COMMUNITY NURSING 3: Report on the Aged Population in Melrose, MA

This community nursing report focuses on the health needs of the aged population within the Melrose, Massachusetts community. It begins with an executive summary that highlights the identification of the elderly as a vulnerable group, detailing the causes and consequences of their vulnerability, and emphasizing the importance of community resources. The report provides an overview of the aged population, discussing risk factors like mental and physical impairments, and barriers to healthcare access. A windshield survey reveals the demographic composition of Melrose, including the percentage of elderly residents and their living conditions. The report identifies various community resources, such as hospitals and senior living services, while also pointing out the lack of certain facilities like mental health clinics. A key objective is established: reducing emergency department visits due to falls among older adults, which are recognized as a significant health concern leading to morbidity and mortality. The report concludes by summarizing the vulnerabilities of the geriatric population, the available healthcare resources, and the primary nursing goal of reducing fall-related hospitalizations.

Running head: COMMUNITY NURSING
A community report on aged population
Name of the Student
Name of the University
Author Note

1COMMUNITY NURSING
Executive summary
Identification of a vulnerable population group and determining the cause and consequence of
their vulnerability is of primary concern. It is an essential social task. The report aims to identify
a vulnerable population in the Melrose community and will illustrate the community resources
that are available for the identified group with the help of a windshield survey. The older
population will be elaborated in this report and the factors that increase the risks of chronic
physical and mental disorders among them will be discussed. The community report will further
determine a health objective and will shed light on the practices that are needed to be followed to
achieve that health objective.

2COMMUNITY NURSING
Table of Contents
Overview of the vulnerable population...........................................................................................2
Risk factors and barriers..................................................................................................................3
Community Resources.....................................................................................................................4
Community health problem diagnosis.............................................................................................4
Summary..........................................................................................................................................5
References........................................................................................................................................6

3COMMUNITY NURSING
A community report on aged population
The report is based on the Melrose community. Melrose is a city, which is located in
Middlesex County, Massachusetts (Greater Boston metropolitan area). According to the 2016
Census, its population is around 27,928. The community is basically a suburb, found the north
direction from Boston at a distance of approximately seven miles (Cityofmelrose.org, 2017). The
City of Melrose was founded in the year 1900. There are several schools and healthcare facilities
located in the region. The purpose of the assignment is to assess the community health needs of
the elderly population of the neighborhood and to identify the different risk factors and barriers
that impair their health.
Overview of the vulnerable population
Older adults have been chosen for this community report as they are more vulnerable to
health disasters due to several reasons. Mental and physical impairments are generally seen
among the older population and this creates difficulties for them to take self-care (Cahir et al.,
2014). This creates difficulties for them to reach the nearby healthcare centers and can also lead
to imminent death (Abad-Díez et al., 2014).
Reports from the windshield survey suggest that the predominant median age of the
community is 41.4 years and there are 48.8% males, and 51.1 % females. The older vulnerable
population is present at a rate of 15.8% in the region. Handicapped people show either physical
or mental impairments. Elderly females were found to walk using walkers, without the assistance
of wheelchairs. Many old people were found to congregate in groups in the neighborhood and
engage in conversations. Moreover, the presence of handicap access in the buildings and
sidewalks facilitate transportation of the vulnerable group. The older population has been found

4COMMUNITY NURSING
to participate in taking care for their grandchildren at homes. Several elderly people were found
to participate in different activities in the assisted living homes. Therefore, the potential health
problems prevalent among the older adults residing in the community were identified to be
injuries due to issues in behavioral health, decrease in years of life and the increase in burden
that occurred due to chronic illness such as obesity, arthritis, respiratory trouble, cardiovascular
disease and stroke.
Risk factors and barriers
Notwithstanding their physical and mental limitations, it is often found that older adults
contribute meaningfully to the improvement of health of their community, society, and family
members. The strengths of an elderly population lie in the fact that they are involved in
mentoring the youth population on their life. Older people often give unconditional love to their
grandchild, which helps in building family binds. They are also engaged selfless volunteering
services in the community (Dong & Simon, 2014).
The majority of disease burden that arises in older people is due to the presence of non-
communicable chronic diseases such as cancer, cardiovascular, respiratory, and mental disorders.
The poor people have low access and coverage for these diseases, which ultimately creates
adverse health effects and leads to an increase in mortality (Prince et al., 2015). The article
further illustrated that lack of income security and low social protection worsens the condition.
The presence of appropriate care services and reforms will help in developing a framework for
integrated care and will increase attention to the demands of older people. This will help in
limiting their dependence and disability.

