Person-Centered Assessment of Older Person - Essay Example

Person-Centered Assessment of Older Person Name: Course: Presented to: Date: Introduction A person-centered assessment refers to gathering of information about needs and preferences of a person through conversation and/or observation. It is a practice that involves understanding the respondent as a person, his or her beliefs, aspirations, preferences and values and social care and health needs (Council on Quality Leadership, 2012). The main purpose of conducting such an assessment is to develop a plan that will assist the respondent in making informed decisions and choices about various issues affecting his or her life. The outcomes of a person-centered assessment are shared with the respondent to enable him or her make independent choices based on the best evidence available. The respondent is also assisted in interpreting evidence and any complex concepts (Council on Quality Leadership, 2012). This paper presents a critical reflection of my discussion with my neighbor, Mr. Smith, aged 77 years. 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 with be given, drawing from the literature review and 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. Critical reflection discussion with an older person As mentioned earlier, I conducted a person-centered assessment on Mr. Smith, a neighbor aged 77 years. 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; involving his family and friends as partners in the assessment process; 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. Adherence to these principles helped to maximize assessment outcomes and to ensure that dignity of Mr. Smith was sustained. 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 by 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. Literature review Some of the key issues of concern for older people include health problems, inadequate finances, loss of friends and loved ones and worry over being a burden to others (Kulkarni, 2009, p. 9; Neikrug, 2003, p. 326). A study conducted by Neikrug (2003, p. 326) found that people approaching retirement are the most worried about old age. Retired persons aged between 65 and 74 years are comparatively less worried because they often find fewer challenges than expected. However, there is a sharp increase in the degree of worries among persons above the age of 75 years. Graham (2003, p. 323) also found that there is an overall decline in worry and degree of anxiety disorders in older adults aged between 65 and 75 years and that the characteristics of worry among may differ depending on the severity of anxiety. Graham (2003, p. 323) also found that there is a positive relationship between anxiety and worry among older persons. Thus, keeping anxiety levels down may help to reduce worries among older persons. Financial security is a major issue of concern among older persons, as identified by Neikrug (2000, p. 326). According to Worawet (2009, p. 50), a significant percentage of older persons in the world depend on family members for financial support. A Survey conducted in Thailand, in 2007 noted that 31.3% of elderly people in this country do not have any savings or financial assets. Consequently, they depend on their children for financial support to cater for their overall needs. Worawet (2009, p. 50) suggests that Thailand government can rescue the situation by creating systems that will enable citizens to make savings that will be paid back to them in old age. Woo (2004, p. 47) found similar results in a study on elderly persons in South Korea. Older persons in South Korea depend on their children for financial support. Social isolation from family members and friends is another issue affecting older people. Social isolation refers to the absence of contact with other people leading to feelings of loneliness (Victor et al, 2009). Loneliness among older people affects their social and health wellbeing. A study carried out by Hawton et al, (2010, p. 57) indicated that social isolation is negatively related to health status and health related quality of life of older persons. In other words, isolation may lead to loneliness and stress and may lead to adverse affects on health and wellbeing of older persons. Discussion 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, p. 4). This can be achieved through getting more workers in workshops, providing in-service training and monitoring. Secondly, there should be effective communication of 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 needs and concerns of elderly persons and uses available information to find the most suitable solutions of care (Adams & Grieder, 2004, p. 5). Staff in a healthcare organization should always focus on interacting more with older persons. They should develop 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, p. 271). This would help to alleviate feelings of loneliness among the older persons. Additionally, 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 to the implementation of person-centered care (Orentlicher, 2008, p. 272). 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, p. 273). Conclusion In conclusion, person-centered assessment helps to determine specific concerns and needs of a respondent. 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 discussion with Mr. Smith and the literature review, 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, most old people accept these problems as inevitable and look at life from 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. 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. References Adams, N. & Grieder D. M. 2004. Treatment Planning for Person-Centered Care: The Road to Mental Health and Addiction Recovery. New York: Academic Press. Graham, C. 2003. Worry and anxiety in old age: Aging & Mental Health Journal. 7(5), 323–325. Hawton, A., Green, C., Dickens, A. P., Richards, S. H., Taylor, R. S., Edwards, R., Greaves, C. J. & Campbell, J. L. 2010. The impact of social isolation on the health status and health-related quality of life of older people: Quality Life Research 20, 57-67. Kulkarni, J, Bharati, V & Rekhade, N. 2009. Adjustmental problems of old age. Food and Nutrition International Journal. 2(9) 9-15. Neikrug, S. M. 2003. Worrying about a frightening old age: Aging & Mental Health Journal. 