Nutritional Risk in an Urban Homebound Older Population, Essay Example

Two of the most important populations that require additional healthcare screening are the homebound and the at-risk.  Individuals that are restricted to their homes are either immobile or unable to leave.  Typically, this involves the handicapped and the elderly.  Meanwhile, at-risk populations include individuals that engage in at-risk behavior, such as sexual deviancy, transmission of fluids, and drug and alcohol abusers.  These unhealthy behaviors enable high prevalence of multiple diseases that can greatly impact the entire sociological environment in which these people live.  Within these populations, there is quite a bit of research that notes the importance of healthcare screening to allow for diagnosis of diseases and to provide treatment.

The most common problem within these populations is a lack of healthy nutritional status.  According to Millen et al. (2001), “nutritional status is poor in homebound persons of very advanced age with substantial co-morbidity and functional dependency” (p.275).  These researchers produced a study to examine the prevalence of disease and medical disorders within a select group of elderly individuals that were specifically homebound.  The results of the study showed that 77% of the subjects studies had three or more chronic medical conditions, over half of the subjects consumed diets that deviated from recommended standards, and 60% of subjects were diagnosed as either underweight, overweight or obese (Millen et al., 2001, p. 276).  This strong percentage of chronic medical conditions, poor nutritional diets and unhealthy physical conditions supported the researchers’ hypothesis that homebound and at-risk populations must receive healthcare screenings in order to avoid contracting harmful health conditions or risking unfortunate advancement.

Additional studies were provided that analyzed additional under-eating of homebound and at-risk subjects within multiple varying socioeconomic backgrounds and age groups.  The researchers Locher et al. (2008) declared results of their study that “found that 70% of participants were under-eating, defined as not consuming enough calories to maintain their current body weight” (p. 231).  Under-eating is a major cause of poor nutrition and the development of health disorders.  The study also stated that individuals that are at a higher risk of under-eating included men, people that receive infrequent or over-frequent care from a caregiver, people that had been hospitalized prior to receiving home health services, and people with a higher body mass index (Locher, et al., 2008, p. 231).  These multiple characteristics frequently exist within the majority of homebound and at-risk individuals.

Findings from the previous studies have soundly supported the inclusion of healthcare screening programs to diagnose, monitor and treat health problems within homebound and at-risk populations.  These studies, among other things, “provide an initial foundation for the development of targeted evidence-based behavioral nutritional interventions that are noninvasive and cost effective” (Locher et al., 2008, p. 232).  Furthermore, Zoidis & Dirican (1997) discussed the benefit of Nutrition Screening Initiative that included many different screening tools to help identify minor and major indicators of malnutrition and provide for effective, appropriate use of healthcare resources for treatment (p. A86).  It is important that researchers develop appropriate information to quantify screening procedures and health characteristics that enable healthcare professionals to properly diagnose and treat individuals within these populations.  The Nutrition Screening Initiative screening tool includes objective data such as height, weight, body mass index, albumin, and cholesterol to identify malnutrition more accurately in this population (Zoidis & Dirican, 1997, p. A86).  By identifying such problems as malnutrition, healthcare providers will be able to examine problematic health situations for the homebound and at-risk.  Without such screening options, these individuals can develop highly advanced medical disorders and spread disease within their social networks to many people.

References

Locher, J.L., Ritchie, C.S., Robinson, C.O., Roth, D.L., & West, D.S. (2008). A Multidimensional approach to understanding under-eating in homebound older adults: the importance of social factors. The Gerontologist, 48, 223-234.

Millen, B.E., Silliman, R.A., Cantey-Kiser, J., Copenhafer, D.L., & Ewart, C.V. (2001). Nutritional risk in an urban homebound older population: the nutrition and healthy aging project. The Journal of Nutrition, Health & Aging, 5(4), 269-277.

Zoidis, L.A., & Dirican, A. (1997). Enhancing the accuracy of the determine checklist for frail, homebound elderly. Journal of the American Dietetic Association, 97(9), A86.