The character Dorothy said in The Wonderful Wizard of Oz, “there is no place like home” (Baum, 1960, p. 45). Sadly, many of our elderly live in Long Term Care Facilities (LTCF). The transition from living in their own homes, to living in a LTCF, can be a traumatic experience. Poor adaptation to a LTCF may cause depression, malnutrition and significantly reduce the lifespan of the elder. Thus, it is imperative, that nurse’s recognize this promptly.
According to Agnes and Guralnik (2008) adaptation is “a gradual change in behavior to conform to the prevailing cultural pattern (p. 15).” When elders are placed in a LTCF, whether it be voluntarily or involuntarily, they must give up certain liberties that are taken for granted. This includes independently bathing, cooking their meals, and having the freedom to come and go. In most LTCF’s there are scheduled routines of activities, to include meals, bathing, a few physical activities and a lot of down time. The down time can be especially hard for the elders. It is in this period of time, when they may think about family, friends, and other activities they have had to give up.
Parker (2013) mentioned to me in an interview, she is very fortunate to have family members that still care for her since moving into the nursing home. Her daughters and sons come multiple times throughout the day and evening checking on her. She goes on to say that, many of the other residents do not have family or friends. They just sit in their chairs, and stare off into space, wasting away. Nursing homes have been looked at as institutions, rather than homes for the elderly. This leads to more negative thoughts about LTCF’s and the care provided there.
As Whitaker (2009) mentions, LTCF’s enc...
... middle of paper ...
....). Skilled nursing facilities and convalescent homes. Retrieved November 20, 2013, from http://www.helpguide.org/elder/nursing_homes_skilled_nursing_facilities.htm
Ackley, B. J., & Ladwig, G. B. (2011). Nursing diagnosis handbook: an evidence-based guide to planning care (9th ed.). Maryland Heights, Mo: Mosby.
Agnes, M., & Guralnik, D. (2007). Webster's New World college dictionary (4th ed.). Cleveland, Ohio: Wiley.
Baum, F. (1960). The wonderful wizard of Oz. New York, NY: Dover Publications.
Bergland, A., & Kirkevold, M. (2005). Thriving in nursing homes in Norway: Contributing aspects described by residents. International Journal of Nursing Studies, 43, 681–691. Retrieved November 20, 2013, from the Ebsco database.
Whitaker, A. (2009). Family involvement in the institutional eldercare context towards a new understanding. Journal of Aging Studies, 23(3), 158-167.
Ackley, B. & Ladwig, G. (2010) Nursing diagnosis handbook:an evidence based guide to planning care. Maryland Heights, MO: Mosbey.
Mollie is the patient in our case study. Mollie lives with her daughter and son in law, both in their 70’s. A home health aide assists Mollie five days a week for three hours each day. At age 94, Mollie is an older adult, considered to be part of a vulnerable population, at risk for hearing, visual and mobility deficits. This at risk population can experience changes in cognitive or physical status making the activities of daily living difficult to perform (Meiner, 2011). As people like Mollie age, gradually becoming less able to function independently, their grown children, potential caregivers, may be preoccupied with the demands of their own lives and not prepared to care for an older
Landau, Sidney I., ed. The New International Webster's Collegiate Dictionary. Naples: Trident International, 2002. Print.
Long-term care (LTC) covers a wide range of clinical and social services for those who need assistance due to functional limitations. These limitations usually result from complications associated with age related chronic conditions, from disabilities related to birth defects, brain damage, or mental retardation in children; or from major illnesses or injuries suffered by adults (Shi L. & Singh D.A., 2011). LTC encompasses a variety of services including traditional clinical services, social services and housing. Unlike acute care, long-term care is much more complicated and has objectives that are much harder to measure. Acute care mainly focuses on returning patients to their previous functional level and is primarily provided by specialty providers. However, LTC mainly focuses on preventing the physical and mental deterioration of an individual and promoting social adjustments to suit the different stages of decline. In addition the providers of LTC are more diverse than those in acute care and is offered in both formal and informal settings, which include: hospitals, physicians, home care, adult day care, nursing home care, assisted living and even informal caregivers such as friends and family members. Long-term care services have been dominated by community based services, which include informal care (86%, about 10 to 11 million) and formal institutional care delivered in nursing facilities (14%, 1.6 million) (McCall, 2001). Of more than the 10 million Americans estimated to require LTC services, 58% are elderly and 42% are under the age of 65 (Shi L. & Singh D.A., 2011). The users of LTC are either frail elderly or disabled and because of the specific care needs of this population, the care varies based on an indiv...
Elderly Culture and Nursing Homes Nursing homes offer a wide range of long-term care assistance for older adults to be able to meet their everyday needs. Older adults from different cultural backgrounds experience conflict with their decision to participate in a nursing home, catalyzing the underlying stigma different cultures hold towards nursing homes. In many cultures, older adults look for family as their primary source of care. However, when their needs cannot be met due to disability and mental health issues, it begins to take a toll on the person’s instrumental activities of daily living (IADL). IADLs are complex daily actions that are needed to live (Cavanaugh & Blanchard-Fields, 2015).
