NUR341 Healthy Aging

Why Have You Not Signed Up for Residential Aged Care?

Residential aged care is offered to the aged who live in nursing homes full-time. The case study indicates that Alan lives alone and has the responsibility to take care of all his requirements himself. I would therefore be interested in understanding why this is case especially since he has trouble moving about and carrying out normal house chores due to his high Body Mass Index (BMI). Living alone for older people may not be out of choice, it could be due to the lengthy procedure involved in signing up for the residential aged care in nursing homes, the need for privacy or even due to age limitation. Most care services in Australia are aimed at elders who are above 75 years of age, assuming that the younger ones are healthier. This could be the reason Alan still lives alone but to be certain, I would ask him this question.

Why Have You not Signed Up for Home care Services?

This case would go to Alan and other older people who live alone and do not have anyone to help them with their daily chores. Home care services’ objective is to sustain an aged individual’s quality of life while still at their homes by helping them with their physicalnecessities and day-to-day deeds. In Alan’s case this question would be directed to him in the instance that he has decided to remain in his home (Bally & Jung, 2015). 

Are You Satisfied With the Services You Receive?

The only services Alan receives are a renewal of his multiple subscriptions every two months from his General Practitioner (GP). It is thus important to find out if this is how he has chosen to live and if he is satisfied with the services.

Poor self-care

Lack of senior nutrition (Malnutrition)

Problems with Medication

Decline of Physiological system: this indicates that older adults are less able to prevent and recover from diseases

Decreased functional mobility

Loneliness

Poor vision

Falls

Nutrition and a balanced diet is vital for Alan and other elderly as it increases their energy levels, helps them maintain a healthy weight and gives them the nutrients they require. For Alan’s case in particular, a balance diet would give him enough energy to move from one place to another and ensure that he does not add any more weight.

Physiological System comprises of the respiratory system, the digestive system, the cardiovascular system, the immune system, the nervous system,the endocrinesystem, the skeletal system, the muscularsystem, the renal systemand the reproductive system. It is very important for Alan and other older individuals to ensure a healthy physiological system through healthy diet, exercise whenever possible and observing their prescriptions in order to avoid the onset of more diseases (Thakur et al., 2013).

Functional mobility is a huge challenge for older people. The decreased mobility can hinder their ability to carry out their daily chores. This can only be addressed by advising them to seek out help either from residential aged care or home care services.

Alan goes out every two months to get a renewal of his prescriptions. Observing these prescriptions and following the instructions given is critical to the older people. The elders who live alone like Alan may not remember the instructions or the specific medicine to take at what specific time which is a major issue that can enhance their health problems.

Loneliness is an issue while living alone, particularly for the older adults. It is dangerous for them to live alone due to their health issues. They can also harm themselves unknowingly. The elderly should be convinced to join a residential aged care where they can interact with other older people and avoid this loneliness. Alternatively, they should be convinced to accept help form other persons through home care services in which case they would have a service provider to commune with for at least a part of the day (Kusumoto et al., 2018).

Self-care is important for everyone and especially the aged as it may help them to prolong their lives and feel more energetic. Alan is obese which portrays poor self-care. He gets food supplies every few days but is obviously unable to fix himself a balanced meal which could lead to further medical issues. This also include observing personal hygiene and ensuring a good social life and emotional self-care (McBride et al., 2012).

Alan is unable to drive due to his poor vision. This is a sign of cognitive impairment which comes about due to old age. It is therefore a problem that can be identified with many older people and makes it unsafe to live by themselves at home.

Falling can be accidental or as a result of health problems. In Alan’s and many older adults’ cases, falling is mostly a result of inability to move easily. This can be very dangerous as it can lead to injuries and even death (Reuben et al., 2017).

Physiological Systems

It is a Registered Nurse’s duty to ensure that Alan’s physiological system is as healthy as possible. The physiological system is basically made up of all the major organs and processes of the human body. It however declines with age and the organs start functioning less effectively while the body processes such as digestion and respiration are less efficient. A decline in physiological systems make the aged more susceptible to deconditioning, that is, a decrease in the heart’s responsiveness that may be made noticeable by a reduction in blood volume. Upon return to normal conditions, this blood pools in the legs (Makwana et al., 2012).

Alan’s obesity is not only a result of poor diet but also a decline of the functioning of his physiological system. His digestive system is no longer functioning as it used to leading to increased weight. This decline is therefore a major medical issue for Alan and should be a priority for the nurse for the nurse to address. He or she should be sure to keep a close eye on Alan and ensure that he leaves his home more regularly to get some exercise which is good for his cardiovascular system and physiological system in general (Collins, 2012).

Medication

The nurse should make it a priority to ensure that Alan takes his medication. His health problems are serious at his age and thus the nurse should take a further step in ascertaining that Alan not only has the right medication for his health issues but that he also takes the right medicine at the right time. With his poor eyesight, Alan can confuse which medicine bottle contains which kind of drug and therefore mix them up. Also, he can keep his medicine bottles some other place other than his medicine cabinet and therefore end up taking something else in the name of medicine. In addition, Alan can forget the time he is supposed to take medicine or forget he is supposed to take it altogether. All these and many more are ways in which Alan can fail to follow the instructions given and unintentionally endanger his own life (Romagnoli et al., 2013).

It is hence the obligation of the nurse to make certain that Alan has the right prescriptions in his medicine cabinet and takes his medicine at the right time.Although one of a registered nurse’s role in healthy aging is ensure autonomy for the older adult, failure to do this would be a violation of the other role of minimizing the effects of disease and disability (Smolowitz et al., 2015).

