Providing Care for an Elderly Patient

As we age, the body goes through a number of changes that may be musculoskeletal or those that involve the sensory organs such as the skin, which can change lifestyles and contribute to the quality of life or the levels of care someone requires. This essay will discuss the qualities, knowledge and skills a 48-year-old man with limited mobility would expect his nurse to have.

For a 48-year-old male patient with limited mobility who is cared for at home, there are many factors that should be taken into account whilst assisting him with movement. One factor is the aging of skin which the patient expects the nurse to have sufficient knowledge of Royal College of Nursing in order to fully understand his needs and to be in line with the principles of nursing practice. As the skin ages, it becomes dry, thin and inelastic due to cellular changes which also means there is less fat. Additionally, the process of wound healing will slow down, making it more important to prevent the tearing of the skin, otherwise it can become a serious problem in terms of infection due to slow healing. As a result, due to the patient having limited mobility, assistance with movement should be done with extra care to prevent tearing the skin, and to ensure comfort because some positions may become less comfortable as there is less fat around bony areas. One good quality of a nurse that would minimize the risk of tears in the skin and infection is to have short, clean polish-free nails, and to avoid jewelry such as rings or watches that could catch. They should also always wear protective clothing such as gloves even if the hands have been decontaminated (WHO, 2009).

The 48-year-old patient may also experience changes in sight where his peripheral vision, light perception and depth perception may be affected. Damage to these areas can hinder the ability of the older person to judge the height of steps. Therefore, for a 48-year-old patient who has limited mobility and is cared for at home, he may not be able to see properly in the same lighted conditions as the nurse, so he should be given more time to move on steps in order to reduce the risk of falls. The patient may also be unaware of his surroundings as his peripheral vision is reduced. It is important for the nurse to ensure that they can be seen by the patient during assistance in a well-lit environment, as well as making sure that any visual aids such as glasses are always kept clean and within reach of the patient.

Wax in the ear is produced more viciously as people age which can lead to dull hearing, disturbed balance, and dizziness. In many older people, this can lead to high-frequency hearing loss at first which will gradually worsen. This can make it difficult for patients to hear instructions, especially when there is background noise. As a result, they may be unable to follow instructions adequately. When assisting the 48-year-old patient with movement, a good quality to have, is to be able to communicate clearly with him instead of shouting or speaking in an exaggerated way as this would undermine his dignity which must be upheld (GOV.UK, 2015). Clear communication is also a good quality for a nurse to have as it allows them to establish a successful relationship with their patient to deliver a high standard of care (DOH, 2012).

Another reason why patience is a good quality for a nurse to have is because an older patient may take longer to react as nerve cell function decreases with age. The transmission of signals between and along nerves is slower resulting in slower reactions. This can also affect some functions in the brain leading to communication barriers such as difficulty processing language, or short-term memory loss. Therefore, when assisting the 48-year old patient with movement, the nurse should be patient and allow more time for him to react to any instructions as he may take longer to process them, experience memory loss, or not hear them properly. Also, instructions should be repeated if the patient has memory problems. Therefore, clear communication and patience are both good qualities for a nurse caring for a 48-year-old male patient with limited mobility.

As well as clear communication, a patient-centered approach is also central to providing a high standard of care. A successful nurse-patient relationship is shaped by basic communication techniques such as open-ended questions to gain more insight, listening to non-verbally communicate interest, and support. The relationship may also be therapeutic through the alleviation of stress (Bach and Grant, 2009) as more trust is developed and the patient may confide in the nurse. Other factors may also shape nurse-patient relationships, such as self-disclosure where certain life experiences are shared to show that you understand what they are going through. As this patient is a 48-year-old man, the nurse may not be old enough to empathize, so she may choose to share stories of family members who have experienced a similar situation. Interpersonal skills are also a good quality for a nurse as they are useful for comforting or educating patients and their families, especially in difficult situations.

