Health Literacy and the Older Adult via Clinical Advisor

Health Literacy and the Older Adult

Clinical Advisor: 2.27.2019 by Gwenn Scott RN, DNP, CNS, FNP-BC

Mr C, a 72-year-old patient with type 2 diabetes, is brought to the emergency department comatose with a blood sugar of 29 mg/dL.  When seen in his primary care provider’s office the previous day, his blood sugar was 456 mg/dL; he was prescribed fast-acting insulin with meals in addition to an increase in his insulin glargine.

Every day, low health literacy results in patients’ misunderstanding the instructions of their clinicians, sometimes with very serious consequences. Mr C did not understand his clinician’s verbal and written instructions and took too much fast-acting insulin at breakfast.

An estimated 90 million people in the United States have low basic literacy skills, with the average adult reading at an eighth-grade level. Almost 20% of American adults cannot read and almost 30% do not read well, for a combined level of approximately 50% who have some difficulty reading at even a fifth-grade level.  This group of Americans with limited reading skills comprises several demographic groups, including older adults, Latinos, African Americans, American Indians, and Alaskan natives.

Health Literacy

This low basic literacy is combined with widespread illiteracy associated with health information.  Health literacy is multifaceted and includes printed literature, oral communication, and numeracy. Printed literature requires reading and writing ability, while oral literacy requires the ability to listen and speak. 

Many older adults have vision and/or hearing loss that represent additional obstacles to health literacy. Numeracy — the ability to understand and use numbers — is especially important with respect to medication dosages.

Even people with high basic literacy skills can have low health literacy, and medical jargon can seem like a foreign language to many people.  The most widely used definition for health literacy is “the ability to obtain, process, and understand basic health information and services needed to make appropriate healthcare decisions and follow instructions for treatment.”

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Older Adult Learning Theory

Before we can address best practices to overcome low health literacy, we need to understand how older adults learn and factors that could impede older adult learning. Geragogy involves the principles of older adult learning theory. Factors affecting learning can be physical functions such as vision, hearing, and mobility. Increasing age can be associated with a decrease in vision and hearing, as well as slower psychomotor abilities.  Adjustments in teaching will need to be made when educating these patients. Cognitive factors need to be considered. 

Older adults may have decreased short-term memory and a tendency to be distracted. Repetition is a key element in teaching the older adult.

Elliot identified the following principles of older adult learning:

➤ “Approach the older adult in a way that communicates respect, acceptance, and support.  Create a learning environment in which the patient can feel comfortable when expressing what is and is not understood.”

➤ “Schedule teaching session in mid-morning when energy levels are usually highest for the older adult. Conduct several brief sessions over different days rather than one long session, which may cause fatigue.”

➤ “Provide more time for the older adult to process new information.”

➤ “Link new knowledge to past experiences.  Reminiscing helps the older adult reconnect with lived experiences.”

READ MORE >>

Literacy Reports & Statistics

Health

Quick Guide to Health Literacy and Older Adults, US Dept of Health & Human Services

2019: Health Literacy in the 50 States, Health IQ (an Insurance Co.)

2018: How Health Literacy Got Started, Helen Osborne

2017: Hidden Cost of Healthcare System Complexity, Accenture

2015: Health Literacy & Patient Engagement, 12th Annual Report, US HHS Sep 2015

2011: Health Literacy Interventions Outcomes: Updated Systematic Rvw, AHRQ

2010: Health Literacy, NNLM

2010: Health Literacy: Accurate Accessible Actionable Health Info. for All, CDC

2009: Reaching America’s Health Potential Among Adults, RWJ Foundation

2009: Low Health Literacy, NAAL 2003

2004: Literacy and Health in America, ETS

2004: Health Literacy: A Prescription to End Confusion, National Academy of Sciences

Literacy – Spanning the US :: Bartlesville OK :: Cazenovia NY :: Garden City KS

Literacy: Spanning the U.S.     

@bvillelibrary

Program’s Tutors Change Lives

Examiner Enterprise: 1.25.2019 by Roseanne McKee

A friend’s experiences in literacy tutoring sparked Dean Jones to try it. Jones decided to tutor in the Bartlesville Public Library’s English as a Second Language program several years ago.

Today, tutoring is an experience he wouldn’t exchange for anything in the world.

“I know how much she (Jones’ friend) enjoyed this, and since I have an academic background that includes languages and linguistics, I explored local opportunities here in Bartlesville,” Jones said.

