Models of Interdisciplinary Geriatric Care Teams – WEEK 3 DQ

Models of Interdisciplinary Geriatric Care Teams – WEEK 3 DQ

Models of Interdisciplinary Geriatric Care Teams – WEEK 3 DQ

Models of Interdisciplinary Geriatric Care Teams is a NURS 6540 Week 3 Discussion. Here, we have three cases: Case Study 1: Mrs. Martinez is an 83-year-old Mexican American widow…; Case Study 2: Mr. Williams, a 79-year-old African American widower…; and Case Study 3: Mrs. Randall is a 77-year-old female who resides in a long-term care facility… to get them done for you by our erudite writers!!

Models of Interdisciplinary Geriatric Care Teams

With the growing population of frail elders, there is an increase of geriatric patients requiring ongoing care for multiple medical conditions. This creates the need for interdisciplinary geriatric care teams. Often, the dynamics and culture of these teams differ across various sites of care, such as assisted living, home care, hospitals, long-term care, and rehabilitation facilities As an advanced practice nurse, it is important to understand your role in the care team as well as your potential impact on patient care. In this Discussion, you explore models of interdisciplinary geriatric care teams for different sites of care and the varying roles of the advanced practice nurse. Consider the following three case studies:

Models of Interdisciplinary Geriatric Care Teams – WEEK 3 DQ Case Study 1:

Mrs. Martinez is an 83-year-old Mexican American widow who lives in her own home and is cared for by her adult daughter. Mrs. Martinez owns the home, and her daughter lives with her and provides the care. Her daughter brought her mother to the clinic today to ask to speak to the social worker. She requests that her mother be placed in a nursing home. The daughter states that her mother has nothing to do during the day The television is on The Weather Channel most of the day because Mrs. Martinez has limited English capability and is unable to read closed-captioning. Mrs. Martinez also has two sons who do not live in the local area, but they do call regularly and check in with their mother and sister. The two sons are opposed to moving their mother to a nursing home because they had promised her that they would “never put her away.”

Models of Interdisciplinary Geriatric Care Teams – WEEK 3 DQ Case Study 2:

Mr. Williams, a 79-year-old African American widower, resides in a foster care home. He has lived there for 4 years since his wife died. He is a former minister. His medical history includes long-term diabetes, high blood pressure, and benign prostatic hypertrophy. The home care provider has requested a home visit to evaluate Mr. Williams’s ability to remain in the home. The provider states that because Mr. Williams’s vision is seriously compromised (he is nearly blind), and because he has been unable to get to the toilet as quickly as necessary (he is very unsteady on his feet), his care is becoming burdensome. According to the home care provider, for safety reasons, Mr. Williams may not fit the criteria for remaining in the foster care home.

Models of Interdisciplinary Geriatric Care Teams – WEEK 3 DQ Case Study 3:

Mrs. Randall is a 77-year-old female who resides in a long-term care facility. She has a history of frequent falls and is severely cognitively impaired. The nursing staff at the long-term care facility called the nurse practitioner at the medical home office to report the recent development of productive cough and high fever. There have been cases of flu in the facility; however, Mrs. Randall has had a flu shot. The nurse practitioner in the office requests a chest x-ray in the long-term care facility. The nurse on duty in the facility states that there is no portable chest x-ray equipment available. She further requests that Mrs Randall be transferred to the emergency room of the local hospital. Mrs. Randall’s daughter has durable power of attorney for health care decisions for her mother. The long-term care facility has notified the daughter of the change in her mother’s condition. The daughter says whatever the nursing home wants is fine with her.

To prepare for Models of Interdisciplinary Geriatric Care Teams – WEEK 3 DQ:

Review this week’s media presentation, as well as the American Geriatrics Society and Arbaje et al. articles in the Learning Resources.

Research models of interdisciplinary geriatric care teams that are used at various sites, such as assisted living, home care, hospitals, long-term care, and rehabilitation facilities.

Consider the model used for the interdisciplinary geriatric care teams at your current practicum site. Compare this model to models used at other sites.

Reflect on how the role of the advanced practice nurse differs according to the site of care.

Select one of the three case studies. Consider how care should be facilitated for the patient in the case you selected based on the model used for the interdisciplinary geriatric care teams at your practicum site.

Post on or before Day 3 a comparison of the model used for the interdisciplinary geriatric teams at your current practicum site to models used at other sites. Then, explain how the role of the advanced practice nurse differs according to the site of care. Finally, explain how care should be facilitated for the patient in the case you selected based on the model used for the interdisciplinary geriatric teams at your practicum site

Read a selection of your colleagues’ responses.

Respond on or before Day 6 to at least two of your colleagues on two different days in one or more of the ways listed below. Respond to colleagues who selected different case studies than you did.

Offer and support an alternative perspective based on your own experience and additional literature search.

Validate an idea with your own experience and additional literature search.

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NURS 6540 Week 10 Discussion – Community Advocacy Agencies

Having received a diagnosis of Alzheimer’s and encountering the associated stigmas, Michael Ellenbogen encourages increased advocacy efforts for the geriatric population struggling with this disease. He says, “We did nothing wrong to get this disease, and we need to speak up to let our voice be heard…There are no excuses for not wanting to help. The human cost factor is too high, and we are all accountable to do something” (Ellenbogen, 2012). As an advanced practice nurse caring for the geriatric population, it is important for you to join in advocacy efforts within your community whether it is in support of Alzheimer’s or another prevalent need such as abuse. You should be aware of community agencies that advocate for the well-being and care of your local geriatric population, as these agencies often provide resources and assistance to the elderly in need. In your role of care, you are able to identify prevalent needs and work with patients, their families, and agencies to promote change and impact lives.

