Caring for the Elderly, Capstone Project Example

Introduction

The Mary Wade Home

The Mary Wade Home is a five-star senior community that aims to provide personalized care. This assisted living facility and short term rehabilitation program is designed to meet diverse needs. The purpose of the Mary Wade Home is to provide a sense of community among residents and provide a high quality of life. The mission of Mary Wade is to “provide high quality medical care, social programs, and supervised residential services to those in need” (Mary Wade Home, n.d.).

Mary Wade Home’s goal is to provide its clients with the highest quality of care available in the state of Connecticut. Since Mary Wade hires medical specialists with a variety of skills and knowledge to help seniors live a comfortable lifestyle. Mary Wade Home is sets the industry standard for senior living. Mary Wade makes itself stand out from the rest in terms of the level of assistance it’s able to provide its residents both in terms of medical care, entertainment, and community services. Mary Wade regularly invests in state of the art medical equipment and technology to find new ways to provide quality care to its resident population, which contributes to its overall efficacy and appeal as an organization.

“A description of programs and agencies in Connecticut that serve this population.

The Mary Wade Home.”

From the writer: This section clearly asks me to explain the Mary Wade home program, which is accomplished here. I submitted several versions of the paper to your professor and tutor who did not comment this as not matching this requirement.

Background

Aging is a natural process. As we age, our physical and mental health requires increased attention and they’ll often need additional medical care to support their ability to live independently and in a manner that allows for an increased quality of life (Shrivastava, Shrivastava, & Ramasamy, 2013). Elderly patients are typically considered to be those who are 65 years of age or older (Shrivastava et al., 2013). When people reach the age of 65, their life becomes more difficult in terms of biological processes. For example, it becomes more challenging for these individuals to regrow and maintain body cells (Shrivastava et al., 2013). This contributes to tissue and organ damage, which ultimately has the ability to negatively impact health (Shrivastava et al., 2013).

Elderly adults occasionally need increased monitoring in terms of health care maintenance and their daily activities because simple tasks become more challenging for members of this patient population and accidents in the forms of falls can result in life threatening injuries (Shrivastava et al., 2013). The number of elderly adults is on the rise, with a total of 1.2 billion adults over the age of 65 as early as 2025. It is therefore necessary for health care to evolve in a manner that lends to the support of these individuals and their unique health care needs (World Health Organization, n.d.).

Elderly patients are more likely to suffer from a series of illnesses and therefore have a higher risk of chronic diseases, physical disabilities, mental illnesses and other co-morbidities (Shrivastava et al., 2013). It is valuable to consider the cognitive, emotional, behavioral, educational, legal factors related to the elderly population as a whole because by doing so, it is possible for health care providers to deliver holistic care to their patients (Shrivastava et al., 2013). While health care professionals consider the health needs of their younger patients according to independent diagnoses, it is beneficial to consider the health of elderly patients as a whole because different illnesses are often related to the same factors that contribute to the aging process (Shrivastava et al., 2013). Therefore, by considering the connection between the mental and physical supports needed for members of this patient population, it becomes possible for medical professionals to contribute to the development of innovative care methodologies to support their well-being.

One of the most important aspects of health care management for elderly populations is the understanding that a majority of efforts should focus on preventative care (Shrivastava et al., 2013). In doing so, elderly patients should be provided with the resources necessary for them to reduce life threatening health risks, including falls and organ dysfunction (Shrivastava et al., 2013). To support the physical and mental health of elderly patients, it is beneficial to support the use of physical activity, increase their socialization, and provide them with medication to support bodily function (Shrivastava et al., 2013). Furthermore, many of these activities work to support the quality of life of these patients as well (Shrivastava et al., 2013). It is beneficial for nursing homes and other facilities for the aging to support a combination of these services so that members of the elderly patient population are able to receive the health care assistance that they deserve.

