything and have lost the ability to
feel happy.

 Feeling exhausted and lacking energy all the time.

 Continuous and long mood swings, when you change from feeling sorrowful or
angry and irritable.

 The things that used to give you enjoyment or make you happy leave you feeling
numb or uninterested.

 Feeling that you don't want to talk to family or friends.

 Difficulty concentrating or a losing interest in your work.

 Putting on or losing a lot of weight.

 Different sleep patterns. You might not be able to fall asleep or you can’t get up
in the morning.

 Some women suffer from postnatal depression after having a baby.

 Feeling guilty for doing something terrible or feeling worthless as a person.

 Feeling so bad that you think it would be a relief to die or hurt yourself.
 Sourse: www.thepavlovictoday.com, 2018

Investigating depression impact in the life of the older person.

Clinical depression in the elderly is common. That does not mean this mental disorder
is normal. The symptoms of depression are being displayed differently, and therefore only
10% receive treatment. Depression in the elderly is also frequently being confused with the
effects of multiple illnesses and the medicines used to treat them.
Depression affects older people in a different manner than the younger people. In the
first one, depression often take place with other medical related illnesses and disabilities that
last for longer time.
Depression in the elderly is connected with an increased risk of cardiac illnesses and
an increased risk of death from illnesses. In the same time, depression is reduce an older
person’s ability to rehabilitate. Depression also has been associated with increased risk of
death following a heart attack. For that reason, it is very important to make sure that an older
person being suspected with symptoms of depression, to be evaluated and treated, even the
illness is mild.
Depression also increases the risk of suicide, especially in elderly white men.
The suicide rate in people ages 80 to 84 is more than twice that of the general population. The
National Institute of Mental Health considers depression in people age 65 and older to be a
major public health problem.
 In addition, advancing age is often accompanied by loss of social support systems due
to the death of a spouse or siblings, retirement, or relocation of residence. Because of changes
in an elderly person's circumstances and the fact that elderly people are expected to slow
down, doctors and family may miss the signs of depression. As a result, effective treatment
often gets delayed, forcing many elderly people to struggle with depression.
 3.Impact of ageing
The world’s population is ageing: virtually every country in the world is experiencing growth
in the number and proportion of older persons in their population. Along with ageing, there a
complex of processes happening in the human body, characterised by physiological,
psychological and social impacts on the older person.
Population ageing is poised to become one of the most significant social
transformations of the twenty-first century, with implications for nearly all sectors of society,
including labour and financial markets, the demand for goods and services, such as housing,
transportation and social protection, as well as family structures and intergenerational ties.
Healthy ageing
Every person in every country in the world should have an opportunity to live a long
healthy life. Yet, the environments in which we live can favour health or be harmful to it.
Environments are highly influential on our behaviour, our exposure to health risks (for
example air pollution, violence), our access to quality health and social care and the
opportunities that ageing brings. Healthy ageing is about creating the environments and
opportunities that unable people to be and do what they value throughout their lives.

meeting basic needs

Healthy ageing

ability to learn, grow and make

decisions

be mobile, build and maintain

relationships
 Everybody can experience healthy ageing. Being free of disease or infirmity is not a
requirement for healthy ageing as many older adults have one or more health conditions that,
when well controlled, have little influence on their wellbeing. WHO defines Healthy ageing
‘’as the process of developing and maintaining the functional ability that enables wellbeing in
older age’’. Functional ability is about having the capabilities that enable all people to be and
do what they reason to value. (Organisation, https://www.who.int, 2018)

Global and National trends of ageing process

Globally, population aged 60 or over is growing faster than all younger age groups. In
2017, there are an estimated 962 million people aged 60 or over in the world, comprising 13
per cent of the global population. The population aged 60 or above is growing at a rate of
about 3 per cent per year. Currently, Europe has the greatest percentage of population aged
60 or over (25 per cent). Rapid ageing will occur in other parts of the world as well, so that
by 2050 all regions of the world except Africa will have nearly a quarter or more of their
populations at ages 60 and above. The number of older persons in the world is projected to be
1.4 billion in 2030 and 2.1 billion in 2050, and could rise to 3.1 billion in 2100. Globally, the
number of persons aged 80 or over is projected to triple by 2050, from 137 million in 2017 to
425 million in 2050. By 2100 it is expected to increase to 909 million, nearly seven times its
value in 2017.

