Module 11 Assignment: Reflection on your development

Rasmussen University

NUR2214: Nursing Care of the Older Adult

Professor Name

Date

Analyze the increased complexity of care among older adults.

The care for the older adults is very complex compared to standard nursing. There are

factors that should be taken into consideration when addressing the care of the elderly. Nursing

practice requires geriatric competency such as knowledge, skills, and attitudes to safely manage

and care for older adult clients with multiple chronic diseases including mental health conditions.

Nurses must practice effective communication, human relation skills to ensure safe care

coordination. As well as promoting health and wellness, involving the clients and their families

as active participants of the care plan. Important issues associated with aging and older adults’

medical care are:

o Social-

As individuals grow older, the aging process increases one’s risk of illness, poor health, and

functional abilities. Leading to an increase in sudden health events and co-morbidities that

require greater utilization of primary, acute, and long-term care.

 Health promotion

 Disease prevention strategies and education

 Chronic disease management

 Functionality and independence

 Transitions of care

 Family dynamics

 Care coordination

o Demographics

This refers to the age, gender, race, and socio economics status of the individuals. Today, older

adults are living longer because of the accessibility to medical care, technology, and initiatives

focused on health promotion and disease prevention.

o Economics

Millions of older adults live below the poverty level. This negatively impacts health and lifestyle

behaviors. Gender, race, education, and literacy levels can significantly impact the older adult’s

health behaviors and compliance with medical treatment. Care is also shifting away from acute

care settings to community-based settings such as long-term facilities, home care, and

ambulatory care.

 Housing

 Income

 Socioeconomic status

o Political

Shifts in health policy and funding have helped to shape geriatric nursing practice. Factors such

as Medicare/Medicaid, Affordable care, Healthcare cost containment and Value-based care play

important roles in nursing care for older adults (Rasmussen College, 2021, Module 01).

 Compare care models for nursing practice specific to the older adult.

Geriatric care models are essential to the management and control of chronic diseases, healthcare

costs, and high utilization of healthcare services of older adults. Various programs and care

models have been implemented to save money on healthcare costs and monitor and promote

health while improving overall health outcomes of the older adult client.

o Hospital-based Models of Care

  Acute Care for Elders (ACE) Model- designed to mitigate risks and

improve healthcare outcomes from clients who experience disease exacerbations and

various other illnesses and are admitted into the acute care setting.

o Improves health outcomes

o Improves costs

o Reduce hospital stay

o Improve medication reconciliation

o Minimize restraint use

o Interprofessional teams

  Healthy Aging Brian Center (HABC)- Center-based memory care

clinics that improve care coordination in clients prone for Sundowners. It was also

designed for clients prone to dementia, post intensive care syndrome and delirium often

experienced in the acute care setting.

o Sundowners

o Dementia

o Post-intensive care syndrome

o Delirium

MODULE 11 ASSIGNMENT- REFLECTION 5

o Transition Care Model- Used to ensure the coordination and continuity of healthcare as

patients transfer between different locations of different levels of care within the same location.

  IMPACT (Improving Post-Acute Care Transitions)- Initiated to ensure ideal

transition in geriatric care.

  Project RED (Re-Engineered Discharge)- Initiated to transition a unique set of

patients from the post-acute setting to the community

o Outpatient-based Models of Care

 GERI-PACT (Geriatric Patient-Aligned Care Teams) care model- Is a

specialized patient care medical home model initiated by the Department of Veterans Affairs to

provide high quality coordinated care to older adults over 65 with more risk of negative health

and psychosocial outcomes similar to that of transition models.

 Outpatient geriatric evaluation

 Specialized medical home model  Chronic disease

 Multidisciplinary team

o Community Related Models of Care

Patient-Centered Medical Home Model- Developed to provide more

timely access, coordination, and patient-centered care in primary care settings. It is designed to

focus on older adults with multiple chronic conditions.

MODULE 11 ASSIGNMENT- REFLECTION 6

 Home-based Primary Care Models- Used to promote value-based care for clients

receiving primary and social care in the home to avoid emergency room visits, acute

hospitalization, and institutionalizations. Provides quality, patient-centered care for

people underserved where the patient must travel to the provider.

 Complex Care Model (C5-75) Case-Finding for Complex Chronic Conditions in

Seniors over 75 Model- A model aimed at identifying frailty and commonly associated

geriatric conditions among older adults and targeting interventions for identified

conditions using a feasible systematic, evidence-informed multi-disciplinary approach.

