Professional Perspectives on Care of Old People - Essay Example

Professional Perspectives on Care of old people By {Student’s name} Code+ course name Professor’s name University name City, State Date Professional Perspectives on Care of old people Introduction Every human being is destined to grow old. Therefore, time plays a crucial role in ones’ life. Normally, an individual’s sense of control, as well as choice decreases as he ages. Thus, a person- centered assessment is required in order to determine an old person’ needs. Neighbors and family members play a crucial role in older people’s lives (The council on Quality Leadership, 2012). A research which was carried out by the council on Quality Leadership (2012), described a person centered assessment as a process whereby one identifies an older person’s needs and preferences through questions and observing with a view of informing a plan of care. According to the Council on Quality Leadership (2012), person centered assessment is vital to the older person because it assists in determining the older person’s past preferences and values. In so doing, it enables one to maintain dignity as far as older-person’s care is concerned. Also, it encourages the older person to express their preferences and subsequently make key decisions regarding their lives (Hughes, Smith & Dan, 2003). In addition, conducting a person centered assessment enables one to evaluate the older person’s strengths, resilience and capacity and also, determine the fundamental areas of care (Victor, Scramber & Bond, 2009). This paper presents a critical reflection of my discussion with my neighbor, Mr. Smith, aged 77 years and mentally ill. The purpose of that discussion was to determine what was important to him in the past and what is important to him now. A critical review of the current literature will be conducted to determine the various issues described by older persons regarding their beliefs, values, aspirations and preferences and social care and health needs. Finally, recommendations for evidence based best practice will be given, drawing from the discussion with Mr. Smith. As Council on Quality Leadership (2012) explains, person-centered assessment is important to older persons because it makes them feel empowered to manage self, feel fully heard, feel supported to make behavioral changes, remain in authority over their lives and feel that they are valued. The Situation As mentioned earlier, I conducted a person-centered assessment on Mr. Smith, a neighbor aged 77 years and who is mentally ill. During the process, I ensured strict adherence to core principles of person-centered assessment practice, namely, focusing on Mr. Smith as an individual and his needs; focusing on the capacities and future of Mr. Smith and ensuring that there is a clear commitment to continued discovery of changes in his capabilities and needs. Prior to engaging in the discussion, I designed several questions that guided me in the process. During the discussion with Mr. Smith, I discovered various issues that were of great concern to him. First, I learnt that old persons are concerned about whether they will have enough money in the future to cater for their needs. Mr. Smith stated that his body parts have become weaker, and he has become more vulnerable to both minor and major ailments. From the discussion, I learnt that older persons are uncomfortable with regular medical aid and assistance that becomes a routine in their lives. Older persons are often faced with the problem of loneliness and sometimes feel that they are isolated from family members and friends, as expressed by Mr. Smith. However, they agree that old age is an integral part of human life and are willing to face these challenges. Mr. Smith appreciates the fact that he is full of experiences, and he has been of help to many young people who seek advice from him. Generally, I learnt that old age comes with various problems, but people find a way to make life look better. I listened patiently to Mr. Smith and then clarified that it is normal to experience problems while ageing. During the discussion, I focused on several issues and concepts connected to the holistic care required for the elderly people in the society. I also thought about the effects these concepts and issues had on the health care sector, as well as, the community. I got to understand how to explore psychosomatic needs among the elderly, individuals in extensive health care. I got to comprehend that effective coping skill, optimistic internal focus on control and positive adjustment can boost psychological well-being of the older people. This can be achieved by lowering the effect of negative life events and optimizing current situations of such individuals. Mr. Smith disclosed that he had suffered loneliness and mental illness as a result of old age. According to him, he feels too embarrassed, out of sorts, feels too lousy and lacks self confidence. As a registered nurse, I recommended psychiatric admissions as well as several drug admissions. I promised to work tirelessly to get Mr. Smith into help. Over the next 12 months, Mr. Smith endured psychiatric admissions in the hospital where I work and several drug admissions. Feelings The medications which I recommended had terrible side effects. This, in turn, made him uneasy, gave him blurred vision, and made him drowsy and unmotivated. He spoke in low tones and was catatonic most of the time. As a registered nurse, I was willing to help Mr. Smith get out of his condition. However, according to Rapp and Goscha (2006), much focus on professionally led integration efforts typically does not necessarily cure the individual’s condition. Mr. Smith has been constantly subjected to professional medical care whenever his illness re-lapses. Disappointingly, such response has always rubbed Mr. Smith the wrong way and at some instances, thinking that I am out against him. Nevertheless, assisting the patient to improve her social functioning could be paramount in preventing the condition re-lapse. Independent living and the patient’s ability to get her involved in healthy social interactions could be a major step towards recovery (Strauss, 