Jones received the required training. He has been tutoring with the Literacy Council of Bartlesville for about 2 1/2 years.

@ODLtweet

Jones is one of 35 tutor who have taken the Open Minds Tutor Training, designed by the Oklahoma Department of Libraries literacy office, Bartlesville Public Library Literacy Service Coordinator Karen Kerr-McGraw said.  READ MORE >>

Family Literacy Outreach Has Big Pay-Off

Oneida Dispatch: 1.29.2019

@CazPubLib

Cazenovia Public Library Literacy Outreach has provided free literacy services to the community since 2006, offering programs in partnership with CazCares, Madison County Reads Ahead, and New Woodstock Free Library.

The Story Room Family Literacy Program, which operates out of CazCares Food Pantry, 101 Nelson St., provides valuable early literacy, adult literacy, and parenting programs to visitors. In 2018, the program experienced a notable increase in its numbers. In total, the Story Room recorded 788 children’s visits (100 more than the previous year) and 2,083 books distributed (500 more than the previous year).

“We are thrilled that so many children’s books are taken home to be enjoyed over and over again,” said Library Director Betsy Kennedy. “Studies show that the number of books in a home is a good indicator of a child’s readiness for Kindergarten.”

Each summer, CazCares opens an additional learning area for school-age children. The Story Room numbers were robust throughout the 2018 summer season as a result of the expansion and participation in the popular Summer Reading and Family Read-Aloud programs.

More than 200 parents consulted with Cazenovia Public Library literacy coordinators on reading habits, parenting topics, kindergarten readiness, and more.  READ MORE >>

Library, Neighborhood Learning Center Host Sessions To Practice English

Garden City Telegram: 1.31.2019 by Amber Friend   

  

Finney County residents from more than six countries gathered around a table at the Finney County Public Library Thursday afternoon, speaking out in new and native languages so they could share one conversation.

The subject? Birthdays.

Since October, the library and LiveWell Finney County Health Coalition’s Neighborhood Learning Center have hosted weekly Conversation Circles, an hour of informal discussion for adults to practice speaking English and learn about other residents’ cultures. The sessions are open to anyone and begin at 2 p.m. every Thursday, alternating between the library and learning center every other week.

Pam Tuller, library director, said she often had seen local residents new to English struggle with language barriers at the library. After looking into similar programs at other libraries, Tuller and her staff partnered with Birgit Lemke at the learning center, who was able to help recruit attendees and select relevant conversation topics.

“I think it’s a valuable service because ... it helps people understand that the library is for everybody. It’s not just for a certain culture or a certain economic standard. It is for everybody and anybody who wants to come to the library. Having a program that reaches out to the people that may not know that is really important to the community...” Tuller said.

By offering chances for people to learn together and from each other, the classes strengthen the community overall, Lemke said.  READ MORE >>

National Literacy & Library Events :: March 2019

National Literacy & Library Events :: March 2019

Literacy & Library Events & Conferences

Events-National & International Events

Events-International: Language Magazine

National Reading Month

Read Aloud Month

Women Scream Intl Poetry Festival

Mar. 02              Read Across America Day

Mar. 02              World Book Day

Mar. 03              Teen Tech Week

Mar. 03              Arizona Adult Literacy Week

Mar. 04              March Forth for Literacy

Mar. 04              National Grammar Day

Mar. 04              Everyone Reading Conference CUNY Graduate Center

Mar. 04              Open Education Week

Mar. 06              NABE Conference Lake Buena Vista FL

Mar. 07              Beyond the Bars Conference Columbia University NY

Mar. 07              Public Library Think Tank Miami Dade Library FL

Mar. 08              Nevada Reading Week Reno NV

Mar. 12              TESOL Convention Atlanta GA

Mar. 13              Library 2.09 Shaping the Future of Libraries

Mar. 13              TASP Conference James Madison University VA

Mar. 14              Power of Play Marbles Kids Museum Raleigh NC

Mar. 15              National AfterSchool Conference NY NY

Mar. 16              Freedom of Information Day

Mar. 16              ASCD Conference Chicago IL

Mar. 17              Children's Literature Festival U of Central Missouri

Mar. 19              Read To Me Day

Mar. 20              World Storytelling Day

Mar. 21              World Poetry Day

Mar. 21              Health Literacy Conference Portland OR

Mar. 22              KidLitCon 2019 Providence RI

Mar. 23              National Black Writers Conference Medgar Evers College CUNY

Mar. 25              Cause Camp NonProfit Hub Lincoln NE
Mar. 25-29        Reading Gives You Superpowers Week Scholastic

