The Risk of Disability and Disease - Essay Example

Running Head: Case Study- Research Proposal Introduction One major problem that greatly affects the older people is the risk of disability and disease (Koenig & Kuchibhatla, 1999). Diseases affect the health of the aged but some which are all most common include stroke, cancer, heart attack, Arthritis and diabetes among many others (Lynn, 1994). These diseases impose heavy health and economic burden to those affected as they spent a considerable percentage of their hard-earned savings in diagnosis and treatment of these chronic diseases. Also depreciation of the ability to see and hear is almost a natural phenomenon to the aged. This diminishes their quality of life and increase health care costs even though early detection can either prevent or lessen or postpone some of the emotional social and debilitating physical effects that these impairments have on the older people (Parmeleet al, 1992). The major key issue that I have encountered in this field is that those who have the responsibility of taking care of the aged always have a negative opinion towards the behavior of the aged people; they claim that, the aged are too demanding and always complaining. In addition to poor memory and loss of important sense which disable them to understand, reason and act as expected and due to these complications they create an unpleasant relationship with nurses in care homes and public in general and this sometimes results in neglect, abuse and mistreatment (Lau et al, 2001). Due to the above issue I propose that the following points should be considering in order finding a solution to the problem. (i) The Design Nursing homes should be located in a serene cool environment free of any form of disturbances and pollution with access to shops public transport and most importantly close to family and friends. It should also be designed such that it contains:- Non slip surfaces Good a and reliable source of power Grab rails by shower bath and toilet Adjustable equipments to fit various needs Locks that permit the unlocking and opening of a door with a single hand incase of emergency can be opened from inside easily Constant supply of clean water and proper sewage disposal. These properties ease work and reduce e stressing conditions experienced by nurses. A nursing home should also contain occupational and recreational facilities for the needs of its residents (Parmeleet al, 1992). There should be also sufficient security to ensure maximum safety and must of course comply with the building regulations and with general fire and safety rules since the homes are required to provide the residents with comfort. A nursing home must ensure that suitable, sufficient, nutrition and a variety of food is provided since dietary restriction on medical or religious grounds must be common also involving the residents in planning meal time and choice of food will reduce the rate of conflicts (Zerhusen et al, 1991) (ii) Education and training Nurse's area very busy due to the amount of work involved in nursing homes and must be in relatively good physical shape. They should also be good in communication skills in order to deal effectively with their patients by practicing good listening and giving clear directions to both patients and aides (Zerhusen et al, 1991). This is essential in dealing with human suffering and emergencies. In addition to fostering mutual understanding between the nurses and aged, the nurses must completely undergo through training in state approved practical nursing programs, which can be offered through community based, and technical programs. Also periodic licensing renewal is essential where the nurses are interviewed and their performance scrutinized and their service record checked (McCurren et al, 1999). In the improvement of prompt service provision new technology has to be implemented and this calls for further training of the nurses in regard to new systems and equipments introduced. Educating the nurses increases their understanding; attitude and insight in dealing with debilitating diseases. The heavy physical and psychological work load combined with poor conditions of work, that is, limited possibilities to observe clinical improvement consequently cultivates negative effects to the patients (Lynn, 1994). Training on fields of competence and conduct systematically changes the quality of care offered to the aged and increase motivations and understanding in the nursing home environment (Lynn, 1994). (iii) Experience and maturity Maturity and experience outweigh formal education in the field of nursing due to the core nature of work, which needs a greater understanding perspective and patience (Neese et al, 1999). Younger people tend to lack control of temper and can develop hatred quickly compared to mature hence while employing nurses in nursing homes experienced nurses are recommended. This is due to their accumulated knowledge in answering patients bell call and delivering messages, serving meals, feeding patients who are unable to feed themselves, making beds and bathing and dressing the aged people of which can be very challenging task. Mature nurses are more caring and have a higher probability of making the right decisions as individuals in democratic society nurses have a right to make moral judgments and their experience encourages them to discuss ethical issues openly, this has equipped them with strategies which help them cope in real, emotionally