Source: United Nations, 2018

 Ireland is getting older, faster. The feat of an ageing population is considered a
societal success – a measure of how health services successfully battle disease and of ever-
improving social conditions. But it brings its own problems. Even as the shortage of hospital
beds has caused widespread angst and pain for patients and their families in the last week,
concern is growing among healthcare professions that urgent action is needed to head off
something potentially worse in the near future.
The number of people in Ireland aged 65 and over has increased by 32.8 per cent
since 2007, a faster rate of growth than other EU countries. It is expected to have significant
implications on healthcare demand and expenditure. The Central Statistics Office (CSO)
estimates that by the year 2046, Ireland will be home to just over 5.6 million people.
(Hiliard, 2017)

Over the last 50 years, Ireland has changed significantly. We have a multi-national,
cosmopolitan and globalised society with an increasing population. Our population aged 65
years and over is growing by approximately 20,000 each year and will have increased by
111,200 people by 2022. Similarly, our population aged 85 years and over is growing by 4%
each year.

Source: Healthy and Positive Ageing for All Research Strategy 2015-2019, HSE
The country is projected to witness a major growth in the number of persons aged 50 years
and older, with a significant increase occurring in those 80 years and over. The proportion of
people aged 50 years and over will increase from 27.7% (1.3 million) of the total population
to nearly 41% (2.3 million) by 2046. (HSE, 2015) This is based on the Central Statistics
Office (CSO) population projections using the M2F2 scenario.
The number of those aged 65 and over is projected to increase significantly from
531,600 to 1.42 million (or by 167%); and oldest population (i.e. those aged 80 years and
over) is expected to nearly quadruple, increasing from 128,000 to 476,700.

Ageing process and physiological changes

Physiological changes occur with aging in all organ systems. The cardiac output
decreases, blood pressure increases and therefore arteriosclerosis develops. The lungs show
impaired gas exchange, a decrease in vital capacity and slower expiratory flow rates.
Functional changes, largely related to altered motility patterns, occur in the gastrointestinal
system with senescence, and anthropic gastritis and altered hepatic drug metabolism are
common in the elderly

Sourse: www.pocketdentistry.com, Physiological changes in elderly, 2015

 Progressive elevation of blood glucose occurs with age on a multifunctional basis and
osteoporosis is frequently seen due to a linear decline in bone mass after the fourth decade.
The epidermis of the skin atrophies with age and due to changes in collagen and elastin the
skin loses its tone and elasticity. Lean body mass declines with age and this is primarily due
to loss and atrophy muscle cells. Degenerative changes occur in many joints and this,
combined with the loss of muscle mass, inhibits elderly patient’s locomotion.
(https://motioncares.ca, 2018)
Psychological processes of ageing.
The ability to adapt to everyday life may be influenced by the effects of aging on
mental abilities. Cognitive abilities may also affect self-respect and how individuals view
their own aging process. However, normal age-related changes are not all negative, in spite of
some losses in speed and memory in later years. Elderly people can compensate for memory
changes by devising a balanced attitude in their self-concept. (https://www.speedyceus.com,
2018)
Function Psychological Change
Area
Cognitive Memory Short-term memory declines; visual memory declines,
especially after seventy
Ability to learn Over 70; decrease in ability to learn oral material
Vocabulary No change
Speech More difficult to retrieve needed words while speaking;
speech may become more ambiguous
Information Response to stimuli: reaction time slower. Greater
chance of being inaccurate
processing
Problem solving Speed of decision-making: Older adults can arrive at an
answer more quickly than younger persons who do not
have knowledge basis as well stored or categorized
Focus, Attention Less likely to inhibit processing of irrelevant
information
Intelligence Health status affects intelligence test performance.
Usually some decline with age. Older adults who
demonstrate more flexible attitudes and personality
style are less likely to experience a decline in
intellectual functioning
Personality Traits Personality traits remain basically the same overtime.
More likely to use defence mechanism which control
negative emotions or that attempt to put situations into
perspective. Coping: Less likely to react in self-
destructive or emotional ways
 Social impact of ageing

