世界卫生组织引领 2021 至 2030 年健康老龄化十年

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After the last 2 years where Coronavirus 19 (COVID-19) devastated the older adult population across the globe, it is exciting to see the efforts by the United Nations (UN) General Assembly (World Health Organization, 2021). The UN General Assembly declared 2021 to 2030 the Decade of Healthy Aging. The World Health Organization (WHO) is leading the global implementation. This focus on healthy ageing is essential. As we have seen over the last 2 years, countries faced major challenges in ensuring the health and social systems to address the current aging population during the COVID-19 pandemic (WHO, 2021). A decade of concerted effort and collaboration in healthy ageing is needed to change the population view of ageing from a challenge to an opportunity (WHO, 2020, p. 5). This builds upon the efforts of the Reframe Aging (2021) Initiative started in 2012 as a social change endeavor to improve peoples’ understanding of the many ways older adults contribute to society.

There are four areas of action within the efforts to implement the Decade of Healthy Ageing are outlined in the WHO (2020) Plan of Action. These four areas include: (1) changing how we think feel and act towards age and ageing; (2) ensuring communities foster the abilities of older people; (3) delivering person-centered integrated care and primary health services responsive to older people; and (4) providing access to long term care for older people who need it (WHO, 2020, p. 4). The four areas of action are grounded within an equity lens to optimize health of all older adults. This requires multiple stakeholders to be involved. For example, Older adults, health sectors, finance, long-term care, social services, education labor, housing, transportation, information, and communication systems will need to engage to support the Decade of Healthy Ageing (WHO, 2020, p. 6). The WHO has put forth 17 ambitious goals required for healthy ageing. The goals range from being able to meet your basic needs due to no poverty, or hunger to goals for reduced inequalities to peace, justice and strong institutions (WHO, 2020, p. 7–8).

Goal 4 has been particularly difficult these past 2 years. But hopefully will lead to lasting changes in how we care for older adults. Access to long-term care particularly nursing homes and assisted living facilities over the last 2 years have been particularly dangerous for older adults with more than 61,000 nursing home residents dying from COVID-19 in the United States alone and an additional 23,000 older adults in assisted living facilities dying of COVID-19 (AARP, 2021). Others have suffered from social isolation, limited physical and recreational therapy and thus have rapidly declined physically and emotionally (LeVasseur, 2021). Technological interventions have helped for the more cognitively intact older adults in long-term care. However, short of social assistive robots, there were minimal interventions available for persons with Alzheimer’s Disease and Related Disorders to provide comfort during social isolation due to COVID-19.

As nurses, the Decade of Healthy Ageing provides a framework for us to engage stakeholders and address not only the terrible impact COVID-19 but to engage in the four areas for action. For the first area of action all nurses can engage in trainings on how to avoid ageism and improve the way we interact with older adults. Nurses can engage with their communities in Age Friendly Community Initiatives. Age Friendly communities must include the following eight domains for older adults: outdoor spaces, transportation, accessible housing, respect and inclusion of older adults, social opportunities, civic participation and employment opportunities, providing accessible communication and information as well as community support and health services (Rural Health Information Hub, 2021). Nurses involved in these domains support the Decade of Healthy Aging. Delivering Person-Centered integrated care and primary health services comes naturally to the majority of nurses but can also be contradictory to some cultures where family and church may supersede the individual. This is where nurses who are culturally informed can support person-centered care within individuals’ cultural context. And finally, providing access to long-term care for older adults when they need it can be provided in innovative ways where nurses can lead. Examples of innovative programs in the United States include Programs of All-Inclusive Care for the Elderly (PACE) (npaonline.org). Another nurse led initiative is the Integrated Memory Care Clinic (IMCC) at Emory School of Nursing (2018). Nurses are leading programs such as Dr. Szanton’s CAPABLE project, Dr. Marilyn Rantz’s Missouri Quality Initiative and Dr. Naylor’s Transitional Care Model are all transforming the care of older adults (Cacchione, 2020). Nurses and nursing has an opportunity to take the lead in their communities or health systems to address the four action areas of the Decade of Healthy Ageing. I invite you to read the Decade of Healthy Ageing Plan of Action developed by the WHO to see how you can become involved within your global context. The Decade of Healthy Ageing Plan of Action can be found here: decade-proposal-final-apr2020-en.pdf (who.int).