fraught situations where temptations to make judgmental decisions is at its strongest (McCurren et al, 1999). (iv) Democracy. Nurses should not be subjected to restraining forces such as fear of accountability, lack of confidence and limitations I openly think that a democratic environment should be set to allow nurses to air their views, share concerns and ideas thereby actively participation in decision making. A random evaluation has instinctively shown that this process was successfully implemented to the satisfaction of old patients and the nurses in general. Its positive change has encouraged other nurses to become more proactive in discovering section of change in management for the purpose of improving the relationship between the aged and the nurses (Lynn, 1994). There are various factors that influence the relationship between nurses and old people some of these factors are: (a) Language barrier Communication is an essential tool in every institution and nursing homes are not exceptions (Lynn, 1994). As nurses realizes the value of communication attempt to explain the significance of communication to nursing as it is plays a major role between the patient-nurse relationship since assessment, interpretation, decisisons making and valuating of care implementation, greatly depends on communication. The nurses have collaborated, coordinate and optimize while working towards the establishment of trusting and caring environmement with team members (Parmeleet al, 1992). Translating these activities into words that explain patient care and that can be qualified as and used to describe what a nurse does each day without offering un endless list of tasks is a real challenge overcoming various translations role confusion and consistent use of language while simultaneously attempting to measure and compare the competitiveness of a nurse calls for a common spoken and written language that is consistent to all people involved (Parmeleet al, 1992). The challenge is to identify the best way to describe a patient's condition and associated care using nursing language even though the elderly might have knowledge of different languages learned in their lifetime a chance will occur that they cannot be in many languages (Parmeleet al, 1992). The nursing homes should at least have one or more translators who are proficient in many languages and can translate any language when need be. Also the nurses should also learn a variety of the languages to improve the communication between them and the people they are taking care of. This improves efficiency and also crates some friendship thus eliminating bad blood amongst the nursing home societies (Zerhusen et al, 1991) (b) Economic barrier. Medical personnel are people who often strive to help but death is a constant reality. Primary care nurses often see aging patients with chronic diseases or those who have health issues because of psychological or economic problems, these nurses are very critical to the patient. Otherwise they cannot add more stress to an already stressful situation leading to a complete burn out (Zerhusen et al, 1991) Most nursing homes have the habit of underpaying nurses due to economic constraints this lowers the nurses morale by subjecting them to poor living standards. In my opinion it is sometimes not genuine to underpay a nurse who is taking care of a dying millionaire. It sounds ironical and definitely he/she must develop hatred towards his/her patient who is dying rich. Also so as to reduce running cost as much as most of the nursing homes have become profit-oriented the nurse-patient ratio has increased considerably. Higher nurse patient ratio has significantly been associated with patient mortality in addition to long working hours with poor pay leads to fatigue and dissatisfaction hence leading to poor quality service Various governments should be encouraged to finance nursing homes and also enact policies that will see the working standards of nurses improved as well as their salaries since this issue is a non-profit making donors also should be involved where donations will be directed from other fields to this forgotten and important field (Neese et al, 1999). Donations should not only be from big institutions but also individuals who feel they are capable of donating anything ranging from assets basic needs and if possible cash to finance nursing homes. This will profoundly help in running the institutions hence improving the environment in the nursing home in general (Neese et al, 1999). Due to the publics negative opinion on nursing there has been a very low recruitment of nurses also the media publicizes the plight of nurses leading to many people feeling unsafe to leave their families and taking the responsibility of joining the nursing homes to take care of the aged and the ailing. Like many other predominant female professions the public under values nursing while on the other hand they base their trust on them. Infact even the nurses themselves tend to discourage their children to consider nursing, as a career their constant complains about their work tends to diminish their actins leading to sever labor supply and tension in nursing homes. Central to this is the issue s the need to revise how nurses are valued. Initiatives at the local level can affect the compensation and work environmement issues also all nurses need to be aware of the way in which they discuss their work in public. Nurse executives can be helpful in