Introduction
Due to the sedentary lifestyle and a lack of physical activity, older adults are prone to developing pressure ulcers. Other risk factors faced by the elderly are flawed community infrastructure, deplorable home conditions, and relationships within the family. These factors may lead to a less active lifestyle and affect the health conditions of older adults. Furthermore, there is a risk of poor nutrition, since the elderly might often neglect the significance of consistent food intake. Therefore, to minimize the risks of developing pressure ulcers among older adults, there is a need for a comprehensive care plan.
Priority-Nursing Diagnoses
As a first step, it is crucial to properly determine priority-nursing diagnoses based on the health risks among older adults. The most significant factor in the diagnosis is the priority of the needs of the patient. Since pressure ulcers are not immediately life-threatening, the priority-nursing diagnosis should be conducted based on the biological and physiological needs of the patient. In the case of pressure ulcers, the two priority-nursing diagnoses are directly the evaluation of the injury and the issues that led to the immobility of the patient. Frequently, these factors include fractures, post-surgical procedures, spinal cord injuries, and progressive neurological disorders. It is vital to determine which of these ailments have caused immobility to propose the care plan for the patient.
Strategies to Address Nursing Diagnoses
There are a few strategies to address the above-mentioned nursing diagnoses and to avoid the expansion of pressure ulcers. The first strategy to address the injury is the constant repositioning of the patient. It is vital to rearrange the position of the patient every two to three hours to avoid the pressure on particular local points. As Mervis and Phillips (2019) state, the groups of people that are repositioned every two hours recover faster than the groups that are repositioned every three or more hours. Furthermore, the head of the bed should be angled as low as possible to decrease the amount of shear and friction force on the patient (Mervis & Phillips, 2019).
The second strategy addresses the specialized support surfaces that are used for accommodating patients. Nowadays, there is a high variety of beds, mattresses, and other types of pads to minimize the friction force on the patient. There are mainly two types of overlays designed for patients with the injury – low pressure (CLP) and alternating pressure (AP) devices (Mervis & Phillips, 2019). The former type is a high-quality surface that adjusts to the body type of the patient. The latter one is an overlay that constantly changes with the help of air-filled compartments, therefore, equally distributing the weight of the patient. Both support types have their advantages and disadvantages, but scientists are still uncertain whether one of the types is superior to another (Mervis & Phillips, 2019).
Another strategy concerns the nutrition of patients with pressure ulcers. Diet plays a significant role in the wound healing process and is crucial to the recovery from pressure ulcers (Saghaleini et al., 2018). Malnutrition may cause such problems as unplanned weight loss, lower resistance to infections, and slower wound healing. Weight loss in the range of more than two percent in a week or more than five percent in a month is a sign of severe malnutrition (Saghaleini et al., 2018). Weight deviations of such impact should be considered a major risk for pressure ulcer development (Saghaleini et al., 2018). Furthermore, poor nutrition might lead to skin breakdown due to a lack of vitamins (Mervis & Phillips, 2019). A patient must be provided with a diet consisting of high-protein supplements and vitamins A, C, and E since these complements are vital for wound healing (Saghaleini et al., 2018).
Disaster Management Plan
The selected aggregate is highly susceptible to pressure ulcers largely because of the sedentary lifestyle. Besides, some situations force people to such an inactive way of living. For instance, natural and human-made disasters might cause severe economic damage and leave thousands of people homeless. During the relocation process, a significant number of people are immobilized and prone to injuries such as pressure ulcers. Furthermore, natural disasters might directly cause injuries and worsen various chronic diseases. De Carvalho et al. (2017) stated that injuries like pressure ulcers and infected wounds are the most prevalent complications in the postsurgical period after natural disasters. It is a nurses’ responsibility to look after the patient, preventing them from developing such conditions,
Taking into consideration the wide prevalence of pressure ulcers resulting from natural disasters damage, there is a critical need to create preventive and management strategies to reduce the risks. One possible strategy to minimize the damage from natural disasters, like hurricanes and floods, is to immediately provide shelter and food to the victims. It is particularly relevant to accommodate people who not only lost their homes but who also became immobilized or had severe injuries. Timely actions and prompt providence of medical care will minimize the risk of ulcer development.
