Care plan Management

Question: Explain Care plan for Mr. Lee. Answer: Care plan for Mr. Lee PROBLEM/ISSUE GOAL OF CARE NURSING INTERVENTIONS RATIONALE INDICATORS PLAN IS EFFECTIVE PHYSICAL Mechanical fall and risk of harm Prevention of fall for promoting independence, enhancing physical movement and providing safe environment Appointing a support worker to Mr. Lee. Assessment of his vision and physical ability Balance assessment- for promoting his muscle strengthening Assessing his eyesight is the primary intervention for Mr. Lee to reduce his fall risk because the blurred or impaired vision is general symptoms in older adults of his age. The blurred or impaired vision enhances the risk of fall and chances of physical injury (Morgan Yoder, 2012). As he has a history of fall from tool during gardening, reducing the risk of fall is necessary. Appointing a support worker would be helpful for Mr. Lee because the support worker would enhance his ability to complete his ADLs. the support worker can assess his mobility and physical ability regularly and based on the reports proper interventions can be recommended (Reuben Tinetti, 2012). Mr. Lee participated in a 12 week program for enhanced balance and muscle strengthening. The support worker reduced the harmful and hazardous materials from Mr. Lees house. Mr. Lee showed empowered behaviour and improved mobility Physical exercise including aerobic and walking interventions Physical exercise is necessary with age the normal muscle strength declines with increased risk of falling. It would also enhance his abilities of movement and completing ADLs (Rosemond et al., 2012) Eliminating hazardous materials from his surrounding areas within his home As Mr. Lee stays alone at his home, the chance of falling enhance along with risk of physical harm. The support worker would reduce harm through the elimination of hazardous elements including acids, knife, chemical strippers and fire extinguishers (Brownie Nancarrow, 2013). Enhanced mobility Gardening interventions Onder et al., (2012) analysed the role of gardening in mental and physical wellbeing of older adults. It enhances the hand strength and pinch force. Positive results from gardening would enhance the self-esteem level. Along with the exercise program. Gardening can be both energetic and relaxing for him MENTAL Deterioration in mental health, Loss and grief, Risky behaviour Enhancing mental relaxation decrease sympathetic outputs Tai chi intervention Tai chi is a traditional Chinese exercise which is used as martial arts for health benefits. The practice involves sequences of flowing movements along with changed mental focus, coordination, breathing and relaxation. It would help Mr. Lee to improve her mental health. The intervention has been reported as the meditative movements for enhancing mental functioning (Gillespie et al., 2012) Tai chi and person-centred care were useful for their enhanced recovery of mental health. After attending a 8 week counselling session, he showed enhanced self-confidence and decreased hesitation. Enhancing self--confidence Person-entered Health counselling Person-centred health counselling and therapeutic communication stimulation can be the best intervention for Mr. Lee to enhance his self confidence. Upon assessment, the person-centred counselling would help him to deal with his loss and grief for his wife and dear ones (Cameron et al., 2012) Making him aware of his status and promoting self-help Individual Health promotion Health promotion is necessary for Mr. Lee for enhancing his knowledge about his actual health status. In this health promotion, Mr. Lee would be provided all the necessary information about his health assessment, counselling and other health intervention along with their importance (Takahashi et al., 2012). It would help him to build sufficient knowledge to promote self-management and self-management is important at this age. Aged And Community Services Australia (ACSA) (www.agedcare.org.au, 2016/ 0396001988/ Blackburn North Victoria) is another organization which provides care to the patients by developing adequacy and development in both political and public areas. they are always ready with their legal advices for the patient whenever needed. They also provide different kinds of information like the eligibility and conditions for the location by giving the pamphlet. They also give design employment to the unemployed people by creating social clubs also provide home furnishing to the immigrants. Lee is excited to use this services as his friend has given positive feedback about this services. SOCIAL Social isolation, Less involvement with others, silent most of the time, Decreased self-confidence Enhanced social involvement Involvement with catholic groups at St. Pauls church regularly Mr. Lee has a background of migration from China to Australia at the