Old age is accompanied by role change and, often, role loss. Most people can expect
transformations in occupational, family, and community roles, and for many, the number of
different roles declines in later life. Some of the major contributors to social problems for
seniors are as follows:

1. Loneliness from losing a spouse and friends.

2. Inability to independently manage regular activities of living
3. Difficulty coping and accepting physical changes of ageing
4. Frustration with ongoing medical problems and increasing number of medications
5. Social isolation as adult children are engaged in their own lives
6. Feeling inadequate from inability to continue work
7. Boredom from retirement and lack of routine activities
8. Financial stress from the loss of regular income.

Attitudes to ageing and older people

Ageism is a prejudice against older people because they are old, and while racism and
sexism is now regarded as politically incorrect, ageism seems to slide under the radar. There
are all kinds of myths about being older in Ireland. One is that the majority of older people
live in nursing homes. In fact, just six per cent of over 65s are in residential care, very
different from the stereotype. Much prejudice is based on ignorance, and ageism is no
different. It thrives because of the segregation between the generations.
(http://www.thirdageireland.ie, http://www.thirdageireland.ie, 2016)

Ageist actions involves talking down to older individuals, according less weight to
their attitudes, needs and beliefs and taking their health and welfare needs less
seriously. Ageist attitudes can also take in seeing paid work as the only work of value, a
whole myth because if volunteers in Ireland downed tools tomorrow, the country would grind
to a halt. Ageism also connects physical beauty with early stages of life.

The reality is very different from the stereotype. The truth is that older people are part
of the demographic bounty available to Ireland in 2016. Never before have people lived so
hopefully or so long. Today older people are continuing to contribute as workers, parents,
grandparents, neighbours, friends, mentors, coaches, volunteers and social activists. And
silver-haired screen heart throbs. While active independent lives are the reality for many
older people, this is often not acknowledged, allowing our society to continue to hold many
often unconscious negative attitudes to ageing.

The point of all this is the stereotype. Ageism is fuelled by the creation of stereotypes.
A stereotype is a generalisation, which gives to particular group characteristics, which are
simplistic and unrepresentative. Stereotypes are often used to justify discrimination.

Age discrimination damages us all. It allows us to overlook the resources that older
people offer, it allows us to patronise and exclude them, thereby creating a less just
society. Most of all, it allows us to deny the reality that one day we will all grow old, and can
create a self-fulfilling prophecy - the kind of life I fear I may have when I grow older is more
likely to happen unless stereotypical attitudes are challenged now.
 4. Health promotion
Health promotion is the combination of instructive and environmental supports for
actions and conditions of living conductive to health. The aim of this chapter is to relate
about health promotion in care settings, and about initiatives for promoting health. As well, I
will relate the benefits of health promotion and how might therapeutic interventions influence
social interactions and quality of life.

It is widely accepted that health promotion, for a long healthy and active life should
ideally begin as early as possible, since habits formed when young may well be maintained
into old age. Young and middle-aged people are often more receptive than older people to
changing their lifestyles and, as such, they tend to dorm captive audiences for health
promotion programmes, being easily recognized in the school or the workplace.

