Aged Care Assignment Essay Example

  • Category:
    Nursing
  • Document type:
    Essay
  • Level:
    Undergraduate
  • Page:
    4
  • Words:
    2366

10AGED CARE

Aged Care Assignment

Aged Care Assignment

Introduction

The ageing population is presently one of the leading concerns facing health care systems the world over. Indeed, it is a fact that with advancing chronological age, the prospect of developing a variety of health problems and chronic diseases increases and subsequently, escalates the demand for appropriate health care resources (Phelan, 2011). Consequently, with the global trend towards a progressively more ageing population, it is evident that health practitioners, nurses in particular, require to be equipped with the appropriate knowledge and expertise to accomplish significant roles in dealing with future health and support needs (Topaz & Doron, 2013). Notably, one prominent concern in gerontology is discrimination against persons based on their age, a phenomenon commonly referred to as ‘ageism’. Extensive research has shown that ageism has a negative influence on the nature of health care services that older individuals are given, both explicitly, by providing poor quality and offensive treatment, and implicitly through unfair resource allocation by the stakeholders (Eymard & Douglas, 2012). Negative biases and ageist attitudes amongst care providers, principally nurses, toward elderly persons in care settings, are among the more notable expressions of ageism within the health care system (Holroyd, Dahlke, Fehr, Jung, & Hunter, 2009). Accordingly, identifying these attitudes institutes the first phase in understanding the numerous aspects of interactions among nurses and elderly patients.

The current paper critically analyses the attitudes and beliefs of nurses towards the aged that underlie such comments and how such attitudes may affect the nursing care for this patient. Further, this essay includes an analysis of how the responding nurse’s values and beliefs could impact on the practice of other health care professionals. Moreover, this paper will explore these issues and review the role of all health care practitioners towards changing their attitudes and developing more positive relationships necessary to respond the unique needs of this population.

Assessment of the patient and early assessment

This essay discusses the phenomenon of ageism in healthcare settings with reference to the case of a confused elderly man, presenting to the ED for quality care. The elderly patient, approximately 65 years of age, is in a disheveled and unkempt condition, and is unable to give any coherent information regarding his condition, address or himself. From his physical appearance and odor it appears that the patient has not had a shower for a long period of time. An examination by the ED nurse reveals that his breath has an acetone odor, a 50cm hematoma on the right side of his forehead, and a frequent need for urination. When the ED nurse hands over the elderly patient, the colleague nurse taking over remarks says that she does not like taking care of older patients since they smell and are all senile.

Discrimination of the elderly person known as ageism is evident in this case. Elder people are regularly stereotyped as negatively, frail, sick, and disabled, or positively stereotyped as wise or caring. However, both forms of stereotypes are detrimental, since the extensive range of attitudes hinders individuals from accurately evaluating and responding to social issues and conditions of elderly adults. Further, the potentially damaging implication of ageism is reflected in the opinion that elderly individuals are a burden and that the ageing process is associated with the loss of self-control, loss of independence, social isolation and overall disengagement from life. Further, ageism regularly leads individuals to view elderly adults as depressing and sickly, unproductive, and to consider cognitive impairment as a natural outcome of the ageing process.

Extensive gerontology research has shown that healthcare professionals and caregivers are particularly vulnerable to ageist stereotyping due to their augmented exposure to ill and infirm elderly individuals According to Rodgers & Gilmour (2011), healthcare professionals both, consciously and unconsciously, share identical ageist attitudes that pervade the general society, further compounded by a disease-oriented training and experiences oriented towards the extreme illness and dying component of the ageing spectrum (Rodgers & Gilmour, 2011). Such ageist attitudes within the healthcare system are manifested in career choices that circumvent health care settings for elderly individuals and in interactions with elderly patients that inhibit the potential for enhanced health and well-being (Doherty, Mitchell, & O’Neill, 2011). Similar to the current case, elderly patients are often considered as a nurse’s burden and a hindrance to the more vital work of providing care to younger adults. Indeed, some studies have shown that some nurses tend to find the care of confused older patients frustrating, and also tend to identify with the prevailing societal culture, which undervalues elder adults (Liu, Norman, & While, 2012).

