The Experience of Ageing in Community Healthcare, Essay Example

Introduction

This case analysis is designed to show the impacts of aging on Merindah, is a 79 year old Indigenous woman who lives in Cootamundra in Wiradjuri country. Despite her old age, he is a very active member of the local community. She has a good understanding of the health care field because she served as a register nurse before her retirement. However, she is now feeling the effects of aging. Merindah notices that her skin is becoming dry and wrinkled and she claims that she is starting to feel cold all of the time. As a consequence, it seems that Merindah feels very aware that she is aging and that this is impacting her both physically and mentally.

Merindah is suffering from many physical health problems that are typical for a person her age. Three months ago, she needed a hip replacement and she has not been able to recover from this procedure very quickly. Because of this slow healing, Merindah has become frustrated because she needs others to help her with activities that appeared to be daily and routine. In particular, she has trouble supporting her own personal hygiene because she has a small bathroom. Furthermore, she cannot cook for herself because standing for too long becomes a tiring and painful experience. She also has trouble accessing her medication and her daughter is afraid that she might fall if she is home by herself.

Despite the problems that Merindah and other elderly individuals like her face, it is important to support the health needs of these patients. It is difficult for them to live safely, so it is the responsibility of the nurse to provide them with information that will help them through their troubles. Since Merindah is frustrated at her need to rely on others for help for basic tasks, it is important for the nurses that care for her and those like her to help them remain as independent as possible. It is important for Merindah and others to continue participating in the activities that they enjoy so that they are able to remain happy and have a high quality of life in spite of their physical difficulties.

Experience of Ageing and Psychological Theories of Ageing

It is important for nurses to understand the theories of ageing that relate to the psychological needs of the patients. Interesting understandings of ageing can often be related to the psychosocial stages of development created by Erik Erikson in order to better understand human development. As people age, they are required to go through predefined stages of development that determine their ability to achieve happiness or a state of mental distress. Because we are dealing with an older population, we must consider that the patients we regularly work with have been required to go through these stages of development. As a result, they have had an increased opportunity to have failed to achieve the proper developmental achievement. When people who are adults have had trouble as children, they are more likely to have trouble adults. This understanding is important when we are trying to help these people cope with ageing.

The last step in Erik Erikson’s developmental stage is called ego integrity versus despair. This state is used to describe senior citizens, aged 65 and up (McLeod, 2008). Erikson believes that at this point in life, people are able to either appreciate the accomplishments they have made and the life that they have lived and come to terms with their ageing. If this does not happen, they will be depressed because they still want to be able to do the things they couldn’t when they were younger. Patients that were unable to accomplish these dreams when they are young are more likely to become depressed because of their ageing. It is these patients that are the most likely to need additional psychological support.

Even though Erikson’s model only gives two options, nurses can help senior citizens in the despair stage recover from their depression. Therapy can be used to help them cope with their ageing experiences and come to accept that they are in this stage of life. Even though Merindah is sad because she cannot clean herself, cook, and her hair is turning gray, she has a supportive daughter and medical staff that is able to help her through this hard time. Therefore, even though she currently appears to be in the despair stage of psychosocial development, she appears to have the ability to achieve the ego integrity stage.

Communication Theories for Interaction

It would be helpful to use the humanizing nursing communication theory to help Merindah (Duldt-Battey, 2004). Because she was a nurse, Merindah already understands some of the communication techniques so it is important to use one in which she feels like she is being respected and helped. The humanizing nursing communication theory focuses on showing compassion for the patient based on listening to the needs of the patient and then providing them with self-disclosure. Feedback and trust are also important parts of this relationship. Therefore, when hearing Merindah’s needs, it is important for the nurse to listen to her carefully and then to provide her with insight that will help her through her time.

It is important to approach Merindah from a place of caring. She is very distressed that she is unable to perform some of the tasks that she enjoyed doing when she was younger. In addition, she is noticing that her physical health is not improving. Therefore, she is very worried. In communication with Merindah, it is therefore important to talk to her in a manner that will not increase her worry. Since she is knowledgeable about health as well, it is also important to be honest to her in order to establish trust. Therefore, nurses should never be dishonest with her about her medical situation or she will stop trusting the information that they give her. Listening to Merindah’s concerns and giving her feedback based on these concerns is the best way to ensure that she is able to receive helpful treatment. New advice that Merindah doesn’t already know will also be helpful and she will respect the nursing team for giving her this information.

Age-Related Changes that Relate to the Person

It is apparent that Merindah’s needs are related to both physical and mental symptoms. However, the mental symptoms result from the physical ones. Because Merindah is ageing, her once black hair is turning grey and she notices this change. In addition, her skin is becoming very wrinkly and dry. It seems that she remembers a time in which this was not the case, so she is having trouble accepting that this is happening to her. Furthermore, while these appear to be the symptoms of ageing on the surface, Merindah is suffering from medical problems that are making her day to day life more challenging.

