Osteoporosis Intervention Program for the Elderly

Question: Discuss about theOsteoporosis Intervention Program for the Elderly. Answer: Introduction Osteoporosis is a big public health issue worldwide. It is a medical condition caused by degeneration of bones in the body, the bones are characterised by being slender and are prone to fractures. These fractures can lead to other problems like pain, changes in the body posture, (Pisani et al., 2016). The burden of cost of osteoporotic management is high considering the continuous rise in the population and increase in the life expectancy of the people, (Holryod et al., 2008). The disease affects the quality of life immensely and hinders the physical, mental status and the well being of the individuals, (Lips Schoolar, 2005). Clinical diagnosis is characterised by bone mineral density of 2.5 standard deviations, (Nguyan, 2016). Worldwide over 200 million are affected by osteoporosis. In Singapore and the larger Asia region, osteoporosis is a rising public health concern which its prevalence is rising daily. Population at risk in Singapore women before age 45 are at high risk while men and women above 65 are at risk of osteoporosis, however women are prone by 20% than men, (MOH, 2017). In Singapore the hip fracture ration incidence has increased 1.5 times in men than in women, a similar trend observed in various countries. Mortality rates associated with hip fracture is estimated to be between 20 %- 27 %. This high ratio has caused significant cost on health care cost of the average Singapore citizen, (MoH, 2017). High costs of osteoporosis is associated with hospital care in Singapore, thus better financial management skills for the elderly enables preventive and proactive measures, (Ng, Lau, Ko, 2017)) The objectives of the intervention are; To raise the awareness level of risks associated with osteoporosis among the elderly. To provide a nutrition intervention approach for managing and preventing osteoporosis To provide support for the osteoporotic patients in the community. Background Old age is a blessing and a curse in disguise. With old age there several physiological changes that happen to the body and needs medical interventions. According to World Health Organisation, incidences of osteoporosis increases with old age. 8 % of the population aged between 60-69 years have developed osteoporosis and 25% further to those between 70-79 years and 48% for those 80 years or older. Women are more at risk for osteoporosis as they lose more bone mass after menopause. Women after the age of 45 are at greater risk. In general men and women above 65 years are at high risk of getting osteoporosis Osteoporosis has been identified by the ministry of health in Singapore and given priority for implementation of care. The importance of osteoporosis is the increased risks of fractures among patients with the disease. Often this fracture requires medication and consequent hospitalization, which lead decreased quality of life and may require long term care. In Singapore, fractures of the hip associated with osteoporosis are 30% who are semi dependant, causing major financial, medical and social constraints to the patient. The ministry of health clinical practice guidelines on osteoporosis was first published in year 2002, has been forming the framework for provision of care for the elderly and those at risk for osteoporosis and fractures. The content has served the best purpose in it being a guideline for management and prevention. The target group for this health intervention program will be elderly above 65 years hospitalized. The elderly population with osteoporosis continues to increase in Singapore due to rapid growth of population and improved quality of care among the elderly, (Tan, Low Shen De, 2015). Osteoporosis is characterised by decreased bone mass and structural differing of the bone tissue. The target group for this intervention will be sourced for the hospital, set up. The intervention will target the elderly who have been admitted in one of the major hospitals in Singapore, Alexandra Hospital, and Queen town in the Central region of Singapore. Rationale of the Intervention Osteoporosis is major old age disease which needs urgent intervention. Statistics show that 1 in 3 women over the age of 50 will experience osteoporotic fractures and 1 in 5 men will be a victim, (Ruby Rebecca, 2005). Approximately 75% of hip, spine and distal foreman fractures occur among older persons aged 65 years old and over. By the year 2050, worldwide incidences of hip fracture in men is expected to increase by 310 % while 240% in women, (Judith Sari, 2011). The ageing population in Singapore is increasing rapidly; the older persons incidence rate in 1 in five residents will have developed fractures at a rate of 1.5 times in men and 5 times in women, (Bee Chandran, 2014). Treatment costs for osteoporosis are high with estimates of hospitalisation cost of S$10,555, thus signifying high economic burden and treatment medications are comparatively high, which burdens the patient from attending Medicare and thus increase the risk of mortality, (Lee Lim, 2008). With this