Week 4 Discussion 1: Pros and Cons to delivering Community Based Participatory care to those who are Vulnerable
The purpose of this study is to discuss how the APRN can apply the principles of Community-Based Participatory Research (CBPR) in identifying the health assessment needs of the elderly population; incorporating their health problems, health-related asset, cultural beliefs and behaviors, and to highlight the advantages and disadvantages of CBPR in promoting the health of the vulnerable elderly population.In the United States, the chronological age index of an older adult starts from 65 years, and health disparities among these groups of population vary from one person to another (Holtz 2013 p 482). Some older adults might be in good health while some other ages, 75 years and above, might be limited with comorbidities. Performing CBPR can be a governing methodology that assists in building alliances within the community members from conceptualization to dissemination of resources in a way to promote health equality among the elderly population ( Health Resources & Services Administration, 2019; Chesnay & Anderson 2016). According to Holtz (2013 p 489), the World Health Organization (WHO) adopted a concept referred to as Disability-Adjusted Life Expectancy (Dale) to determine the expected number of years to be lived in full. Although research studies provide insignificant information to establish the life expectancy of the elderly, however, the study categorized the elderly age group as young-old (65 years and above); oldest-old (85 years and over); and the centenarians (100 years and older, Holtz 2013 p 489-490).Multiple comorbidities are relatively common and increase the complexities of managing the elderly group. Health problems such as diabetes and its complications, hypertension, coronary heart diseases, musculoskeletal disabilities, Alzheimer’s/dementia, incontinence, to mention a few (Heflin 2020). These health problems place the elderly population at a greater risk of increased mortality (Pender 2015, p 257). In addition to their ill-health, poor social, distributive equity, and health illiteracy are other factors that further deters the older population from access to the resources they need to alleviate their health concerns. The elderly population becomes isolated, deprived, and worried about the end of life, which further complicates their needs. Completing the activities of daily living tasks becomes increasingly challenging for those oldest-old and the centenarians due to disabilities and lack of sufficient resources (Pender 2015, p77). To mitigate the elderly health problems and reduce mortality, the CBPR project implementation can identify the needs among the vulnerable older adult in the community and help direct resources through the utilization of the community healthcare works knowledge, the participation of the healthy older adults, and collaborative services. The advantages of CBPR are as follows:1. CBPR involves the community members who were initially disenfranchised from the research process to participate as co-investigators and to contribute meaningfully throughout all phases of the research design implementation. CBPR allows the data obtained from the health needs assessment strategy to be used to identify the potentially eligible participants of the focused population (Lumbay, 2018; Pender 2015, Heflin, 2020).To facilitate success and minimize the health disparities among the elderly population, the CDC advocates the identified health assessment to guide the implementation of resources for the elderly need obtained by the community healthcare workers in that area. The health care workers are the people who are indigenous to a target community, who understands the cultural norms, religion, and beliefs of the community, they associate with the vulnerable elderly and also specifically are acquainted with their health disabilities (Brown et al. 2019; Health Resources & Services Administration, 2019)2. CBPR is a collaborative investigation that equitably involves those affected by problems and is meant to educate and create social change. The Advanced Practice Registered Nurse (APRN) must acknowledge that understanding community culture, religion, and beliefs promote the dynamic that can translate complex health literacy into simpler formats. This understanding dispels the shame and social isolation often felt by the older groups so that the distribution of resources is easily accessible to meet the need identified by the community members. Alternatively, the lack of cultural understanding and health illiteracy can hamper the CBPR and defeats the goal of health promotion altogether ( Chesnay & Anderson 2016; Pender 2015).3. CBPR has an advantage in mobilizing financial resources to remote communities who are deprived of transportation for the elderly and promote workforce retention in remote communities. Accessing health resources is challenging for the disabled elderly and even the abled ones who have limited access to transportation with limited finances. Moreso, in remote communities, local health centers struggle with the retention of healthcare workers, which results in poor staffing and a lack of workforce to care for the elderly population in that community (Health Resources & Services Administration, 2019).4. CBRP can also simplify how the elderly can access their Medicaid resources and mobilizes the equity so that the elderly can afford the personal carer they need in meeting their activities of daily living, on-time food services delivery, and produce. The logistics for care delivery can be facilitated by the community groups who oversee the affairs of the elderly population ( Brown et al. 2019; Lonbay 2019; Heflin 2020).The cumulative disadvantages of CBRP’s are delays and the bureaucracy involved in the mobilization of care and resources to the elderly population (Health Resources & Services Administration, 2019). In most instances, the logistics involved in mobilizing these resources can involve complex official forms, official procedures, and ambiguous terminologies. Easier logistical formate can be adopted to prevent service delays by mobilizing the community members who understand the focus group (Brown et al. 2019).SummaryUnderstanding the cultural beliefs, health problems, and socio-economical needs of the elderly population is a stringent strategy in fostering CBPR (Holtz 2013, p 489-490). APRNs can participate in advocating for these vulnerable groups through the implementation of health policy and the promotion of health literacy publications (Brown et al. 2019; Health Resources & Services Administration, 2019). Once the CBPR is established, APRNs must collaborate with the local communities and other allied healthcare workers (e.g., social workers) to review the distributive process and ensure effective communication exists among these vulnerable groups to access required services and reduce the elderly disabilities and mortality rates.
Brown, A., F., Ma, G., X., & Miranda, J. et al. (2019). Structural Interventions to Reduce and Eliminate Health Disparities. American Journal of Public Health, 109, S72â€“S78. https://doi.org/10.2105/AJPH.2018.304844Chesnay, M. D., & Anderson, B. A. (2016). Caring for the vulnerable: perspectives in nursing theory, practice, and research. (4th ed.) Burlington, MA: Jones & Bartlett LearningHealth Resources & Services Administration (2019). Culture Language and Health Literacy.[Online]. Retrieved from: https://www.hrsa.gov/about/organization/bureaus/ohe/health-literacy/culture-language-and-health-literacyHeflin, M., T. (2020). Geriatric health maintenance. Uptodate. Retrieved from: https://www.uptodate.com/contents/geriatric-health-maintenance?search=Health%20promotion%20Vulenarble%20elderly&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1Holtz, C. (2013). Global Health Care: Issues and Policies. (2nd Ed.). Jones & Barlett Learning, Burlington, M.ALonbay, S., P. (2018). ‘These are vulnerable people who don’t have a voice’: Exploring constructions of vulnerability and ageing in the context of safeguarding older people. British Journal of Social Work, 48(4), 1033â€“1051. https://doi.org/10.1093/bjsw/bcy045Pender, N. J., Murdaugh, C. L., & Parsons, M. A. (2015). Health promotion in nursing practice (7th ed.). Upper Saddle River, N.J.: Pearson