starting an organizational campaign to educate their staff about how to communicate in social and community settings each nurse is a potential recruiter for an institution (McCurren et al, 1999). Rather than having competing advertising campaigns for nurses health care organizations could combine their resources and develop strategies to elevate the image of nursing also aging practicing nurses should be used to prepare and educate new nurses on curriculum developmement and performance measurement skills so as to improve patients care and service delivery (Lynn, 1994). A general way forward is implementing of Kogan's Attitude where Kogan proposed that the church should play a major role in elimination of elderly mistreatment religious leaders need some awareness on the scope of elderly abuse (Lynn, 1994). The roles they can play in prevention and eradication of this bad the first step that should be taken by the clergy is clear understanding of the degree of elder abuse raging from psychological physical and financial. The National center of Elder Abuse (NCEA, 1998) defines elder abuse as the mistreatment of an older person by someone who has special relationship with senior. Faith leaders should run nursing homes since their experience with the elderly provides comfort support and guidance (Lynn, 1994). Even though some of the barriers identified by Kogan in religious institutions tend to limit access of information from the clergy on elderly abuse(Lau et al, 2001). Mainly comes from confessions then its ideological for the clergy to run the nursing homes using the information gathered. Also the elderly should be given the liberty to choose whether to go into nursing homes or not since some of them are seen as liabilities to their families hence at the end of the day they are forcibly taken to the nursing homes so as a solution the clergy should counsel their community on the consequences of forcing the elderly into nursing institutions this in return makes them arrogant and aggressive as they view themselves as social misfits (Lynn, 1994). Since the clergy is among the most trusted members of a society then they should be encouraged to make frequent visits to the residents and making the necessary recommendations, which should be enforced by the law. For a better service to the elderly, religious elders should act as a link between the community and the elderly and they should be accountable to their community for their actions. This can be easily achieved through proper training and education of the clergy. Government policy should also not be left out in relation to the elderly on my opinion the government should enact laws that will protect the elderly. This because is little consensus on the best ways for caring for older people (Katz et al, 1989). Also the government is spending less money on subsiding care home places and many care homes are closing down and the gap between the council fees and the reasonable costs of running a good quality care home is increasing hence this prompts the government to increase its funding even if it means to tax pensioners and civil servants (Lynn, 1994). It may be that we need a new community structures to provide and manage the humanitarian services, which we provide to citizens in need (Koenig & Kuchibhatla, 1999). Neither the government nor the church always has physical and mental welfare of less fortunate citizens (Katz et al, 1989). This is due their primary objective for this may be the first step to developing a more balanced society and in escaping all the embracing ideologies, which have tyrannized the 20th century and threaten 21st century (Lynn, 1994). There should be introduction of an immediate sanctions policy for homes found to repeatedly harm residents and development of a new data system to improve management of the enforcement process (Covinsky et al, 1991). These sanctions should be imposed without giving homes an opportunity to correct serious anomalies that have resulted in actual resident harm or put residents at risk of harm or injury. Departmentation of a nursing by order of either race, type of ailment, age e.t.c., anything that makes the patients share one thing in common helps them atleast reduce stress by discussing common issues. This also eases the work of a nurse, as she will not be required to attend to different situations at ago (Kumar V et al, 2001). However, this may encourage racism but the advantages outweigh the disadvantages and furthermore it is limited to a single institution alone (Lynn, 1994). Patient satisfaction is a responsibility of the nurse even though the nurse can provide services to her best of ability (Lynn, 1994). It is not a guarantee that the patient will be satisfied. But the management of a nursing home should work tirelessly to produce an environment that is as pleasant and accommodating as possible. The internal customers consist of the personnel, the nursing home employees and a primary reason a nursing home will be common is a reputation it creates to the residents and public in general plus a good relationship between the residents and the nurses (Ball C, 2003). In conclusion, elderly people should be given a lot of care. This is because at this age, their bodies' immune system is weak and therefore vulnerable to many undesirable health conditions. Governments should therefore come in and provide the necessary inputs towards their health care needs. 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