1. NUR 429 Week 3 Wellness promotion- Healthy People 2010 Transition Theory Revisited Chronic Illness Clinical Conference

2. Wellness Promotion Prevention of illness will be the emphasis of the future health initiatives. We will see a balance of health care dollars spent on prevention and tertiary care. Currently only 10% of the health care dollar is spent on prevention Population based initiatives are underway : Healthy People 2010 Goals - To increase quality and years of healthy life To eliminate health disparities

3. Population based initiatives are underway : Healthy People 2010 Goals - To increase quality and years of healthy life To eliminate health disparities Indicators for a Community Health Profile Sociodemographic Characteristics Health Status Health Risk Factors Healthcare Resource Consumption Functional Status Quality of life

4. Healthy People 2010 Leading Indicators Physical Activity Overweight and Obesity Tobacco Use Substance Abuse Responsible Sexual Behavior Mental Health Injury and Violence Environmental Quality Immunization Access to Health Care

5. Five dimensions of wellness Review page 63 of text (Box 3-5) Self Responsibility Nutritional Awareness Physical Fitness Stress Management Environmental Sensitivity

7. Transitional stages in life Transitional periods help us understand aging from a sociologic perspective Age related transitions are socially created and shared and acknowledged The expectations placed on an individual by society will change as they transition through the various phases Society has recently embraced promotion of wellness concepts with aging so we are experiencing a change in societies perceptions (Freidman,2003)

8. Transitions from life events Birth Death Graduation Marriage Divorce Employment Unemployment Relocation Illness Grand parenting Retirement College War Natural Disasters Trauma Death of Spouse

9. Transitions of Older Adults Creates feelings of loss: Loss of control Loss of integrity Loss of self Loss of power Loss of purpose Loss of strength Loss of cherished relationships

10. Health- illness transitions Older adults experience more chronic illness and disabilities Transitions resulting from illness are complicated by: Pain Grieving Loneliness and isolation Loss of physical ability Loss of mental ability

11. Health- wellness transitions Focus on the importance of keeping physically and mentally active Stress socialization and community Stress health screening and prevention Encourages mental and physical preparation for the changes that will occur with aging Stress spirituality Encourages self- actualization Promotes life reflection and legacy-leaving

12. Family transitions with the aging adult

13. Zilbach’s Stages of the Family (Freidman et al,2003) Forming and Nesting- coupling, becoming three Middle Stages: Family separation processes – entrances, expansions, exits Last Stages: Finishing- Becoming smaller, death

14. Grandparenting In today’s society 11% of grandparents over 50 y.o. are raising grandchildren as primary care givers (AARP, 2000) Additional 8% of grandparents provide regular daycare for their grandchildren. (AARP,2000)

15. Middle age couples-caring for parents Eighty- six percent of middle-aged couples have at least one parent each still living. Daughters traditionally undertake the responsibilities of caring for the elder parent in our society (Freidman et al.,2003) Multiple intergenerational roles, relationships and responsibilities are the result for the middle aged couple

16. Marital Relationships for the older adult Now that the couple is really alone, after many years of raising children, there needs to be a conscious attempt to renegotiate the marital relationship as a dyad. Post-parental years for couples may result in: Bliss Bliss Blahs Blahs Comfortable rut Comfortable rut

17. Older adults negotiate transitions by: Self-talk Prayer Letting-go Realigning relationships Reframing decisions Giving-up Seeking support and resources ( permission from Dr. Gladden )

18. The Paradox of Time (1875) Time goes, you say? Ah no! Alas, Time stays, we go.

19. Chronic Illness (show DVD) “Living Old”

20. Next week Submit Wellness Assessment and Strengths Based Inventory Read Chapter 23, pages 616- 654 in text Read Chapter 21, pages 567- 599 in text