Upon growing older there are many decisions to be made. Among one of the most difficult and perhaps most important decisions is where the elder person will live and how long-term care needs will be met when he/she is no longer capable of doing so independently due to the incapacity that accompanies many with old age. Nursing homes seem to be the popular choice for people no matter the race, gender, or socioeconomic status with 1.5 million Americans being admitted to them yearly.[3] Because nursing homes are in such a high demand and are not cheap, $77.9 billion was spent for nursing home care in the United States in 2010 alone, they are under criticism of many professions including the legal profession, which is in the process of establishing elder law as a defense to issues with in the elder community. Nursing homes have a duty to provide many things to the elderly including medical, social, pharmaceutical, and dietary services so that the individual may maintain the highest well-being possible.[4] Stated another way 'a nursing facility must care for its residents in such a manner and in such an environment as will promote maintenance or enhancement of the q...
Craven, R., & Hirnle, C. (2009). Fundamentals of nursing: Human health and function (6th ed.). Philadelphia: Lippincott.
There are changes in the demographic as the population grows older, the number of older adult’s increases and thus, there is an increase of proportion of patients that are older adults for nurses to take care of (Wells, Y., Foreman, P., Gething, L., & Petralia, W., 2004). The nurses are there to assist and support the older adults in achieving wellness within their situation through empowering the clients (Touhy, et al (2012). Caring for older adults is important as there is an increase in population with deteriorating health. When caring for a client it is important to incorporate Jean Watson’s caring theories and Carative Factors to help influence and support the care. She encourages nurses to co-participate within the caring process by establishing unity and trust between the nurse and client. First, this paper will explain a situation in where I cared for an older adult and it will then introduce Jean Watson’s lower order needs, specifically the need for activity and how it relates to the older adult I cared for. Lastly, this paper will explain the nursing interventions I implemented to meet the lower order need, with a discussion of Carative Factor #4 relating to the client.
No one ever expects to live out his or her later years in life in a nursing home. When people are young they may not realize the obstacles in life that may cause them not to have a place or person to spend their older years in life with. Regrettably, many of the elderly are not treated with the care and respect they deserve. “Poor quality of care is endemic in many nursing homes” (Fernandez, 2011). It is the responsibility of the younger generation to make sure that the elderly are taken care of and that neglect does not happen. Nursing homes have too many patients and not enough care-givers compared to home care that has familiar one on one care. Home-based
Potter, P. & Perry, A. (2009). Fundamentals of Nursing (7th ed.) St. Louis: Mosby Elsevier, 1029-1084.
Neufeldt, Victoria, ed. Webster's New World Dictionary of American English. New York: Simon & Schuster, Inc., 1988.
Assisted living is an effective type of care facility programmed towards helping older individuals with their increasing disabilities. “The fit between individual capacity and the availability of satisfying activities within an environment is an important aspect of positive aging and an especially salient issue for ALF [Assisted Living Faculty] management, given the role of activities in the consumer selection of assisted living”.2 This isolation of this quote is “positive aging”. Positive aging is important since it leads individuals to have a happier and more fulfilling life, and it can be supported through everyday activities and through the living environment. In nursing homes, each individual needs help with making sure that they are given care that meets their needs. This varies through different states and also communities. The purpose of the quote is to show that each person should be evaluated individually, meaning everyone needs a different approach to deal with the aging process.
Fjelltun, A., Henriksen, N., Norberg, A., Gilje, F., Normann, H. (2009) Nurses’ and carers’ appraisals of workload in care of frail elderly awaiting nursing home placement. Scand J Caring Sci [online] volume 23, p57–66 Available from: http://web.ebscohost.com/ehost/pdf?vid=9&hid=2&sid=3f0cc818-facd-44f5-99fc-3c06a0edbd5c%40sessionmgr104 [Accessed 23 March, 2010]
After having attained a Bachelor’s degree in Zoology and a Master’s degree in Gerontology, I felt I should gain some first-hand experience in physical therapy and thus volunteered to work as a caregiver in a reputed Evergreen rehabilitation center Ga. However, while working as a caregiver I realized I needed to learn much more in order to provide better care in meeting the psychological and physical caring needs of the elderly. I have always had the inherent desire to serve the elderly in reducing their hardships and providing them with the much needed physical and psychological support so that they can lead a happy and trouble-free life.
Limited mobility is a factor that creates a situation where people once social butterflies become home bound, creating a need for increased care (Berger, 2014). As age increases, more support may be needed creating a situation where a nurse would need to support my aunt in the care for my grandmother. Respite care and/or some form of assisted living may be on the horizon; however, as of right now my grandmother is in her home where she wants to be with the ability to stay for the unforseen