The older adults are at the risk of diminished health. According to the United Nations (UN), the number of adults above the age of 60 years increased by 2% in the years 1950-2000. This increase saw the older people increase from 8% to 10% of the population. By the year 2050, it is estimated that the number of old adults will rise to 22% of the total population due to the increase in life expectancy. While life expectancy for women and men was 77 and 69 years respectively in the 1980s, it is expected to increase to 83 and 75 respectively by the year 2040 (Milanović et al., 2013). Due to this, there is need for effective methods of engaging the older people to ensure they are physically strong to have an independent physical fitness.
A major factor affecting the independence of the older adults is lack of physical exercises. Lack of physical exercises lowers the functional capability thus affecting the quality of life. If an older person does not have the functional capacity required to undertake the daily activities, then, that person is not independent since some form of intervention is required. The ageing process normally tends to reduce physical fitness and makes it difficult to undertake day-to-day activities (Milanović et al., 2013). The level of activities undertaken by the older adults decrease with age depending on muscle mass and strength. Between the ages of 30-80 years, muscle strength and muscle mass decrease by 50%. However, this can be prevented by undergoing resistance training (Patil et al., 2014). If physical activity is not maintained, other chronic medical problems arises. Physical activity is the key to making the older adults active and healthy. A study conducted in Ireland revealed that the rank of physical activity decreases with age and is associated with a decline in physical fitness (Naughton et al., 2011). This reveals that increased physical activity increases fitness and that any kind of physical activity is better than being inactive. The study also found the decline in muscle strength to be 1% for the physically active adults as compared to 50% for the inactive adults (Rasheed & Woods, 2013).
Lola attends Yoga classes when she has a chance and maintains garden at home. The garden maintenance is not hard but she also walks from the bus stop carrying groceries every day. It is clear that even though Lora is undertaking some physical, activities, they are not enough to maintain her muscle strength (Villareal et al., 2011). At this rate, she may not be independent in undertaking her daily activities in future. The best intervention would be to encourage her to take the yoga classes seriously and attend every day. She should also exercise regularly by jogging to maintain her strength.
Another factor that affects the independence of the older adults is malnutrition. In older people, malnutrition is common but frequently overlooked. With the older population projected to increase in future, the number of adults at risk of malnutrition is set to increase. The malnutrition prevalence increases with decreasing physical independence and frailty. With malnutrition, the older people experience loss in body weight and a decline in muscle strength and mass (Visvanathan, Newbury & Chapman, 2014). In the aging process, this is both an outcome and a process. Older people experience appetite losses, which may result to undesirable weight loss.
Malnutrition in older people can be because of different reasons. Physical factors such as lack of appetite and failure to feed oneself can lead to malnutrition (Rasheed & Woods, 2013). However, there are other non-physical factors such as economic and social economic factors. Most of the bolder people are retired and have no income flow. They may not have enough money to maintain a good diet. In addition, being alone can be depressing and lonely. Such factors are seen to reduce the appetite levels on the older people. For people like Lola who have no one to cook for anymore, cooking becomes a burden and an irritation. For the older people, taking light and prepared food can lead to more chronic problems like diabetes. In addition, for some adults, losing a loved one raises the stress level thus inducing a high appetite, which in turn lead to diabetes and other problems such as asthma (Volkert, 2013). As one gets old, the muscle energy and mass reduces which may in turn cause chewing and swallowing problems. This combined with other chronic problems associated with old age will ultimately lead to malnutrition. Rist, Miles & Karimi (2012) reported that 34.5 of the older people residing at home are at risk of undernourishment. The situation is worse with the economic conditions existing today.
Lola no longer cooks though she is not ill. She just does not feel like cooking since she has no one else to cook for any more. She depends on easy dinners like toast and crumpets for dinner. In addition, she is sometimes too tired and does not eat three times a day. She does not eat fruits, vegetables, and daily products on most days. In addition, she does not take enough fluids on daily basis. Lola has enough money to buy food but does not eat properly. For her age, malnutrition can easily kick in and affect her muscle mass and strength, which will ultimately limit her physical activities like walking to the bus stop. A good intervention would be to monitor her diet and make sure she eats properly.
