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Health Promotion and Disease Prevention: Osteoporosis in the Geriatric PopulationKailey HamrickAuburn University/ Auburn University MontgomeryHealth Promotion and Disease Prevention: Osteoporosis in the Geriatric PopulationAccording to the Centers for Disease Control and Prevention (CDC, 2013), by 2030 20% of the United States population, approximately 72 million people, will be geriatrics over the age of 65. With these numbers predicted to grow so rapidly and extensively, healthcare providers must be ready to handle the unique challenges that caring for older adults entail. The geriatric population has unique health promotion and disease management needs when compared to those of adults under the age of 65. To best educate this population on their unique needs, healthcare providers must be aware of the changes older adults experience that affects how they learn. Many geriatrics have physical changes, such as decreased eyesight and hearing, psychological changes, such as trouble with their memory and problem solving, and socio-cultural changes, such as a decrease in independence and confidence (Kececi & Bulduk, 2012). Effective health-management programs that consider these differences when teaching geriatrics key healthy behaviors, such as getting recommended screenings, can help the population manage their chronic diseases better and prevent or delay associated conditions and disabilities (CDC, 2013).One such disease relatively unique to the geriatric population is osteoporosis. Osteoporosis weakens the bones, which can lead to fractures, pain, impaired mobility, and possible mortality (Perry & Downey, 2012). Approximately 10 million Americans over the age of 50 have osteoporosis and roughly 34 million have osteopenia, or low bone mass, which increases the risk for developing osteoporosis (AACE, 2010; Perry & Downey, 2012). As the geriatric population increases so will the number of patients with osteoporosis and the incidence of fractures and other complications secondary to the disease. Fractures can cause the patient pain and disability and increase their risk of mortality by 17-30% (AACE, 2012). For these reasons it is of utmost importance we educate our geriatric population to the best of our ability on osteoporosis and the preventative measures they can take to ensure a healthy life.John Keller created a model of motivational design called the ARCS model to help educators analyze their audience and create specific strategies to teach said audience (Keller & Suzuki, 2004). The ARCS model involves four components; attention, relevance, confidence and satisfaction. Keller believed to effectively teach, the learners attention must be gained, the relevance of the information to the learner must be established, the learner must have confidence that successful outcomes can be obtained, and learner must experience satisfaction upon completion of the education (Keller & Suzuki, 2004). This was the model used to educate the geriatric population seen by Dr. Ramroop at the Montgomery Family Medicine Associates office on osteoporosis risk, prevention, and screening. Dr. Ramroop is a board certified family practice physician who has a large geriatric patient population. She therefore felt it especially important to focus on osteoporosis and fracture prevention in order to help decrease the risk of serious complications in a large portion of her patients. Together we came up with a flyer on osteoporosis to give to patients over the age of 65. The patients reviewed the flyer in the office as well as took the flyer home for continued education on osteoporosis, fall, and fracture prevention. This flyer focused on why osteoporosis matters, who should be checked, risk factors, reducing risk, and preventing falls/fractures. The flyer was printed in large bold font to cater to common vision changes in the geriatric population (see Appendix A for the flyer). Pictures were also used to enhance understanding of the disease and gain their attention. The flyer was given to qualifying patients for them to review before seeing Dr. Ramroop and myself. After reviewing the flyer the patients were able to ask questions or concerns they had about what they had learned or not learned regarding their relevance with osteoporosis and its’ prevention. The qualifying patients were also given a flyer survey which had 4 questions meant to reflect the patients’ confidence in regards to osteoporosis prevention. Under each question was a scale of numbers one to 10 signaling the patients’ feelings on the flyer with one being none, five being average, and 10 being a lot. For question one, how much did you know about osteoporosis before the flyer, the average answer amongst the patients was 6.25/10. For question two, how much did the flyer help you understand your risk for osteoporosis, the average answer amongst the patients was 6.0/10. For question three, how much did the flyer help you understand how to reduce your chance of getting osteoporosis, the average answer amongst the patients was 7.25/10. For question four, how much did the flyer help you understand how to reduce falls at home, the average answer amongst the patients was 6.0/10. The patients where then asked for further feedback on the flyer in order to comprehend patient satisfaction toward the education material. A comment made by a patient was that he didn’t understand the picture of bones. A few patients had just had a DXA scan and osteoporosis screening done in the previous month so the flyer did not tell them much that they did not already know. Some patients however stated they did not know a great deal about osteoporosis before the flyer and liked it because it opened their eyes to something they did not know they were at risk for and could help prevent. Disease prevention is important because thwarting diseases before they occur allows for people to live long and healthy lives as well as reduce healthcare costs. In order to give patients the optimum medical care possible, primary healthcare providers cannot only treat active diseases, they must continually educate patients on ways they can prevent future diseases and their complications.ReferencesAACE. (2010). American association of clinical endocrinologists medical guidelines for clinical practice for the diagnosis and treatment of postmenopausal osteoporosis. Endocrine Practice 16(Suppl 3).Centers for Disease Control and Prevention. (2013). The state of aging and health in America. Retrieved from , A., & Bulduk, S. (2012). Health education for the elderly. Retrieved from , J. M., & Suzuki, K. (2004). Learner motivation and e-learning design: A multinationally validated process. Journal Of Educational Media, 29(3), 229-239. doi:10.1080/1358t65042000283084Perry, S. B., & Downey, P. A. (2012). Fracture risk and prevention: A multidimensional approach. Physical Therapy, 92(1), 164-178. doi:10.2522/ptj.20100383Appendix AOSTEOPOROSISWhy does it matter??? Weakens the bones and increases risk for fractures (bone breaks), pain, disability, and deathWho should be checked??Women older than 65 OR Younger women post menopause and men with risk factorsRisk FactorsPrevious fractureFamily history of hip fractureLoss of 1.5 inches of height Daily steroid useLow body weight (less than 127 pounds)Current smoker/ alcohol drinkerChronic liver disease Reducing RisksCalcium- dairy, medsVitamin D- fish, medsAlcohol- less than 2 drinks dailySmoking- stopWeight-bearing exercise- (walking) 30 minutes 3 days a weekCaffeine- No more than 2 drinks/day (coke)DXA scan every 2 yearsPrevent falls/ fractures: nonskid mats, no clutter on the floor or loose wires, light hallways, wear sturdy, low-heeled shoes ................
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