Physical Support for the Elderly

Individuals living in retirement homes are usually 65 years of age or older and typically require regular physical therapy and medical care services to support their health (Packham 1989). It is important for medical professionals, volunteers, and other individuals that regularly work in retirement homes to consider that the needs of each individual living in a retirement home is significantly different from their peers (Packham, 1989). As a consequence, it is necessary to provide care to seniors in a personalized and thorough manner (Packham, 1989). While some individuals living in retirement homes are highly dependent on medical care for survival, other members of nursing homes are fairly independent and able to go about their daily activities with minor supervision (Packham, 1989).

In order to maximize care for elderly adults living in retirement homes and communities, it is therefore essential to consider the etiological causes of their need to remain at a retirement home, which is an important changing point in the lives of senior adults. In addition to the cognitive, emotional, and behavioral issues that present, it is necessary for health care professional to determine what types of therapy, care, and activities these individuals could benefit from. It is also valuable for educational and legal factors to be considered because it is necessary for professionals who work in retirement homes to consider the value of improving the quality of life for people who live there.

First, it is necessary for caregivers in the nursing home setting to consider the importance of providing physical exercise and physical therapy to the individuals under their care. As individuals age, it becomes more challenging for their bodies to physically support the maintenance of their muscles and bones. When seniors do not exercise, muscular atrophy and bone degenerative diseases become common (Camp, Johnson, Bugnariu, Lardner, & Knebl, 2015). Therefore, it is necessary for health aides and other health care professionals to consider the value of helping to supplement the physical abilities of their patients or to provide these individuals with regular stretching if they are not able to move on their own (Camp et al., 2015). The extent to which this is possible is different for different members of the retirement community. For example, some individuals lack mobility, which will necessitate that they receive extra help in being stretched or massaged by a health aide. Others pose a fall risk and are unable to exercise on their own and should be supervised. Yet others may experience minor pains after exercise and should be treated on this basis. Physical therapy services would be beneficial for both day clients and live-in clients because this medical intervention will help also reduce the likelihood of muscular atrophy, bed sores, and related disorders (Camp et al., 2015). The literature demonstrates that one of the most important methods that can be used to support the health of seniors is by ensuring that they are able to regularly move and workout to support their health.

Studies have also shown that physical therapy has the potential to decrease the risk of falls in patient care settings (Camp et al., 2015). When senior adults work out their muscles, they are employing the use of techniques that will help support their own ability to walk and conduct regular activities. Physical therapy is a valuable component of senior therapy because it will allow these individuals to be independent for a longer period of time. Seniors need more care when they begin to lose their ability to act independently. Therefore, nursing homes and other senior care centers are able to benefit their patients by contributing to an enhanced quality of life for a longer period of time.

Nutritional management can also be utilized to support the physical health of the elderly patients living in nursing homes (Liu, Tseng, Li, Wu, Cheng, Yang, Chou, Chen, & Shyu, 2014).  Specifically, enhanced nutrition will decrease the likelihood of hip fractures and other conditions that will severely contribute to inhibited movement and increase the likelihood of mortality (Liu et al., 2014). A combination of diet and exercise are recommended to support the health of patients at any age, but these activities become especially important for seniors because the maintained health of their muscoskeletal system is directly dependent on these lifestyle habits. When seniors begin to eat health diets and exercise at an early age, they are more likely to prolong their abilities to live independently as older adults.

Cognitive and Psychological Supports for the Elderly

Cognitive and psychological supports have the ability to contribute to the efficacy of the physical supports that elderly patients receive. Studies have shown that massage could be used to reduce the pain levels experienced by patients with dementia (Kapoor & Orr, 2015). This works both in a physical and psychological manner to help assist elderly patients with their pain management (Kapoor & Orr, 2015). Dementia and Alzheimer’s are among the most common mental disorders that elderly patients develop in the retirement home setting. It is therefore valuable to consider how supports can be provided to enhance patient functionality in spite of the development of these symptoms.

On a physical level, massage helps reduce the amount of inflammation that an elderly individual experiences, which contributes to enhanced movement. On the other hand, massage contributes to decreased stress. By improving the mindset of an individual through the use of massage and other techniques, older adults are less likely to experience mental disorders related to depression. Additional studies show the importance of the elderly receiving daily physical activity in order to support brain function and to prevent cognitive decline in these populations (Buchman, Boyle, Shah, Wilson, & Bennett, 2012). Therefore, the use of physical health techniques also has the ability to contribute to mental health.

