Introduction
The growing number of people older than 65 years has an impact on the social service agencies and gerontological nurses who provide care for them. Nurses with special skills in this area oftentimes work in rehabilitation centers, nursing homes, geriatricians’ offices, and patients’ homes to care for elderly patients (Aiken, 2019). As the aging population keeps growing, the providers must anticipate future increased needs of services for this demographic group in the society. This paper will focus on old patient-centered care, intentional learning in caring for the elderly, and evidence-based gerontological nursing concepts. Further, it will look into the assessment of the aging patients; leadership in aging patients assessments and interventions; therapeutic communication with the old patients; and collaborative approach in promoting healthcare for the older population.
Patient centered care of the older adult population
The provision of high-quality healthcare to the aging population is a big challenge to many nurses and other health practitioners. This problem can be overcome through patient-centered care, or client-centered care approach. This concept involves incorporating multidimensional needs and preferences of the older population including their individual needs, goals, abilities, as well as their families’ social norms (Ebrahimi et al., 2021). It focuses on the older person and involves shared decision-making and excellent communication between the care provider and the patient as partners. Further, the care for the aging population should be carried out while observing morals, mutuality, and respect for the patient (Ebrahimi et al., 2021). Currently, this approach to care for the old is increasingly guiding healthcare policies for the aged in Europe, the US, Australia, and across Scandinavian counties. The patient-centered care for older people should take into account the fragilities of the aging population including their cognitive decline, chronic conditions, and coexistence of disability. There is evidence that when patients are involved in decision-making about their own care, the quality of the care outcomes improves.
Knowing the older person as a whole
The healthcare providers should be able to create a functional relationship between them, the older patients, and their families so as develop excellent patient-centered care. Nurses must understand the needs, resources, preferences, spiritual beliefs, cultural diversity, and language barriers of the patients. Therefore, the nurse should be able to pay home visits to the old patient to visually identify a wide range of their home and personal safety needs, cultural norms and values, and their physical conditions. The older population, consider person-centered care as being hospitable, welcoming, safe, homely, neat, and clean surrounding (Ebrahimi et al., 2021). Thus, the nurses must ensure that the environment is set to meet these standards to make the patients feel relaxed and comfortable.
Goal setting through partnerships
Nurses need to set goals and objectives by directly engaging the elderly and their families as partners in decision-making and participation in care activities. The shared power and responsibilities will ensure that the older population and their families are engaged in goal-oriented programs related to self-care (Ebrahimi et al., 2021). This process of personal goal setting enhances the patient’s motivation toward meeting their goals as agreed between them and the medics. Further, it creates a platform where the nurse and the patient plus the family members support one another in making daily decisions to improve the patients’ well-being. Additionally, goal setting through partnerships ensures that the interventions offered are tailored to meet the specific needs of the patient such as enhanced health, good nutrition, mobility, and decreased body pain.
Intentional Learning in Caring for the Ageing Patients
Intentional learning relates to caring for the older adult patient by continual understanding and acquiring knowledge on how to handle the patients. This is by establishing a connection between their way of life and how it impacts the provision of health services to them (Rojas-Ocaña et al., 2021). The nurses should undergo training programs that equip them with skills and knowledge to understand older people in the domestic context, their health problems, and how to manage their family dynamics in homes. Intentionally, the medics must adopt skills that allow them to provide interventions that respect the patients’ and their families’ personal space, cultures, and norms (Rojas-Ocaña et al., 2021). This can be done better at the home-care level because it allows nurses to identify and understand the patient’s cultures, norms, language challenges, and beliefs. Home-care will also enable the healthcare providers to learn how to strengthen the understanding with the patients and their families which boosts their partnership in decision-making in terms of patients’ health problems.
Evidence based gerontological nursing concepts
Nurses should have competencies such as participation and empowerment of the patient and family. They must be skilled in comprehensive geriatric assessment, development, implementation, and evaluation of care plans for the elderly (Bahrami et al., 2019). In addition, nurses must be good coaching so that they can work effectively during the care of aging patients. The concept of participation incorporates competencies such as evaluating family abilities to carry out self-care, needs, and stress levels in cooperation and providing care for the elderly (Bahrami et al., 2019). It necessitates helping families to reduce stress, maintain their physical and mental health.
