My Assigned Patient For The Week Is JC An At-Risk 86-Year-Ol

My Assigned Patient For The Week Is Jc An At Risk 86 Year Old Asian M

My assigned patient for the week is JC, an at-risk 86-year-old Asian male. The case description provides plenty of contextual information that would guide my initial interaction with the patient. The first key revelation is that JC is physically and financially dependent on his daughter, who is herself a single mother. Furthermore, it appears that JC feels he has become a burden to his daughter, and that she “has little time or money for her father’s needs.” I would be curious to understand where this sentiment arises from. It is common for older patients to develop such feelings as they grow older and become more dependent on their families for their sustenance and to help them with activities of daily living (Shorey & Chan, 2021).

I would consider involving JC’s daughter in the patient’s long-term treatment plan, and I would prioritize ascertaining whether she is indeed struggling to attend to his needs while also fulfilling her own motherly obligations. The patient’s daughter may also be more reliable as a source of information on his health, and may be useful for seeking follow-up information on the progression of his health after he is discharged (Ko & Berkman, 2010). In addition, JC’s daughter may be a useful intermediary or translator that helps the attending practitioner to communicate more effectively with the patient. Depending on the specific culture from which JC and his daughter hail, it may be normal for Asian families to assume responsibility for caring for the older members of their families. For example, in traditional Chinese culture, parents often move in with their children’s families after retirement (Ko & Berkman, 2010).

Beyond these issues, the patient presents with several chronic conditions, and is on a medication regimen that requires consistent conformity. I would want to determine whether JC is capable of managing his medication alone, and if not, I would work with him and his daughter to find a viable solution that will ensure he takes his medication on time and in the required quantity. In the absence of a caregiver, technological solutions like smartphone-based reminders can help older patients adhere to complicated medication plans that they cannot manage on their own.

When interviewing an older patient, it is important to remain civil, respectful, and patient. The appearance of condescension or a patronizing attitude may put off a patient and prevent him from interacting positively with the practitioner (Koskenniemi et al., 2018). As such, I would remain respectful, acknowledge JC’s concerns and preferences, and solicit his input on the relevant aspects of his treatment that he can contribute to. Assuming that I succeed in securing the involvement of his daughter, I would also encourage her to reassure JC and alleviate any fears that he may have become a burden to her. The geriatric depression scale (GDS) would be a useful assessment instrument for determining whether JC is depressed, and consequently incorporating therapy into his care plan.

I would prioritize the following questions in my initial interaction with the patient: 1. How is your overall health? Which particular health issues trouble you the most? 2. When was your last hospital visit? 3. Do you have difficulties taking your medication as prescribed? Or how often do you miss taking your medication? 4. What are your beliefs about healthcare? 5. How is your relationship with your daughter?

Paper For Above instruction

The management of elderly patients necessitates a holistic approach that considers medical, psychological, cultural, and social factors. The case of JC, an 86-year-old Asian male who is physically and financially dependent on his daughter, exemplifies the complexities involved in delivering effective geriatric care. Recognizing and addressing these factors early in the interaction can significantly influence health outcomes, patient satisfaction, and overall well-being.

Understanding Cultural and Family Dynamics in Elder Care

JC’s reliance on his daughter echoes traditional family dynamics prevalent in many Asian cultures, where filial piety often dictates the care of older family members. According to Ko and Berkman (2010), in Chinese and other East Asian societies, it is common for aging parents to live with or be cared for by their children. Such cultural expectations influence how care is organized and perceived, and acknowledging these values can facilitate better communication and cooperation between healthcare providers and family members.

Building rapport with JC involves understanding these cultural norms and demonstrating respect for the family's role in caregiving. Involving his daughter in the treatment planning process not only ensures continuity of care but also aligns with cultural expectations. This inclusion can also serve to alleviate JC’s fears of being a burden, as family-centered care is often highly valued in these communities.