7(5), 326–333. Orentlicher, M. L. 2008. Striving for Typical: Collective Experiences of Person-centered Planning for Young Adults with Disabilities During Transition. New York: ProQuest. The council on Quality Leadership 2012. Exploring Factor One: Person-centered Assessment and Discovery for Older Adults. [Online] available from: http:// thecouncil.org/factoroneageing.aspx [accessed 30 April 2013]. Victor, C., Scrambler, S., & Bond, J. 2009. The social world of older people. Oxford: Oxford University Press. Woo, D. S. 2004. Long-term care policy for functionally dependent older people in the Republic of Korea: International Social Security Review. 57(2), 47-62. Worawet, S. 2009. Poverty and Financial Security of the Elderly in Thailand: Ageing International Journal. 33(1), 50–60. APPENDIX 1: SUMMARY OF MY CONVERSATION I conducted a person-centered assessment on my 77 year old neighbor, Mr. Smith, on his experiences in the ageing process. Mr. Smith is a former employee of government research institute in Australia. I started by asking him to brief me on his concerns over his physical wellbeing. He expressed that his speed and agility has slowed down. He has become slower in walking and in carrying out of many tasks. In addition, he indicated that he has developed poor eyesight, and he can only manage to read while wearing glasses. He is diabetic, and he is more susceptible for fall sick from minor ailments. He explained that he strives to live a healthy life by engaging in exercises, eating a healthy diet and attending for regular medical checkups. I also needed to know what pleases him more in his old age. He stated that he loves the fact that he has much experience in life, and many young people approach him in search of advice. He also enjoys being accorded respect by younger generations. He stated “I always feel loved and appreciated when a younger person stands and offers me his sit.” Mr. Smith also pointed out that he is weak, and his capacity to work has become impaired. He has not engaged in significant income-earning activities for several years, and this has made him face difficulties in fulfilling most financial needs. However, he mentioned that his children have been providing with funds to fulfill some of his financial needs. He also stated that he is lonely most of the time since he stays alone during day time. He stated “my wife died in an accident, my children are always occupied with their jobs and my grandchildren and always in schools ….. I am left with no one to talk to.” Though these issues were of great concern to Mr. Smith, he stated that he understands that this happens everywhere and is inevitable. He expressed his will to face challenges as they come. APPENDIX 2 Authors Study design Sample Intervention Findings Implications Graham, C. 2003. Random Sampling Three groups of older adults obtained from an electronic register. disorder The study investigated causes of worry among older persons. The author sought to determine the nature and extent of worries among older adults Respondents were worried about death, their families, personal, financial abilities in the future and health. Older persons have different degrees of worry depending on causes. Planning for care should consider individually differences Hawton et al, 2010. Controlled randomized clinical trial sampling Individuals aged 50 years or above who were deemed to be socially isolated or at risk of social isolation This study analysed the relationship between social isolation, health status and health related quality of life among the older people. This approach enabled the researchers to examine the respondents closely and to control the variables that could affect his results. The study found that 24% participants were socially isolated, 17% severely socially isolated, and 59% were at risk of Social isolation. In addition, the health status and health related quality of life of older people subjected to social isolation was very low. This study shows that social isolation negatively affects the health and well-being of the older person. Thus, a plan for care should allow for interaction of an order person with other people. Kulkarni, J, Bharati, V & Rekhade, N. 2009 Random sampling A sample of 100 persons above 50years was selected This study investigated adjustment problems of old people in the society after retirement. This approach ensured that elements of the larger population had an equal chance of being selected. This study found three major adjustment problems among the participants, namely, social adjustment problem, emotional adjustment problem and material adjustment problem. The results of this study indicate that financial, social and emotional problems are some of the major concerns of old people. Thus, they should be considered when developing a plan for care. Neikrug, S. M. 2003. Convenience sampling design 344 individuals consisting of middle-aged and older persons from four organization The study examined various cases into the various worry among. This approach ensured that the sample used represented the whole population in the best way possible used in the study. The study found that middle aged people (55–64) year olds worry the most and those between 65–74 years have lower levels of worries. Planning for the older persons should consider the age-set of a client. Woo, D. S. 2004. Cohort studies Older persons in State of Korea The study looked the implementation of long term care policies for the older people in Korea. The approach was used so as to give an effective representative population to study. This study found that due to the increase in the population of the older people in Korea, then long term care support systems are essential which will be used to offer support to older persons on one hand The study outline various strategies to implement person-centred care such as education and training, providing financial support and care organizational support Worawet, S. 2009. Cohort studies The elderly people in Thailand State The study examined the elderly people in Thailand and ways to reduce their poverty levels and guarantee financial security. The approach was chosen as it assisted in getting a representative sample from the overall population. This study found that older persons in Thailand have financially difficulties and depend on their children for survival. This study shows that financial challenges is one of the concerns of older people and should be considered when planning and implementing person-centred care Read More