age of 12 and he has lost his father at early age. Therefore, there was a cultural issue identified and at his end of life stage. Therefore, his involvement with his society can improve his health and well being (Smith et al., 2012). Therefore, the nursing intervention would be targeted towards his enhanced involvement with catholic church. Decreased social isolation would reduce the risk of depression Attending creative workshops and his involvement with his catholic society friends at St. Paul church enhanced his negative thinking towards his life as well as enhanced his creative thinking Enhanced interaction with others and mental wellbeing Group creative education Creative interaction with others is a great way to engage older people in community it also helps to enhance their self confidence and the urge of living. Creative education would include art and craft education which is a well known recreation activities suitable for aged care services. Creative practices like painting, participating in art and craft workshops and creation of art and craft would promote the critical thinking and judgement skills, thereby enhancing positive interaction with others (Zarit Zarit, 2012). EMOTIONAL Anxious nature Behavioural and communication improvement Behavioural activation and pleasant events, cognitive training The behavioural activation programs through the therapeutic communication stimulation can be helpful for Mr. Lee to improve his current health status. The therapeutic stimulation would initially need the establishment of positive relationship within the nurse and Mr. Lee (Wright Leahe, 2012). It would enhance his cognitive thinking and positivity which would be sufficient for his emotional well being. The support from the positive relationship with the nurse would promote his positive judgment and wellbeing. Carers Australia (www.carersaustralia.com.au, 2016/+61 262790200) is the foundation of the old aged homes. One of the Australias integral health care system. it is mainly responsible for the medication management. It provides social, financial and emotional support to the elderly patients. Mr. Lee is looking forward to this service to improve social connectedness. The organization help the patients to get organized, remind them with the dates of their appointments and with the dealing of the emergency. They also provide transportation assistance in case of medical urgency. They also look after the Holocaust elderly survivors. The sessions of therapeutic communication stimulation helped Mr. Lee to improve his communication and interaction which reduced his risk of anxiety. The relaxing and supportive exercise helped in improving his emotional wellbeing Decreased mobility and related depression Improving physical disability and related emotional wellbeing Exercise and walking Relaxing exercise and regular walking has been reported to enhance the emotional well being of geriatric patient. The physical disability is one of the most common causes of emotional issues. A walking programme for three times a week over six months can improve the mental and emotional well being (Li et al., 2012). It has been also reported that relaxing physical exercise improve the hormone regulation in the body and thereby controlling depression and anxiety related symptoms. Engagement in regular exercise and walking program would also help him to reduce his loss and grief related depression symptoms. Decreased sense of emotion Emotional health boost Computer games and brainstorming It has been proved that older adults, who are involved in computer games and brainstorming activities, have been shown to have positive results in recreation programs. It can also enhance his social involvement with others who plays videogame, thereby reduction of his loneliness and social isolation problem would also be resolved. The Aged And Care Assessment Team (www.myagedcare.gov.au, 2016/1800200422) is an independent multi disciplinary organization, which provides free care to the people with age above 65 years. It relates to respite and transition care, aged care of residential and packages of home care. The respite care is like an emergency or temporary care, which is given to the elderly people who have an intellectual disability. This care provides a positive feeling to the patients receiving this. Lee is excited to use this services as her friend has given positive feedback about this services ACAT gives continuous services by doing their daily tasks and looking after their personal care 24x7. They try to make the patients feel at home and comfort them in every means. HANDOVER TO ACAT RN Identify- Peta Harbour, registered nurse, New South Wales hospital Situation- The patient has been come for primary health care facility after completing his 75+ annual health assessment with a health care practitioner. He has been reported with