To prepare:

Review this week’s media presentation, as well as the American Geriatric Society’s Public Policy and Advocacy website in the Learning Resources

Locate and research two agencies that advocate for the elderly in your community. Consider their current advocacy actions and/or campaigns.

Reflect on your experiences and observations at your practicum site. Consider new advocacy actions you might suggest to the agencies you selected. Based on these advocacy actions, think about new policies that might improve the care of the population at your current practicum site.

Post on or before Day 3 a description of two agencies that advocate for the elderly in your community, including their current advocacy actions and/or campaigns. Then, explain new advocacy actions you might suggest to these agencies based on your experiences and observations at your practicum site. With these advocacy actions in mind, suggest at least one new policy that might improve the care of the population at your current practicum site.

Read a selection of your colleagues’ responses.

Respond on or before Day 6 to at least two of your colleagues on two different days who are in different practicum settings than you. Explain issues within your own community that might impact the advocacy actions and policies suggested by your colleagues.

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NURS 6540 Week 11 Discussion – Discussing End-of-Life Care

There is a human tendency to postpone uncomfortable or unpleasant tasks.

—Nancy Kummer, geriatric patient

This human tendency to avoid the unpleasant makes end-of-life care and hospice decisions difficult for many patients to discuss with their families. Kummer is a former social worker who used to counsel patients with terminal illnesses, yet she avoided discussing her own end-of-life wishes with her children. While many Americans, like Kummer, agree that these discussions need to take place, few have actually had these conversations with their families (Lazar, 2012). Although initiating conversations about end-of-life care and hospice might be difficult for patients, as an advanced practice nurse, facilitating these conversations is an integral part of your geriatric nursing practice. For this Discussion, consider how you would facilitate care conversations with the patients and families in the following case studies:

Case Study 1:

Mrs. Sloan, a 69-year-old widow, is about to enter the hospital for an elective cholecystectomy; she is being medically cleared by her primary care provider. During the discussion, she requests to be placed on a no code status during her hospitalization. Mrs. Sloan claims that besides her gallbladder problem, her general health status is good. She wishes to have the surgery to avoid any further attacks, which have been very painful. She states, however, that if during surgery or her postoperative period, she undergoes a cardiac arrest, she would prefer not to be resuscitated. She has read about the chances of successful resuscitation, and has determined that the risk of brain damage is too high. For this reason, she is requesting a no code status.

Case Study 2:

Ms. Stearns is an 83-year-old nursing home resident with hypertension, coronary artery disease, arthritis, renal insufficiency, hearing impairment, and a previous history of stroke. She also has a foot deformity from childhood polio. She is disoriented at times. She has lived in the nursing home for 10 years and rarely leaves the chair beside her bed. She has recently developed urinary incontinence, but has refused a bladder catheterization to determine postvoid residual urine or possible bladder infection. She does not have a diagnosis of dementia; however, current testing reveals that she performs poorly on a standardized mental status examination. She can, however, identify all the staff in the nursing home, and she can describe each patient who has been in the bed next to hers over the past 10 years. When asked to explain why she does not want bladder catheterization, she gives several reasons. She states that the incontinence does not bother her, and that she has always been a very private person. She particularly dislikes and objects to any examination of her pelvic organs; in fact, she has never had a pelvic examination nor has she ever had sexual intercourse. She realizes that she has a number of medical problems and that any one of them could worsen at any time. She states she is not willing to undergo any treatment for any of her current problems should they become worse.

Case Study 3:

Mr. Marley, age 91, is admitted to the intensive care unit following a stroke. The stroke progressed from mild hemiparesis and difficulty speaking to complete unresponsiveness and an inability to swallow. His daughter feels certain, based on prior explicit conversations with her father, that he would not want to have any treatment that would prolong his life and leave him in a severely disabled state. Mr. Marley’s oldest son disagrees with his sister’s assessment of their father. The son claims that their father still has a strong desire to live, and that he has been very active in his church until this stroke. Because Mr. Marley cannot swallow, he cannot be fed The family is asked about insertion of a feeding tube. It is explained to the family that without food and fluids, their father will die fairly quickly. There are no existing advance directives or a designated health care decision maker noted for Mr. Marley.

To prepare:

Review Chapter 14 of the Holroyd-Leduc and Reddy text.

Reflect on the role of the advanced practice nurse in facilitating the discussion of end-of-life care with patients and their families.

Think about how you, as an advanced practice nurse, would approach a family who wants “everything” done for a patient with only a limited time to live.

Consider when it is appropriate to involve hospice and how to approach patients and/or families who refuse hospice services.

Select one of the three provided case studies related to the end-of-life care of the frail elderly. Reflect on potential patient outcomes and how you would facilitate the discussion of care with this patient’s family.

Post on or before Day 3 an explanation of the role of the advanced practice nurse in facilitating the discussion of end-of-life care with patients and their families. Explain how you would approach a family who wants “everything” done for a patient with only a limited time to live. Then, explain when it is appropriate to involve hospice and how to approach patients and/or families who refuse hospice services. Finally, explain potential outcomes of the patient in the case study you selected and how you would facilitate the discussion of end-of-life care with this patient’s family.

Read a selection of your colleagues’ responses.

Respond on or before Day 6 to at least two of your colleagues on two different days who selected different case studies than you. Based on the site of care, suggest strategies for establishing the role of advanced practice nurses in end-of-life discussions with patients.

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