A number of musculoskeletal changes occur with age such as the loss of bone density which contributes to a higher risk of fractures and shortening of the vertebrae resulting in the reduced height and stooping of the patient. Moreover, the 48-year-old patient will also have decreased muscle mass and strength, therefore, he will experience weakness and slower movement. Consequently, nurses must allow for slower movement and they must be aware of the weaknesses that their patient has in order to avoid putting extra stress on their joints that could cause further damage. These skills will help to maintain the safety of the patient in care. This is another good quality as preserving the safety of those receiving care not only allows the nurse to practice effectively, it also displays commitment to a high quality of care as more trust is built. Building on commitment in the relationship with the patient allows the nurse to continue to improve the experience for them in order to meet all of their needs. It also allows the nurse to build a therapeutic relationship with their patient.

Sometimes, especially in collectivist cultures, family members prefer to help with the care of their relatives, for example by helping them eat. If the patient accepts this, then they expect the nurse to encourage the relative to assist them at meal times. The purpose of this is so that the patient and the relative can feel comfortable. Furthermore, by including relatives in the care plan, they are more reassured that their loved ones are being cared for properly. Families can also be included in devising care plans or when providing information that they want to know about their health. For this reason, being able to speak in a way that others can understand by avoiding jargon is a good quality for a nurse looking after an elderly patient. By speaking in a way that is understood by everyone, it benefits those in the nurses care as well as colleagues as everyone is aware of what the patient is going through and how they are being cared for.

Another way in which the family can be included is by helping the nurse to perform more private acts such as personal hygiene care, or by choosing to perform it themselves so that the patient feels less embarrassed. By encouraging the family to get involved in this way, it is a good quality for a nurse to have as it allows the nurse to identify “any specific requests they may have related to their culture or religion”. Another reason why this is a good quality for a nurse to have is because it means that they do not discriminate between different cultures or religions. For example, in some religions like Islam, modesty is held in a very high regard so patients who follow this religion may request more privacy during personal hygiene care than others. This is also in line with the NHS constitution which pledges that health professionals should provide a service for everyone regardless of factors such as religion, in order to promote equality in care (GOV.UK, 2015). Therefore, by being aware of cultural differences in care and preferences, this is a good quality for a nurse as it allows a more suitable method of care for the patients to allow them to be comfortable as well as their families by including them too.

A holistic approach is also very important for a nurse to follow as it assesses patients individually so that their spiritual, physical, psychological and social needs are properly accommodated in their plan of care (Campbell, 2012). Families may face a number of stressors whilst a member is receiving professional care such as financial concerns for a 48-year-old patient with limited mobility being cared for at home. This can stem from making adjustments in the home to make it safer and easier for them to move, for example, fitting stair lifts or grab rails for assistance with movement. If a family has a higher level of stress, they may not be able to support the patient as they transfer their stress to them. This can have a negative effect on the patient’s health. Therefore, it is a good quality for a nurse to take a holistic approach as it relieves financial stress on the family which allows them to relax more, as well as care for the patient in a dignified manner. Additionally, large amounts of stress in the family may lead to distrust of healthcare professionals who would prevent adequate care from being delivered, so it is beneficial for everyone that the family is supported as well as the patient. For example, younger members of the family may feel as though they are being isolated from other family members if they focus heavily on caring for the 48-year-old patient with limited mobility. It is a good quality for a nurse to relieve family stressors in suitable ways such as adjusting care plans, or reassuring families of the care being provided as it allows them to minimize stress from the very beginning.

In conclusion, a 48-year-old man who has limited mobility and is cared for at home expects their nurse to have sufficient knowledge on the effects of aging on their ability to move. The nurse should have knowledge on changes to the skin, sight, ears, the musculoskeletal system and the brain. From this knowledge, the nurses should be aware of the skills required to accommodate any difficulties created as a result of the changes, for example, less flexible skin means that nurses must be able to move patients carefully to avoid tearing. The qualities the patients expects their nurse to have are good hygiene and protective clothing, clear communication, patience, preserving safety, being observant and no discrimination. All of these qualities allow the patient to be more comfortable around the nurse by being provided with a high standard of care and keeping the patient safe.