Mar. 26              Computers in Libraries Arlington VA

Mar. 27              Oxford Conference for the Book University of Mississippi

Mar. 28              Literacy Connections Conference Barbara Bush Foundation ME

Mar. 28              Plain Language for Health Tufts Boston Campus

Mar. 30              Money Smart Week

Mar. 31              COABE New Orleans LA

Mar. 31              Intl FundRaising Conference San Antonio TX

Mar. 31              Value of Play Clemson Univ SC

State Library Associations :: Conferences

African American Book Events

Book Fairs by State Library of Congress

Children’s Book Council Kid Lit Events

College Children’s & Young Adult Literature Conferences Festivals

Everfest Book Festival Calendar

ILA :: Literacy Calendar Worldwide

Storytelling Events

US Book Festivals

A History of the American Public Library via CityLab

A History of the American Public Library

CityLab: 2.19.2019 by Ariel Aberg-Riger

A visual exploration of how a critical piece of social infrastructure came to be.

The story of how America’s public libraries came to be, and their uneven history of serving all who need them.  SEE MORE >>

Literacy – Spanning North America :: Bartlesville OK :: Bronx NY :: Sydney NS :: Greenwood Co SC

Literacy: Spanning North America      

@bvillelibrary

Understanding Doctors Orders

Bartlesville Examiner-Enterprise: 1.24.2019 by Kris Dudley

    

Reading and understanding a doctor’s directions or prescriptions can be mind boggling, for anyone, but if you’re not a reader, imagine the implications and frustrations.

Knowing when, what dose and time of day is frustrating and downright dangerous for those with poor reading skills and comprehension.

Taking steps to help people are medical clinicians and pharmacists who see a number of people who can’t read or don’t speak English.

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Patty Leach, director at Family HealthCare Clinic, 1820 Hensley Blvd., sees poor literacy as a problem at her medical facility.

As a proactive prevention step, the facility engages clients in several steps. Little paperwork is required by patients to fill out to avoid confusion or embarrassment. An intake nurse visits with the patient and records medical information.

This is helpful for two reasons.

Relationships are developed between the staff and patient, and eliminates embarrassment for the client who perhaps cannot read.

“One of the major tips we receive is ‘Can you read this? I forgot my glasses.’ We always know then,” said Leach.

Directions are reviewed before patients go home, and clients are free to call if questions arise.

If the medical facility knows a patient can’t read, a pharmacist is alerted to make sure directions are read to the patient before they leave the pharmacy.

The Bartlesville Public Library also has ways of helping with prescription questions.

“The library is pleased to be our community’s source of information. Our reference desk has printed medical and prescription resources that we can direct patrons to, or assist them with. We also suggest internet resources and assist with internet research when asked. We love to help,” said Shellie McGill, library director.

The Bartlesville Literacy Council focuses on four divisions, Joanie Elmore said. Elmore is a literacy council member who speaks to area clubs and organizations about the council’s work. Health literacy is one of those four.  READ MORE >>

@samaritanny

Jail Program Teaches Inmates About Parenting

Bronx News 12: 1.28.2019

A program in the Vernon C. Bain Center helps inmates learn about what it means to be a parent.

The program, called SMART, stands for Specialized Model for Adult Re-entry and Training and is done in partnership with the nonprofit organization Samaritan Daytop Village.

During the class, inmates are taught how to be a good parent outside of jail. They are asked to reflect on their own childhood experiences and who they viewed as a role model growing up.  WATCH 01:45

@CBRLibrary

Family Key To Literacy, Say Cape Breton Advocates

Cape Breton Post: 1.27.2019

Family time plays a major role in literacy, according to reading advocates.

During an annual literacy day event in Sydney, the McConnell Library hosted a children’s carnival with a variety of activities meant to be fun and inspiring.

Tara MacNeil, library program co-ordinator, said family plays a major role in developing a child’s reading and math skills.

“Even if you’re a mom or dad, your schedule is busy — you’re up, you’re doing things — but that bedroom story is important, or helping with homework, or showing your child how to measure,” said MacNeil.

“All of these things are teaching your kids lessons and making the world around them more familiar.”

