Barbara Resnick, PhD, CRNP, FAAN, FAANP


Topics in Advanced Practice Nursing eJournal. 2001;1(1) 

In This Article

Appropriate Health Promotion Practices for the Old-Old Adult

Health promotion has been defined as an approach to any health-related interaction or activity that is characterized by holism, equity, participation, collaboration, individualization, negotiation, facilitation, and support.[34] This characterization is in contrast to the management of acute illness, which is typified by a prescriptive, authoritative approach. In order to help older adults engage in health promoting activities, interpersonal skills such as active listening, responding to cues, reinforcement, and open questioning should be used. In light of the incidence of disease in the old-old age group, the pros and cons of screening should be addressed with these individuals, and the older adult helped to make educated decisions about participating in health behaviors to prevent disease ( Table 2 ).

While mammography is generally recommended as an important screening measure for the older adult, it is possible that after the age of 85 years, the risks and discomforts of mammography may outweigh the benefits.[35] Similarly, the recommendations for Pap smears are inconsistent and suggest guidelines ranging from screening every 3 years to no screening after the age of 65 years.[36] Moreover, recommendations for screening should be based on specific risk factors such as whether the woman is sexually active and/or if she had adequate screening with normal results prior to the age of 65 years.[37] These factors need to be discussed with the older woman to appropriately determine the need for screening and the risks/benefits of this procedure.

Likewise, aggressive, automatic attempts to control cholesterol in asymptomatic adults over the age of 75 years may not be appropriate.[38] However, monitoring the diet to maintain a reasonable weight is important to help maintain functional status and avoid exacerbation of degenerative joint disease.


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