knowled ge, the health care cost associated with the elderly is expected to rise concurrently with the rise in the life expectancy, (Kim, Lee, Kim Lee, 2016) thus the need for an effective intervention to manage it. Lifestyle Management Intervention A lifestyle management based approach will be used for this study. A dietary and environmental based will be used in this study. The intervention will be geared towards improving the health status of the community especially older adults at Alexandria medical facility. There is sufficient evidence linking bone mass modulation by changing and modifying the lifestyle habits of the populations at the early ages increase the skeletal maturity. Nutrition Based Approach Calcium rich diet should be emphasized in diets is evident. Increased calcium intake among the elderly will be able to prevent further depletion of the bone density mass thus reducing the effect of the diseases later. Calcium not exceeds 1000 mg per day. Intake of calcium rich diet is crucial; they include milk, dried milk, yoghurt, ice cream and assorted fruits and vegetables. Vitamin D is crucial in the management of osteoporosis for absorption of calcium. An adult over 50 yers needs 1200 mg of calcium on a daily basis. It is obtained through the sunlight or through the diet or supplements, (Dawson et al., 1997, Lips et al., 196). Exercises Studies and sufficient evidence suggest that women with osteoporosis who practise exercise have improved muscles and postural stability and increased density in the bone, (Shea et al., 2004, Englund et al., 2005). The exercises have shown beneficial effects on the well being, improved muscular strength strength and posture of the older adults. Excess exercises should be minimised as they can be detrimental to the health state of the patient. Implementation of the Project Hospital visitation will be initiated with the elderly patients identified through the admission entry of the hospital. The intervention will target both their care takers and the elderly themselves. Care full designed information pamphlets will be used. The pamphlets will have what it pertains osteoporosis, which can be at risk, healthier foods to be consumed and day and venue where screening activity will be carried out. Promoting healthy living through, healthy activities like, increasing physical exercise, maintenance of healthy weight gain and eating a healthy and a balanced diet. The patients who are ready to be discharged will be targeted for focus groups whereby question and answer session will take place hereby it will be question and answer time assisting the elderly in understand the basic concepts of osteoporosis and how it is useful to them. The sessions will be delivered in the social halls of the facility this is the place where patients who can be mobile normally come to rest. Stakeholders Community health workers will also be engaged in the program. Community health worker in the community health centre or in the community will be involved as they understand how the community function other stakeholders will involve geriatricians in the facility, physiotherapists, dieticians and patient representatives at the hospital. The hospital staff will be key in implementation of this program as they form the entry into the care center, thus the need for building comprehensive teamwork and approach. Also the hospitalised obtained their through hospital provision thus working with the facility is key towards assessing the diet the elderly receive in relation to osteoporosis risks. Resources Needed For effective implementation of the program there is need to identify and locate the resources. Promotional items will be made available, informational brochures human resource personnel, communication equipment and posters. Evaluation Evaluation of the program will be done based on the objectives set. Follow ups visits of the older patients in the acute centre will be done upon discharge to assess whether they are practicing or not. It is expected that after the intervention, there will be a behaviour change in terms of nutrition and physical activity interventions. Recognition of the risk should enable them to adopt behaviour change towards improved nutritional intake in relation to osteoporosis. The work is anticipated to be expanded upon rolling out the initial phase and doing critical evaluation and correcting any hindrance that might have been observed and encountered in the implementation phase. Conclusion In implementation of this intervention care will be keenly observed on how information will be disseminated, as older adults have cognitive impaired abilities, thus educating them needs a lot of patients which must be utilised. It is anticipated that there will be a behaviour change among the older adults due to the perceived danger of osteoporosis. References Bee, C. S., Chandran, M. (2014). A Review of the 2008 Singapore Ministry of Health Clinical Practice Guidelines on Osteoporosis and an Update. Journal of the ASEAN Federation of Endocrine Societies, 27(2), 159. Committee on Ageing Issues: Report on Aging Population. 2006. 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