Many elderly patients suffer from depression because they are unable to complete many of the activities that they previously enjoyed (Buchman et al., 2012). While this is often due to physical limitations, people who are experiencing severe depression are less likely to engage in these activities because they do not have enough energy or feel that they cannot even though their bodies will let them (Buchman et al., 2012). By encouraging elderly adults to engage in a regular pattern of exercise, it is possible to support their mental health.

Elderly patients that experience depression for the first time typically experience onset after age 60 (Fiske, Wetherell, & Gatz, 2009). It was found that up to 71% of depressed patients living in nursing homes were experiencing their first depression episode (Fiske et al., 2009). Thus, there is a connection between the need for an individual to live in a nursing home, their age, and the tendency to develop depression (Fiske et al., 2009). In this setting, people are living in a location in which they have modified access to the outside world and a diminished ability to pursue their interests (Fiske et al., 2009). The symptoms that these patients manifest are typically less severe than those of patients who present with major depressive disorder (Fiske et al., 2009). Therefore, it is important to consider that treatment should be modified for these individuals as well.

Common symptoms that are reported among elderly patients with depression include appetite suppression, agitation, a loss of interest in previously enjoyed activities, and withdrawal from communication with others (Fiske et al., 2009). Common treatments include conventional pharmaceutical therapy, which includes the use of serotonin re-uptake inhibitors, tricyclic antidepressants, and monoamine oxidase inhibitors (Fiske et al., 2009). In addition, psychologists will work with elderly patients through a form of therapy known as life review therapy (Fiske et al., 2009). This therapy is implemented to help aging patients cope with their elderly status by helping them feel satisfied that they have lived meaningful lives. Although depression in elderly patients is treated in many of the same ways as patients of different ages, the focus of counseling procedures is designed to be relevant to the causes of depression to treat these symptoms at their source.

Another important understanding to the cognitive health of individuals living in a nursing home is that a sense of community helps these individuals remain happy and mentally healthy (Hurd, Martorell, Delavande, Mullen, & Langa, 2013). When a group home is organized in a manner that promotes maximum conversation and collaboration between these older adults, they are more likely to be able to fight depression (Hurd et al., 2013). Nursing homes that have trouble with this social factor can help improve their efforts by organizing group activities for their seniors to participate in on a regular basis (Hurd et al., 2013). Doing so will allow it to be easier for seniors to find a way to forge friendships that will help support them during their stay at the nursing home.

Economic Concerns for the Elderly

According to the National Council on Aging, “Over 25 million Americans aged 60+ are economically insecure—living at or below 250% of the federal poverty level (FPL) ($29,425 per year for a single person). These older adults struggle with rising housing and health care bills, inadequate nutrition, lack of access to transportation, diminished savings, and job loss” (NCOA, n.d.). It is important to consider that economic concerns have the potential to contribute to mental instability and related problems in the nursing home setting. Because economic concerns contribute to the development of stress, these stress related symptoms have the potential to manifest in the form of depression, anxiety, and other mental disorders in the elderly population (Hurd et al., 2013).

Since these individuals are highly susceptible to stress, it is beneficial for medical professionals and other support staff members to find a way to protect senior adults against monetary related anxiety. It is therefore important for elderly individuals to find cost effective ways to support their livelihood and for their health to be managed appropriately. Often, elderly adults are not able to take finances into their own hands because most are unable to work. Monetary problems result when an elderly adult has not been able to save up enough money throughout their lives to support them in their old age or if their family is unable to pay their high health care expenses. Therefore, this responsibility falls to social workers and other individuals that work in the assisted living setting to provide support to the elderly patients. These individuals are often able to attain federal and state funding to help these patients or these individuals can apply for governmental benefits on their own (Yeo, 2013).

