...A written assignment that evaluates comprehensive approaches to nursing assessment for an older person with multiple health problems. The account should reflect on how the multidisciplinary team and other agencies including the family, may contribute to these assessment approaches. Particular attention should be paid to national policies in this area and evidence of best practice. The patient that will be discussed within this assignment is a 70 year old male admitted to hospital following a stroke. Pressure ulcer risk assessments and nutritional risk assessments will be discussed within this assignment looking at how they are used in the assessment of an older people with multiple health problems. A stroke occurs when there has been a disturbance or cut off of blood flow within the brain, this disturbance damages or destroys brain cells preventing these cells from doing their job. Damage to the brain causes problems with bodily functions and can also affect mental processes (Stroke Association, 2010). A stroke can cause sudden weakness or paralysis which often only affects one side of the body and is one of the most common symptoms of a stroke. It can also cause swallowing difficulties (dysphagia), speech and language (dysphasia) can be affected also, patient may have difficulty in understanding and basic things such as reading and writing following stroke. Problems with eyesight, perception and interpretation, mental processes, bladder and bowels, mood swings, sensation and...
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...CLINICAL ISSUES Acute care management of older people with dementia: a qualitative perspective Wendy Moyle, Sally Borbasi, Marianne Wallis, Rachel Olorenshaw and Natalie Gracia Aim and objectives. This Australian study explored management for older people with dementia in an acute hospital setting. Background. As the population ages, increasing numbers of older people with dementia are placed into an acute care hospital to manage a condition other than dementia. These people require special care that takes into account the unique needs of confused older people. Current nursing and medical literature provides some direction in relation to best practice management; however, few studies have examined this management from the perspective of hospital staff. Design. A descriptive qualitative approach was used. Method. Data were collected using semi-structured audio-taped interviews with a cross section of thirteen staff that worked in acute medical or surgical wards in a large South East Queensland, Australia Hospital. Results. Analysis of data revealed five subthemes with the overarching theme being paradoxical care, in that an inconsistent approach to care emphasised safety at the expense of well-being and dignity. A risk management approach was used rather than one that incorporated injury prevention as one facet of an overall strategy. Conclusion. Using untrained staff to sit and observe people with dementia as a risk management strategy does not encourage an evidence-based approach...
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...“How can nurses ensure that older people are treated with respect and dignity whilst being cared for in a hospital or in the community?” Providing dignified care is at the very heart of nursing and is the responsibility of everyone (Royal College of Nursing (RCN) 2008). Nurses play an important part in the care of older people and quality nursing care can make a substantial difference to physical and emotional well-being (Nursing and Midwifery Council (NMC) 2008). 'Dignity' as defined by the Social Care Institute for Excellence (SCIE) (2009) is ‘A state, quality or manner worthy of esteem or respect; and (by extension) self-respect’. Adopting dignity in practice should generate an environment that supports and promotes self-respect, allowing it to flourish by the maintenance of autonomy and informed choice, NMC (2008). The 2006 Commission for Social Care Inspection (CSCI) publication ‘Living well in later life’ highlighted the lack of dignity and respect for older people in acute hospitals as a major area of concern citing that 45% of NHS resources are spent on older people and this accounts for the greatest use of acute hospital services This discussion will identify the specific needs of the older person from a bio-psychosocial perspective incorporating complicit ethical issues. The role of the nurse in the provision of quality and comprehensive care delivery will of course be examined, integrating theory and practice and exploring the implications for inter-professional...
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...NUR1099 Professional Nursing for the Older Person Assessment Two Template Marks out of 100 Weighting: 70% Due: Week 9 Thursday 13th September 2012 & Upload via Ease There are five main categories for this assessment. Please use this template for categories 1,3, 4 & 5, while category 2 is the concept map and will require the mind map software to complete. The mind map is to be uploaded as a separate document into ease with this completed Assessment Two template. 1. KWL Chart (20 marks) 2. Concept Map (25 marks) 3. Written prose – justification (35 marks) 4. Nursing Process of Care – Care Plan (20 marks 5. Academic writing and referencing. (Deductions up to and including 5 marks) The following information on pages two - six of this document details each category. 1. 1. KWL - Using the ‘KWL’ template provided, fill in the four column template. Theme Headings – Identify ten major themes for approaching holistic patient care K – What do I already know about the older person and caring for the older person? W – What do I want/need to know about the older person and caring for the older person? L – What have I learnt about the older person and caring for the older person? Theme Headings(Identify the ten major themes) | K | W | L | 1. | | | | 2. | | | | 3. | | | | 4. | | | | 5. | | | | 6. | | | | 7. | | | | 8. | | | | 9. | | | | 10 | | | | (20marks) 2. Concept Map – (Please...