Comprehensive geriatric assessment
This concept entails the capability of the nurses to undertake comprehensive health status and social support for aging patients. Nurses must be competent in assessing spirituality needs, aging syndromes signs, elderly’s supportive resources, risk factors for the older patients, and distinction of normal aging from illness (Bahrami et al., 2019). They must know signs of chronic and acute illnesses, diseases of old age, complications, and treatment challenges in the vulnerable old population, and interpret tests depending on the values of aging adults.
Nursing Self-Care
The quality of gerontological nursing can be enhanced when the nurses pay close attention to their self-care. They must promote their own well-being in all aspects of life and professional development. When nurses take care of themselves, it helps them boost their overall healthcare provision for other people. This effectively enables them to better manage work-related stress and thereby provide continuous quality services to patients irrespective of their cultural diversities (Bahrami et al., 2019). In terms of professional development, the nurses must take opportunities to grow their expertise in gerontological care.
Assessment of the Ageing Patients
The elderly population oftentimes has many complex care needs which require a highly skilled assessment process. Their examination must adopt a comprehensive, multidisciplinary, patient-centered approach (“NT Contributor,” 2019). This assessment could be performed in a number of healthcare services for the elderly including hospitals, community care, and at their homes. The nursing team conducting the assessment could include nurses, nursing assistants, nursing associates, and healthcare assistants (“NT Contributor,” 2019). During this examination, the comprehensive assessment should cover both patients’ physical, psychological, functional, social, and spiritual domains (“NT Contributor,” 2019). Nurses performing this must demonstrate and use their knowledge of patients’ body systems, human anatomy, genomics, pharmacology, and social and behavioral sciences to help them get patient-centered results.
Geriatric assessment
This standard for assessing the elderly population involves a multidimensional interdisciplinary diagnostic process focused on determining a frail older person’s medical, psychological and functional capability. It enables medics to develop and integrate a coordinated plan for patient treatment and follow-ups (“NT Contributor,” 2019). Therefore, the assessment should of the old patients be able to address their medical, psychological, and functional domains; and incorporate coordinated teams from many disciplines within the medical field.
Different Setting, and Focus
Assessment of the older people can occur in different care settings such as hospitals, community care, and in their homes. A multidisciplinary approach that supports the elderly’s dignity and independence is recommended for all the settings (“NT Contributor,” 2019). However, depending on the place, the examination may have a different focus to the other. For example, in an acute care environment, the focus could be on what is urgent for the immediate well-being of the patient (“NT Contributor,” 2019). In contrast, the assessment in community care is normally focused on enhancing and supporting the patient’s independence. While at home, the basis would be on controlling the patient’s condition in their preferred lifestyle.
Leadership in Ageing Patients Assessments and interventions
Nursing leaders must create a conducive working environment that caters to older patients’ safety. Fundamental changes in terms of how the nurses incorporate patient safety in their daily healthcare provision are very necessary. The nurse leadership must have the ability to transform the physical environment, cultures, norms, beliefs, and practices of nurses taking care of the aging persons. This can be done by establishing the policies and practices in an environment under which elderly patients receive healthcare (“BMC Nurs,” 2020). Nurses caring for old patients must demonstrate their capabilities to practice leadership that benefits patients and their families irrespective of their diversity. Leadership during the assessment and interventions should meet the patient’s and family’s needs, preferences, and ability to identify old people’s life history.
Therapeutic Communication with the Old Patients
Therapeutic communication is defined as the face-to-face process of interaction that focuses on advancing the physical and emotional well-being of a patient. Nurses use therapeutic communication techniques to provide education and support to patients while maintaining objectivity and professional distance (“National Institute on Aging,” 2017). It requires the nurses to talk slowly in a normal tone without shouting or raising their voices to the patients. The nurses must avoid high-pitched voices, face the patient directly at eye level when speaking so that the patient could lip-read or grasp visual clues. The effect of this technique is that the older patients are likely to adhere to treatment, express satisfaction with the services, and have good outcomes from the treatment.