Each year, ABC Life Literacy Canada hosts its Family Literacy Day in January — considered the largest national family literacy event in Canada.  READ MORE >>

@GwdCoLibrary

Library To Create Digital Literacy Curriculum With Dream Literacy Grant

Index Journal: 1.30.2019

Greenwood County Library has been selected as one of 16 public libraries nationwide to receive a $10,000 American Dream Literacy Initiative grant from the American Library Association (ALA) and Dollar General Literacy Foundation.

With the funding, Greenwood County Library will create an entirely new Digital Literacy curriculum for adult literacy and English as a Second Language learners, conduct the classes, create a computer lab learning space for the classes and expand the current Adult Literacy and ESL collection of materials available at the library.

Prudence Taylor, Director of the Greenwood County Library said, “This grant money will be vital in helping us offer computer and internet access to many of our students and other community members who are currently unable to navigate the internet on their own. Nearly every occupation requires a basic level of digital literacy with web navigation, email access and participation in social media. Now, so many job listings and applications are exclusively online that it is very difficult for persons who are unable to use a computer to find employment.”

Pattie Fender, Adult Literacy and ESL Program Coordinator concurs. “It is almost impossible for many of our students to reach their employment and personal goals without the requisite computer skills. This grant will allow us to create a curriculum and lab space especially for our adult learners with instruction tailored specifically to their needs.”  READ MORE >>

Easy News Issue February 2019 :: United Response

February 2019

@unitedresponse

Easy News Issue February 2019 Out Now

United Response

Easy News aims to encourage discussion around news stories and keep readers informed about the world around them. Easy News uses simplified text and useful pictures to create accessible, politically neutral summaries of key news stories and events.

The stories are selected and translated by UR Consultants, a group of people with learning disabilities and autism who are experts in easy read communication.

Easy News Issue 36

Drones stop all flights from Gatwick Airport at Christmas

China lands on the dark side of the Moon

UK politics faces crisis

British woman held prisoner in Iran

Brazil has a new president

Gaming making billions

+ Quick News

Previous issues

You can read every issue of Easy News, plus our Special Editions, in our archive:

2018 2017 2016 2015 2014 2013

Nine Essential Skills Every Employee Requires via AWES

@awesalberta

Nine Essential Skills Every Employee Requires

Alberta Workforce Essential Skills

Workplace essential skills are the nine foundational skills required for learning all other skills at work. They are:

Reading

Writing

Document use

Numeracy

Oral communication

Digital technology

Thinking

Working with others

Continuous learning

Essential skills are used in every task a worker performs. Workers use essential skills to complete simple tasks, such as filling out a form or giving a verbal update at a meeting, to more complex tasks, such as writing an operational plan with sophisticated computer software. Employees need essential skills in order to perform their current jobs competently and to learn new skills to advance in their careers.

Descriptions of the nine essential skills

> ESSENTIAL SKILL

> DEFINITION

> EXAMPLES OF THE SKILL IN USE

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WHY ARE ESSENTIAL SKILLS IMPORTANT?

The nine essential skills enable Canadians to evolve with their jobs and adapt to workplace change. Today’s work world demands a broader range of skills with increasing degrees of complexity, even for the most basic employment. Employees who have completed grade school may find that the work world demands they use their skills far differently from what they did in school.

For example, reading in school and reading at work are not necessarily the same thing. Employees who were fluent readers at school may not be able to pick up a workplace document, quickly interpret the structure, find the needed information and then use that information properly.

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The Return on Investment (ROI) of essential skills

Research into literacy skills – reading, document use, numeracy and problem solving – reveals the ROI of increasing the essential skills of Canadians. The 2005 report, Public Investment in Skills: Are Canadian Governments Doing Enough?, by the C.D. Howe Institute, explains this:

➤ For every 1% increase in literacy skills in a nation, economic productivity increases 2.5%, which results in a 1.5% permanent increase in Gross Domestic Product (GDP).

➤ For employees, it means more choices in the labour market.

ESSENTIAL SKILLS LEVELS

Each essential skill has levels of complexity on a scale from 1 (most basic) to 5 (most advanced). Employment and Social Development Canada’s Essential Skills Profiles provide details on the specific essential skills and complexity levels in over 350 occupations. The complexity levels explain the skill needs in each occupation.

The following chart gives examples of what complexity levels look like in a broad range of occupations.  READ MORE >>