In particular, her hip problem is a concern because it shows that not only does she have osteoporosis or general bone weakness, she is also having a difficult time recovering from theses fractures. Therefore, it is important for her and her family to help her prevent falling at all costs. In addition, she is experiencing a lot of pain from standing which is in part due to her weak bones. At her last visit, it appeared that Merindah was bruised and experiencing more pain than she usually does. As a result, is clear that she has suffered trauma and has been unable to recover correctly. She is having a challenging time recovering because ageing individuals have cells that multiply less slowly (A Place for Mom, 2015). Therefore, it is hard for her to recover from any of the things that happen to her, so it is likely that prevention is the best method.

Keeping Patients as Independent as Possible

In order to allow an elderly patient to remain independent, it is important for the nurse to perform an assessment that will allow them to gain a greater understanding of the risks inherent to the patient’s case. In particular, a fall risk is an important analysis to conduct for elderly patients. Methods such as the Hendrich II Fall Risk Model can be easily used to determine if Merindah and other elderly patients have a high risk for falls (Hendrich, 2013). This particular test uses a mixture of demographic and health data to determine if the individual patient is likely to fall. This test is based on statistical information that helps determine the risk based on past cases. For example, since women are more likely to have osteoporosis, they would be more likely to rank high on this model. If the risk is low to medium, then the elderly patient should be allowed to be independent as possible. However, if there is a high risk, it is important to have their activities compromised or guided. Since Merindah has a medium fall risk based on her past experiences, it is likely that she will continue to be able to independent if she is able to be under the supervision of her daughter. However, her recent bruising episode indicates that she may be becoming weaker, so as time continues, she will likely have to become more dependent on others because of her high fall risk.

Medication Implications

 Currently, Merindah is taking Panadeine Forte 2 BD, Digoxin 0.625mg mane, Celebrex 100mg BD, Mylanta 10ml PRN, and Coloxyl and Senna 2 BD PRN. Panadeine Forte is used to control severe pain and for fever. Digoxin is generally used to control heart failure, Celebrex is used to treat arthritis, Mylanta is used to ensure digestive regularity, and Coloxyl and Senna is used to treat constipation. The fact that Merindah is taking both Panadeine and Digoxin is concerning because Panadeine can become dangerous when it is taken with other prescription medications, especially those that thin the blood (My Dr, 2015). Therefore, it would be necessary for her to receive a different combination of medications.

Nursing Interventions and Rationales

It is important for Merindah to be under the constant supervision of a friend or family member due to her high risk for falling and inability to complete her own hygiene and cooking needs. If it is not reasonable to get her help from these individuals, it may be necessary for her to recruit the help of a home health aide (HHA). Furthermore, Merindah’s health care team needs to conduct a careful review of the medications she has been prescribed. It is unreasonable for her to be taking both Panadeine and Digoxin. Furthermore, her case study revealed no history of heart problems, so it may be possible to remove her from the Digoxin altogether. In fact, this blood thinner may be contributing to the increased incidence of bruises seen in the patient if this prescription drug is not medically necessary.

Conclusion

In conclusion, elderly patients have many unique health care needs. Overall, it is important for their caregivers to understand that as people age, their bone stability becomes reduced and they are more likely to fall and hurt themselves. The recovery process takes a long time because the body does not have the same healing ability as it once did. In addition, it is important for the health care team to carefully look at the medications that elderly members of the population are given. It is important to make sure that a combination of drugs will not contribute to an adverse health effect because elderly people take make drugs and the chance that this will happen is increased as a result. Last, it is important to make sure that all drugs prescribed are completely necessary and are therefore given to support the health of the patient.

References

A Place for Mom. (2015). Elderly Bruising: Risk Factors & Prevention. Retrieved from http://www.aplaceformom.com/senior-care-resources/articles/elderly-bruising

Duldt-Battey, B.W. (2004). Humanism, Nursing, Communication, and Holistic Care. Retrieved from http://www.bwbatteyconsult.com/position_paper.pdf

Hendrich, A. (2013). Fall Risk Assessment for Older Adults: The Hendrich II Fall Risk Model. Retrieved from http://consultgerirn.org/uploads/File/trythis/try_this_8.pdf

McLeod, S. (2008). Erik Erikson. Simply Psychology. Retrieved from http://www.simplypsychology.org/Erik-Erikson.html

My Dr. (2015). Panadeine Forte® Tablets. Retrieved from             http://www.mydr.com.au/medicines/cmis/panadeine-forte-tablets