Ageing with Asthma

Jones et al. (2011) comment that ‘Despite the high prevalence of asthma in the elderly, its development, diagnosis, and treatment are under-researched’.

This is alarming when considering that the prevalence of asthma rises with age. Considering the ageing population, it can be suggested that asthma rates will continue to rise, increasing the burden of disease on the health system.

The Australian Institute of Health and Wellbeing (2017) conveys that as many as 1 in 9, or 2.5 million Australians have asthma! The death rate of asthma is 1.5 per 100,000 population; with Indigenous Australians nearly twice (1.9 times) as likely to have asthma than non-Indigenous Australians (AHIW, 2017). It is reported that only 20% of Australians over age 15 with asthma have a written asthma action plan and only 41% of children aged 0-14yrs (AIHW, 2017).

Another important factor to be aware of is that people with asthma are more at risk of anxiety, depression, lower self-reported quality of life, and feeling that they are not in control of their health (Jones et al., 2011). Therefore, there is a need to improve community awareness of asthma, self-management of asthma, diagnose and treatment of asthma for older adults, and understanding of asthma’s relationship to the ageing process.

Similarly, Gillman and Douglass (2012) assert that there is a need to improve self-management and treatment for older people with asthma.

They (Gillman & Douglass, 2012) state that there has not been adequate exploration of medication strategies for older populations, as medication strategies and self-management have often been focused on younger populations that may have dissimilar needs.

Ageing with Asthma – Age-Specific Concerns

A concern for older clients with asthma, that may affect adherence to treatment plans, can include the adverse effects of their medications (Gillman & Douglass, 2017). Moreover, older clients face diverse issues compared to many younger adults or adolescents in that their disabilities may restrict their ability to utilise their inhalers (Gillman & Douglass, 2017). Thus, reinforcing the need for further research into age-related asthma, as well as improved diagnosis and treatment of the condition and increased awareness of the ageing-asthma relationship.

When older people develop asthma, they are still likely to experience similar symptoms to other age groups, which includes: wheezing, coughing, shortness of breath, and chest tightness (Asthma and Allergy Foundation of America, 2017).

Asthma can be triggered by respiratory infections, viruses, exercise, allergens, or air pollution (Asthma and Allergy Foundation of America, 2017).

The reason that asthma can be more problematic for older people is that they are more at risk of complications (such as respiratory failure) from mild symptoms (Asthma and Allergy Foundation of America, 2017).

The Asthma and Allergy Foundation of America (2017) suggests that older people experiencing mild asthma symptoms could have equivalent breathing troubles to a younger person having a severe asthma attack. Another concern is that asthma is a threatening and chronic condition that is unlikely to go into remission for older adults (Asthma and Allergy Foundation of America, 2017). Furthermore, difficulties in diagnosis are issues for older clients – as earlier raised by Jones et al (2011) – as health professionals may interpret some asthmatic symptoms (e.g. cough-producing sputum) as results of other conditions or co-morbidities (e.g. heart failure) (Asthma and Allergy Foundation of America, 2017).

Resources

It is important to adhere to your organisational policies and procedures, and best practice standards; this being said, you may wish to look into quality improvement of your workplace services to see what kind of information you are able to provide your clients to help them manage their asthma. For example, the following resources provide checklists for older adults with asthma to better manage their symptoms, allergies and home environment (Asthma and Allergy Foundation of America 2017):

• http://asthmaandallergies.org/wp-content/uploads/2015/08/Older-Adults-with-Asthma-Checklist-Version-B-PDF.pdf
• http://asthmaandallergies.org/wp-content/uploads/2015/08/Older-Adults-with-Asthma-Checklist-Version-B-PDF.pdf

Other useful resources can include the Australian Asthma Handbook, which can be found at: http://www.asthmahandbook.org.au/. This is ‘endorsed by the Royal Australian College of General Practitioners (RACGP), the Australian Primary Health Care Nurses Association (APNA) and the Thoracic Society of Australia and New Zealand (TSANZ)’ (National Asthma Council Australia, 2017).

The ‘My Asthma Guide’ found at: https://www.nationalasthma.org.au/living-with-asthma/resources/patients-carers/brochures/my-asthma-guide aims to make the guidelines more ‘understandable’ for clients and their families (National Asthma Council Australia, 2017).

The Global Initiative for Asthma (GINA) (2017) organises World Asthma Day for the aim of improving asthma awareness and care worldwide.

Furthermore, should you wish to improve your asthma management nursing skills, there are a list of continuing professional development (CPD) activities below:

• Online learning at https://www.nationalasthma.org.au/health-professionals/education-training/online-learning
• Respiratory nursing course (10 CPD hours) (2 day seminar in Sydney 4^th-5^th December 2017) https://www.ausmed.com.au/course/respiratory-nursing
• Asthma: Fast Facts eBook at https://www.ausmed.com.au/online/fast-facts-asthma-ebook-2817084
• Respiratory library resources https://www.ausmed.com.au/online/topic/respiratory-health
• Aged care assessment courses https://www.ausmed.com.au/learning-centre/agedcare-assessment
• Or you could even do postgraduate courses dedicated to respiratory nursing!

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References:

• Asthma and Allergy Foundation of America 2017, Asthma in older adults, AAFA, viewed 13 April 2017, http://asthmaandallergies.org/asthma-allergies/asthma-in-older-adults/
• Australian Institute of Health Welfare 2017, Asthma, AIHW, Australian Government, Canberra, ACT, viewed 13 April 2017, http://www.aihw.gov.au/asthma/
• Gillman, A & Douglass, JA 2012, ‘Asthma in the elderly’, Asia Pacific Allergy, vol. 2, no. 2, pp. 101-8.
• Global Initiative for Asthma 2017, World Asthma Day, GINA, viewed 13 April 2017, http://ginasthma.org/wad/
• Jones, SC, Iverson, D, Burns, P, Evers, U, Caputi, P & Morgan, S 2011, ‘Asthma and ageing: an end user’s perspective–the perception and problems with the management of asthma in the elderly’, Clinical and experimental allergy: journal of the British society for allergy and clinical immunology, vol. 41, no. 4, pp. 471-81.
• National Asthma Council Australia 2017, Australian Asthma Handbook, viewed 13 April 2017, https://www.nationalasthma.org.au/health-professionals/australian-asthma-handbook

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