Factors Affecting Nurses’ Perceptions of Older People

Ageism is a general form of discrimination that affects the elderly population particularly older patients, both directly and indirectly. In its broadest meaning, ageism is seen as the stereotyping of, discrimination against and prejudice towards any individual or individuals directly and exclusively as a function of their having reached a chronological age considered or defined by their social group as “old” (Simkins, 2008). Indeed, current literature regarding attitudes toward older individuals has placed more emphasis on the nurse or caregiver’s training and personal traits, as well as the overall work environment. Primarily, empirical findings and theoretical models have suggested that personal traits influencing a nurse’s attitudes regarding ageing include age, gender, and education level (Topaz & Doron, 2013). Further, environmental factors influencing these attitudes include (a) area of employment in nursing (emergency care, long term care, acute care, or rehabilitation settings); (b) amount and type of exposure to older persons; and (c) type of department in which nursing staff are employed (Klein & Liu, 2010). However, to date, research has recognized the nurse’s level of knowledge of the ageing process as the most important factor influencing geriatric patient care (Holroyd, Dahlke, Fehr, Jung, & Hunter, 2009). Notably, studies show that nurses, who have higher levels of formal training in gerontology and geriatrics, exhibit more positive attitudes as compared to those with little or no training in the field (Higashi, Tillack, Steinman, Harper, & Johnston, 2012). Other studies have also shown that nurses with higher education levels in geriatrics and gerontology demonstrate advanced levels of understanding of the needs and desires of elderly patients, and display a more positive attitude toward the older populations (Meisner, 2012).

With regard to the case scenario, the nurse may have a skill or knowledge deficiency in the field of geriatric care, leading to a lack of understanding of the ageing process and older people. Notably, elderly patients require intensive and quality care, which demands, on the part of nurses, specialized education and extended time at the patient’s bedside, as well as personal traits such as patience and humility. In the current case, the nurse has specialized in the emergency department care where the main priority is the delivery of efficient and rapid care for acute care for younger patients (Asomaning & Broek, 2011). Moreover, the nature of the ED environment involves making patient observations, giving medications and conducting procedures under time constraints. Conversely, the care of elderly patients requires special attention to their hygiene, nutrition, mobility, elimination, educational needs and allocation of elongated time periods for recovery (Dahlke, 2011). As such, the ED nursing routines curtail the provision of effective quality care, required by geriatric patients. Subsequently, such gaps in the care routines and patient needs, lead to the development and internalization of negative attitudes on the part of the ED nurse, founded on the view that elderly patient is a burden on time management (Asomaning & Broek, 2011). In addition, the nurse may have had negative experiences with elderly patients, in the past, which may have formed the basis of such negative attitudes and perceptions of older individuals. Besides, the nurses are of specialization is the ED, and as a result, she may have a lack of interest resulting in negative attitudes and beliefs towards the elderly (Eymard & Douglas, 2012).

Impact of Negative and Ageist Attitudes on Provision of Care

Primarily, elderly patients have a longer stay in hospitals and hence, the development of functional relationship between the nurse and elder patient is a critical element of patients’ satisfaction (Bakhtiari, Zadeh, & Moshtagh, 2007). Accordingly, where this relationship is dysfunctional, the social process an involvement of the elders is impaired and, therefore, their cooperation decreases. This is a potential causal factor in nurses’ negative attitudes and stress regarding elderly patients. Notably, this relationship with elders requires particular care since it is influenced by a variety of obstacles including time constraints, privacy, physical and mental disabilities as well as cultural differences. Moreover, the changes associated to the sensory system also affect on elders’ communication skills. As a result, elders are subjected to disrespect and discrimination, which may cause them to form a defensive wall to shield themselves against disquieting perspectives. To remove this wall, nurses are required to address patients with positive attitudes, honesty and friendliness, as well as providing personalized care (Bakhtiari, Zadeh, & Moshtagh, 2007).

Conversely, in the case, the nurse has exhibited a negative attitude towards the elderly, which may impact the nature of care given to the patient. Research shows that caregivers’ or nurses’ attitudes toward older individuals influence the nature and quality of health care services the elderly patients receive (Topaz & Doron, 2013). For instance, potentially remediable or manageable health concerns such as problems in balance, incontinence and pain are attributed to the ageing process rather than being identified as health issues to be dealt with efficaciously. Further, nurses may view such problems of elderly patients as irreversible, untreatable and unexciting and hence, provide substandard care to them (Laidlaw, Wang, Coelho, & Power, 2010). Similarly, nurses may invariably view elder people as annoying, stupid, decrepit, smelly, feeble and unusually eccentric (Liu, Norman, & While, 2012). Consequently, when caring for elderly patients, these nurses are more likely to disregard autonomy and dignity of such patients; use physical restrictions; use inappropriate and inadequate communication and generally discriminate against them (Topaz & Doron, 2013).

