Nursing makes an important contribution to the health and well-being of the elderly
Nurses are involved in ensuring that older people's healthcare and social needs are met in a timely, appropriate, and efficient manner. Nurses employ clinical judgment to assist older people in maintaining, improving, recovering, and coping with health-related difficulties, thereby improving their quality of life. An examination of primary health and community healthcare is one of the essential areas where nursing care is required. Assessment is the first phase in the care process since it gives information that aids in the development of care plans and actions to be taken. Evaluation of older persons involves collecting biological, physical, psychological, psychosocial and other functional aspects of the older person. This paper presents a critique of an older person assessment carried out by Robyn, and Aged Services Emergency Team (ASET) Registered Nurse as she assesses Max in an Emergency Department in a rural hospital. The Critique will focus on age-related physiological changes and communicate with an older person, the actual process of assessment, and strength-based assessment.
Person-centered Communication with an Older Person
The patient indicates that he has hearing problems, he is anti-social and suffers from depression. According to Yorkston, Bourgeois, and Baylor (2010), communication changes occur in older persons. They say that "with typical aging, communication skills change subtly at least in part because of changes in physical health, depression, and cognitive decline" (Yorkston et al., 2010, p. 310). Aging is attributed to physiological changes in voice, hearing, and speech processes. It is evident from the assessment video that the nurse has to pay close attention to what Max is saying because his voice tone has decreased. Change in the communication skills like a change in voice may be subtle. However, they lead to life consequences like avoiding social situations. Although Max does not explain the reasons for his anti-social behavior, changes in his communication abilities could contribute to his avoidance of social situations. Max indicates that he has hearing problems which could further compound his communication problem. As Yorkston et al. (2010) says, communication is vital for the day to day functioning of any individual: personal relationships, community engagement, social activities, and meeting other daily needs. To assess and help the patient, the nurse first identifies the communication strengths and weaknesses. She finds out the extent of Max’s hearing and eye problems. Throughout the assessment, Robyn takes extra time to understand what the patient is saying. In most instances, she repeats what Max says as a way of ensuring what she heard is what was communicated. Additionally, she ensures that the environment is quiet and conducive for the interview. Robyn does not give long sessions of information; she offers limited information where need arises. At the same time, she explains the reasons for her suggestions. However, in some instances, she asked closed questions which limits the opportunity to probe the patient further. It is critical to acknowledge that the ability to attain the best outcome of assessment is dependent on how inquisitive the care provider is. Indeed, as a nurse, it is vital that one asks questions which are likely to yield the best outcome through proper treatment (Curtis et al., 2013, p2275). For example, failing to ask questions in a given way could result in the patient not providing all of the information that could be essential in ensuring the attainment of better outcomes (Fastré et al., 2013, p627). Consequently, the effect would be a failure to provide proper aged care to the individual patient. The nurse should evaluate such aspects.
The Process of Assessment
One of the most important consideration when carrying out a health assessment for older persons is obtaining informed consent. At the beginning of the conversation, Robyn explains to the patient whom she is, what she would be doing and its importance. She seeks consent from the patient who obliges. It is recommended that when executing an assessment, one focus on the day-to-day activities. In providing care to patients, it is vital to come up with an approach that adequately illustrates what should be done and in which manner. Indeed, as a care provider, the engagement with the patient is imperative since it would provide an avenue through which they are treated (Hanna et al., 2016). However, the ability to do so is dependent on the creation of a good rapport between the nurse and the patient (Williams et al., 2016, p220). It is for such a reason that Robyn attempts to create a good relationship with the patient in an effort to ensure that the best outcomes are attained. In response, it is evident that the patient obliges. They should be linked to the overall health because they give an indication of the status of the individual. Robyn starts the assessment with finding out about the background of the patient. The determination of the patient background is critical since it forms the basis of treatment. For example, a patient could be having a given history which is imperative in the kind of treatment that is provided. For instance, in a scenario where a patient has a history of a given disease, it becomes essential to take into consideration that information when offering care to the patient (Kohut, 2013). She finds out what areas help in maximizing Max’s life potential, preventing distress and maintaining good health. Indeed, the approach is beneficial since it will result in the achievement of quality treatment. In general, it is the mandate of any given care providers to prioritize on the kind of care offered to the patient. The attainment of better outcomes, following treatment, depends on the approaches which are adopted. It is out of such understanding that efforts are undertaken to ensure that information which is critical to the well-being of the patient is attained (Gagnier et l. 2014). In essence, that would form the basis of care, leading to achievement of better and high-quality outcomes of treatment. However, it is critical to understand that such effects are only possible to the extent that the patient is cooperative.
Strength-based Assessment
Strength-based assessment that focuses on moving attention away from problems and tasks to seeing the person involved and the abilities he has (Moyle, 2014, p. 41). Additionally, this approach assumes that the patient will do better if they are assisted in recognizing and using their strengths and resources available to support them. The ASET RN encourages the patient to continue performing the activities the patient executes like doing laundry, buying groceries, and mowing the lawn. This is in line with the principles of strength-based assessment since in spite of their diminished functioning ability; older people retain valuable abilities in life which help them to engage in activities independently (Janssen, Regenmortel, & Abna, 2011, p.145). Encouraging Max to continue engaging in these activities optimizes his independence and reduce the perceived caregiver burden. Max mentions that he suffers from depression and is positive that he can handle the problem alone. However, the nurse encourages him to talk to someone in case he feels low because it helps ease the burden on the mind. Another aspect of strength-based assessment is the focus of the patient’s family members (Benzein et al. 2015, p137). In this assessment, Robyn finds out the kind of relationship that the patient has with his family: his wife, children, and cat. The strengths and capabilities of the family are involved in the support system and promotion of good health for the patient (Pulvirenti et al., 2014, p305). For instance, whether Max can talk to his wife about his health issues, and if he is able to reach his children if need be. Some techniques recommended by Moyle (2014) include self-determination, empowerment, and collaboration, reflection on change, community engagement, and regeneration. Nurse Robyn does a great job at using these techniques. For instance, she allows Max to self-assess on the progress he has made. Additionally, she encourages the patient to be socially active which does not only help with the depression problem but helps in engaging in physical activity (Grecucci et al., 2015, p70). The nurse applies the ROPES model in assessing the client. She explores the resources available to the client. She also suggests how the patient can deal with his problem: for instance talking to his wife, and seeking help from a resource center. She excellently offers solutions as the conversation progresses. She suggests actions to take and explains how they support his health. For instance, when she describes the precautions the patient need to consider when transferring from a chair to standing. In terms of possibilities, the nurse asks the client if he knows where to access help and offers information on the website to use and the resources he would need. At this point, she wants to find out if Max has access to a computer and internet which are essential resources Max can use in looking for help.
Conclusion
Nurses continue to play a critical role in ensuring the attainment of better outcomes for patients. Indeed, the ability to successfully deliver the best-aged care is dependent on the type of plans which are enacted. The establishment of a clear framework that leads to the achievement of improved care is critical since it will result in better outcomes for the patients. Consequently, it is imperative for the nurses to ensure that they embrace proper actions of care. The paper provided an in-depth analysis of aged care. The approach was based on the understanding that such individuals are at risk of suffering from adverse conditions hence the need to develop proper ways of care. The assessment, based on a critique offered by Robyn and Aged Services Emergency Team is instrumental in offering insight into aged care.
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