Academic journal article Journal of Allied Health

Integrating Health Promotion, Patient Education, and Adult Education Principles with the Older Adult: A Perspective for Rehabilitation Professionals

Academic journal article Journal of Allied Health

Integrating Health Promotion, Patient Education, and Adult Education Principles with the Older Adult: A Perspective for Rehabilitation Professionals

Article excerpt

With demographic changes and an increase in the number and proportion of older adults, there is now a greater demand for health promotion and patient education by rehabilitation professionals who are experts in their respective fields and who are knowledgeable about normal and pathologic aging. Older adults are more at risk for chronic illnesses and are interested in learning more about their own health. Many interrelationships between health promotion, patient education, and adult education exist in the context of rehabilitation for older adults. Changes in the U.S. health care system have decreased resources for long-term rehabilitation so that interventions must have the maximal impact possible. Health promotion and patient education are within the scope of practice of rehabilitation professionals, but the effectiveness of these efforts are diminished unless concepts and approaches for teaching and interacting with older adults are used. This commentary discusses the rationale for integrating these three aspects of patient care. J Allied Health. 2003; 32:106-109.

PROFESSIONALS FROM THE DIVERSE rehabilitation disciplines of physical therapy, occupational therapy, and speech-language pathology (hereafter referred to as rehabilitation professionals) can enhance their traditional therapy with older adult patients by emphasizing principles from the fields of health promotion, patient education, and adult education in their practice. Incorporating the patient's perceptions of the problem and using teaching methods and tools targeted specifically to adult learners can have a positive impact on the effectiveness of the intervention. Rehabilitation professionals are routinely expected to educate patients about risk factors for disease, ways to maintain their health, and strategies to prevent a recurrence of a condition such as stroke or heart attack as part of their scope of practice.1-4 Thus, every effort should be made and every available tool used to ensure that the educational interventions are effective and obtain the highest functional outcomes possible.

Although most older adults are healthy, the risk of disease and chronic illness increases with advancing age,5 and the U.S. population rapidly is growing older. The population of adults age 65 and older increased from 20 million in 1970 to 34 million in 1994, nearly a 75% increase, and this group will number 50 million by 2050.5 At least 21% of adults age 65 and older have a disability, and 17% need assistance with one or more activity of daily living.5,6 Many older adults have multiple chronic health conditions,7,8 including arthritis, cardiovascular disease, hypertension, and diabetes.6

Changes in health care funding have shortened hospital stays and limited the time available for rehabilitation, requiring the rehabilitation professional to place a greater emphasis on patient education.9-11 Patients return home medically stable, but they may be unable to perform basic functional tasks related to self-care, work, and leisure activities. The patient and family are expected to assume increasing levels of care and need support to remain in their homes at the highest level of independence. Rehabilitation professionals should design and provide individualized patient education programs mindful of these parameters and considering the discharge environment and the patient and family's unique needs.12,13 Goals should be to decrease disability and to maintain healthy status in other areas.

Health Promotion

Rehabilitation professionals may be unsure about how to integrate health promotion into their current clinical practices. Traditional rehabilitation has focused on tertiary care by treating active diseases and medical conditions after their onset.14 The goals of primary prevention are to identify and eliminate potential risk factors, such as smoking, noise exposure, or obesity, that may predispose an individual to an illness or disability. By addressing these risk factors, the onset of a disease may be avoided, and the individual's susceptibility may be decreased. …

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