The old people are at the risk of mistreatment by caregivers or other strangers. The World Health Organization has recognized older people abuse as a global problem. Older people abuse violates on their rights and affects their quality of life. Abuse refers to any action that causes harm or develops a risk of harm (De Donder et al., 2011). Older people with impairments are more possible to be abused. Specifically, older people with dementia are at a high risk of abuse. Dementia is a disorder of the mental processes and can be caused by brain disease, personality cages or impaired reasoning. The ageing process is associated with impaired reasoning and personality changes, which can cause dementia. As reported by Yan & Kwok (2011) after conducting a study in China, physical and verbal abuse is common for older Chinese living in Hong Kong. The percentage of caregivers who admitted to have displayed violence towards an older recipient of care was 62%. The high rate is contributed by shared living environment. The fact that shared living environment increases risk of abuse complicates the case given that the risk of abuse by strangers while living alone is high for older adults. In addition, living alone can lead to other complications such as failure to eat due to physical inactivity.
Physical abuse can lead to physical injuries, which deteriorates the health of an old person. However, verbal abuse is worse since it is not evident in most of the cases. For adults with Dementia for example, complains of verbal abuse can be viewed as the effects of the Dementia and not taken seriously (Friedman et al., 2011). This can elevate the Dementia problem or cause other problems such as depression. For Lola she lives alone in a safe neighborhood with supportive neighbors. However, she is exposed to foul language at the bus stop, which is disappointing to her. As her ageing process progresses, she may be forced to employ a caregiver. In such a case, she would be at risk of abuse either verbally and physically. Having no family to depend on, any cases of abuse may never be discovered. Lola should reside in a care giving home at her older age to prevent such occurrences. In addition, social changes can change the security situation in her neighborhood.
With the ageing process, several factors aggravate the risk of depression. These include sadness, weight loss, and aggravated pains, and aches, lack of motivation or feeling of helplessness (Bouchonville et al., 2014). These are common factors among the old people. Research has shown that 15% of the older adults are at a risk of depression. According to estimated from the WHO, adults above 65 years commit suicide more often than any other age group (Harvath & McKenzie, 2012). With the ageing population, increasing worldwide, identification and prevention of depression is paramount in controlling the increasing costs of health care. Increased depression rates are observed in brain disorders including dementia, stroke, and Parkinson’s disease.
In late life, many life changes occur such as retirement. Ones daily routine is disrupted and this can cause sadness, which can aggravate to depression. The level of satisfaction with life determines how one feels about one’s existence (Cahoon, 2012). In addition, depression leads to other medical problems such as dementia in which case one is at risk of other risks such as abuse. Depression can also lead to stroke which cause physical inactivity. Inactivity at old age as discussed earlier is dangerous since it reduces muscle mass and energy. In addition, the death of family members in the ageing process can cause loneliness and later depression. Combined with other issues such as appetite loss and lack of motivation, an older person can feel helpless (Fakhouri et al., 2012). All these factors are common with the older generation and depression.
Lola is satisfied with her life. She feels wonderful to be alive and energetic. However, she feels hopeless. Such a feeling is not good at her age. As she grows older, the feeling of hopelessness will graduate to sadness and then later to depression. Without proper social support, she is at risk of acquiring mental problems later in her life. The yoga class used to help her full energetic but since she does not attend daily, she sometimes feel weak. In addition, walking from the bus stop carrying groceries causes tiredness, which can aggravate to pain. Such factors can easily lead to depression. The best intervention in this case is increased social support (Rodda, Walker & Carter, 2011). Lola should attend yoga classes, interact with others, and make new friends. In addition, the yoga classes will help with her muscles thus reducing pain and aches.