Health promotion strategies

There are a considerable number of initiatives in Ireland which encourage the health
of older people, originating the statutory and voluntary sectors. There are general community
initiatives specially made for older people, which encourage participation in a large variety
of social and cultural activities, as well as initiatives which are directed at improving older
people’s lifestyles, for example, in relation to physical activity and diet. There are also
programmes which aim to improve the environment in which older people live, for example
those addressing security and safety issues. A variety of other programmes address issues
such as preparation for retirement and mental well-being.
However, although there are recent improvements in respect of the co-ordination of
services for older people, there are no integrated approach to health promotion for older
people. Both current and proposed health promotion initiatives for older people must be
developed within a planned structure. Many sectors contribute to health promotion for older
people, and its achievement will depend largely on the incorporation of their individual
actions. (www.lenus.ie, 2018)
Mr Jerry O’Dwyer, Secretary General, Department of Health, identified major
challenges for promoting health in later life as being addition of life during the extra years -
in effect, adding years to life, and life to years. He noted that reduced health and disability,
mainly when they lead to loss of mobility, were by far the strongest providers to distress and
low confidence among older people. These issues place a particular onus on all the service to
plan, organise and deliver a health service to plan, organise and deliver that has at least four
characteristics:
 The service must be delivered promptly to older people, in particular to the
very old. A service, which is not delivered in time, is of no use, no matter how
good it may be.
 The service must be comprehensive - not one that is just good in parts. The
service must be of equally good quality across the board and be seamless in its
delivery. Mr O’Dwyer noted that it is accepted that this is not being achieved,
that some of the most basic things are lacking, for instance, a patient-
identification number.
 The service must be delivered sensitively to people who are old or very old
who may be experiencing difficulties in comprehension that sometimes goes
with old age. It is useful to observe and listen to the way older people are
treated in different settings, but especially if their hearing is poor or their
comprehension is limited
 The service must support older people to remain independent. There are many
facets to this but the most important is not to treat older people as children.
Given that well-being includes people’s feelings about themselves, then health
promotion must encompass the way we care for people and must include the
attitudes displayed towards them when they look for services, whether
preventative, curative or rehabilitative.
The publication of Adding Years to Life and Life to Years A Health Promotion
Strategy for Older People, in association with the Department of Health and Children, marks
the launch of the Council’s Healthy Ageing programme. The strategy complements the
existing national strategy on health promotion and reflects the thinking of other relevant
national strategies and policies, for example, the national cancer strategy and the national
alcohol policy.
It gathers together and analyses much of the information which is available on
mortality, morbidity, lifestyle and behaviour trends amongst older people in Ireland. National
goals and targets for improving the health and well-being of older people are set and
recommendations for action, which build on existing initiatives, are outlined.
The National Positive Ageing Strategy is a commitment in the Programme for
Government and was published in April 2013. The Strategy is a high level document
outlining Ireland’s vision for ageing and older people and the national goals and objectives
required to promote positive ageing. It is an over-arching cross-departmental policy that will
be the blueprint for age related policy and service delivery across Government in the years
ahead.
A Healthy and Positive Ageing Initiative (HaPAI) has been established to implement
the research objective of the National Positive Ageing Strategy. It is a joint initiative
between the Department of Health, the HSE’s Health and Wellbeing programme and the
Atlantic Philanthropies and will run from October 2014 to December 2017, with a
commitment to Department of Health funding for a further two years. The Initiative will
monitor changes in older people’s health and wellbeing linked to the Goals and Objectives of
the Positive Ageing Strategy. (www.health.gov.ie, 2018)
Health promotion programmes for older people and the settings in which they are
provided must take account of the physiological, social and economic changes which are
associated with ageing and which are often beyond the control of older people themselves.
Programmes also need to take account of the fact that many key determinants of health for
older people are outside the health care sector. Thus, policies in a wide range of areas
including pensions, housing and transport have a major impact on the health and well-being
of older people.
Health promotion for older people also has an important role to play in reducing the
disabling effects of illness among those who are already ill. Early recognition and treatment
of illness is essential in enabling older people to cope with illness and to prevent the onset of
psychological distress and possible withdrawal from society. For many older people who are
ill, housebound or living in residential care, measures which enable them to remain mentally
and physically active and to participate in the wider community are essential for improving
their quality of life.
CARDI launched the report Keeping Active for Better Ageing at The International
Association of Gerontology and Geriatrics European Region Congress 2015 in Dublin today
(Friday 24 April 2015). The research paper examines the factors that encourage more
physical activity in older adults with a particular focus on potential policy and practice
interventions. At a policy level programmes that support older people to increase their
physical activity are most successful when they contain specific, attainable and tailored
targets. (Restrepo, 2018)
 Tackling poverty, addressing structural inequalities and promoting healthy ageing
may also help in addressing the socio-economic factors that prevent some groups of older
people participating in physical activity. Involving medical professions in promotion and
‘prescription’ of physical activity may also help increase levels of physical activity in older
people.