Notably, privacy and confidentiality in decision making is an essential component of care for every patient. However, in the ED setting, nurses are prone to breach this privacy due to overcrowding due to inadequate space. In the current case, the nurse breached the patient’s privacy since her comments were audible to other nurses and possibly patients in the ED. In this way, the nurse may have impacted the patient’s wellbeing and possibly the formation of negative self-beliefs in the patient (Marshall, 2010). Another essential component in efficient geriatric nursing care is communication, which helps build a functional nurse-patient relationship and enable the patient to develop a better understanding of their condition (Pope, 2012). High level communication is particularly critical in elderly patients with cognitive impairments such as confusion. Accordingly, inadequate or insufficient communication and over-accommodation through baby talk, patronizing and controlling speech may impact the patient’s self-perception and self-image. Inadequate communication means that the patient lacks access to relevant support and necessary information regarding medical procedures and medication as well as the expected changes in their conditions and during hospital stay (Winterstein, 2010). Insufficient communication also means a lack of autonomy in the decision making process of the patient and subsequent dependence on the hospital staff. Dismissal of symptoms as a part of the ageing process is also detrimental to the level of care provided. In the scenario, the nurse may ignore the patient’s confusion and body odor due to her ageist attitude, and subsequently ignore potential disease symptoms rendering it untreatable in future (Marshall, 2010).

References

Asomaning, N., & Broek, K. (2011). Enhancing Geriatric Care in the Emergency Department. The Journal of Emergency Medicine, 107(8), 12.

Bakhtiari, S., Zadeh, S., & Moshtagh, Z. (2007). Nurses’ attitudes toward the obstacles in their relationships with elderly patients. Iranian Journal of Nursing and Midwifery Research, 12(4), 120-124.

Dahlke, S. (2011). Examining Nursing Practice with Older Adult Through a Historical Lens. Journal of Gerontological Nursing, 37(5), 41-48.

Doherty, M., Mitchell, E., & O’Neill, S. (2011). Attitudes of Healthcare Workers towards Older People in a Rural Population: A Survey Using the Kogan Scale. Nursing Research and Practice, doi:10.1155/2011/352627.

Eymard, A., & Douglas, D. (2012). Ageism among health care providers and interventions to improve their attitudes toward older adults: an integrative review. J Gerontol Nurs. 38(5), 26-35.

Higashi, R., Tillack, A., Steinman, M., Harper, M., & Johnston, C. (2012). Elder care as «frustrating» and «boring»: understanding the persistence of negative attitudes toward older patients among physicians-in-training. J Aging Stud. 26(4), 476-83.

Holroyd, A., Dahlke, S., Fehr, C., Jung, P., & Hunter, A. (2009). Attitudes toward ageing: Implications for a caring profession. The Journal of Nursing Education, 48(7), 374-380.

Klein, J., & Liu, L. (2010). Ageism in Current Practice: Experiences of Occupational Therapists. Physical & Occupational Therapy in Geriatrics, 28(4), 334-347.

Laidlaw, K., Wang, D., Coelho, C., & Power, M. (2010). Attitudes to ageing and expectations for filial piety across Chinese and British cultures: A pilot exploratory evaluation. Ageing & Mental Health, 14(3), 283-292.

Liu, Y., Norman, I., & While, A. (2012). Nurses’ attitudes towards older people: A systematic review. International Journal of Nursing Studies, 1-12.

Marshall, L. (2010). Potential implications of registered nurse attitudes towards caring for older people. Contemporary Nurse, 35(1), 95-99.

Meisner, B. (2012). Physicians’ attitudes toward aging, the aged, and the provision of geriatric care: a systemic narrative review. Critical Public Health, 22(1), 61-72.

Phelan, A. (2011). Socially constructing older people: examining discourses which can shape nurses’ understanding and practice. Journal of Advanced Nursing, 67(4), 893-903. doi: 10.1111/j.1365-2648.2010.05536.x.

Pope, T. (2012). How person-centred care can improve nurses’ attitudes to hospitalised older patients. Nursing Older People,Volume 24, Number 1, 32-36.

Rodgers, V., & Gilmour, J. (2011). Shaping student nurses’ attitudes towards older people through learning and experience. Nursing Praxis in New Zealand,27(3), 13-20.

Simkins, C. (2008). Ageism’s Influence on Health Care Delivery and Nursing Practice. Journal of Nursing Student Research: Vol. 1: Iss. 1, 24-28.

Topaz, M., & Doron, I. (2013). Nurses’ Attitudes Toward Older Patients in Acute Care in Israel. OJIN: The Online Journal of Issues in Nursing Vol. 18 No. 2, 9-10.

Winterstein , T. (2010). Nurse’s Experiences of the Encounter with Elder Neglect. Journal of Nursing Scholarship, 44(1), 55-62.