5COMMUNITY NURSING
Community Resources
There are many hospitals located in the region that provide care to the patients who are
vulnerable. The Melrose-Wakefield hospital is one of them, which works towards providing
patient-centered care services. There is lack of urgent clinics and family planning services. Most
of the doctors have clinics outside the community. There are 2 dental offices and orthodontic
offices that practice alternative health practices. Acupuncture and yoga facilities are also present
in the community (Cityofmelrose.org, 2017).
4 nursing homes are built with the aim of providing temporary or permanent care to the
population. There are 2 senior living services and 1 rehabilitation centre that offer assistance to
senior citizens in a friendly environment. However, no mental clinics, mobile health facilities or
homeless shelters are present. Most of the resources are thereby appropriate to provide health
assistance to the vulnerable group. The presence of a mental clinic would prove extremely
beneficial.
Community health problem diagnosis
The health objective that has been selected for the aforementioned vulnerable population
is “Reduce the rate of emergency department (ED) visits due to falls among older adults” (OA-
11) (Healthypeople.gov, 2017). Falls among older adults lead to morbidity and mortality. They
regarded as avoidable injuries and are influenced by various factors. The major falls occur when
elderly persons drop from a standing position, or from elevated positions like stairways
and ladders (Kennedy et al., 2014). This severely impacts their health, leads to fractures,
abrasions and dislocations and can often cause serious brain injuries, which may lead to death.
Thus, the quality of life gets deteriorated.

6COMMUNITY NURSING
The objective aims to reduce the hospitalization rates that occur due to falls in the
geriatric population. The objective can be achieved by providing support to the elderly in taking
simple steps while walking, discussing their health conditions with the family members and
identifying problems in self-health management (Bekhradi et al., 2014). Improving their
strength, gait and balance by the assistance of a physiotherapist and seeking the help of an
occupational therapist to improve the lighting, floors and stairs in the household wil minimize
chances of these incidents (Hong et al., 2016).
Summary
Thus, it can be concluded that there are several conditions such as age, poor health and
living conditions, lack of healthcare access and decreased satisfaction with life that make the
geriatric population a vulnerable group in the community. Frailty in the population describes the
age-related deterioration of physiological systems that decreases their functional capacity, and
leads to adverse health outcomes such as morbidity, hospital admission, disability, dependence
and death. The Melrose community has several healthcare resources for the old people. This
report recognized falls among the elderly as one of the major health concerns and stated that lack
of support, problems in balance and gait and chronic health conditions increase the incidence of
these falls. Thus, the primary nursing goals would be to reduce hospitalization rates that occur
due to elderly falls in the community.

7COMMUNITY NURSING
References
Abad-Díez, J. M., Calderón-Larrañaga, A., Poncel-Falcó, A., Poblador-Plou, B., Calderón-Meza,
J. M., Sicras-Mainar, A., ... & Prados-Torres, A. (2014). Age and gender differences in
the prevalence and patterns of multimorbidity in the older population. BMC
geriatrics, 14(1), 75.
Bekhradi, A., Yannou, B., Farel, R., Jena, S., & Zimmer, B. (2014). Simulating global utility of
design solutions to elderly falls by building relevant usage segmentation. In DS 77:
Proceedings of the DESIGN 2014 13th International Design Conference.
Cahir, C., Moriarty, F., Teljeur, C., Fahey, T., & Bennett, K. (2014). Potentially inappropriate
prescribing and vulnerability and hospitalization in older community-dwelling
patients. Annals of Pharmacotherapy, 48(12), 1546-1554.
Cityofmelrose.org. (2017). Home - City of Melrose Massachusetts. City of Melrose
Massachusetts. Retrieved 11 November 2017, from https://www.cityofmelrose.org/
Dong, X., & Simon, M. A. (2014). Vulnerability Risk Index Profile for Elder Abuse in a
Community‐Dwelling Population. Journal of the American Geriatrics Society, 62(1), 10-
15.
Healthypeople.gov. (2017). Search the Data | Healthy People 2020. Healthypeople.gov.
Retrieved 11 November 2017, from
https://www.healthypeople.gov/2020/data-search/Search-the-Data#objid=4971;

8COMMUNITY NURSING
Hong, C., Won, C. W., Kim, B. S., Choi, H., Kim, S., Choi, S. E., & Hong, S. (2016). Gait speed
cut-off point as a predictor of fall in community-dwelling older adults: three-year
prospective finding from living profiles of elderly people surveys in Korea. Korean
journal of family practice, 6(2), 105-110.
Kennedy, B. K., Berger, S. L., Brunet, A., Campisi, J., Cuervo, A. M., Epel, E. S., ... & Rando,
T. A. (2014). Geroscience: linking aging to chronic disease. Cell, 159(4), 709-713.
Prince, M. J., Wu, F., Guo, Y., Robledo, L. M. G., O'Donnell, M., Sullivan, R., & Yusuf, S.
(2015). The burden of disease in older people and implications for health policy and
practice. The Lancet, 385(9967), 549-562.