Learning Objectives
By the end of this section, you will be able to:
- Discuss health challenges encountered with young adults
- Discuss health challenges encountered with middle-aged adults
- Discuss health challenges encountered with the older adult population
As individuals grow and develop throughout their lives, health challenges and health-promotion opportunities change. The type of health issues and methods of health promotion must take into consideration a wide range of factors, including health literacy, physical limitations, motivations, family dynamics, support systems, and access to health services. Creating health-promotion activities with these factors in mind can increase the success of the activity.
Young Adults
The young adult age group is 18 to 35 years old. Erik Erikson (a human growth and development theorist) described the goal of this age group as intimacy versus isolation and summarized the challenges for this group as trying to achieve affiliation, community, and love (Erikson, 1995). The major events in a young adult’s life include attending college or career training, entering the workforce, living independently for the first time, navigating a serious intimate relationship, becoming a parent, and making the adjustment to adulthood (Edelman & Kudzma, 2022). Accidental injury, via motor vehicle accidents primarily, is one of the leading causes of death in the young adult age group (CDC, 2024). When providing health promotion and patient education to young adults, nurses should keep in mind possible financial constraints (students or entry-level employees) and focus on building a healthy foundation for optimal health as they age (Table 3.4).
| Category | Education Topic |
|---|---|
| Nutrition |
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| Substance use |
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| Mental health |
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| Safety/violence |
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| Reproductive health |
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| Cancer screenings |
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| Infectious diseases |
|
Middle-Aged Adults
The middle-aged adult group comprises people ages 35 to 65 years old. The Erikson growth and development stage applied to the middle-aged adult group is generativity versus stagnation, which focuses on their need to be productive in society and make an impact on the world (Erikson, 1995). Most middle-aged adults are creating or raising a family and may also be needed to assist in the care of aging parents. Being in between these two groups and having to provide both groups with care earns the middle-aged adult group the nickname the “sandwich generation” (Edelman & Kudzma, 2022).
Cultural Context
Chronic Kidney Disease
For 37 million individuals in the United States, chronic kidney disease (CKD) is an everyday reality (Phillip et al., 2022). One of the identified social determinants of health, food insecurity, plays a significant role in the progression of CKD. Dietary choices directly impact complications such as high blood pressure. Notably, food insecurity is more prevalent among Black and Hispanic population groups (Phillip et al., 2022).
In the realm of CKD and associated diagnoses of high blood pressure, patient education and health promotion are indispensable for fostering self-management of the disease processes. While educating patients about healthy food choices is crucial, it becomes complex when dealing with patients experiencing food insecurity, influenced by factors such as food deserts and socioeconomic status. In these instances, nurses need to be mindful of tailoring information to the patient’s specific circumstances.
Addressing food insecurity involves identifying community resources that can provide healthy food options for affected patients. Additionally, a critical aspect of patient education for those with CKD and high blood pressure is the importance of a low-sodium diet. Unfortunately, readily available and affordable foods like potato chips, canned goods, processed meats, and snacks are often high in sodium. This poses a challenge for individuals facing food insecurity who may have limited access to healthier alternatives. The relationship between food insecurity and health conditions highlights the challenges faced by individuals striving to make healthy choices, particularly those contending with severe health conditions alongside food insecurity.
Health promotion for middle-aged adults should focus on disease prevention and lifestyle modifications for health optimization. The most common causes of death for middle-aged adults include cardiovascular disease, cancer, and unintentional injuries (CDC, 2024). Because of the large amount of modifiable risk factors associated with these causes of death, health promotion for the middle-aged adult is of great importance. A factor that a person can control that increases the probability that the person will get a disease is called a modifiable risk factor. An example of a modifiable risk factor is diet, whereas race, age, and genetic make-up are nonmodifiable risk factors. A nonmodifiable risk factor is a factor that is out of a person’s control. Identifying modifiable risk factors and educating patients about them is part of health promotion.