Other than poor vision, decreased functional mobility and poor diet have an impact on Alan’s medication. Inability to move from place to place can render Alan unable to make his two month trip to his general practitioner to obtain the prescriptions’ refill. Poor diet can tamper with the medicine’s ability to restore his health as best as possible.

Australian Home Care Services has offered care at home for over 30 years and thud the clinician would have confidence that they have experience in what they do. He or she would be assertive that Alan will receive help from a qualified service provider and will take his medicine when required. Additionally, it is open during the day and night and thus Alan would get the assistance he needs in time.

Eremea Home Care Services is known for its service provision to older adults from various cultures. It offers a service provider who speaks the same language as the amenity recipient (aged) thus eliminating the problem of any language barrier (Davis et al., 2017). The clinician would be assured of an effective and efficient way of service provision as Alan can communicate his needs and requirements to the provider without the worry of being misunderstood. The facility provider can also explain to Alan the benefits of observing good self-care in an operative manner (Mozley, 2017).

These two organizations are most efficient for Alan as they are open for 24 hours a day and thus are effective for timely provision of services (Palesy et al., 2018). They also assist with his daily activities so that he does not fall while moving from place to place.

According to the case study, Alan was working for the public up to 4 years ago. This means that he has pension money which caters for his daily requirements and his medicine as well. His pension fund would therefore be used to pay for the home care services which would be a wiser use for his money as with a provider in his aid he is exposed to less health problems.

The two major issues mentioned above, problem with medication and decline of physiological systems would have an effect on Alan on admission in the Acute Assessment Unit (AAU). This is because these are major medical issues which could have caused the problem leading to admission in the first place (Pesko et al., 2018). These issues would indicate to the nurses and the doctor that Alan’s condition is a serious one and requires instantaneous attention and addressing.

During an admission in an acute ward, the registered nurse should ensure that Alan gets immediate help to avoid enhancement of the disease (Gausvik et al., 2015). He or she should first find out the kind of medication Alan was taking before admission and determine the cause of the current problem. If possible it would be important to talk to Alan in order to try and define the problem from his actions. The diagnosis can then be carried out to establish the actual medical problem (MBAa & Ellen, 2016).  

References

Collins, T. L. (2012). Reflections of a hospice physical therapist: patient-centered care bringing quality toward end of life. Home Healthcare Now, 30(3), 199-200.

Davis, J., Morgans, A., & Burgess, S. (2017). Information management in the Australian aged care setting: An integrative review. Health Information Management Journal, 46(1), 3-14.

Gausvik, C., Lautar, A., Miller, L., Pallerla, H., & Schlaudecker, J. (2015). Structured nursing communication on interdisciplinary acute care teams improves perceptions of safety, efficiency, understanding of care plan and teamwork as well as job satisfaction. Journal of multidisciplinary healthcare, 8, 33.

Kusumoto, Y., Makita, H., Nagai, K., & Yamane, T. (2018). Recognition of roles of various professionals by home-visiting specialists. Journal of Physical Therapy Science, 30(6), 800-803.

Makwana, N. R., Shah, V. R., Kalpesh, G., & Sudha, Y. (2012). Health problems in geriatrics-A cross sectional study. J Pharm Biomed Sci, 20(16), 1-4.

Mozley, C. (2017). Towards quality care: outcomes for older people in care homes. Routledge.

Palesy, D., Jakimowicz, S., Saunders, C., & Lewis, J. (2018). Home care in Australia: an integrative review. Home Health Care Services Quarterly, 37(2), 113-139.

Reuben, D. B., Gazarian, P., Alexander, N., Araujo, K., Baker, D., Bean, J. F.,& Leipzig, R. M. (2017). The Strategies to Reduce Injuries and Develop Confidence in Elders Intervention: Falls Risk Factor Assessment and Management, Patient Engagement, and Nurse Co?management. Journal of the American Geriatrics Society, 65(12), 2733-2739.

Romagnoli, K. M., Handler, S. M., & Hochheiser, H. (2013). Home care: more than just a visiting nurse.

Smolowitz, J., Speakman, E., Wojnar, D., Whelan, E. M., Ulrich, S., Hayes, C., & Wood, L. (2015). Role of the registered nurse in primary health care: meeting health care needs in the 21st century. Nursing Outlook, 63(2), 130-136.

Thakur, R. P., Banerjee, A., &Nikumb, V. B. (2013). Health Problems Among the Elderly: A Cross. Sectional Study. Annals of medical and health sciences research, 3(1), 19-25.

McBride, S. E., Beer, J. M., Mitzner, T. L., Springman, J. M., & Rogers, W. A. (2012, September). Challenges of training older adults in a home health care context. In Proceedings of the Human Factors and Ergonomics Society Annual Meeting (Vol. 56, No. 1, pp. 2492-2496). Sage CA: Los Angeles, CA: SAGE Publications.

Bally, K., & Jung, C. (2015). Caring for older people: is home care always best?.

Landers, S., Madigan, E., Leff, B., Rosati, R. J., McCann, B. A., Hornbake, R., ...& Lee, T. (2016). The future of home health care: a strategic framework for optimizing value. Home health care management & practice, 28(4), 262-278.

Pesko, M. F., Gerber, L. M., Peng, T. R., & Press, M. J. (2018). Home health care: nurse–physician communication, patient severity, and hospital readmission. Health services research, 53(2), 1008-1024.

MBAa, P. S. D. M., & Ellen, J. (2016). Homecare nurses’ decision-making during admission care planning. Nursing Informatics 2016, 28.