Advanced nurse role in the era of digital health care: opportunities and challenges

Abstract

<p>The United Nation Decade of Healthy Aging 2021-2030 calls for proactive and collaborative strategies to optimize the functional capacity and thereby enable ‘living well’ of older adults. As the World Health Organization defines functional capacity of older adults as the compatibility of their intrinsic capacity (IC) of older adults and the environment, the Integrated Care of Older People (ICOPE) is promulgated as a comprehensive framework to guide the IC assessment and thereby sensitive care prescription to promote healthy aging.</p><p>In this presentation, the speaker will present a nurse-led capacity-building initiative which adopts the WHO-ICOPE approach to promote the healthy aging in Hong Kong. From Sept 2022 to Jun 2023, a nursing team has conducted a territory-wide ICOPE-based comprehensive health assessment to about 3,000 older adults from seven geographic regions in Hong Kong. Those who have signs of accelerated aging were referred to a 12-week Jockey Club Pathway to Healthy Aging Program (JC Path-HA Program). The Program adopts a health-social collaborative approach, together with the concepts of clinical critical pathway, empowerment-based behavioral modification and health-orientated peer support, to offer person-centered care to optimize the functional status of the older adults.</p><p>Referring to the health screening data (N=3,070), the prevalence of accelerated aging, which defined as a decline in two functional aspects of the ICOPE model, is more than 50%. Among the five dimensions, the physical functioning and metabolic health of the older adults are most affected. By latent class analysis, four composite health profiles were identified, including the musculo-mobility class, the metabolic-sensory class, the nutritional-metabolic class and the psycho-cognitive class. </p><p>Among this cohort, a total of 806 older adults with accelerated aging were referred to the JC Path-HA Program. Goal-oriented person-centered functional optimization care plans were provided. Multiple strategies including health coach enhanced health counseling, case management lifestyle monitoring and multi-media health coaching were provided according to the individualized health needs. Outcome-focused evaluation identified the significant improvement in their mobility function, hand grip, nutritional status, cognitive function, and geriatric symptoms including insomnia and depressed mood. They were found to report a significantly better quality of life. The JC Path-HA Program is still ongoing. Based on the interim experience, the speaker will share the opportunities and challenges of rolling out the care model to promote healthy aging in aligning with the global advocacy. The presentation will be concluded with a number of remarks to inform the future initiative to prepare the society for population aging.</p>