Social and Familial Support

Regular and effective communication with friends and family is an important social support for people of all age groups (Galvin, Braithewaite, & Bylund, 2015). However, in the nursing home setting, a primary social problem is that many residents do not often see their friends and family. This is occasionally related to the proximity of these groups; it is challenging for them to travel to the nursing home on a regular basis to see their loved ones because of where the nursing home is located or because of the job responsibilities that the family has (Galvin et al., 2015). On the other hand, lack of communication with friends and family could be attributed to the physical and mental health of the nursing home resident. Still, it is possible that the resident no longer has any living friends or family members, which contributes to their depression with respect to the ability to be social (Galvin et al., 2013)

It is valuable for nursing homes to consider the value of technology in providing recreation and social activities for seniors. For example, Internet use has the potential to reduce feelings of loneliness among older adults (Cotton, Anderson, & McCullough, 2013). Using social media, chat rooms, forums, and other platforms can help seniors communicate regularly with friends and family and even meet new people with whom they can regularly talk. As people age, they have a more challenging time communicating effectively with those around them (Yorkston, Bourgeois, & Baylor, 2012). However, the ability to communicate verbally no longer applies through the use of the Internet and seniors who have been trained to use computers and related technologies have found that these are excellent tools to remain in communication with their loved ones. It is therefore beneficial to help find ways to allow these individuals to still reduce feelings of loneliness in spite of these increased communication barriers. While face to face conversation is still needed to support the health and happiness of individuals in these nursing homes, the use of the Internet is a beneficial way to supplement the efficacy of social strategies and programs.

Social Services

It is especially challenging for elderly individuals who are immigrants to find suitable and affordable retirement homes due to socioeconomic disadvantage (Yeo, 2013). Many seniors have worked throughout their lives and not been able to amass a significant amount of savings. Furthermore, studies have shown that simply being aged has necessitated increased living expenses in the form of medical care (Hurd et al., 2013). Living with dementia and related disorders in the United States has been shown to be highly expensive and individuals who suffer from these disorders are often unable to cover the costs of their care due to their age and disease status (Hurd et al., 2013).

Social security, in addition to Medicare and Medicare withholdings are government programs that are used to support the finances of individuals who fall into these positions (Hurd et al., 2013). However, with a growing number of senior adults who require this care, it is becoming more challenging for even the government to step in and provide programs that support the care of these individuals. It would therefore be beneficial to create programs, such as additional government subsidies which will help these individuals ensure that they will be able to receive care when they are no longer able to work or take care of themselves. Furthermore, by helping patients engage in preventative care, it is possible to enact primary prevention that will help support their health at an earlier age, therefore eliminating the need to conduct these additional expenditures in some instances.

Psychological Care of the Elderly

Geriatric care typically involves psychological treatment in addition to physical treatment because elderly adults are more likely to require mental supports to remain health in terms of their cognitive and emotional health (Resnick, 2013). Furthermore, becoming involved in therapy programs allows these senior adults to gain many of the social interactions that they need to support their well-being (Resnick, 2013). While many studies have been conducted to determine the impact of group therapy on the cognitive health of senior adults, these therapy sessions are now considered to be a common practice and very few studies to support their continued use have been conducted in the past two decades.

However, because group therapy and individual therapy is historically used to support the health of patients of all ages, evidence indicates that it is beneficial to support the cognitive and social needs of elderly patients in this manner as well (Ba, 1991). These previous studies indicate that when seniors interact with one another in a manner that allows them to communicate positively with their peers (Ba, 1991). Individual and group therapy should therefore become an intrinsic part of care for elderly adults, which can be used to support their minds (Ba, 1991). However, in spite of the utility of these therapies, they cannot be used to counter normal cognitive aging (Harada, Love, & Triebeld, 2013). It is therefore beneficial to use these therapies in combination with other supports to confer health to the elderly.

Evaluation of the Mary Wade Home

Evaluation from the Management Perspective

The management of the Mary Wade Home appeared to be integral in the success of the program for its residents. With 93 beds and 93 residents, it is necessary for the management team to optimize care in a manner that enables each individual to receive personalized attention in a regular and timely manner. One of the primary benefits of the operations implemented in Mary Wade House is that the management staff operates the home as if it were a business. This is beneficial in terms of the service offerings they are able to provide their patients, because it ensures that medical resources are always available and that staffing is always adequate. In addition, the home considers its budget in a manner that directly relates to the efficiency of its practices. There are always additional funds allocated for emergencies and other unforeseen needs so that financial difficulty is not a problem that Mary Wade House often faces. Furthermore, high quality programs are offered to the residents of the Mary Wade House due to the finesse that the management team displays in managing their finances and physical resources.

