Question

Discuss what policies might a residential facility develop to minimize the chances that its residences will develop "institutionalism"?

Discuss why such polices are relatively uncommon?

Determine which stage of Erikson's psychosocial development an aging adult may be in if they are suffering from institutionalism

Explain how understanding of the: social, emotional, cognitive, and physical development of the Aging Adult can be helpful in a clinical setting?

Answer 1

Institutionalism

Institutionalism refers to the Physical, emotional, social and behavioural effects on quality of life(QoL) of elderly patients due to their life in an institutional setup.
Active aging depended on the following factors:
⁃ physical, social and mental well being
⁃ Social participation
⁃ Protection
⁃ Safety
⁃ Proper care to avoid disabilities
⁃ Chronic diseases
⁃ Less use of health care services
The lack of care from the family is the reason behind the increase of institutionalisation which then causes community-dwelling aged people to become residents of nursing homes.
The main predictors of the institutionalization process are the following:
⁃ Advance age
⁃ Not having a home or a partner
⁃ Low educational level
⁃ Sedentary life style
⁃ Poor self rated health status
⁃ High number drug prescriptions
⁃ Functional and cognitive impairments
⁃ lack of support and assistance during daily activities

1.
The quality of life(QoL) of elderly people can generally measured by favourable perceptions of their position in life within a cultural context, in relation to their goals, expectations, concerns and desires.
To reduce the rate of institutionalism nursing homes should provide good quality of life for the elderly people with the implementation of following policies:
⁃ proper support system
⁃ Assistance for carrying out daily activities
⁃ Performance of Cognitive exercises
⁃ Increasing social interaction
⁃ Proper treatment for depression and anxiety
⁃ Increasing family visits
⁃ Emotional support from caregivers
⁃ Increase leisure activities
⁃ Effective communication
⁃ Empathetic consideration of needs of elderly
⁃ Efficient medical support system
⁃ Adequate nutritional and healthy lifestyle

2.
Why the above mentioned policies are uncommon ?
⁃ As a result of increased longevity and lower mortality, the number of elderly people is huge in worldwide.
⁃ Large economic burden caused by aging population
⁃ Multiple medical comorbidities
⁃ Complexities of family system
⁃ Functional and cognitive impairments.
⁃ Advanced age
⁃ Not having a home or a partner
⁃ Low educational level

3.
Erickson’s stages of psychosocial development:
It consists of 8 sequential stages of development of an individual which is influenced by the psychological, physical and social factors during the life span. A 9th stage was added by Erickson’s wife which considers challenges of continued aging. It includes features from all the other 8 stages of psychosocial development.
Elderly developing institutionalism belongs to the 9th stage in Erickson’s model.

4.
Proper understanding of the different aspects of development of aging adult is crucial for the proper management of elderly patients in a clinical setting. Often the elderly patients returns to their earlier stages of psychosocial development due to institutionalism and hence proper understanding of their unique problems has a pivotal role. These individuals often expect more care and attention from their care givers. Empathetic attitude considering their emotional needs soothes their mental disturbances. The regression of cognitive skills of these individuals affects their day to day activities. So they require continuous monitoring and supervision as well as assistance in daily acitivities. Advancement of age causes physical disabilities which restricts their abilities take care of themselves.
In summary, the proper understanding of the psychosocial stage of the aged adult helps to deliver adequate health care.