End-of-life care becomes an issue at some point for elderly clients. Even with the emergence of palliative care programs and hospice programs, most elderly people do not die in their own home as is their preference. What are the reasons for this trend? Discuss what you can do as a nurse to support your clients regarding end-of-life care in accordance with their wishes. Support your response with evidence-based literature.

Expert Answer and Explanation

DQ 1

Aging Patients

Table of Contents

Characteristics of Aging

Scholars have not developed a specific definition of the term aging. However, in general terms, aging in humans is the process of growing older as time goes. In terms of health, aging can be characterized in many ways. Lipska et al. (2016) mention that aging people have the following features. First, an aging person urinates frequently because of relaxed bladder muscles.

The muscles can relax due to irritation, infection, or any other cause. Second, an aging individual has weaker bones, muscles, and joints as compared to a middle-aged or a young person. Also, as a person grows old, his heart rate may pump slower, and thus leading to many medical problems. Lastly, aging is characterized by poor eyesight.

Elder Abuse

Some of the aging characteristics can make gaged individuals face various types of elder abuse. Senior people can be abused because of their poor eyesight. For instance, a person can make them sign fake documents that may cause them to lose their property due to poor eyesight. Also, aged people with hearing problems can be misinformed by people caring for them because of their condition.

Abbruzzese and Simon (2018) mention that senior people might be left in their rooms alone and isolated because they have week joints, muscles, and bones and cannot move.

Caring for Senior Patients

A nurse must consider certain things before they medically assess their patients. First, they must consider their hearing capacity. For elderly patients with hearing problems, the nurses must get their attention through speaking their names and touching their shoulder gently. When the patients have sight issues, the nurses should write instructions in clear and bold handwriting.

References

Abbruzzese, L. D., & Simon, P. (2018). Special Concerns for the LGBT Aging Patient: What Rehab Professionals Should Know. Current Geriatrics Reports, 7(1), 26-36.

Lipska, K. J., Krumholz, H., Soones, T., & Lee, S. J. (2016). Polypharmacy in the aging patient: a review of glycemic control in older adults with type 2 diabetes. Jama, 315(10), 1034-1045.

DQ 1 Alternative Answer 2

Characteristics of the Ageing Process

The human body is programmed to become weaker with age. This is because of a higher rate of cell death and a lower potential of the body cells to regenerate among the older individuals. In the US, there are over 50 million individuals above 65 years, a number which has been increasing over the years (Crimmins et al., 2017).

Most of the theories that explain ageing emphasize on the fact that it is not possible for people to avoid the passage of time, but clearly explain that the rate of aging can definitely be slowed. Nurses who attend to geriatric patients are asked to give more attention to the specific health needs of ageing people such as memory loss associated complications.

Characteristics of the Ageing Process

One of the principal characteristics of the aging process is decline in function of senses that make the geriatric patients unable to live by themselves. For instance, vision loss, which is common among them, means that they can no longer read medical subscription instructions, and can make more mistakes (Crimmins et al., 2017). Hence, nurses are entitled to always assisting the elderly patients with the tasks that are related to sight, hearing, and other senses.

How Some of These Characteristics May Lead To Abuse

Elder abuse may happen when the nurses in charge have the assumption that the geriatric patients are capable of handling their own activities of daily living (ADLs) and even comes to the point of harassing them. A good example of a nurse abuse for geriatrics is the claims by the daughters of Henry Ford II that their mother (and the widow of Henry Ford) was being abused by a dozen nurses (Rowe, Fulmer, & Fried, 2016).

Considerations When Attending To the Health of Ageing Patients

Among the considerations that a nurse should have when performing care to the elderly patients is the fact that most of these elderly patients have already lost a large part of their cognitive function, and should be treated like children. Also, unlike middle-aged adults, the ageing patients are more likely to have less moral support from the family members, and hence nurses should be ready to give them the same.

References

Crimmins, E. M., Beltrán-Sánchez, H., Brown, L., & Yon, Y. (2017). Ageing in North America: Canada and the United States. Oxford Textbook of Geriatric Medicine.

Rowe, J. W., Fulmer, T., & Fried, L. (2016). Preparing for better health and health care for an aging population. Jama, 316(16), 1643-1644.

DQ 2 Expert Answer and Explanation

Role of Nurses in End of Life Care

During old age, most patients wish to die in their lovely homes beside in the presence of their loved ones. However, their wishes may not be fulfilled due to many factors. Most senior patients still die in hospitals because some of the illnesses ailing them are not covered by palliative care and hospice programs. Therefore, when they get ill, they are run to the hospital to get proper medical attention.

Another reason is that some family members may not allow their loved ones to die on their watch (Chan et al., 2016). Thus, instead of letting the elderly patients die at home, they take them to various hospitals in a move to save the patients’ lives. Also, patients may die in hospitals because their diseases cannot be managed at home. For instance, patients who need intensive care units, CT scans must be taken to a medical facility and might die there when receiving treatments.

Nurses play critical roles at the end of life care. Wright et al. (2016) argue that they can offer guidance and counseling to families faced with a challenge to provide proper care for their loved ones. For instance, nurses can provide medication that can help the patient die in peace without pain. During the end of life, families are often scared, confused, and overwhelmed.

Nurses can help these families by offering emotional support to families (Chan et al., 2016). Lastly, nurses’ role during this time is to provide pain management medication that can make their patients feel more comfortable. Also, they must physiologically help the patients and their loved ones accept the sad reality.

References

Chan, R. J., Webster, J., & Bowers, A. (2016). End‐of‐life care pathways for improving outcomes in caring for the dying. Cochrane Database of Systematic Reviews, (2).

Wright, A. A., Keating, N. L., Ayanian, J. Z., Chrischilles, E. A., Kahn, K. L., Ritchie, C. S., … & Landrum, M. B. (2016). Family perspectives on aggressive cancer care near the end of life. Jama, 315(3), 284-292.

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