Preventing Loneliness and Social Isolation, Patient-Centered Care for Older Adults with Multiple Chronic Conditions - Literature review Example

Critical Appraisal of Qualitative Research Article Name: Course: Institution: Date: Critical Appraisal of Qualitative Research Article Introduction The society constitutes different individuals that of divergent ages. These include the children, the youth, adults and the old. These individuals are often in need of different levels of care depending on their ability or inability to perform certain tasks. The youth and the adults are considered as the most energetic compared to children and the old. This provides perfect explanation why the children and the old need more care from those who are considered strong. The plight of the old, weak and lonely forms the basis of discussion for this paper. This is largely based on the case concerning the death of Barbara Mary Piro in October 2008. Her death is believed to have resulted from pulmonary thromboembolism and subcutaneous abscess formation which must have complicated pressure sores and mal-united the dislocation at the point of fracture of the right ankle. According to the postmodern findings by Dr. Gilbert, immobility must have been the cause of her thrombosis which resulted in her demise. It is important to note that the main reason for her death was majorly negligent on the side of caregivers who failed to seek the appropriate medical attention that could have played a significant role in saving her life. Despite the fact that Mrs. Piro was a very elderly woman, adequate medical attention and care at home would have served to reduce the pain and infections that resulted from ankles and bed pressure sores that could have been traded through medical interventions. Susan Piro, daughter to the deceased, was considered as less caring individual considering that she was aware of her mother’ status but she was still able to travel leaving her mother not only bed ridden but also unable to take care of her personal hygiene. It is important to note that as Susan left for America, her mother in a state where she was unable to take care of her personal hygiene, and welfare in terms of proper diet. The sanitation in the house was also bound to be pathetic despite the presence of a commode in her bedroom. This was because her mother was unable to empty it or dispose of any wastes accrued. Just like most elderly individual in the society today, Mrs. Piro was left unattended despite the fact that she was frail and elderly. Her daughter just like most individuals in the society followed the ambitions of her lifetime by allowing her ailing mother to make decisions about her trip. Inasmuch as Susan was entitled to enjoying her individual freedom, she exercised poor judgement. Instead of criticizing her mothers’ judgement, she acted as if unaware of her mother’s situation and this is not only a sign that she as less concerned of her wellbeing but also that she was largely negligent. It is possible to express the hope that Mrs. Piro’s case should lead to great awareness of the plight of the aging, frail and isolated in the society. Research Question Central question What is the role of the community in ensuring that they listen to the plight of the old, frail and isolated in the community? Sub questions What is the role of the children in ensuring sufficient care for their aging parents? How can the society ensure the happiness and comfort of individuals in their old days? Critical appraisal of 10 qualitative research articles Clark et al (2009, p. 4) in the article The experience of socially isolated older people in accessing and navigation the health care system explores the challenges and the experience that the frail, socially isolated and old members of the society in their endeavours to access healthcare facilities. Insufficient awareness, their physical wellbeing skills are contributing factors to their inability to seek adequate medical attention whenever faced with any health complications. This requires the society to institute measures aimed at sensitizing and empowering not only the professionals in the medical field but also community and family members of the aged. While using the qualitative integrative approach in collecting data it was possible for the researchers to listen to the narratives of the socially isolated, the frail and the older individuals in the target area. Fear was revealed as the central feature that characterized those whose health was deteriorating. Bazalgette et al (2011, p. 13) in the article Coming of Age view acknowledge that aging in the society is often a phenomenon that the society tens to view as a challenge which must be managed. This requires that the society must develop strategies on how to cope with pressure on national health services considering that there is a high number of the aging population in the society. In addition, the cost of maintain the old can be considered as the reason for most of these individuals to be neglected by members of their families. The need of sustaining these individuals requires proper structures of pension and social care to ensure that the family. There are positive experiences that hate ageing face in the society despite the fact that most of them are neglected and frail, there is greater confidence and peace that is derived from self-acceptance. There is need for the society to help the frail and the old to feel positive about the opportunities that arises from the ability to accept their status. This can be facilitated by engaging these individuals in important social contributions such as volunteering. While agreeing with the strategies on how best to take care of the aging and the frail, Rowntree (2010, p. 4) in the article Older people with high support needs: how can we empower them to enjoy a better life, agrees that there is need of supporting the old in the society. This is largely because the society is increasingly diverse and dynamic and