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Case Study Of An Older Person With Complex Care Needs

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1. Strengths-based approach

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“Strengths-Based Care (SBC)” can be regarded as the approach in elderly care that considers the person individually by focusing on the functionalities and working procedures of the well-being. It also focuses on the things that the person is best at and the resources available for the individual to deal with the obligations of life, health care and health more effectively (Gibson et al. 2020). The strength-based approach for older people suggests that the old individuals manage the changes positively basically through the mode of supportive relationships in the context of family, friends, professionals as well as networks of other care.

The strength-based approach to elderly care regards mobilising, recognising, developing and capitalising on the strengths of the person for promoting health as well as facilitating health (Nguyen et al. 2020). The example related to the strength-based approach in aged care states that if an individual identifies faith for the importance of that particular person in their life, then they could answer significantly how faith supports the individuals in passing through the obligations (Nelson-Becker et al. 2020). Thus, this could bring a wide range of resources and strengths in relation to connections to the community and resilience.

The significance of the strength-based approach lies in the fact that it possesses the potential for improving the well-being and mental health of the caregivers of the family along with the older person (Gao, 2021). As per the case study, Kathy being a patient of osteoarthritis requires an individual to help her with cleaning, cooking and other household chores as no one is present to help her. Although Kathy lives with her mother Ann at age 85 years, still she needs some individuals to help her with household work and to take care of her mother. This will help her to get relief from the pain in her knees while standing continuously for a long time.

It has been observed that Kathy can opt for a strength-based approach underpinned by a recovery framework to provide care to elderly people. The approach also affirms enhancing the capabilities by encouraging the satisfaction of life as well as reducing the burden of the caregiver (Gao, 2021). Thus, from the case study, it has been observed that Kathy can undertake a strength-based approach to see herself at her best by seeing and analysing her own value by capitalising on her strengths rather than focusing on the negative characteristics.

The strength-based approach states the fact that nurses have been regarded as the best support for helping as well as caring for the older patients, communities and families for developing, coping, thriving, growing and transforming significantly. The approach represents the reconceptualization of taking care of another person in times of need so that they do not feel alone while combating and standing up against their diseases (Waterworth et al. 2020). The SBC approach intends new ways for shifting radically and thinking differently towards the responsibilities of the new orientation of healthcare professionals, nurses and individuals related to the current system of healthcare.

Thus, as per the case study, it has been observed that Kathy requires ADLs, that is “activities of daily living” for describing collectively the fundamental skills that require for caring for oneself independently such as mobility, bathing, eating and other activities. According to Ncbi.nlm.nih.gov (2022), ADL has been termed as the indicator for analysing the functional status of individuals that are predicted by the nurses specifically. Moreover, ADLs have been significant for the individual as it accomplishes the inability for doing daily activities to enhance the quality of life. Hence, it has been observed that ADLs will help Kathy to perform the six activities significantly by herself such as feeding, dressing, ambulating, personal hygiene, toileting and continence.

2. Critical reflection

The two key issues that have been observed from the case study from the perspective of older individuals state the requirement of ADLs for helping elderly people and the need for someone to get relief from knee pain. Kathy has been facing problems with her knees while working continuously with the household chores or standing due to L-salpingo-oophorectomy and hysterectomy. Thus, according to the perception of elderly people, they need someone such as nurses or healthcare professionals to cope with the issue. Along with this, Kathy has an urgent need for ADLs who will guide her in the specification and prioritisation of her daily activities significantly. Thus, it has been observed that if Kathy can perform her daily activities sincerely then this will impact the health of Kathy towards healthy ageing. It helps individuals to empower themselves towards their daily activities and provides value to themselves as well as the caregivers of the family. 

Moreover, the strength-based approach can be termed as a comprehensive introduction towards the care of elderly persons especially for the profession of nursing in clinical practice. It has been observed that the approach relates to the care planning on the strengths of elderly individuals with the context of the perspective of individuals. It has been seen that Kathy can pick a strength-based approach supported by a recuperation structure to give care to old individuals. In addition, the strategy emphasises enhancing capabilities by encouraging life satisfaction and lessening caregiver burden (Gao, 2021). As a result, the case study shows that Kathy can use a strength-based approach to see herself at her best by focusing on her strengths rather than her flaws and recognizing and analysing her own value.

According to the strength-based approach, nurses have long been regarded as the best resource for assisting older patients, communities, and families in developing, coping, thriving, growing, and undergoing significant transformation. The strategy represents a new way of thinking about helping someone in a difficult situation so that they don't feel alone as they fight and fight their diseases (Waterworth et al.). 2020). The SBC approach proposes novel approaches to radically altering and rethinking the roles and responsibilities of the new orientation of healthcare professionals, nurses, and individuals associated with the existing healthcare system.

As a result, the case study reveals that Kathy requires ADLs—also known as "activities of daily living"—to describe the fundamental abilities necessary for self-care, such as mobility, bathing, eating, and other activities. ADL has been referred to as the indicator for analysing the functional status of individuals predicted by nurses specifically, according to Ncbi.nlm.nih.gov (2022). ADLs have also been important to the person because they help them overcome their inability to perform daily tasks and improve their quality of life. Consequently, it has been seen that ADLs will assist Kathy with playing out the six exercises fundamentally without help from anyone else like taking care of, dressing, moving around, individual cleanliness, toileting and self-restraint.