Assessing Functional Capacity and Medication Management

Chronic illnesses and complex medication regimens are common among the elderly, often leading to medication non-adherence, adverse drug events, and hospitalization. JC’s medication adherence should be thoroughly assessed, perhaps through direct questioning or tools like medication adherence scales. If JC demonstrates difficulty managing his medications independently, interventions such as involving a caregiver, using pill organizers, or utilizing technological aids like smartphone reminders can be implemented.

Evidence suggests that technological interventions can improve adherence among older adults, especially when tailored to the individual’s technological literacy (Kirk, 2017). Involving JC’s daughter in medication management can also ensure safety and adherence, especially if she is able and willing to assist. Additionally, a comprehensive geriatric assessment can evaluate JC’s functional status, cognitive capacity, and social support system, all critical factors influencing medication management.

Effective Communication and Building Trust

Older patients often face barriers in communication such as sensory deficits, cognitive impairments, or cultural differences. Hence, practitioners must adopt patient-centered communication strategies, including speaking clearly, listening actively, and demonstrating respect. As Koskenniemi et al. (2018) highlight, patients’ perception of being respected by healthcare staff impacts their engagement and satisfaction.

In JC’s case, involving his daughter and perhaps a bilingual or culturally competent interpreter can enhance understanding and comfort. It is vital to remain non-patronizing and attentive to JC’s concerns, preferences, and emotional state. This respectful interaction can foster trust and encourage honest dialogue about health issues and concerns, which is crucial for effective care planning.

Addressing Mental Health and Social Isolation

Older adults are at increased risk for depression, loneliness, and social isolation, factors that negatively impact overall health. Using screening tools such as the Geriatric Depression Scale (GDS) can identify depression early, allowing for timely intervention. JC’s feelings of being a burden suggest potential emotional distress worth addressing through counseling or therapy.

Encouraging social engagement and community involvement can also mitigate feelings of isolation. Understanding JC’s relationship with his daughter, and facilitating open communication within the family, can improve psychological well-being and reduce depressive symptoms.

Holistic and Culturally Sensitive Care Planning

Comprehensive care for JC involves an interdisciplinary approach integrating medical management, cultural considerations, mental health support, and social services. It requires collaboration with family members, community resources, and possibly home health services to ensure continuity of care. Respect for cultural values, patient autonomy, and family involvement enhances adherence and satisfaction.

In conclusion, caring for elderly patients like JC calls for sensitivity to cultural norms, diligent assessment of medical and psychosocial needs, and effective communication strategies. Tailoring interventions to respect individual circumstances and cultural backgrounds ensures not only improved health outcomes but also a dignified aging experience.

References

• Ko, E., & Berkman, C. S. (2010). Role of children in end-of-life treatment planning among Korean American older adults. Journal of Social Work in End-of-Life & Palliative Care, 6(3-4), 245–263.
• Kirk, S. (2017). Utilizing technology to improve medication adherence among older adults. Journal of Aging & Social Policy, 29(3), 177–191.
• Koskenniemi, J., Leino-Kilpi, H., Puukka, P., Stolt, M., & Suhonen, R. (2018). Being respected by nurses: Measuring older patients’ perceptions. International Journal of Older People Nursing, 13(3), e12197.
• Shorey, S., & Chan, V. (2021). The experiences and needs of Asian older adults who are socially isolated and lonely: A qualitative systematic review. Archives of Gerontology and Geriatrics, 92, 104254.
• Kim, S., & Lee, J. (2019). Cultural influences on caregiving attitudes among Asian families. Asian Journal of Gerontology & Geriatrics, 7(2), 45–52.
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• American Geriatrics Society. (2012). Expert Panel on the Care of Older Adults: Summary of guidelines for managing medication adherence in the elderly. Journal of the American Geriatrics Society, 60(9), 1734–1741.
• Carpenter, B. C., & Krawinkel, M. (2016). Addressing health literacy in older adults: A review of strategies. Journal of Community Health Nursing, 33(4), 190–199.
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• Hebert, J. R., et al. (2014). Culturally competent geriatric assessment and care planning. Geriatric Nursing, 35(6), 473–481.