全文翻译（仅供参考）

在过去 2 年中，冠状病毒 19 (COVID-19) 在全球范围内摧毁了老年人口，看到联合国 (UN) 大会（世界卫生组织，2021 年）所做的努力令人兴奋。联合国大会宣布 2021 年至 2030 年为健康老龄化十年。世界卫生组织（WHO）正在引领全球实施。这种对健康老龄化的关注至关重要。正如我们在过去两年中所看到的，在 COVID-19 大流行期间，各国在确保卫生和社会系统以应对当前人口老龄化方面面临重大挑战（世卫组织，2021 年）。需要在健康老龄化方面进行十年的共同努力和合作，才能将人口老龄化的观点从挑战转变为机遇（世卫组织，2020 年），第 5）。这是建立在 2012 年开始的Reframe Aging (2021)倡议的基础上的，该倡议是一项社会变革努力，旨在提高人们对老年人对社会做出贡献的多种方式的理解。

世卫组织（2020 年）行动计划概述了在实施健康老龄化十年的努力中的四个行动领域。这四个方面包括：（1）改变我们对年龄和衰老的看法和行为方式；(2) 确保社区培养老年人的能力；(3) 提供以人为本的综合护理和初级卫生服务，以响应老年人的需求；(4) 为需要长期护理的老年人提供长期护理服务（世卫组织，2020 年），第 4）。这四个行动领域以公平视角为基础，以优化所有老年人的健康。这需要多个利益相关者参与。例如，老年人、卫生部门、金融、长期护理、社会服务、教育劳动力、住房、交通、信息和通信系统将需要参与支持健康老龄化十年（世卫组织，2020 年，第 6 页） ）。世卫组织提出了健康老龄化所需的17个雄心勃勃的目标。目标范围从能够满足由于没有贫困或饥饿而导致的基本需求到减少不平等的目标，以实现和平、正义和强大的机构（世卫组织，2020 年，第 7-8 页）。

在过去的两年里，目标 4 尤其困难。但希望这会导致我们照顾老年人的方式发生持久的变化。在过去的 2 年里，获得长期护理，尤其是疗养院和辅助生活设施对老年人来说尤其危险，仅在美国就有超过 61,000 名疗养院居民死于 COVID-19，另外还有 23,000 名老年人在接受援助死于 COVID-19 的生活设施（美国退休人员协会，2021 年）。其他人遭受社会孤立、有限的身体和娱乐治疗，因此身体和情绪迅速下降（LeVasseur，2021）。技术干预有助于长期护理中认知功能更完整的老年人。然而，由于缺乏社交辅助机器人，阿尔茨海默病和相关疾病患者在因 COVID-19 与社会隔离期间提供舒适的干预措施很少。

作为护士，健康老龄化十年为我们提供了一个框架，让我们与利益相关者接触，不仅解决 COVID-19 的可怕影响，而且参与四个行动领域。对于第一个行动领域，所有护士都可以参加有关如何避免年龄歧视和改善我们与老年人互动方式的培训。护士可以在老年友好社区计划中与他们的社区互动。老年友好社区必须包括以下八个老年人领域：户外空间、交通、无障碍住房、尊重和包容老年人、社会机会、公民参与和就业机会、提供无障碍通信和信息以及社区支持和健康服务（农村卫生信息中心，2021）。参与这些领域的护士支持健康老龄化十年。提供以人为本的综合护理和初级卫生服务对大多数护士来说是自然而然的事情，但也可能与一些家庭和教会可能取代个人的文化相矛盾。这是具有文化知识的护士可以在个人文化背景下支持以人为本的护理的地方。最后，可以在护士可以领导的情况下以创新的方式为老年人提供在需要时获得长期护理的机会。美国创新计划的例子包括老年人全包式护理计划 (PACE) ( npaonline.org）。另一个由护士领导的计划是埃默里护理学院的综合记忆护理诊所 (IMCC)（2018 年）。护士是领先的项目，例如 Szanton 博士的 CAPABLE 项目、Marilyn Rantz 博士的密苏里质量倡议和 Naylor 博士的过渡护理模式都在改变老年人的护理（Cacchione，2020 年）。护士和护理人员有机会在其社区或卫生系统中发挥带头作用，以应对健康老龄化十年的四个行动领域。我邀请您阅读由世卫组织制定的“健康老龄化十年行动计划”，以了解您如何参与到您的全球环境中。健康老龄化十年行动计划可在此处找到：decade-proposal-final-apr2020-en.pdf (who.int)。

原文链接：https://doi.org/10.1177/10547738211065790

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