Moreover, in such critical situations, where many people are injured and kept in the same facility, it is challenging for nurses to look after each patient properly. Immediate shelter organization would allow reducing the number of possible casualties in the post-disaster phase. Additionally, it will prevent the patient’s from prolonged care and further inquiry of collateral illnesses. This strategy is especially significant for coastal cities like Miami, as there is a permanent danger of hurricanes, floods, and even sea level rise. However, it is essential not only to shelter the victims but to also constantly work on the improvement of the living conditions.
The location of Miami exposes its residents to various natural disaster risks, whereas it is the government’s responsibility to enact as many strategies to prevent or effectively manage them. The geographical location of the city is the underlying cause of all-natural disasters happening in the area. Low-lying Miami is highly prone to tsunamis and rising sea levels. In case of any inconvenience, it is the official’s responsibility to provide immediate shelter to the victims ensuring high-class medical care. On the medical staff side, it is critical to deliver care that will prevent the development of supportive diseases, one of the most common being pressure ulcers.
Another type of natural disaster that is particularly dangerous for older adults is heat. While within normal parameters, it does not pose a threat to the accustomed people of Florida; it promotes a more sedentary lifestyle for the elderly. Furthermore, extreme heat is not uncommon for Miami, and it may cause even further troubles for the aggregate population. Hospitalization resulting from heat weather conditions provokes a high risk of developing collateral skin diseases, including pressure ulcers. Lack of moisture and proper hygienic care lead to the development of ulcers accompanied by pain, depression, and, most critically – infections. For older adults, such conditions may result in various consequent inconveniences, including further health deterioration, prolonged patient suffering, longer hospitalization, early mortality, and increased cost of treatment (Jaul et al., 2018).
The possible solution to this problem is the improvement of infrastructure. Creating more opportunities for physical activity for the elderly is vital in promoting a more active lifestyle. Besides, the facilities for exercises should ideally be indoor and have proper thermoregulation. Summing up, it is crucial to create more stimuli for older adults to give up a sedentary lifestyle and move more to minimize the risks of the development of pressure ulcers.
It is also essential to have a proper disaster supplies kit ready in case of a possible natural disaster. Such a kit should necessarily include the supplies of water and non-perishable food for several days, a first aid kit, and a change of warm clothing. There is a high chance that roads would be inaccessible after the natural disaster, and people would have to survive on their own for several days. Therefore, it is recommended to have a sufficient amount of food and water, enough to survive a couple of days. If possible, one should also have a flashlight, a whistle, a battery-powered radio, and a few extra pairs of clothing.
Conclusion
To conclude, pressure ulcers pose a particularly serious threat to older adults due to their sedentary lifestyle. Additional health risk factors for the elderly include poor nutrition and flawed community infrastructure. Furthermore, the conditions might worsen significantly for the aggregate due to the unstable hydrometeorological conditions in Miami. Therefore, there is a necessity for a comprehensive care plan to minimize the risks of the development of pressure ulcers among the elderly.
References
De Carvalho, M. L., Freitas, C. M., & Miranda, E. (2017). Evidence in the literature about physical rehabilitation after natural disasters. In W. L. Filho & L. E. de Freitas (Eds.), Climate change adaptation in Latin America (pp. 429-444). Springer International Publishing.
Jaul, E., Barron, J., Rosenzweig, J. P., & Menczel, J. (2018). An overview of co-morbidities and the development of pressure ulcers among older adults. BMC Geriatrics, 18(1). Web.
Mervis, J. S., & Phillips, T. J. (2019). Pressure ulcers: prevention and management. Journal of the American Academy of Dermatology, 8(4), 893-902. Web.
Saghaleini, S. H., Dehghan, K., Shadvar, K., Sanaie, S., Mahmoodpoor, A., & Ostadi, Z. (2018). Pressure ulcer and nutrition. Indian Journal of Critical Care Medicine, 22(4), 283-289. Web.