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Geriatric Placement
With the rapid increase in the aging population, it is important for the advanced nurse to assess the factors that influence the placement appropriateness. My experiences in geriatric placement have made me learn that the patient’s transition from home into permanent nursing home can be traumatic, especially because such placement occurs often during distress and crisis (Desai & Grossberg, 2010). For effective transitions, the patient must be prepared psychologically. Change is not rapid and it can be overwhelming if not properly planned.
For instance, Mrs. B, 76 years old Puerto Rican female lived in New York City. Her neighbourhood was a low income neighbourhood, where she lived with her son George. She had a myriad of diseases including diabetes, asthma, hypertension and cancer. On this particular day, it was noted that the patient was not compliant to medication. She had failed to honour the last six follow up clinic.
Upon the analysis of her environment, it was clear that the patient was not safe (Payne, Hahn & Mauer, 2013). The patient was placed at CDE home care settings as the patient need palliative care. This is one of the most challenging cases as it was my first assignment as an advanced practitioner.
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The patient cognitive impairment had progressed significantly. The patient health status and financial instability are some of the factors that hindered effective transition from one healthcare setting to another. The situation was stressful as the patient thought of leaving all they have known was unbearable. This made the patient to be vulnerable as she felt like she had lost her identity and independence (Phillips & Guo, 2011).
She became so depressed that within the first month she had Alzheimer disease mild symptoms. Few weeks later, she fell into a comma. Fortunately, during one of her clinics she had filled an advance directive that stated that she did not favour mechanisms of having her life prolonged. She passed on one day later. I believe the poor planning of her transition was so traumatizing for her health to embrace the change.
From this experience, I have learnt to develop tailor made strategies to help the patient and their family members when dealing with healthcare setting transition. The general matters such as finance issues are discussed before transition to ensure that the patient understands their responsibilities as well as the sources the patients are eligible. Secondly, I have learnt that it is important to have an open communication. This enhances trust and relationship that makes the client feel secure about their decisions (Bauer & Nay, 2011).
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References
Bauer, M., & Nay, R. (2011). Improving family-staff relationships in assisted living facilities: the views of family. Journal Of Advanced Nursing, 67(6), 1232-1241. http://dx.doi.org/10.1111/j.1365-2648.2010.05575.x
Desai, A., & Grossberg, G. (2010). Psychiatric consultation in long-term care. Baltimore: Johns Hopkins University Press.
Payne, W., Hahn, D., & Mauer, E. (2013). Understanding your health. New York, NY: McGraw-Hill.
Phillips, L., & Guo, G. (2011). Mistreatment in Assisted Living Facilities: Complaints, Substantiations, and Risk Factors. The Gerontologist, 51(3), 343-353. http://dx.doi.org/10.1093/geront/gnq122
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