2005). Experience Evaluated Following this short episode, several debates concerning patient centered care of old people were discussed. I realized that Mr. Smith’s options were not considered. Like any other sector, working in a health care environment demands a high level of professionalism (Larkin, 2006). Health practitioners are thus expected to behave in an ethical manner by conforming to some moral standards or code of ethics. The main rationale behind professional code of ethics is to protect the interests of patients by offering what benefits them. The laws together with the professional codes are used to regulate ethical issues in health care profession (Basford & Slevin, 2003). Respect for autonomy is the most fundamental ethical principle as far as the health care profession is concerned (Jacobson, 2004). White (2005), in his studies argued that, health care givers are required to be compassionate while attending patients. With this regard, nurses are obliged to respect each patient by treating each one of them unique and in a dignified manner (White, 2005). This principle calls for health care givers to make respect the independence of the patients. As a nurse, I did not respect Mr. Smith’s autonomy by failing to consult with him, and obtain agreement from families before recommending some medication. Psychiatry is an area that deals with treatment, management and prevention of mental disorder. In addition, it concerns examining mentally ill patients based on history about the disorder and application of various psychological tests. Undeniably, psychiatry service has changed with time. Indeed, mental medical services have significantly improved as new legal guidelines continue to take shape. Mostly, old patients with mental disorders often referred to psychiatric patients are handled depending on the severity of their mental illness (Cox, 2004). In this matter, they are either treated when they voluntarily present themselves for medical attention or under forced circumstances when a patient resists going for mental treatment. Mental health laws allow for forceful admission of mental health patients when a patient is a threat to own life, those of others or has a mental health condition that requires treatment as an inpatient. Admission to mental health care facility requires proof from either a family member or a doctor indicating that the patient meets the statutory criteria for admission. As a healthcare professional, I had the role of making key ethical -legal decisions while take care of patients. However, negligence was apparent as far as Mr. Smith’s options were concerned. Legal concepts and laws can also be used to guide nursing staff on how to solve ethical conflicts and dilemmas. The law is normally set in order to protect both patients and nurses' interests. Patients should be educated about their rights such as the right to respectful care, the right to be informed about the treatment options, the right to receive continuous care among others. A nursing staff can face legal consequences if she breaches any of the nursing ethics (Haskins & Sawhill, 2009). As a nurse, I failed to adhere to the Law and Professional Nursing Standards. Reflections (Learning Opportunities) The incident with Mr. Smith left me uncomfortable because my approach to ageing and mental illness was unprofessional. Opponents of managed mental health care argue that being unprofessional erodes and jeopardizes patient cum psychiatrist relationship. Amid this observation, it becomes difficult to separate ethical defensible concerns from indefensible ones considering the views of proponents of managed mental health care. Coercing aged and mentally ill patients to accept certain types of medications is considered unethical. The argument behind this is that a patient may feel intimidated by either the health care professional or the family member who is considered a threat to involuntary confinement and forceful administration of medication (Strauss, 2005). Coercion and undue influence have seen Mr. Smith develop a negative attitude towards me. Typically, psychiatrists and other clinicians are expected to abide to patient preferences with the exception of extreme mental conditions. However, giving clinician latitude to override patient preferences undermines the intention of patient preferences, hence attracting much resistance and violence from the patient (Halvorson, 2007). The nursing process refers to tailored scientific approach. It employs clinical judgment to reach the balance of epistemology, between individual interpretation and research evidence. In this case, I got to understand that research in clinical practice and decision making was necessary in evaluating the condition of the patient through several approaches as elaborated by nursing theory. Research in nursing would assist me to identify the particular needs of patients. Through research, I will learn how to effectively communicate and interact with patients, and identify the appropriate theory for application according to the requirements of the patient. Further, I will apply nursing theories in solving identified challenges of my patients. I got to understand several leadership and management skills required in the nursing profession. A nursing environment is leadership oriented. As such, I am supposed to be empowered to reach decisions within my staffing unit. I found out that there is a need for professional nurses to have some degree of autonomy. In order to effectively plan my work, there was a need to get a clear understanding of the oldest in the society and their immediate needs. There was also need to gain the necessary competencies required for evaluating old people’s health conditions in order to plan their care. Conclusions From the above reflection, I have drawn several conclusions as discussed below; First, patient centered care is quite a challenging task that requires excellent listening as well as interpretation skills. A person-centered care catering for the needs and concerns of older persons can be implemented in a healthcare organization in various ways. To start with, staff at all levels should be provided with education and training regarding