 STRIDE (assisted early mobility for hospitalized older veterans) Model- Associated

with walking and musculoskeletal health. It is a walking program for hospitalized older

adults focused on maintaining musculoskeletal strength and mobility.

 Telehealth Model- Used to improve access and quality of dementia care to patients and

their caregivers in rural areas.

 Return to Community Initiative (RTCI) Model- Facilitates consumer choice in care

setting and to achieve cost savings for the consumer and the medication

program(Rasmussen College, 2021, Module 4).

 Design plans for care specific to the older adult.

Geriatric nurses must utilize the nursing process and perform a complete head-to-toe assessment

on the older adult before designing a plan of care specific to their needs. They must gather both

objective and subjective data to formulate problems and the plan of care. The health assessment

will include the SPICES assessment a geriatric assessment and screening tool. This known as

sleep disorders, problems with eating and feeding, incontinence, confusion, evidence of falls, and

skin breakdown). It is a nurse’s duty to create appropriate nursing diagnosis and intervention

related to assessment findings (Rasmussen College, 2021, Module 5).

 Identify local, state, and national resources which facilitate safe and effective transitions

of care for older adults.

Older adults often require various services and resources at the local, regional, and national

levels because they may not have the skills, knowledge, and attitudes to improve their health or

take preventive measures. The healthcare team must advocate for the client to ensure access to

safe and quality care and quality and safe care.

o Local- The nurse is the case manager at the local level and recognizes the essential health

needs of the client so that care can be individualized, and resources and interventions

implemented.

o Regional- Nurses can influence change at the state department regarding policies specific to

older adults. Having a voice at the state level through various legislature meetings and hearings

is an ideal way to advocate for older adults.

o National- Actions are taken to change and better understand public policy. Nurses can

collaborate and speak to various civic groups and furthermore advocate and lobby for older adult

rights and best practices.

 Community and Home Health Services/Homemaker Services

 Senior Centers

 Adult Day Care Services

 Nutritional Services

 Transportation Service

 Telephone monitoring and personal emergency service (Rasmussen College, 2021,

Module 8)

 Incorporate professional values, attitudes, and expectations regarding ageism when

caring for the older adult.

Nurses and other healthcare providers are in prime positions to advocate for older adults who are

victims of age discrimination. Reshaping the perceptions about aging is a necessary

improvement measure. It is important to assess the patient initially to determine their abilities

when providing care and treatment. It is also important for healthcare providers to provide

effective communication about medical decisions during their treatment and allow the client to

have autonomy for the type of care they receive. It is also important to not provide the same care

for older adults as everyone else. Healthcare providers must uphold the oath to implement equal

care for everyone regardless of their age, sex, nationality, religion, race(Rasmussen College,

2021, Module 9).

 Outline the importance of advocating for older adults in management of their care.

When it comes to providing care, it’s much more than providing medical care. As a nurse you

play an important role as an advocate for the client. With aging, older adult’s health status often

leads to changes in living arrangements both in homes and institutions. These changes affect not

only the older adult, but also often their family and others who must see to their care and living

needs. Without enacting appropriate interventions and resources, this can lead to neglect,

deliberate abuse, or exploitation of older adults. As older adults’ abilities to manage their

personal affairs are compromised, the necessity of turning the management of certain activities

over to others may also lead to mistreatment. Nurses must be alert to recognize signs and

symptoms of abuse and caregiver stress, which can be in many forms. They must be advocates

for older adults who may not have a voice in the matter or are told they will be black mailed if

they report abuse. Any indication of abuse in an institutional setting must be reported as soon as

it is suspected so that appropriate action can be taken and the abusive person removed (Meiner,

n.d., p. 33) & (Rasmussen College, 2021, Module 10).

Throughout the course I was able to achieve each of these competencies in various ways.

I was able to apply the knowledge learned to virtual scenarios during clinicals. I also took the

information provided during lecture and incorporated it into many assignments, and additionally,

a course project about hypertension in older adults. The knowledge gained enabled me to

critically think during the lab simulations with case studies on specific scenarios for older adults.

This course material will impact my nursing practice in a positive way to care for and treat older

adults professionally and specifically to their individual needs. I will not show ageism towards

older adults and respect them and care for them as equally as I would any other patient I

encounter.

References

Meiner, S. E. Gerontologic Nursing, 6th Edition [VitalSource Bookshelf version]. Retrieved

from vbk://9780323498111

Rasmussen College. (2021). Module 01: Trends and Issues. In NUR2214: Nursing Care of the

Older Adult[Lesson]. Retrieved from