Reflection On Your Development - Rasmussen University

Reflection On Your Developmentrasmussen Universi

Analyze the increased complexity of care among older adults. The care for the older adults is very complex compared to standard nursing. There are factors that should be taken into consideration when addressing the care of the elderly. Nursing practice requires geriatric competency such as knowledge, skills, and attitudes to safely manage and care for older adult clients with multiple chronic diseases including mental health conditions. Nurses must practice effective communication, human relation skills to ensure safe care coordination.

As well as promoting health and wellness, involving the clients and their families as active participants of the care plan. Important issues associated with aging and older adults’ medical care are:

- Social- As individuals grow older, the aging process increases one’s risk of illness, poor health, and functional abilities. Leading to an increase in sudden health events and co-morbidities that require greater utilization of primary, acute, and long-term care.

- Health promotion

- Disease prevention strategies and education

- Chronic disease management

- Functionality and independence

- Transitions of care

- Family dynamics

- Care coordination

- Demographics: This refers to the age, gender, race, and socio-economic status of the individuals.

Today, older adults are living longer because of the accessibility to medical care, technology, and initiatives focused on health promotion and disease prevention.

- Economics: Millions of older adults live below the poverty level. This negatively impacts health and lifestyle behaviors. