Diagnosis, Treatment and Management of Asthma in Older Adults

Diagnosis, treatment and management of asthma in older adults 65 years and above
Introduction
There is a high prevalence of diseases in the older people. The older people are referred to those
aged 65 and above. Currently, various people of this age have been diagnosed with various
conditions and are under medications. Other people in the elderly population have been under
home based care due to their high need of special care as a result of sicknesses. These diseases
include diabetes, coronary heart diseases, arthritis, dementia and cataracts among others (Li et
al.2015). these comorbidities have been the highest percentage cause of morbidity and mortality
amongst the elderly. Many older people have been diagnosed with asthma and it has greatly
impacted their health and wellbeing. Statistics show that the people who mostly die of asthma
and other airway diseases are aged 55 and above. They mostly suffer this condition because of
the ageing pulmonary changes, the old people perception of dyspnea, asthma diagnosis
difficulties, medication and comorbidities burden. Asthma diagnosis difficulties, medication and
comorbidities burden has made asthma a distinct problem amongst the elderly that needs specific
examination, research and therapeutic intervention.
Background
There are key points that should be considered when making the diagnosis of asthma. Clinicians
have the responsibility of determining the episodic symptoms that led to the obstruction of the
airway / deterred the airflow, he/she has to determine whether the airflow obstruction is partially
reversible and determine the exclusion of the alternate diagnoses (U. S. Department of Health
and Human Services, Health, & National Heart Lung Institute, 2012).The health practitioner has
the responsibility of coming up with the right diagnoses through making focus of a detailed

medical history of the patient, focusing on the upper respiratory tract physical examination which
includes the chest and skin and also perform spirometry to assess reversibility and demonstrate
the underlying obstruction ("Asthma: pathophysiology, causes and diagnosis " 2014). This
should be done across all the ages when an asthma case is reported. Determination of an
increased FEV1 to 12% or more shows reversibility or a prediction of an FEV1 more than 10%
after a patient uses a short acting bronchodilator shows reversibility. There are special
considerations that should be made when making diagnosis of an elderly asthmatic patient.
His/her past history of any prior lung disease should be examined in which the inhaling of a
bronchodilator shown a FEV1 that is less than 60%. Nocturnal symptoms should be considered
as well to asthmatic patients who had earlier cases of COPD, the patient’s adverse drug reactions
and any other additional medical problem. The period of sickness should be examined to
establish any allergic components (Epstein & Nyenhuis 2019).
After making the nursing diagnosis, various interventions for treatment are made. One of these
interventions include giving an inhaler that should be used for daily basis to prevent
inflammation. nebulizers are given out which in solution form can be inhaled via inhalers
(Epstein & Nyenhuis, 2019). Nebulizers are composed of different types of medications. In this
study, we shall examine whether the commonly used nebulizer called ipratropium bromide
together with salbutamol is effective in the treatment of asthma in the elderly.
The Rationale for diagnosis
The rationale for the diagnosis, treatment and management of Asthma in the elderly is that there
are difficulties in successful treatment of asthma, medications and associated comorbidities. This
has made it a burden to the elderly and their families to treat the condition and has rendered them
medical seekers at most of the times for asthma treatment or its associated comorbidities.

Asthma has to some extent remained fatal to the elderly due to poor diagnosis. Research in this
topic shall make it possible to identify the right diagnosis for asthma and its associated
comorbidities and how to treat them to reduce an all-time care burden from the elderly and their
families. The PICO question in this research is that majority of the elderly are treated with
nebulizers whose components are ipratropium bromide and Salbutamol. what evidence is there to
show that nebulized ipratropium bromide should be combined with salbutamol to successfully
treat patients with life – threatening or acute severe asthma?
The aim and objectives of this review
One of the aims of this review is to identify the present nursing diagnosis towards the asthmatic
elderly patients and to assess the common treatment used in treating asthmatic patients. The
effectiveness of the treatment currently used shall be examined through research from Fiona
Stanley hospital and TLC aged care hospital. The respondents shall be inpatients in both the
hospitals and outpatients who have been diagnosed of asthma. Data shall be collected using
various data collection methods after which they shall be analyzed to determine the effectiveness
of the current asthma diagnosis and treatment.
Research methodology
Data collection methodology shall involve systematic reviews and meta-analysis, Randomized
control Trials and cross sectional surveys. Systematic reviews and meta-analysis are
advantageous over the other methods because they give a definite answer towards a specific
research question based on the current available evidence. Its implications are very reliable as
compared with other methods. They summarize various studies findings to create more
understanding and reduce bias due to accurate conclusions made. They help in establishing the