Gerontology Case Henry Williams Part3 GRQ PDF

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Henry Williams, Part 3 Guided Reflection Questions Opening Questions How did the simulated experience of Henry Williams’s case make you feel? Overall, a little confused but what I was supposed to accomplish. Henry, while he was the one hospitalized, seemed to be mostly independent otherwise. However, his wife, Ertha, was the one he was mostly concerned about. I was confused because the admission for the assisted living facility seemed to have most of the questions based around Henry, despite Ertha having more issues that required assistance. I felt like I was only evaluating Henry when it was the entire couple that was going to be moving into assisted living. What nursing actions did you feel were appropriate within this scenario? I felt like doing the activities of daily living and transitional care management evaluation were both appropriate to determine their readiness to transfer to an assisted living facility, as well as what level of help they would need upon transferring. I felt like doing the depression screening was appropriate, since the daughter Betty was concerned about Henry’s mental health. Scenario Analysis Questions* PCC What services need to be available at the assisted living facility to meet the safety and health care needs of Henry Williams and his wife, Ertha? He is going to need assistance with prepping and cooking meals, as Henry stated this was something he had a hard time with. They are also going to need help with medication management, since he has over 6 medications and endorses a hard time keeping them sorted. They will also need to help Henry when it comes to watching Ertha while he participates in activities or providing transportation as needed. PCC

What is the importance of the home health nurse in the continued care of Henry Williams and his wife? The home health nurse will be able to help with Henry’s medications and any respiratory treatments he may need. Henry also vocalized needing help with his wife so that he can participate in activities again. The home health nurse would be able to relieve some of this stress that Henry and their daughter Betty are dealing with. The nurse will also be able to provide assistance to Ertha with activities of daily living, as well as monitor her for any mental status changes.

From vSim for Nursing | Gerontology. © Wolters Kluwer Health.

T&C/S How would you use situation-background-assessment-recommendation (SBAR) format to communicate transition of care from the acute care nurse to the pulmonary rehabilitation nurse? Situation

Background

Assessment

Recommendation

PCC

Henry Williams is a 69-year-old male who was transferred to the rehab facility 10 days ago for pulmonary rehabilitation. Henry Williams has a history of COPD for which he takes multiple medications. Both him and his daughter Betty have voiced concerns about his wife, Ertha, and her memory lately. Upon my assessment, Henry has a negative Mini-Cog, a score of less than 5 on the Geriatric Depression Scale and seems accepting of an assisted living facility. His biggest concern is Ertha and his ability to care for her as she needs. My recommendation is transfer to an assisted living facility and regular evaluations of both Henry and Ertha’s ability to handle their activities of daily living. Ertha, in particular, needs a better assessment to rule out any underlying causes of her memory impairment.

Now that Henry Williams has transitioned home, how do you think Henry and his wife will manage in the next 90 days? Upon transition home, I think Henry will need some assistance with managing Ertha’s care. I think he wants to do what is best for her and right now is able to provide assistance. However, during my assessment he vocalized some fatigue and stress related to caring for her with her recent memory impairments. I think overall, he will see cumulative caregiver stress and will need to get assistance to remain independent.

Concluding Questions Reflecting on Henry Williams’s case, were there any actions you would do differently? If so, what were these actions and why? I felt like more consideration and assessment should have been performed related to his concerns to be able to keep caring for his wife. He vocalized that he was staying home because he was worried and not being involved in activities he enjoys because he felt he couldn’t leave her alone. I think there needed to be a discussion about the toll being her caretaker was having on him overall.

From vSim for Nursing | Gerontology. © Wolters Kluwer Health.

Describe how you would apply the knowledge and skills that you obtained in Henry Williams’s case to an actual patient care situation. I feel like I was able to see the burden and stress that being someone’s caregiver can really place on a person. I feel more comfortable choosing what assessments to do for someone in this situation. I also feel more comfortable discussing assisted living options with patients.

*The Scenario Analysis Questions are correlated to the Quality and Safety Education for Nurses (QSEN) competencies: Patient-Centered Care (PCC), Teamwork and Collaboration (T&C), Evidence-Based Practice (EBP), Quality Improvement (QI), Safety (S), and Informatics (I). Find more information at: http://qsen.org/

From vSim for Nursing | Gerontology. © Wolters Kluwer Health....