Aged Care Services and Interdisciplinary Care
Aged Care Services
A Registered Nurse will promote Alex and Sarah’s independence by first putting them on care in their homes. The care service will offer the old couples things like transport, food, housework, social activities, modification of their home, physio, and shopping (Jorgensen et al., 2018). Another aged care service for Alex and Sarah is residential care for the couple in an aged care home. When in a residential home care service, they will get all the services they need and tasked to perform on their behalf (Nagaratnam & Nagaratnam, 2019).
Interdisciplinary Care
The following are interdisciplinary referrals that will be used to promote the independence of Alex and Sarah.
- Since both Alex and Sarah have a problem with their appetite and are underweight, the Registered Nurse will refer them to Registered Dietician for nutritional recommendations and assessment.
- When it comes to addressing Alex’s wound in the leg, he will be referred to an Infectious Disease Specialist who will assess the wound and recommend what should be done. Since he is also having pain, he will be referred to a Pain Management Specialist to help manage the pain he is experiencing from the wound.
- Because of Alex’s wound and condition, he uses a wheelchair. For that reason, he will be referred to an Occupational Therapists for assessment and better recommendations.
Rationale
The aged care services and interdisciplinary care referrals for both Alex and Sarah are aimed at improving their health. Care at their homes is an aged care service that will enable the couple to become independent when it comes to transport, housework, social activities, shopping, and physio. Residential care will also be used where the couple will be taken to an aged care home (Leloux-Opmeer et al., 2016). The interdisciplinary referral that will be recommended for the couple will ensure that Alex and Sarah’s health improves. The conditions of Alex and Sarah will be assessed by specialists and recommendations made based on the findings.
Age-Related Changes and Patient Assessments
The five body systems assessed with particular linkage to the case study are the respiratory system, cardiovascular system, digestive system, Immune system, nervous system, and musculoskeletal system (Noé et al., 2019). When it comes to the cardiovascular system, the Registered Nurse will assess how high pressure on Alex’s left lower leg veins have made either the veins be blocked and valves to be weak, causing the backward flow of blood (Andrews et al., 2020). The issue affecting Alex can be because of both the blood vessels and the heart becoming stiffer. The nervous system will enable the Registered Nurse to assess how Alex’s movement has been affected by arthritis pain felt at the knees. The illness is because of the decreased number of nerve cells that affect some body receptors that enhance movement (Maharaj et al., 2016).
The musculoskeletal system will be used to determine the density of bones. When people get older, they tend to develop less dense bones because of less calcium strengthening bones (Noé et al., 2019). Sarah’s digestive system will be assessed to determine why she does not have an appetite and is fussy with food. The reason may be due to less lactase production because of her age, an enzyme used for digestion (Chia et al., 2018). Finally, the immune system of Alex will be analyzed to determine the reasons why his wound was taking long to get healed. Among the elderly, when the immune system slows, the body will not fight foreign bacteria and illnesses (Valiathan et al., 2016).
The five assessments performed on Alex are inspection, palpation, auscultation, percussion, and the neurological examination (Cooke & Lemay, 2017). The inspection will be conducted on Alex to check on the joints’ inflammation and swelling and determine if he has deformities in the leg (Iturralde et al., 2017). Alex is having a problem with walking and uses a stick because of arthritis pain in the knees. Palpation will be used to assess abnormalities in Alex’s body (King-Kallimanis et al., 2018). Specifically, palpation will be conducted on his legs to assess why he is having a walking problem.
Further, percussion will also be conducted to assess the wound that Alex is suffering from. Alex has reported having the wound for more than 3 months. Auscultation will also be undertaken to listen to the heart to identify Alex’s health issues (Cooke & Lemay, 2017). The report has indicated that Alex has hypertension. Therefore, it is essential to assess the situation through auscultation assessment. Finally, the neurological examination will also be conducted on Alex to determine why he has sleeping problems. The evaluation will help determine the central nervous system’s state and the spinal code during the physical examination.
Medication Management
Excretion-in older individuals, renal clearance tends to be aggravated by chronic urinary tract infection or an enlarged prostate (Stader et al., 2020). Acute disease may result in a rapid reduction in renal excretion, especially when it is dehydrated.
Absorption– absorption of drugs among elderly patients is reduced because of decreased gastric acidity, reduced gastrointestinal blood flow, and mucosal intestinal surface loss (Farinde, 2019).
Distribution– The decreased tissue and muscle mass characterized by aging influences drugs’ distribution, just like the reduced flow of blood to an older person’s organs and tissues (Farinde, 2019).
Metabolism-Hepatic clearance of drug metabolism through reduction, hydrolysis, and oxidation tends to be more prolonged in older people (Stader et al., 2020).
The older individuals are vulnerable to adverse drug events because of distinct reasons. Nonetheless, in the case study, factors that increase the risk of an adverse drug event are smoking, poor dieting, and lack of basic home services (Andrade et al., 2017). According to the case study, Alex smokes and, in most cases, roles his cigarettes. Abusing drugs like a cigarette can expose Alex to the risk of adverse drug events (Glantz & Bareham, 2018). On the other hand, Sarah’s poor dieting can also increase the risk of adverse drug events because the body will not contain the drug’s ability to fight illness. Finally, the lack of essential home assistance is also affecting their ability to undergo medication, thereby increasing the risk of adverse drug events because their bodies are weak.