the prevalence of certain conditions. It is important to note that there are numerous needs that the ageing in the society desire and value but age is considered as an impediment to their ability to voice their concerns. It is the responsibility of the community to set up support systems such as residential and nursing care homes as these will reveal some concern to their needs and facilitate comfort in life. An improvement on the life of the aging, frail and isolated in the community involves making fundamental changes on how existing services operate. Holland (2007, p. 22) in the article Carer’s perspective on caring: a qualitative analysis of open-ended responses to the carer health and wellbeing index survey, views the role of carer’s in ensuring comfort to the aging and frail in the society. This article also focuses on the challenges that these individuals face in the process of providing care. The findings of the qualitatively designed apparatus were that the carers felt undervalued in the society and this lack of appreciation led to the insufficient provision of healthcare. In addition, there was need among carers that the plights of the sick and old in the society could only be solved through the use of specialized facilities and training of family members of the said individuals. This would not only provide respite hours to the caregivers but also involve more members of the community in serving the old. Such respite hours also help the carers with time to break away from the monotonous caregiving activity. The frail and the old who are unable to access essential medical services for different reasons often feel traumatized and exiled. This according to Bernoth et al (2011, p. 4-5) is attributable to the shortage of residential aged care places especially in rural settings. Most of the old in such communities are often compelled to live in their homes while accessing care that are relatively distant from their places of residence. Through a qualitative research project founded on phenomenology, the study found out that the loss of family ties contributed to stress and other health hazards associated with old age. The sense of being exiled is experienced not only by the person moving away to the medical facility but also his or her family members, friends and relatives. It is for this reason that the delivery of aged care should be founded on the needs of the individual in question and those who share some form of ties and care for them. Windle et al (2011, p. 3-8) in the article Preventing loneliness and social isolation: interventions and outcomes views older people as essentially vulnerable to social isolation and this is related to loss of essential ties in the form of family and friends. Loneliness often impacts on the quality of life and wellbeing of the older and it intern affects their health while increasing their frequency in social care services. Despite the prevalence of this phenomenon, the society has a responsibility of developing initiatives that aim at tackling social isolation. They include mentoring, befriending the old and frail, deploying community navigators and the introduction of social group schemes. Through such interventions, the society can be able to ensure that these isolated members feel accepted and appreciated by the society. Such initiatives increase the possibility that such individuals will participate in communal activities. In addition, they will be ready to be engaged in life enhancing activities such as community service. Milne and Hatzidimitriadou (2003, p. 389-340) in the article Exploring the contribution and conceptualization of older husbands as carers reveals the role of spouses in providing sufficient care to their spouses in their old days. Families are often considered as the best in relation to provision of social services care to the ageing in the society. This is often applicable in situations where an individual lives with his or her children or relatives without his or her spouse. Those who still have their spouses are believed to be able to provide the mist sufficient and effective care considering that spouses provide this care out of love. This article documents that women have been playing a leading role in the provision of efficient care to their husbands. However, the role of husbands in proving care to their ageing wives is often neglected despite the fact that these men are able to provide this form of care through skills acquired from their experiences in life. Through such care the individuals concerned often feel loved and accepted. While agreeing with the argument that husbands and wives should play a leading role in the provision of care to their ageing spouses, the Canadian Pensioners Concerned, Inc. in the article Holding onto Housing recognises the role of the society and especially the government in ensuring that the plights of the old and the frail in the society. This can be realized through the prison of proper housing facilities. Those in the rural setting, who risk being isolated from the rest of the society especially when receiving services from social service centres, can be solved through the development of proper communication and transport infrastructure that will enable quick access to health and social services. This is not entirely the role of the government but also that of the church, private institutions and the ageing individual to ensure the play a role in ensuring proper supply of essential services to the ageing and frail. IPSOS MORI for age UK (2014, p. 12-18), in the article Understanding the lives of the older people living with frailty: a qualitative study, argue that the old and frail in the society often have numerous needs arising from different circumstances. The provision of any assistance or service to such individuals must therefore be based on the need. Recognizing the diversity that exists amongst the old in the society will help in the allocation of resources as it will also provide the most