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...PYCHOLOGICAL ABUSE 6 neglect & Financial ABUSE 6 Sexual abuse 6 scope of the problem 7 SOLUTION 8 Conclusion 8 Citations 10 Introduction Elder Abuse is any form of mistreatment that results in harm or loss to an older person, elder abuse can be divided into the categories of physical abuse which is physical force that results in any bodily injury or pain this can be assault battery, and inappropriate restraint. Psychological and or emotional abuse which is tearing down their self-esteem, and belittling them. Neglect which is just providing the necessities for everyday living such as food, shelter, health care or protection. Sexual abuse can also be elder abuse it is still non-consensual. Last there is exploitation which is illegal taking of senior benefits. Each year hundreds up to thousands of elders are abused, and neglected for many victims they cannot help themselves since they are older and frail. In the U.S. half a million reports of elderly abuse have reached authorities It is estimated that between 16% and 38% of all elder abusers have a history of mental illness or do not understand that some elderly need helps in everyday living. 92% of nursing homes employ at least one convicted criminal, since there is no background check for nursing home employees. In the year 2030 demographic...
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...In the last 30 years, falls are one of the most frequent incidents occurring today that affects the livelihood of older adults. It is becoming more and more difficult for families to leave adults 65 years and older alone in their homes due to the threat of them falling and not having anyone at their side to either help them back up if they are minor falls or call 911 if they are indeed significant falls. However, these incidents should not just be a worry for older patients who live home alone, but for patients in nursing homes as well. 30-40 percent of community-dwelling adults that are 65 and older fall each year, yet such rates are higher for the same age group residing in nursing homes. Nursing home facilities are set up in aiding their residents, many of whom are elderly, with their living arrangements and making their lives easier and safer. Therefore, improvements must be made amongst many facilities to lower the fall rates of their patients and ensure that such occurrences are not as likely to occur with the use of proper techniques and the development of the right...
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...INTERNAL CRITICISM Adequacy: The Flood’s Theory of Successful Aging (Flood, 2005) was developed to addresses a nursing theory for care of the older adult regarding to the lack of nursing theory that offers clearly delineated guidelines for care of aging. Flood’s(2002) unique definition of successful aging among other explanations includes mental, physical, and spiritual elements of the aging person and emphasizing the individual's self appraisal. She used existing knowledge derived deductively from the Roy adaptation model, one of the most widely accepted nursing theory model, and integrated these ideas with Tornstam's sociological theory of gerotranscendence and literature related to the concept of successful aging to comprise the foundation of the theory (Flood, 2005). The author adequately explains the specific nursing actions that constitute these attributes. Clarity: The attributes of the theory and the model (Flood, 2005) clearly defines the major concepts relevant to successful aging. Flood provides examples of person with cancer that would exemplify the attribute although the physical health is not stated in the assumptions. In addition, there are no ambiguous statements, nor abstract or complex language employed. Nurses can readily understand the language used in the theory. Moreover, guidelines for interventions to help not only for nurses but caregivers to care for elders are provided for a completely understanding. Consistency: Flood’s views of aging and definitions...
