Health Education for Older Adults

Older adults are the fastest growing population in the United States. This requires a large portion of healthcare resources to be exhausted in attempts to keep these patients healthy and living longer. In 2008, 38.7 million Americans were 65 or older. This number will double to 72 million by 2030.1

The World Health Organization defines health as a “state of complete physical, social and mental well-being and not merely the absence of disease or infirmity.”2 Health promotion is becoming more popular with policy makers and has always been an important part of achieving optimal health. The key components of health promotion are prevention, promotion and health education.2 Effective patient teaching is an essential part of achieving optimal health. As the population ages, traditional teaching tools and techniques are becoming less effective and more difficult for patients to understand.1

Developing health education techniques tailored to the elderly population can increase adherence to prevention strategies and treatments. The older adult population confronts numerous age-related changes that make it more difficult for them to learn and understand information presented to them. Normal aging causes changes in the physical and sensory capabilities of older adults.

Effect of vision changes: Presbyopia is the most universal age-related visual change. As we age, our eyes begin to change shape, causing diminished acuity. Older adults are more likely to wear glasses or corrective lenses to improve their visual acuity.3 Other age-related changes that can affect the older population are cataracts, glaucoma and macular degeneration.3 Normal aging processes decrease peripheral vision, depth perception, tolerance to glare, and the ability to adapt to light changes.4 Difficulty with color absorption also develops with age. This causes an inability to distinguish among colors, especially on the cool end of the spectrum.3 These colors include blue, green and purple.3,4

Effects of auditory changes: Numerous changes in the ears cause difficulty hearing and distinguishing sounds. An increase in rigidity of the small bones in the middle ear, decreased elasticity of the eardrum, and atrophy of the inner ear are all normal age-related changes.3 High-frequency sounds and consonants, (f, g, k, s, t) as well as two- syllable words, are difficult to understand.When voices and sounds are in a lower pitch, the patient better deciphers them.3 Speaking louder does not improve an older person’s ability to hear and understand.3,4

Effects of memory changes: Aging can also affect memory and recall information. It may take longer for information to be retained and recalled in older adults than with a younger population.6 Often, elderly patients have a difficult time retaining and storing information due to the pace at which it is presented. Working memory is diminished at older ages and can cause a need for increased learning time.6

SEE ALSO: Pain Assessment in Seniors

When developing a positive learning environment for older adults, it is important to cater to their potential deficits. Strategies include the following:

  • Lighting should be soft white with very little glare.5
  • Maintaining eye contact and keeping your mouth visible to patients with visual and hearing impairments improves understanding.5
  • The learning environment should be free of distractions.3
  • Keeping learning sessions to only five or less teaching points will improve retention and understanding.3
  • Using a variety of media (i.e., written material, illustrations, oral presentations and practice sessions) allows learning to be supported, even if the patient has difficulty understanding a specific type of material.5
  • Printed materials should be created to benefit the patient and allow for him or her to take them home and have time for review and self-paced learning.6 Material should be prepared in 12- to 14-point type; Times Roman font is considered the easiest to read.5 Information should be written in both upper and lower case letters. Using colors from the warmer end of the spectrum (red, orange, yellow) enhances visibility.5
  • Language should be free of medical jargon and should be written at a fifth- to eighth-grade reading level.Doing so ensures that most elderly patients will be able to read and comprehend the information presented.

Lana Reinhardt is a family nurse practitioner at the University of Pittsburgh Medical Center in Pittsburgh.

References
1. Pearson M. Gerogogy in patient education-revisited. Okla Nurse. 2011;56(2):12-17.

2. Young K. Health, health promotion and the elderly. J Clin Nurs. 1996;5(4):241-248.

3. Speros C. More than words: promoting health literacy in older adults. Online Journal of Issues in Nursing. 2009;14(3):6.

4. Ruholl L. Tips for teaching the elderly. RN. 2003;66(5):48-52.

5. Best J. Effective teaching for the elderly: back to basics. Orthop Nurs. 2001;20(3):46-52.

6. Shields Rigdon A. Development of patient education for older adults receiving chemotherapy. Clin J Oncol Nurs. 2010;14(4):433-441.

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