Benefits of health promotion

Health promotion activities, including improving dietary habits and participating in
physical exercise, can contribute to an increase in life expectancy and better health for older
adults. Maintenance of health and function contributes to older adults' ability to care for
themselves, to live independently, and to have a positive quality of life. Health promotion
programs designed for older people should include multiple facets: immunizations, smoking
cessation programs, alcohol counseling, dietary interventions and nutrition education, and
exercise and physical activities. Health promotion activities have been shown to be effective
as secondary health promotion strategies for older adults.
In addition to senior centers, many recreation departments offer programs designed
specifically for older adults. Aquatic exercise programs are especially beneficial for patients
who cannot participate in impact activities. Tai chi classes have become increasingly popular
with older adults, especially those modified for specific conditions. Tai chi arthritis, diabetes
and osteoporosis programs are designed specifically for those with limitations due to chronic
conditions common in older individuals. Tai chi is specifically helpful for people with
balance problems that increase the chances of injury from falls. Fear of falling commonly
limits physical activity, causing a vicious cycle of disability from inactivity. The Academy
for Older Adult Wellness offers classes for health professionals who address problems of
balance.
As patients age, positive attitudes about lifestyle changes can vastly improve their
quality of life. Older adults are seeking health promotion and wellness counseling more
frequently from alternative practitioners. Chiropractors have much to offer this rapidly
expanding demographic group, not the least of which is maintenance of spinal flexibility.
(Gatterman, 2018)
Regular physical activity throughout life is important for maintaining a healthy body,
enhancing psychological well-being, and preventing premature death. Health promotion and
wellness counseling offers an important service for older adults, and is in the patient’s best
interest.
 Therapeutic interventions

A therapeutic intervention is an effort made by individuals or groups to improve the

well-being of someone else who either is in need of help but refusing it or is otherwise unable
to initiate or accept help. The intervention, which can be psychological, physical, or even
pharmacological, may be led or guided by a professional interventionist or by friends or
family members, with or without the help of a professional, depending on the circumstances.
In some cases, an intervention takes the form of a confrontation or meeting between a person
who is engaged in self-destructive behavior and is resistant to help and concerned friends or
family members. In other cases, where individuals are not able to make decisions for
themselves, an intervention is a decision to take action on their behalf. This method may not
work for every person in need.
Interventions can be applied to individuals and used in group settings, such as
rehabilitation centers and psychiatric treatment institutions. Intervention is a tool that may be
used with people who have dementia, borderline-personality disorder, emotional problems,
addictions, eating disorders, dangerous sexual habits, or difficulty adhering to a medication
schedule or other type of treatment. An intervention effort is often made to try to prevent
people with known problems who cannot or will not help themselves from relapsing into
undesirable.
Therapy can help older adults who may have difficulty with the transitions of aging to
manage their emotions, find new sources of enjoyment and meaning, and find new support
systems. It can help people face their fears of death, if they have such fears, and deal
with grief as friends and family members pass on. Family or individual therapy can also assist
family members who may be caretakers of their elder relatives, as it can assist them in
dealing with their emotions, communication issues which may be especially helpful if an
elder has some form of dementia and community resources. Possible diagnoses associated
with aging might be include depression or anxiety. Dementia is technically a medical
diagnosis rather than a mental one, but therapeutic treatment may be able to help treat some
of the symptoms associated with dementia.
Many older adults also enter therapy to seek treatment for mental health issues not
related to aging, in higher numbers than they did in the past. This appears to be due to the fact
that attitudes pertaining to mental health issues have begun to change as awareness increases.
Many older adults grew up in a time when mental illness was stigmatized and when all
mental issues faced by seniors were written off as aging or dementia. But now, therapy is
considered by many older adults as a form of treatment, and research shows that seniors are
often more serious about therapy, realizing that their time is limited, and that they tend to
obtain results more quickly than younger people do. In therapy, seniors may address issues
from childhood or early adulthood; current life adjustments; and issues such as
stress, anxiety, depression, or family concerns, among others. (www.goodtherapy.org, 2019)
Older adults may also be more likely to enter therapy late in life now than they were
in the past simply because people live longer now than they did previously. A person who is
60 years of age is likely to have 15 or 20 years remaining in life, and the transitory period that
occurs for many at this stage may begin a process of reflection that leads many older adults to
seek therapy.
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