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...expectancy increases the number of older adults requiring long-term care of some kind increases. These adults have varying needs, but most adults have problems with skin integrity, muscle weakness, and emotional issues in long-term care facilities. Interventions to meet these needs focus on preventing skin break down, improving muscle strength to prevent falls, and settings that promote usefulness and a feeling of not being alone. Current options available to older adults may not meet all of their needs, and creativity is needed in devising interventions to meet these needs. Structuring long-term care settings to encourage activity in older adults and connecting with other generations can help prevent feelings of loneliness and uselessness, and help older adults live meaningful and productive lives in long-term care settings. Long-Term Healthcare Needs of the Elderly As adults age many will require long-term health care. The evolving needs of the older adult population will require creative and new ways to meet their health care needs. This paper will look at the needs older adults have, and options that are currently available to meet these long-term care needs. This paper will also present new options that have been proposed for long-term health care settings, how these options compare with current interventions, and what outcomes can be expected if these new options are implemented. The Problem As life expectancies increase the older adult population will also increase...
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...home abuse. Everyone should be educated on the issue to discuss with elders what may be the best option for them to help them feel protected. They should be given the care they deserve as well as their freedom and safety. Every year senior citizens are being put into nursing homes and are at risk of getting abused. According to The Meyer Law Firm, “Each year approximately 2.1 million older Americans fall victim to in one or more forms.” (The Meyer Law Firm 4). This is a big rate compared to the 3.9 million elders who are put into nursing homes. The majority of nursing home abuse cases are not reported to police right away and are not taken seriously. President Donald Trump has been a very big barrier to stopping nursing home abuse and...
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...Elderspeak is a common communication method that is used in nursing homes, acute care hospitals, and other settings where elders reside. It is also frequently used when we speak to older adults, regardless of the particular setting. This style of speech is characterized as being much slower, having an exaggerated intonation, elevated pitch and volume, greater repetitions, and incorporates a simpler vocabulary and grammar than normal adult speech. Research has shown that the speech pattern used typically with the elderly is based on stereotyping and myth as opposed to the reality of the aging process. A number of researchers have conducted studies where a brief educational program was designed to increase the awareness of Certified Nursing Assistants (CNAs) regarding their use of elderspeak and strategies that could potentially enhance communication. No research studies can be identified that include Registered Nurses (RNs) and their understanding and use of elderspeak. Educating nurses about elderspeak may serve to enhance the development of a positive relationship between the Registered Nurse and the older client, which could result in an improved therapeutic relationship and improved health status. Social interactions, in all healthcare settings, can potentially make the difference between an individual who is able to be self-sufficient and the one who becomes a dependent member of the community. Social relationships have been described by Abraham Maslow’s hierarchy...
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...Sinclair, a tutor of Professional issues in nursing BN 511 at Sourther Institute of Technology. This report was assigned during orientation week in Fbruary 2015. The aim is to demonstrate that the author is compentant in research by, cdemonstrating the ability to use relevant search parameters in suitable databases. Identify and discuss the not only the methodology but the ethical and legal considerations relating to the said research topic . To understand key components of the research design and discuss the current and/or future implications on nursing practise. The report is to be submitted by 8th June 2015 no later than 1600hrs in assignment box C2-06 Database search procedure The course of action undertaken to find the research study ‘Older persons have ambivalent feelings about the use of monitoring technologies’ are as follows: The author logged onto the Mysit webpage located at web address https://student.sit.ac.nz/MySIT/pages/Home.aspx The author then selected the Study and Course Resources hyperlink on the on the web address https://student.sit.ac.nz/MySIT/pages/MyStudy.aspx t The author then found several further options. The option chosen was Health and Sport under the Online Data bases As the summative assessment required a research article that related to innovation, implementation or delivery of contemporary technology in nursing, the CINAHL (Nursing & Allied Health Index) was used. When the CINAHL (Nursing & Allied Health Index) t was chosen...
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...to clarify the events through nursing practice. A concept analysis provides insight to nursing knowledge and understanding of the concepts allows nurses to determine nursing actions (George, 2011). Quality of Life Quality of life (QOL) is a contemporary phrase which was first heard after the Second World War and, since then, has been frequently used but not well explained (Meeberg, 1993). Most theorists have at least an unexpressed belief that human health and QOL are associated closely. It is the interest of most healthcare providers to promote QOL for those who are seeking help. However, nurses cannot work with clients to attain QOL if the goal is unclear (Meeberg, 1993). Both Virginia Henderson and Rosemarie Parse are influential nursing theorists that share a common concept of QOL. This paper will explore perspectives in regards to QOL between these two theorists. Henderson’s Theory Virginia Henderson believed humans have universal needs of water, air, and food for survival, and everyone plays a part of the contribution to the well-being of each other leading to the creation of a healthy society. Nurses care for patients, sick or well until they can care for themselves independently. However, for the very young and very old, nursing care is needed in particular circumstances (Hargrove-Huttel, 1988). Four metaparadigm concepts of person, environment, health, and nursing share common viewpoints by nursing theorists and how they impact nursing practice (George, 2011). Henderson...