It is evident that a primary concern of management is keeping costs low while optimizing the services that the senior residents are able to receive. According to the Mary Wade House’s website, the daily cost of living for a private room at this facility is $370 while the daily cost of living for a semi-private room is $330 (Mary Wade House, n.d.). These daily costs cover the physical costs of running the facility, food for the residents, the cost of entertainment, and the cost of medical care. Currently, the Mary Wade Home is ranked as the top adult care facility in New Haven, Connecticut and the management team optimizes its practices in order to remain ahead of the competition. Mary Wade Home shows that it is valuable to keep costs low for seniors. Not only is much of the daily living fee covered by private health insurance or Medicare, these prices are calculated in a manner that will keep costs low while ensuring that the quality of services that the seniors receive remain high. In particular, costs directly impact the health care, entertainment, and quality of living that these seniors are able to attain. This helps the management of May Wade House ensure that all of their needs are taken care of, and will help these seniors make the most out of their end of life care.

U.S. Census data has revealed that the elderly population comprises approximately 11% of the population in Maryland. In addition, the number of elderly individuals is expected to grow within the next several decades as the baby boomer generation continues to age and require many of the supports that the Mary Wade Home and other senior centers are able to provide. It is therefore essential for Mary Wade Home and similar organizations to consider how they will be able to support the growing population of elderly patients while maintaining the quality of care that they are able to provide them with. In particular, the Mary Wade Home is currently able to accommodate 93 residents. It is therefore valuable for is community to determine whether it will grow to help provide services to the growing number of seniors present in the population. Since the Mary Wade Home is able to provide a high quality of care to its residents, this decision directly rests on this organization’s ability to balance the quality of services it is able to provide with the number of patient’s that it is able to accommodate.

One of the major advantages of the Mary Wade Home is the staff to resident ratio. In total, there are approximately 30 staff members between members of the management team, professional medical staff (i.e. nurses), medical assistants, health aides, janitorial and kitchen staff, and activity services providers and volunteers. This makes the staff to resident ratio 1:3, which ensures that each resident of the Mary Wade Home is able to receive the attention and support services that they need to thrive. Mary Wade Home attempts to offset the costs of having such a large staff by encouraging members of the community to volunteer and by establishing partnerships with medical training programs. In exchange for providing service to members of the Mary Wade Home, it is possible for members of the community to gain valuable training in medical assisting and service as a home health aide. As a consequence, even though Mary Wade home is a for-profit organization, the expertise that the management employs enables this to be a cost-effective experience for its residents while providing valuable services to the community at the same time.

Mary Wade Home offers a variety of services to residents including hosting an adult day center, assisted living facility, short term rehabilitation services, skilled nursing, end of life and hospice care, Alzheimer’s care, respite care, weekend and medical transportation, in addition to care at home. As such, even though the primary operations of Mary Wade Home function to provide services to seniors living in their assisted living facility, this organization provides a series of other services to patients with varying degrees of independence to ensure that they are able to receive care that is appropriate for their ability levels and family supports. By providing patients with the ability to visit a day center instead of remaining in the assisted living facility, these patients are able to experience an improved quality of life because they are able to receive the supports that they need during the day while enjoying the company of individuals their age. They are then able to return home knowing that they have received the medical assistance that they need to continue living at home with their families.

There is a high need for the services provided by the Mary Wade Home not only because the senior population is continuing to grow, but also because they are able to diversify their services in a manner that applies to geriatric care as a whole. As a consequence, they are able to assess the abilities of their patients without bias and recommend them to one of their many support programs that include home health visits, visits to the day center, and assisted living. Furthermore, once individuals are under the care of the Mary Wade Home, it becomes easier for them to transition to an alternative care situation depending on whether they medical needs have improved or have become exacerbated.