decreased social, physical, mental and emotional wellbeing. Now, the major priority for the patient is to make a action plan for his health and well being after assessing his past history which has been reported by the health care practitioner. Background- Thomas Lee, the current patient is a 68 years old male who has been migrated from china to Australia when he was 12 years old and he is a retired carpenter. He can speak English fluently. He sold veggie at local market. He has lost his wife recently and has no children. It made him lonely as he stays alone at her house. However, he receives aged care pension. Analyzing his current health history, it has been revealed that he received tetanus, pneumonia and influenza vaccines till 2015. His family history revealed that he lost his father when he was a child and his mother died at the age of 89. He has a sibling who lives in another state, thus there is less chance to meet Mr. Lee frequently. Assessment- The current care plan of the patient revealed that improving his mobility, reducing the risk of fall and injury and enhancing his emotional and mental wellbeing are the care priorities for Mr. Lee. In this context, it has also been found that physical exercise plan, social involvement, reducing his loneliness and depression related to loss and grief is important for his palliative care services (Morgan Yoder, 2012). Request- The ACAT assessment and other two community service would provide emotional, financial along with personal care services at any time which is necessary for the older adult people (Reuben Tinetti, 2012). In addition, the ACSA institute helps in development of public and political support for meeting the current personal and medical requirements of Mr. Lee. Therefore, the service would be beneficial for Mr. Lee. Reference List Aged Care Assessment Team (ACAT). (2016). Healthywa.wa.gov.au. Retrieved 23 May 2016, from https://healthywa.wa.gov.au/Articles/A_E/Aged-Care-Assessment-Team-ACAT Brownie, S. Nancarrow, S. (2013). Effects of person-centered care on residents and staff in aged-care facilities: a systematic review.CIA, 1. https://dx.doi.org/10.2147/cia.s38589 Cameron, I. D., Gillespie, L. D., Robertson, M. C., Murray, G. R., Hill, K. D., Cumming, R. G., Kerse, N. (2012). Interventions for preventing falls in older people in care facilities and hospitals.Cochrane Database Syst Rev,12. Gillespie, L. D., Robertson, M. C., Gillespie, W. J., Sherrington, C., Gates, S., Clemson, L. M., Lamb, S. E. (2012). INTERVENTIONS FOR PREVENTING FALLS IN OLDER PEOPLE LIVING IN THE COMMUNITY: FINDINGS FROM THE RECENTLY UPDATED COCHRANE REVIEW.Parkinsonism Related Disorders,16, S9. https://dx.doi.org/10.1016/s1353-8020(10)70034-1 Home   Carers Australia. (2016). Carersaustralia.com.au. Retrieved 23 May 2016, from https://www.carersaustralia.com.au/home/ Li, F., Harmer, P., Fitzgerald, K., Eckstrom, E., Stock, R., Galver, J. et al. (2012). Tai Chi and Postural Stability in Patients with Parkinson's Disease.New England Journal Of Medicine,366(6), 511-519. https://dx.doi.org/10.1056/nejmoa1107911 Morgan, S. Yoder, L. (2011). A Concept Analysis of Person-Centered Care.Journal Of Holistic Nursing,30(1), 6-15. https://dx.doi.org/10.1177/0898010111412189 Onder, G., Carpenter, I., Finne-Soveri, H., Gindin, J., Frijters, D., Henrard, J. et al. (2012). Assessment of nursing home residents in Europe: the Services and Health for Elderly in Long TERm care (SHELTER) study.BMC Health Services Research,12(1), 5. https://dx.doi.org/10.1186/1472-6963-12-5 Reuben, D. Tinetti, M. (2012). Goal-Oriented Patient Care An Alternative Health Outcomes Paradigm.New England Journal Of Medicine,366(9), 777-779. https://dx.doi.org/10.1056/nejmp1113631 Rosemond, C., Hanson, L., Ennett, S., Schenck, A., Weiner, B. (2012). Implementing person-centered care in nursing homes.Health Care Management Review,37(3), 257-266. https://dx.doi.org/10.1097/hmr.0b013e318235ed17 Smith, S. M., Soubhi, H., Fortin, M., Hudon, C., ODowd, T. (2012). Interventions for improving outcomes in patients with multimorbidity in primary care and community settings.Cochrane Database Syst Rev,4. Takahashi, P., Pecina, J., Upatising, B., Chaudhry, R., Shah, N., Van Houten, H. et al. (2012). A Randomized Controlled Trial of Telemonitoring in Older Adults With Multiple Health Issues to Prevent Hospitalizations and Emergency Department Visits.Arch Intern Med,172(10). https://dx.doi.org/10.1001/archinternmed.2012.256 Welcome to ACSA Victoria ACSA - Aged and Community Services Australia (Victoria). (2016). Agedcarevic.org.au. Retrieved 23 May 2016, from https://www.agedcarevic.org.au/ Wright, L. M., Leahey, M. (2012).Nurses and families: A guide to family assessment and intervention. FA Davis. Zarit, S. H., Zarit, J. M. (2012).Mental disorders in older adults: Fundamentals of assessment and treatment. Guilford Press.