Reflection 12172021 PDF

Preview

Summary

Reflection idea for those who may struggle to write reflections at the end of the quarter...

Description

The Older Adult Reflection Mallory Alinder Rasmussen University NUR2214 Section 22: Nursing Care of the Older Adult Professor Jennifer Macik December 17th, 2021

The older adult population 65 and over according to the Census Bureau’s 2019 population estimate has grown roughly 34.2% within the last decade, recently up to 38.4% in 2019, and estimating the population to triple by 2050 (U.S. Census Bureau, 2021). Due to the steady growth of the geriatric population, the healthcare system has needed to adapt and shift care to meet the demand. In this paper I will address the increased complexity of care, different care models specific to the older adult, resources to promote effective care, address professional values, attitudes, and expectations regarding ageism, and the importance of advocating for the older adult in their care plans. As the aging population continues to grow healthcare faces the challenge of maintaining quality care across all care settings that fulfill the needs of each individual while ensuring that the well-being of each person is still met. Overarching complexities contributing to the care of older adults include chronic illness, impaired functional status, and the normal aging process itself (Meiner, 2019). Studies have concluded that at least 80% of the older adult population suffers from at least one chronic disease; including those of dementia, diabetes, hypertension, and heart disease (Institute of Medicine, 2008). In addition to the increased diagnosis of chronic illnesses, older adults tend to have a higher risk of injury and limitations of ADLs (Institute of Medicine, 2008). The number one cause of injuries is due to falls (Meiner, 2019). The root cause of falls is mainly due to polypharmacy- the use of multiple different medications (Meiner, 2019). Limitations of ADLs require older adults to seek healthcare systems and services that can support their needs. Because of these two conditions, older adults tend to seek healthcare services at higher rates than they have before- putting a strain on the healthcare system needing to meet the demand. This increased demand for healthcare facilities results in a reduced number of staff, limited training in geriatric skills, and financial resources for both the older adult and facilities (Institute of Medicine, 2008). While nursing interventions and coordination aid in enhancing the care of patients, geriatric care models are essential in controlling and managing chronic diseases and costs of healthcare services specifically for the older adult population (Powers, 2018). Different care models include hospital-based, transition, outpatient-based, and community-related. All these care models have the commonality of value-based care. This value-based care model establishes the importance of patient-centered care, collaboration, interdisciplinary team approach, and safety (Powers, 2018). Hospital-based care includes acute care for elders (ACE) and health aging brain center (HABC). ACE works towards improving costs, reducing hospital stays, improving health outcomes, and medication reconciliation. HABC takes a more cognitive approach by working with dementia and delirium patients. The transition care model improves

transition care of older adults from acute settings to the community. Outpatient care models work through a multidisciplinary team to give focused care to veterans with chronic or coexisting cognitive, function, and psychological alterations. Community-based care models include patient-centered medical home, home-based primary care, complex care, STRIDE, Telehealth, and RTCI. Moreover, communitybased centered care has the goal of providing services that give the individual flexibility to find local resources that meet their unique needs (Meiner, 2019). As care models are foundational tools to help guide the older adult in the environment in which care will be received, additional resources overarch local, state, and national communities to help aid in care options. Overall, these resources help with financial, caregiver-based, legal, and physical health issues. Agencies that help aid in these categories include AARP, Administration for Community Living, Alzheimer’s Association, Medicare, Council for Better Business Bureau, and Federal Housing Finance Agency (NLS, 2020). Although there are many different care models and resources designed to aid in the geriatric community there is still a stereotype our society associates with the geriatric population. This stereotype is known as ageism. Ageism is the idea that all elderly are predisposed to be “frail and weak”, whereas eastern medicine viewed the old as “wise and strong.” Our society has adapted to the term “gerontophobia” which is the fear of becoming old (Meiner, 2019). Specifically The Levy’s stereotype embodiment theory. It explains that the process of internalizing aging stereotypes begins in childhood. This theory has 4 parts: stereotypes become internalized throughout one’s life, can be unconscious, gain prominence from self-significance, and have multiple pathways (Levy, 2008). Additionally, Roy’s adaptation model, Pender’s Health Promotion Model, and Kolcaba’s Comfort Theory all together promote and unique framework while caring for the older adult. These theories help healthcare teams to put aside any negative stereotypes and biases towards the older adult and rather promote values, beliefs, attitudes, and expectations. Values include obtaining a history of the patient, understanding what values and beliefs are important, and incorporating those into the patient's care. Respecting the client's wishes and beliefs by acknowledging they are an individual with their autonomy and decision making. Furthermore, educating the patient on the outcome of any healthcare provided while still maintaining respect for their values and beliefs will aid in expectations for their care or if changes should be made to promote their well-being. Understanding that transition of care, values, beliefs, and overall and individual autonomy plays a key role in a patient's overall well-being, healthcare professionals should acknowledge and implement

these vital principles into an individual's management of care. It is a healthcare’s teams responsibility to implement ethical responsibilities during care. These responsibilities include autonomy, beneficence, fidelity, justice, nonmaleficence, and veracity (Meiner, 2019). These principles give an individual the right to make their own decision, actions that promote good for others, fulfilling promises, commit to do no harm to the client, and always telling the truth. When these concepts are implemented into a patient's plan of care not only do they promote health and well-being but also advocate a patient's values and beliefs within their care thus advocating for them. Overall, when understanding and implementing these concepts, there is no doubt that a patient shouldn’t receive optimal care. Reflecting on how the older adult population has impacted the healthcare system should never be seen negatively. Rather, an opportunity for learning and adapting to change. Taking the new information, adapting, and implementing it into our community can spread the notion that older adults are seen as “wise and strong.” A generation beyond our mindset that we should care for and nurture. In doing so, we can provide resources, promote health and well-being, respect their values and beliefs, and advocate for them. In doing so, I will take the new knowledge I have learned and apply it to my nursing career, promoting, advocating, and enrinching the lives of the older adult.

References:

Meiner, S. E. ([Insert Year of Publication]). Gerontologic Nursing (6th Edition). Elsevier Health Sciences (US). https://ambassadored.vitalsource.com/books/9780323498111 Levy B. (2009). Stereotype Embodiment: A Psychosocial Approach to Aging. Current directions in psychological science, 18(6), 332–336. https://doi.org/10.1111/j.1467-8721.2009.01662.x Powers, J. (2018). The Importance of Geriatric Care Models. Geriatrics, 4(1), 5. MDPI AG. Retrieved from http://dx.doi.org/10.3390/geriatrics4010005 Resources for senior citizens and their families - National Library Service for the Blind and print disabled (NLS): Library of Congress. National Library Service for the Blind and Print Disabled (NLS) | Library of Congress. (2020). Retrieved December 17, 2021, from https://www.loc.gov/nls/resources/general-resources-on-disabilities/resources-senior-citizensfamilies/...