Accessibility to the community is promoted through the use of private busses commissioned by the Mary Wade Home. These busses provide seniors with the ability to commute to and from the senior care center, and provide occasional trips to movie theaters, recreational facilities, and shopping centers to ensure that seniors are able to enjoy some of the same entertainment practices they did during their youth. However, the ability for these individuals to attend these outings are restricted on the basis of their health care needs. Some individuals need to be accompanied by their health aides during these outings to ensure that the seniors do not harm themselves accidentally and are able to receive the same timely medical treatment that they are provided back at the center.

Since the Mary Wade Home is designed to provide seniors with a range of health support services, it is important to consider that its goal differs from goals of many other health care organizations. Its primary aim is to help seniors maintain their independence or to provide them with supportive services to improve their quality of life depending upon their particular activity restrictions. For individuals in the end of life care program, the goal of their care is to ensure that they are able to die with dignity in a manner that minimizes pain. For individuals living in the assisted living program, the goal is to help these individuals maintain independence and support their health using a variety of chemical and physical interventions. Overall, the goal of the Mary Wade Home is to provide services that are designed to make these patient’s end of life experiences as positive as possible by providing them with the ability to engage in their hobbies, communicate with other individuals, remain active, and access to ideal health care delivered by professionals who are experienced in working with members of this patient population.

A broad range of therapy programs are utilized to achieve program goals and objectives. One of the most important measures of success implemented by this facility is regular feedback provided to patients that ask them to report on the quality of the institution overall, the extent to which they believe that they are making progress, whether the organization is perceived to meet their health care needs, and how their rate their quality of life. This data is collected as a baseline measurement when residents enter the home so that the staff are able to track the improvement of their patients. Furthermore, this data is collected at a regular basis, which enables the management team to determine how health care interventions and other changes made at the center influence the quality of care that their patients are able to receive. Client satisfaction is considered to have the utmost priority at the Mary Wade House.

An internal report is utilized by the management team at the Mary Wade House to determine which interventions were successful and which are not. Interventions that are deemed to be definitively successful are those that have resulted in the improvement of at least 50% of the patient population. It is challenging for the Mary Wade Home to accomplish this type of improvement unless the intervention implemented provides a stark difference in the quality of care that patients receive. As a consequence, this tool is used primarily to measure the influence of major program changes in the community. It is challenging to implement medical interventions in this community because the patient population is constantly changing. Furthermore, it is difficult to measure the direct impact of interventions on patient health due to the diversity and prevalence of existing conditions that the typical members of a nursing home population have. Thus, Mary Wade Home looks for large changes to ensure that changes seen were not due to chance or the presence of confounding variables that are commonly seen in this patient population.

An in depth evaluation of the program or agency in which you are completing your internship, including your recommendation for improvement in services. Use the skills and knowledge obtain from your Program Evaluation courses.

 From the writer: this is detailed program evaluation that describes Mary Wade’s practices and shows how they can be improved. This is the definition of a program evaluation.

Recommendations for Improvement of the Mary Wade Home

Increase the Frequency of Physical and Natural Therapy

Because elderly residents have an increased likelihood of suffering from falls, muscular atrophy, and bedsores, it would be beneficial to increase the frequency of physical therapy that individuals at the Mary Wade Home receive. Physical therapy could help restore the motility of many residents, which will enable them to complete more activities on their own, supporting the aging process (Camp et al., 2015). Furthermore, it would be valuable to reevaluate the nutrition contained in the meals distributed to the residents living in the Mary Wade Home to ensure they not only meet the basic nutrition requirements of individuals of this age group, but also cater to the specific health needs of each individual (Liu et al., 2014). Occasional massages should be provided to patients with dementia to reduce the pain levels that these individuals experience (Kapoor & Orr, 2015). It would be beneficial for increased exercise programs to be provided for individuals who are able to participate in physical activity and for modified programs to be provided when necessary to ensure that physical activity is able to support the cognitive health of these residents (Buchman et al., 2012). Overall, a combination of efforts can be put forth to support the physical health of senior adults in the nursing home setting. If emphasis is placed on exercise and nutrition, the adults living in the senior home will have an increased quality of life and decreased need to undergo extreme medical care, which will help cut both their costs in addition to the costs of the nursing home as well. It is necessary to operate with the consideration that the financial security of elderly Americans is at risk; even though these individuals incur the highest medical expenses, they are often unable to pay for these health care needs, which has the potential to minimize the quality of life that they are able to experience (Cooper & Gould, 2013). By engaging in preventative care, the cost of these risks can be potentially offset.