a person-centered approach (Adams & Grieder, 2004). This can be achieved through getting more workers in workshops, providing in-service training and monitoring. Secondly, there should be effective communication and access to information related to clients. Information about the needs and concerns of older persons should be deliberated during team meetings and should be provided to staff at all levels in a health care organization. The Frontline staff should report any changes in needs or concerns of a client. Generally, effective skills and communication within a healthcare organization will help to ensure that staff readily understands the needs and concerns of elderly persons and uses available information to find the most suitable solutions of care (Adams & Grieder, 2004). Staff in a healthcare organization should always focus on interacting more with older persons (Perez & Luquis, 2008). They should develop a rapport with the older persons and take time to learn and meet their specific needs. They should be caring, patient and respectful to the old people (Orentlicher, 2008). This would help to alleviate feelings of loneliness among the older persons. Additionally, the care planning process within a healthcare organization should reflect a person-centered care philosophy. Information should be sought from family members, friends and Frontline staff. The physical condition of an elderly person should be assessed by different organizational members, including doctors, psychiatrists and physiotherapists. Staffing levels should be adequate to ensure that all clients are well attended to. The whole organization, from Frontline care staff to managers, should be supportive of the implementation of person-centered care (Orentlicher, 2008). The various barriers to the implementation of person-centered care include, time constraints resulting from workloads and low staffing levels, resistance to change by staff and organization, lack of enough resources to facilitate implementation of person-centered care, failure to include Frontline staff in the planning process and lack of organizational support (Orentlicher, 2008). Caring for older or elderly in the society has become an essential part of social development over the recent years. There have been developments of new approaches of social care that improve professional care for older people. Social care for the old in the society is a wide field that incorporates a variety of issues that includes health care and economic support (Basford & Thorpe, 2004). The definition of those eligible to be classified as old in societies depends on the society itself. Creating a balance of service for all social groups is usually a challenge because other groups have increased vulnerabilities, for example, the old and children. Patient-Centered care has proved to be an efficient approach in different areas in caring for older. The objective of patient centered care of the old is to ensure that they live a decent life. Caring for the ageing population reduces economic burdens that come up due to poor social care, for example, health care problems. Person-centered assessment helps to determine specific concerns and needs of a respondent (Azzopardi & Grech, 2012). This helps to understand a respondent better and to provide a solution that is more specific to his or her problems. As noted in the review of my episode with Mr. Smith, old people have numerous concerns, including inadequate finances, body weakness and increased vulnerability to ailments, loneliness and concern over becoming a burden to others. However, older people accept these problems as inevitable and look at life with a positive view. They see themselves as valuable, especially due to the fact that they have much experience in life and have a role to play in giving advice to younger generations (Kronenfeld, 2012). Implementation of a person-centered care system in a healthcare organization involves providing adequate education and training to staff, enhancing effective communication within an organization, adopting effective interaction practices, adopting a person-centered care philosophy and ensuring staff levels are adequate (Gross, 201). It is essential for caregivers to ensure that they make the elderly maintain levels of independence where possible (Basford & Thorpe, 2004). Self-care training for the old is one way in which independence is maintained. However, supervision of the elderly is important, even where they are able to complete self-care activities on their own (Hindle, Coates & Kingston, 2011). Nursing is about ensuring that patients receive the care that they require. The various internal and external stakeholders in a health care profession include doctors, nurses, community, patients, and lawyers among others (Allender, Rector & warner, 2013). These stakeholders normally have an impact as far as nursing home operations are concerned. Nurses usually have the role of enhancing the health and safety of the patients. Nursing staff are confronted with ethical dilemmas in their course of duty (Byrne & Neville, 2009). How nurses solve those dilemmas have an impact on various stakeholders. An ethical theory, that is, deontology provides a range of principles to the nursing staff. Deontology focuses on doing what is right (Kerridge, Low & McPhee, 2005). As a nurse, I would act in a professional manner towards patients. Future Care Mental illness medication alone is not sufficient for managing Mr. Smith’s condition. According to the episode, I have only been prescribed drugs as the only correctional approach. Evidently, Mr. Smith has been suffering serious side effects from these psychiatric drugs and at some point refuse to take them. Therefore, during my incoming shift, I would recommend the patient to feed on nutritious foods and also take food supplements which are critical to regaining energy. Further, Mr. Smith has been spending much of his time in bed hence remaining inactive. Indeed, this could be one of the reasons why he is increasingly growing paranoid and engaging in regular exercises could make him more active and in turn enhance his health status. 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