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...and discrimination against individuals or groups because of their age. It is a set of beliefs, attitudes, norms, and values used to justify age based prejudice, discrimination, and subordination.1 Gerontology - is the study of the social, psychological and biological aspects of aging. It is distinguished from geriatrics, which is the branch of medicine that studies the diseases of the elderly.2 Geriatric Nursing - Nursing care of the aged patient given in the home, the hospital, or special institutions such as nursing homes, psychiatric institutions, etc.3 Issues Facing the Elderly Being old can mean being sick, poor, hungry and depressed, even in developed nations like Australia. What are the issues? In Australia, the ‘elderly’ is generally a reference to people over the age of 65. Lots of over 65ers lead healthy and empowered lives, and many are involved in community volunteering. But for the elderly, health can be a big concern. Their bodies are more susceptible to illness, they may be physically frail, and many are on medications which are costly and ongoing. An elderly person who is able to fund their own retirement is called a retiree. This means they had a job that paid them enough superannuation. Someone who is unable to fund their own retirement, and is paid welfare money by the government is called a pensioner. Pensioners may have difficulty affording medications or groceries on their allowance, especially if they are very sick, or have to pay rent. Care for...
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...Concept Paper 1 Concept Paper Atypical Presentation of Illness in Older Adults 2 An atypical presentation of an illness in an older adult can appear as a subtle, nonspecific, or unusual manifestation that is outside the normal range of signs and symptoms for a specific illness. Nursing care of an older adult requires a through assessment of acute, chronic or complex illnesses. Illness in older adults is complicated by numerous medical problems and the physical changes of aging. Identification of an illness can be overlooked simply because symptoms might be reported vaguely. Multiple overlapping factors such as environmental, sociologic, physiologic and psychologic aspects need to be considered in the nursing assessment. It’s essential that nurses recognize atypical presentations of illness in older adults early to help improve patient care. Early detection can reduce the risk of missed diagnoses, death and/or prolonged hospitalization, and reduce rates of co-morbidity from treatable geriatric syndromes (GrayMiceli, 2007). Aging causes physiologic changes to the body. These normal age related changes could be similar to changes seen in the presence of pathological conditions. This causes a problem when normal changes mask early signs of an acute illness. Changes to the musculoskeletal system can affect a patient’s ability to function. Reduced bone mineral density leads to osteoporosis and an increased risk for fall-related fractures (Ebersole, Hess, Touhy,...
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...surrounding the non compliance of prescribed medication taking in the elderly and the implications of caring for such patients within the community setting. The model of reflection that I have based my writing upon is Gibbs’ model of reflection (Gibbs 1998) which I feel allows me best, in a methodical and logical way, to explore my thoughts and feelings, to evaluate the care delivery and to reflect upon my actions and those of others. Lily (pseudonym NMC, 2008) was referred to the Rapid Response Team by her General Practitioner with pneumonia; Lily has longstanding respiratory and mental health problems. Rapid Response Teams are part of Intermediate Care, formed as a result of the implementation of the National Service Framework for Older People (DOH, 2002) to prevent unnecessary hospital admission during episodes of acute illness. Lily’s GP had requested that we visit to prompt medication and generally provide assistance during this time. I visited Lily with a colleague, prompted her medication as prescribed and asked if she had taken her other medications that morning. Lily’s other medications were in a dosette box, an aid memoir to medication administration used when multiple drugs are prescribed; each box contains an entire weeks medication and is prefilled by a registered pharmacist (McGraw, Dennan 2001). Lily had two such boxes, one which she had started that morning and had taken the wrong day and one from the previous week that still contained various amounts...
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