Cost of Care

From the management perspective, it would be beneficial for the Mary Wade House to review its services to determine if the quality of care could be maintained while decreasing the cost per bed required for its services (NCOA, n.d.) It is necessary for the Mary Wade House to determine how to optimize care while reducing costs of the residents. This can be done by optimizing the aspects of care that is covered exclusively by government issued health insurance, such as through the Medicare program (Cooper & Gould, 2013). A review of the budget implemented in the Mary Wade Home and similar nursing home programs will allow the staff to maximize the care that is delivered to their patients while still being able to maximize revenue.

Visitation Programs

Although the Mary Wade House has a comprehensive family visitation program, it would be beneficial for the program to enhance visitation for individuals without living friends and family in the form of “adopt a grandparent” and similar programs. Not all seniors living at the Mary Wade House have friends and family members that are able to visit them and would still benefit from social interactions with others. Furthermore, residents are more likely to feel depressed when they see that their friends at the home have regular visitation but they do not. Therefore, it is beneficial to supplement this social interaction by inviting youth groups and other organizations to the home to spend time with the seniors. Communication needs can further be supported by providing classes to seniors to help them understand how the use the Internet to keep in contact with friends and family and to communicate with new friends in forums and other discussion formats is a beneficial way to help them reduce feelings of loneliness (Cotton et al., 2013).

Social Solutions

It would be beneficial for the government to provide subsidies to assisted living facilities in order to ensure that elderly individuals with no family or means to care for themselves will be allowed to experience the care they deserve. Mary Wade House can apply for grants and other forms of funding to open a percentage of its beds up to individuals in need that fall into this category. There is also a need to review how money allocated for the elderly in health care is spent. For programs like the Mary Wade Home to be effective, it is necessary to reduce waste in expenditures (Huck et al., 2013). Furthermore, this form of financial review will ensure that elderly adults are able to enjoy social security in addition to Medicare benefits for a longer period of time because the same allocated funds will be able to go a much longer way (Huck et al., 2013).

Mary Wade Home Operations

To continue working towards enhancing the quality of care that patients in the day center and assisted living facility are able to receive, it would be beneficial for Mary Wade to consider how it could implement more specific assessments of interventions on the well-being of their patients. While this organization currently utilizes patient feedback systems to determine how interventions and other changes of practice have the ability to influence patient care, it is important for the management team to consider the value of implementing assessments of smaller improvements that contribute to higher quality practices.

For example, a common problem that is presented within the assisted living setting is the rate of patient falls. Since many of these individuals will suffer from debilitating injury as a consequence of hip fracture and related problems, it is important for the staff members of the Mary Wade House to implement protocol to reduce falls and then determine the impact that this intervention has on the number of fall incidents seen at the institution. An example of a reasonable intervention would be to allow patients to press a button notifying health aides that they need assistance when they are attempting to leave their beds or feel dizzy. This will enable health aides to visit the patient in a timely manner and to take action that would prevent the fall by helping the patient walk or by engaging in other supportive tasks. Since reducing the incidence of falls is a small measurable goal, it is the type of quality improvement practice that could be easily implemented by the staff members of this facility. It is important to consider that while constantly asking patients for feedback is a valuable tool for the assessment of the overall efficacy of the Mary Wade Home, it is essential for staff members within the institution to develop more refined ways to confer quality improvement.

