Slide 2 By Kathie ODell NURS 485 Concordia University Slide 3
vulnerable populations would be any population who does not have
the means to live a fulfilling culturally diverse life of their
choice that is safe from obstacles that may harm them. Within this
conceptualization, vulnerability arises as an emergent
characteristic when connectedness is compromised by a lack of
communication or flawed communication that leads to exclusion from
resources (De Chesnay & Anderson, 2012). Slide 4 The vulnerable
population that I chose was frail elderly who continue to reside in
their own home settings. In Seward, NE 15.1% of the population is
65 years of age and older (United Census Bureau, 2015). Caring for
this growing population of frail elderly people generates many
challenges for our healthcare system (Carey, Covinsky, Lui, Eng,
Sands, & Walter, 2008). This is my now 91 year old grandmother
She lives independently in an apartment in South Dakota Slide 5 It
is difficult for the primary physician to determine when to
transition them to nursing homes or keep them living with
assistance in their own homes. Income has a large influence on the
health of our elderly Cognition and health literacy Mobility the
ability to travel from home to resources Social service support
Compliance in health maintenance Family Support Social networks
Understanding of Medicare benefits Health perceptions Slide 6
Social activities and involvement Family support Religion or
Spirituality Economic Status Adaptive coping skills Health
maintenance and understanding Encountering significant difficult
circumstances, resilience can be described by viewing constant
competence under stress, recovery from a dramatic event, favorable
outcomes regardless of high-risk status, and ability to build and
increase the capacity for learning and adaptation (De Alfieri,
& Borgogni, (2010). My grandmother Marilyn and her special
friend Don Slide 7 Health Beliefs Only go to the doctor when you
are ill Nursing homes are a place to die Health care is too
expensive to use The doctors and nurses are too busy Health decline
is part of aging Customs Using home remedies prior to seeking
health care Including family in the health care plan Children to
care for elderly parent in own home To contradict the elder is
against family structure Most of her family Slide 8 Religious
Attending church/Spiritual services is important Having a
bible/religious book available at all times Being able to attending
church/Spiritual activities and social groups Visits from
clergy/Spiritual leaders and other members Dietary Customs
Following strict dietary religious guidelines o Catholic-fish on
Fridays o Jewish Kosher diet Eating at specific times of day Having
bread and butter at every meal Eating meals with family or friends
Prayers before and after meal Slide 9 Interpersonal Customs for the
frail elderly will follow the person cultural background. o Hand
shake upon meeting o Direct eye contact o Ask about health (how are
you) o Offer food or drink o Offer the elder a chair or assistance
o Visits only in the afternoon o Prefer to have family present when
having visitors Globalization has heightened the need for health
professionals to have a world wide perspective and assume an
ethical-moral obligation to enter and function in a worldwide
community (Leininger 2002). Slide 10 Economic o Cost of health care
insurance copays o Cost of health services o Cost of medications o
Cost of assisted devices Transportation o No longer can drive o No
city services buses o Requires special transportation needs for
wheel chair etc o Hours of transportation services do not meet
appointment times Cognition and literacy o Doesnt remember how to
use phone o Not sure who to call for appointments o Unable to fill
out medical forms o Cannot hear to talk on phone o Cannot see well
enough to read educational materials o Forgot who their doctor is
and unsure of which facility to seek care in Demographics o Lives
in a small town without any health care services o Lives in the
country without transpiration Cultural o Will not seek health care
without family approval o Doesnt feel that health issues can be
treated by local physicians Slide 11 Public Transportation Meals on
Wheels Home health Services Life line or telehealth Pharmacy
Delivery Services Grocery Delivery Services Retirement Community
Centers Medicare enrollment assistance Grandma and her youngest
sister, she is the Second oldest of 9 girls. 7of which Are still
living. Slide 12 Interventions Education about a healthy lifestyle
Injury prevention Nutritional assessment and guidance Medication
education Health screenings Referral for medical treatments
Services and aides to promote independence Theory Roys Adaptation
Theory The process and outcome whereby thinking and feeling persons
as individuals or groups, use conscious awareness and choice to
create human and environmental integration (Masters, 2012)
Physiologic-physical mode the elder can adapt by adjusting diet and
fluid intake. They may need to supplement needs with medications
and oxygen Self-concept-group identity the elder can create
friendships through community and religious activities. Role
Function Mode- interactions with family and friends along with
volunteering at local community groups or long term care facilities
Interdependence mode the elder can create a support system out of
close friends and family members. Slide 13 De Chesnay &
Anderson, (2012). Caring for the Vulnerable: Perspectives in
Nursing Theory, Practice, and Research, 3 rd Ed. Burlington, MO:
Jones and Bartlett Carey, E., Covinsky, K., Lui, L., Eng, C.,
Sands, L., & Walter, L. (2008). Prediction of mortality in
community-living frail elderly people with long-term care needs.
Journal Of The American Geriatrics Society, 56(1), 68-75.
doi:10.1111/j.1532-5415.2007.01496.x De Alfieri, W., &
Borgogni, T. (2010). Through the looking glass and what frailty
found there: looking for resilience in older adults. Journal Of The
American Geriatrics Society, 58(3), 602-603. doi:10.1111/j.1532-
5415.2010.02754.x Leininger M (2002) Transcultural nursing and
globalization of healthcare: Importance, focus and historical
aspects. In Leininger M and McFarland M, Transcultural Nursing
Concepts, Theories, Research and Practice, 3rd ed, pp 344, McGraw
Hill: New York. United Census Bureau, 2015. State & County
Quick Facts. US Department of Commerce. Retrieved 3/10/2015.
http://www.census.gov/quickfacts/ Masters, K. (2012). Nursing
Theories: a framework for professional practice. Sadbury, MA: Jones
and Bartlett Learning