sufficient ad effective resource for the families of the aged and frail in the process of providing care. It is also important for the society to ensure that community service is multipurpose as a way of ensuring that non- health services, which include social care and housing, are equipped to enable easy recognition of any sign of frailty among the aged. One of the greatest problems facing the old, frail and aging in the society is the problem of multiple chronic illnesses. According to Geriatr (2012, p. 2-4), in the article Patient-Centered Care for Older Adults with Multiple Chronic Conditions: A Stepwise Approach from the American Geriatrics Society, one of the major challenges that geriatrics face ids the provision of maximum and sufficient care to the old and frail who are largely suffering from multimorbidity. There is need for various stakeholders are the development of comprehensive strategies for common illnesses. One such strategy is the development of coordinated care and the development of patient-centred medical care which enables such patients to not only consult adequate systems of primary care but also provisions of appropriate structures that will enable the old ad frail to make better decisions essential in the coordination of medical services. The development of a training curriculum can also help family care givers in understanding their role in providing care to the old and frail. Such interventions will not only improve the wellbeing of old but also engage embers of the community in providing better services Patient-Centered Care for older adults with multiple chronic conditions: a stepwise approach from the American geriatrics society. Conclusion The challenges faced by the old and frail in the society are often derived from fear resulting from health complications that are associated with aging. This often leads these individuals to isolate themselves from the rest of the society. The society must ensure that it plays a role in ensuring that these isolated, old and frail individuals are given the necessary care that can lead to the acceptance of their status in life. This can be enabled by the development of different infrastructure that will facilitate an improvement of the facilities that enhance their livelihoods. It is also important to develop a team of experts and members of the community on the best ways to help these individuals to provide comfort in the later days of their lives. The community can also ensure that the old individuals are involved in all the decisions made concerning their lives to enhance ownership and acceptance of their ideas Aim and objective of the research The aim of this study is to understand the problems that the old and frail often undergo in the society as this will facilitate the development of possible strategies to ensure comfort and proper livelihoods for the old, frail and isolated individuals in the society. Objective To understand the problems faced by old, frail and isolated individuals To develop strategies on how to enhance the livelihoods of the old and frail individuals while minimizing the possibilities of isolation Qualitative research design Phenomenology is the best qualitative design approach for this study considering that it describes the experiences as they are lived. When using this method the researcher has the liberty of choosing the method of collecting data since there are no clearly defined steps that can limit the creativity of the researcher. The analysis of data using phenomenology can include classification and ranking data, use of the sense of wholeness. In addition, it allows for an examination of experiences that are beyond human awareness. The outcomes of this study allows findings to be described from subject’s perspective, the researcher is able to identify themes. Furthermore, it enables the development of structural explanation of findings. Through this research design, the researcher will be able to use creativity in designing data collection techniques. In addition, the feelings of the sampled participants will enable the realization of the aim and objective of the study considering that the target participants generate maximum information. References Bazalgette, L., Holden, J., Tew, P., Hubble, N., Morrison, J. 2011, Coming of Age. Magdalene House, London Bernoth, M., Dietsch, E & Dacis, C. 2011, Forced into exile: The Traumatizing Impact of Rural aged care Service Inaccessibility. Sturt University, Wagga Wagga, New South Wales, Australia. Canadian Pensioners Concerned, Inc. 2006, Holding on to Housing: A Participatory Inquiry into the Homeless Among Older People in Rural Areas of Simcoe County. Ontario Division, Canada Clark, R & Greaves, M. The Experiences of Socially Isolated Older People in Accessing and Navigating the Health Care System. Australian Journal of Advanced Nursing. Vol. 27, No. 2., University of Southern Queensland, Queensland, Australia Geriatr, J. 2012, Patient-Centered Care for Older Adults with Multiple Chronic Conditions: A Stepwise Approach from the American Geriatrics Society. American Geriatrics Society Expert Panel on the Care of Older Adults with Multimorbidity. USA Holland, K. 2007, Carers, Perspective on Caring: A Qualitative Analysis of Open-ended Responses to the Carer Health and Wellbeing Index Survey 2007. Faculty of Communication and International Studies, University of Canberra, Australia Ipsos MORI, 2014, Understanding the Lives of the Older People Living with Frailty: A Qualitative Investigation. IPSOS MORI FOR AGE, UK. Milne, A & Hatzidimitriadou, E. 2003, Exploring the contribution and conceptualization of older husbands as carers. Age International, 28, (4), pp. 389-407 Rowntree, J. 2010, Older People with High Support Needs: How can we Empower them to Enjoy a Better Life. Joseph Rowntree Foundation. UK. Windle, K., Francis, J & Coomber, C. 2014, Preventing Loneliness and Social isolation: Interventions and Outcomes. Social Care Institute of Excellence, London. Read More