Aspirin 100mg mane will be used to treat arthritis pain in Alex’s knees. However, the potential complications that Alex may experience while taking the medication is heartburn or stomach pain and throwing up (Cook, & Stevenson, 2016). Perindopril 2mg mane will be used to treat hypertension. The complication that Alex may develop is being tired and being dizzy. GTN 400mcg spray S/L prn will be used to treat angina. The potential complication that Alex may experience for using the medication is dizziness, headache, and nausea (Tofler et al., 2017).
Omeprazole 2omg mane will be used to treat Gastro-Esophageal Reflux Disease (GORD OR GERD) (Forgerini et al., 2018). The medication will affect the ability of Alex to drive because it causes dizziness and visual disturbance. Panadol Osteo 2 tablets twice a day will be used to reduce arthritis pain in Alex’s knees. The potential complication that Alex may experience while taking the drug is a pain in the lower back, sore throat, and sudden rise in the level of urine (Lau et al., 2016). Finally, Ibuprofen 400mg prn will also be used to reduce arthritis pain in Alex’s knees. Nonetheless, the medication’s potential side effects are that Alex will start experiencing headaches, dizziness, diarrhea, and nausea (Asadi et al., 2017).
Reflection
Initially, I thought that every person aged 65 years and above had been enrolled in-home care. It is until I read about Alexander Kumar and his wife Sarah, in the case study, who were seeking healthcare services after developing complications while at home. The couple is living alone in the house and has not enrolled in a home care service while their children live interstate. I have always believed that it is challenging for a couple like Alex and Sarah to juggle between managing their health and caregiving. In the case study, Alexander, aged 85 years old, is the main caretaker of his wife, suffering from dementia, which has made it hard for him to take care of his wound. Although Alex is taking care of his wife, he has not been attending the clinic for over three years despite taking his wife to the clinic for regular checkups. For that reason, I did not comprehend how Alex could manage to take his wife to a clinic for a medical checkup but does not check-in himself.
After analyzing the case study, I feel that the couple require aged care service and interdisciplinary care. I noticed that Alex and Sarah are underweight and that Alex had a wound. Besides, I also noticed that they are wearing little dirty clothes, which was unusual for the couple. Their medical file showed that they did not have services to help them take that they are old and cannot afford to take care of themselves. Alex has not seen a doctor because he could not drive and could not catch public transport, making the couple upset and agitated. Alex and Sarah require aged care services and interdisciplinary care to enhance their independence. In relation to the above, I could not understand why the couple chose not to enroll in an aged care and multidisciplinary service. All the challenges that they were experiencing were a result of not enrolling in the service.
I believe that we all require independence in life regardless of our age. After analyzing the case study, I felt that the couple need aged care services and interdisciplinary care to promote their independence. While I agree that it is the responsibility of children to take care of their parents, they should enroll them in home care if they are engaged in other daily chores or working. Alex is aged 85 years old and is the one who takes care of his wife, Sarah, who is suffering from dementia. Alex and Sarah are sick and require urgent medical attention. For that reason, I feel that they require treatment and be taken in for care in-home services or residential home care services to enhance their independence. Because of their health condition, the couple cannot help each or undertake any home chores. It is essential for people aged 65 years and above to register in care services to live a healthy life and have independence.
I have seen all persons aged 65 years and above being taken to foster care in my locality. We all understand how challenging it can be to take care of an older adult. The case study has taught the importance of registering older people in in-home care services when they get to 65 years. The living condition of Alex and Sarah and their health issues have affected their everyday life. Before the wound, Alex used to take care of his wife, who is suffering from dementia. I believe that due to a lack of services, it became challenging for the couple to get the best assistance on time.
Smoking cigarettes have been proved to affect the health of a smoker. I am of the opinion that it is the responsibility of every individual to ensure that their actions do not endanger their health. For that reason, I found it problematic to understand how Alex was still smoking despite having hypertension, arthritis, and angina. These are serious illnesses that require urgent medical attention and commitment to the part of the patient. Based on the medical file and cross-examination report, I believe that Alex should be prescribed drugs to get better. Besides, I also believe that Alex should start visiting the clinic regularly for checkups to monitor his health and wound. We all understand that when a person gets old, their immune system is weakened, and cannot fight illnesses. Studies have shown that age-related changes impact the health of a person. When an individual is aged 65 years and above, they are prone to disease because their immune system cannot fight illness.
I believe that it is important for individuals older than 65 to frequently visit medical institutions if they are not registered in-home care services for checkups. We only live once, and it is the responsibility of every person to take care of their health. From the case study, we see that Alex had not visited a medical institution for three years despite taking his wife for checkups. Since Alex did not check-in for care services on his wound, the problem became worse, making him unable to drive or catch a public means of transport. Besides, I also believe that it is important for children of parents aged 65 years and above to be near their parents and ensure that they are cared for. If they cannot live with their parents, they should enroll them in a home care service.
Based on my belief and experiences, numerous things were undertaken by the couple that I would have done differently. Since Alex is having a sleeping problem, I would have put Alex on sleeping pills for a certain period. Besides, I would also have put the couple on 24-hour home care services to ensure that Alex gets enough sleep. For that reason, I need to get training in managing patients aged 65 years and above. When faced with such a scenario in the future, I will act the same way to ensure that the aged get enrolled in a home care service. I will also ensure that they are assessed before any medicine is prescribed to them.
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