An additional concern that is relevant for the care of patients living in assisted living facilities is the extent to which medication errors occur. While this type of problem is more prevalent in the hospital setting, health aides, volunteers, and other individuals that regularly interact with seniors to provide them with medications are present primarily to serve as assistants to help patients open their pill bottles, drink water, and remind them of their medication schedule. However, they do not have a significant understanding of dosing and drug interactions, in addition to the ability to identify medications as the proper brand simply by recognizing the shape, color, pattern, and imprinting of the medication. Furthermore, medication errors are likely to occur between shifts due to a lack of communication between employees. This occurrence is intensified when a changing of a shift occurs close to the time in which a patient is expected to take medication. It is therefore possible for the Mary Wade Home and similar senior care centers to optimize their practices to reduce the incidence of medication errors that occur. There is currently not a significant amount of protocol in place at the Mary Wade Home to prevent and address this type of error.

To reduce medication errors that occur at the Mary Wade Home, it would be beneficial for health aides and other assistants responsible for helping seniors take their medication to keep clear records of when the medication was administered. Details on the record should also include information pertaining to the individual who was responsible for helping them, which medications were taken, and what dose. In this manner, if a health care professional checks the record, they will have a clearer understanding of errors that could have been made because they should be recorded in writing. This will also make it easier for health aides to understand what care had been provided to the patient during the previous shift to prevent against duplicate treatments when this would be detrimental to the health of the patient. Health aides should be asked to provide a written copy of the information in the patient’s file, but also to type a copy of this information into the main computer system. In this manner, the health aide will be forced to consider whether the information provided during the initial record was correct, and typing the information will help health aides clarify information that may be unclear as a consequence of the handwriting used during this process.

An additional intervention that could be applied to reduce the frequency of medication errors is to allow staff medical assistants, nurses, or others with approved training to provide a brief professional development session to health aides regarding drug interactions and basic medicine identification procedures. This training should involve how health aides can use certain websites available online to look up drug interaction information and report suspected interactions to the medical professionals at the facility. While the health aides should not make any definitive diagnoses themselves, this education will be effective if they are able to report potential errors to staff members that are able to suggest a medication change.

Mary Wade Home Health Screening

A third intervention that could be used to optimize the practices that occur at Mary Wade Home is the use of regular physical examinations and cognitive tests to constantly track the health status of the patients. While patients are regularly given a physical examination to assess their weight, temperature, pulse, blood pressure, and other features that are common in physical examinations, these evaluations are not very in-depth and do not appear to be able to readily detect the problems that are likely to contribute to a loss of independence among senior residents. Thus, it would be beneficial for a more thorough examination to be conducted regularly among patients that look for mental deterioration, assess bone density, and other testing that is directly related to the ability of a senior to engage in hobbies and other activities that they enjoy. Doing so will ensure that relevant medical interventions will be applied in a timely manner, which can help prevent some of the damage that occurs from failing to detect diminished health statuses.

Conclusion

As the number of elderly patients present in the population increases, there will be a growing need for high quality senior care facilities to support the health and well-being of these patients. Assisted living facilities like the Mary Wade Home provide patients with a variety of medical, entertainment, and related support services to improve the quality of life that these individuals are able to enjoy. The primary goal of this organizational setting is to provide patients with the supports necessary to live in a manner that maximizes their independence. However, end of life care is also made available for those that require this assistance. Overall, Mary Wade House is considered to be a high quality assisted living facility due to its ability to support the health of its patients through a series of medical interventions and quality reviews.

Although the Mary Wade Home attempts to improve the quality of care that it is able to deliver by regularly surveying patients to determine how interventions impact their quality of life, it would be beneficial for this program to incorporate the assessment of smaller goals to determine how interventions can be used to improve a narrower scope of their health care practice. It was determined that implementing an enhanced communication system between health aides has a potential to reduce the frequency of medication errors that occur within the institution, while implementing an enhanced call system that will allow patients to quickly recruit their health aides when they believe that they are in danger of falling or need help moving will help reduce falls. As such, it is possible for the Mary Wade Home to continue optimizing its practices in a manner that will allow it to improve the patient services that it provides. This task will become increasingly important as the number of seniors that require this type of assisted living rises, so it is beneficial to engage in quality improvement to address the changing needs of patients in the health care system.

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