3. Nursing care plan

3.1 Nursing recommendations

Kathy needs proper nursing care for developing her health condition and the osteoarthritis can be improved with proper nursing facility maintenance. The family member of Kathy should give focus on providing a nursing facility and that is required for improving the knee condition of Kathy. Pain management is the main factor in nursing care because Kathy is mainly suffering from osteoarthritis and the minimization of the pain is mainly required. As opined by El-Adham et al. (2019), a nurse should be appointed to take care of Kathy in giving treatment or doing activities for minimising the pain and Kathy can do daily work without feeling a huge pain and that is effective for improving the health condition of Kathy. Pain management can be done with providing proper medicines and except medicines there are many ways to minimise the pain and they are proper exercise, various activities, and others that helps to improve the knee condition. As stated by Swaithes et al. (2020), the nurse should be effective in maintaining the exercise and activity for knee condition and Kathy can increase her ability to move knee more effectively. Proper knowledge of the nurse should be analysed and according to the efficiency of the nurse the activity and exercise should be maintained along with the medicines that are required for improving the condition.

Improving joint function is another process of minimising the impact of osteoarthritis on the health condition and that is important for improving the current knee condition. As opined by Pehlivan & Karadakovan, (2019), the efficiency of nursing care can be increased with giving efforts to the joint function because osteoarthritis reflects an impact on the joint function of the knee and that is causing major issues in Kathy’s health condition. The nurse should give focus on the exercise or activities that can be useful for improving the knee condition and that is important for developing the health of Kathy. As stated by Fertelli et al. (2019), the improvement of Knee condition of Kathy is dependent on the knee condition and that is important for the minimising the impact of osteoarthritis and that should be maintained by the nursing care facilities. Joint is a very important part in osteoarthritis and that should be maintained properly to improve the function and the knee condition can be developed. Kathy can increase her ability in doing daily activities by maintaining the joint function condition and for that, nursing care should be maintained properly.

3.2 Multidisciplinary services and resources

Multidisciplinary service is required for minimising issues of osteoarthritis in Kathy’s health and that should be maintained properly because it helps to improve the discipline maintenance process. As opined by Pradelli et al. (2021), the multidisciplinary service team is made with a physiotherapist, dietitian, occupational therapist, and a social worker and Kathy should get the service team for improving the health condition and that is important for minimising the issues of osteoarthritis. Coordination between patient and caregivers can be maintained through multidisciplinary service and that is required for improvement in knee condition and the daily activity can be maintained with more ease. The efficiency of the service is that there are more effective team members who can maintain all important and specific parts of patients’ health and that is required for improving the current condition of Kathy. As stated by Eyles et al. (2020), the work or responsibility of team members can be maintained properly to improve the condition and that should be maintained for better health management. The efficiency of the team is dependent on the responsibility of maintenance and the multidisciplinary service team is very effective in maintaining the work quality in improving the health condition of patients.

Solid implementation of strategies can be maintained with the help of a multidisciplinary service team because the care strategy can be implemented with the use of the team and that is beneficial for development in the health condition of patients. Kathy is facing a major issue in knee problems as osteoarthritis and that should be minimised by the medical professionals. As opined by Derwich et al. (2020), this multidisciplinary service team is effective in maintaining the factors that are effective in improving the knee condition with specific work maintenance. The team members are efficient in maintaining their responsibility in patient care and Kathy should get proper service from the multidisciplinary service team because it can improve the health condition. As stated by Rafiq et al. (2021), a physiotherapist, dietitian, occupational therapist, and a social worker are required for maintaining the service team and that is useful for improving the condition of Kathy's knee and she can get help in her household work from the team. Proper care can be taken with the service team and for that, her family should search for a local physiotherapist, dietitian, occupational therapist, and a social worker to make the team properly and effectively.

References

  • Derwich, M., Mitus-Kenig, M., & Pawlowska, E. (2020). Interdisciplinary approach to the temporomandibular joint osteoarthritis—review of the literature. Medicina, 56(5), 225. Retrieved from: https://www.mdpi.com/1648-9144/56/5/225/pdf
  • El-Adham, N. A., Abdelhady, M. S., & Osman, Z. H. H. (2019). Effect of Nursing Education program on Knowledge, Uncertainty, Mastery, Pain, and Quality of Life for Knee Osteoarthritis Patients. Int J Novel Res Healthc Nurse, 6(3), 867-881. Retrieved from: https://www.noveltyjournals.com/upload/paper/Effect%20of%20Nursing%20Education%20program-2103.pdf
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  • Fertelli, T. K., Mollaoglu, M., & Sahin, O. (2019). Aquatic exercise program for individuals with osteoarthritis: Pain, stiffness, physical function, self-efficacy. Rehabilitation Nursing Journal, 44(5), 290-299. Retrieved from: https://www.researchgate.net/profile/Ozlem-Sahin-3/publication/324211409_Aquatic_Exercise_Program_for_Individuals_With_Osteoarthritis_Pain_Stiffness_Physical_Function_Self-Efficacy/links/5b5efa43a6fdccf0b200ce92/Aquatic-Exercise-Program-for-Individuals-With-Osteoarthritis-Pain-Stiffness-Physical-Function-Self-Efficacy.pdf
  • Gao, G., (2021). Mapping a Strength-Based Approach to a Standardised Terminology: A Case Study.
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  • Ncbi.nlm.nih.gov, (2022). Activities of Daily Living (ADL). Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK470404/ [Retrieved on: 04.05.2023]
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