Self-destructive lifestyle behaviors such as cigarette smoking, alcohol and caffeine consumption, and unhealthy eating have become more of a problem for middle-aged adults (Eldeman & Kudzma, 2022). Middle-aged adults start to see the effects of these self-destructive lifestyle behaviors on their bodies and may seek out health-promotion information related to these issues (Table 3.5). Still, it is important for nurses to proactively promote lifestyle behavior changes as appropriate regarding these self-destructive behaviors.
| Category | Education Topic |
|---|---|
| Nutrition |
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| Elimination |
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| Physical activity |
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| Sleep |
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| Cognition |
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| Sensory changes |
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| Stress |
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| Menopause |
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| Caregiver role |
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| High-risk lifestyle behaviors |
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| Cancer screenings |
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| Oral health |
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Older Adults
The older adult age group, ages 65 years and older, is the fastest-growing age group (Edleman & Kudzma, 2022). The growth and development stage associated with older adults is integrity versus despair, which suggests that older adults are focused on whether their life has provided them personal satisfaction or has been wasted (Erikson, 1995). The mindset of this age group determines how engaged they will be with health promotion. An older adult who is satisfied with their contributions to society may have more motivation to maintain optimal health than an individual who feels like their life has been a waste of time and energy. People in the older adult age group are often finished raising kids, have retired from jobs, and are adjusting to a new lifestyle. A social determinant of health that is applicable to this age group is poverty since many older adults who are not working depend on Social Security benefits as their only income. Older adults have been found to have poor health literacy, which means that they may not readily comprehend or understand health concepts (Stewart, 2020).
Life-Stage Context
Meals on Wheels
America’s Meals on Wheels Program is a network of 5,000 programs across the nation that provide older adults with healthy meals to help decrease hunger and isolation (Meals on Wheels America, 2023). This rapidly growing population is considered at risk due to their fixed incomes (the inability to make more money), compromised health, and higher risk for malnutrition. Meals on Wheels America delivers 251 million meals a year to older adults. It improves their health, makes them feel more secure, and allows them to live independently for longer.
(Meals on Wheels America, 2023).
Falls are the most common cause of injury in older adults (CDC, 2023a). Fall prevention is crucial for older adults because falls are a leading cause of injury and loss of independence among this demographic. As individuals age, changes in balance, vision, and muscle strength increase the risk of falls. Implementing fall prevention strategies are essential, such as regular exercise to improve balance and strength, home modifications to reduce hazards, and medication management to minimize side effect that could lead to falls. By addressing fall risk factors, older adults can maintain their independence by reducing the likelihood of fall-related injuries that may result in hospitalization or long-term care placement.
Cognitive stimulation is another vital health-promotion topic for older adults. As individuals age, cognitive decline becomes more common, impacting memory, reasoning, and decision-making abilities. Engaging in activities that stimulate the brain, such as puzzles, reading, socializing, and learning new skills or hobbies, can help preserve cognitive function and delay the onset of cognitive decline or dementia. By promoting cognitive stimulation, older adults can maintain their independence by preserving their cognitive abilities, allowing them to continue living actively and autonomously for longer periods. Additionally, maintaining cognitive function enhances overall well-being and quality of life, enabling older adults to remain engaged and fulfilled in their daily activities and relationships
Health promotion for older adults should also focus on preventing new diseases and managing their chronic diseases (Table 3.6). Older adults are at increased risk for developing diseases like dementia, heart disease, type 2 diabetes, arthritis, and cancer (CDC, 2023b). Other topics to consider for health promotion in older adults include warning signs of dementia, caregiver wellness, screening and prevention of disease or disability, promotion of independence, and promotion of physical activity (CDC, 2023b).
| Category | Education Topic |
|---|---|
| Nutrition |
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| Elimination |
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| Physical activity |
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| Cognition |
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| Sensory changes |
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| Community |
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| Chronic disease |
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Link to Learning
Resources for Older Adults
The National Council on Aging presents the Center for Healthy Aging for Professionals. This resource provides evidence-based health-promotion information with the goal of helping older adults live healthier lives.