Try not to Rush Information
Elderly people could have problems following rapid or faster delivery of information. The nurses must, therefore, speak slowly to give them time to process the questions being asked or the message being delivered to them (“National Institute on Aging,” 2017). Avoid hurrying the aging patient, and enough time spent with the elderly will allow the nurse to collect very important information reverent that could lead to enhanced cooperation and adherence to treatment by the patient. When they feel rushed, the clients may think they are not being understood, or that they are not respected.
Demonstrate Empathy
The nurses need to show the older patients that they emotionally care about their situations. Studies have shown that clinical empathy has rewards in terms of patient satisfaction, understanding, and adherence to treatment (“National Institute on Aging,” 2017). The medic attending to the elderly patient could achieve this by facing them, maintaining eye contact with them when they are talking, and actively listening to the patients that let them know that the healthcare provider understands their concerns.
Culturally-Competent Practices in caring for the Elderly population
Cultural competence in healthcare is the capability of the health system to offer care services to patients with diverse values, norms, beliefs, and racial backgrounds. Healthcare must tailor their services to incorporate all patients’ social, cultural, and language needs (Brach et al., 2019). This requires the health providers to have a sound attitude, and policies that enhance interactions across a multicultural environment. Provision of culturally competent healthcare reduces disparities to elderly people from minority groups and this must include the following.
Language Assistance
This can be in the form of bilingual nurses, clinicians, and hiring qualified language interpreters to overcome language barriers between the care providers, the old patient, and their families. Successful application of language assistance depends on the policies on using them, training of the nurses and medical team, and the availability of language interpreters (Brach et al., 2019). If quality language assistance is not in place, the communication between the nurses, the patient, and their families could be impaired leading to errors in medication and poor treatment outcomes.
Cultural Brokering
This strategy involves the mediation between the traditional health beliefs and the patient’s culture on one hand and the healthcare system on the other. It has the potential of improving and increasing the cultural competence of the patient in health intervention. Community health workers, family members, and patient navigators normally play a big role of cultural brokers by serving as a partner for both the patient and the provider (Brach et al., 2019). The brokers must be skilled in the patients’ cultural identity and how to link and demystify it in the context of healthcare provision. This is key because providers cannot understand all the different cultures in the patient population they serve.
Cultural Competence Training
Nurses and health practitioners who are providing care for the elderly should get requisite training on cultural competence. This increases their cultural awareness, knowledge, and skills, leading to behavior change (Brach et al., 2019). Several reviews reveal that cultural education has positive impacts on provider outcomes when it includes organizational changes such as core values on diversity and employing multi-racial staff. The health facilities must be able to take the leading role in embracing diversity for their health employees to follow.
Collaborative Approach in promoting Healthcare for Older Population
The care needed by older adults is diverse, complex, and labor-intensive. It requires cooperation and commitment from community health centers, hospitals, and nursing to deliver quality, comprehensive, and effective geriatric care (Moncatar et al., 2021). There must be collaboration and communication among health professionals across different providers, organizations, and sectors to optimize resources, improve safety, and provide quality healthcare services to older patients (Moncatar et al., 2021). This will ensure cohesion, consistent dialogue, efficient utilization of resources, improved standards of care by reducing duplication and gaps in service provision, and delivery of holistic care. For this to happen, healthcare workers from diverse professional backgrounds must work together with the patients, families, caregivers, and communities to deliver excellent quality care across different settings. Collaboration has the potential of improving patients care outcomes, reducing medical errors, and enhancing the speed of treatment for the elderly (O’Connor, 2019). Additionally, it reduces inefficiencies and healthcare costs to the patients and their families, and improves staff relationships among healthcare professionals.
Conclusion
The provision of high-quality healthcare to the aging population is a big challenge to many nurses and other health practitioners. This problem can be overcome through patient-centered care which involves incorporating multidimensional needs and preferences of the older population. Therefore, nurses should undergo training programs that equip them with skills and knowledge to understand older people and their health problems. The training must sharpen their skills in comprehensive geriatric assessment, development, implementation, and evaluation of care plans for the elderly. Further, nurses who provide care for the elderly population must adopt the face-to-face process of interaction that focuses on advancing the physical and emotional well-being of a patient. They must offer culturally competent care services with diverse values, norms, beliefs, and racial backgrounds to patients. Lastly, there must be collaboration and communication among health professionals to optimize resources, improve safety, and provide quality healthcare services to older patients.
References
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