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.
Simpson, J. A., and E. S. C. Weiner. The Oxford English dictionary. 2nd ed. Oxford: Clarendon Press; 1989.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...
Ackley, B. & Ladwig, G. (2010) Nursing diagnosis handbook:an evidence based guide to planning care. Maryland Heights, MO: Mosbey.
I will discuss how LTC contributes to the U.S. Healthcare System, the targeted clients, employees that work within the long-term setting, the benefits and services offered within LTC, and the expected outcomes for individuals in a long-term facility. I will discuss the legalities and regulatory issues faced within the LTC setting along with ethical issues that may impede successful facilitation of a long-term facility.
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).
With over 1.5 million elderly and dependent adults now living in nursing homes throughout the country, abuse and neglect has become a widespread problem. Even though some nursing homes provide good care, many are subjecting helpless residents to needless suffering and death. Most residents in nursing homes are dependent on the staff for most or all their needs such as food, water, medicine, toileting, grooming- almost all their daily care. Unfortunately, many residents in nursing homes today are starved, dehydrated, over-medicated, and suffer painful pressure sores. They are often isolated, ignored and deprived of social contact and stimulation. Because of insufficient and poorly trained staff commonly found in nursing homes. Care givers are often overworked and grossly underpaid that often results in rude and abusive behavior to vulnerable residents who beg them for simple needs such as water or to be taken to the bathroom.
Touhy, T. A., & Jett, K. (2012). Toward healthy aging: Human needs & nursing response (8th ed.). St. Louis, MO: Elsevier/Mosby.
Taking care of the individuals that are getting older takes many different needs. Most of these needs cannot be given from the help of a family. This causes the need of having to put your love one into a home and causing for the worry of how they will be treated. It is important for the family and also the soon to be client to feel at home in their new environment. This has been an issue with the care being provided for each individual, which has lead to the need of making sure individuals have their own health care plan.
...rcise, social activity, and proper nutrition are important in keeping the patient healthy as well. Any steps toward producing a calm, safe, and well-structured environment may help the patient. Helping the patient and the family with the legal aspects, supporting the family through care giving, and assisting with decisions about long-term care placement are also crucial to help the patient.
Spark Ralph, S. & Taylor, C. M. (2011). Nursing diagnosis reference manual (8th ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
The New International Webster's Pocket Dictionary of the English Language. Naples, FL: Trident International, 2002. Print
Pearsall J (1999) The Concise Oxford Dictionary Tenth Edition page 286 by Oxford University Press in Oxford New York, America
St. Louis, MO: Elsevier Ackley, B.J., Ladwig, G.B., & Flynn Makic, M. (2017). Nursing diagnosis handbook (11th ed.). St. Louis, MO: Elsevier University.
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
Gordon, M. (2007). Manual of nursing diagnosis: including all diagnostic categories approved by the North American Nursing Diagnosis Association (11th ed.). Sudbury, Massachusetts: Jones and Bartlett.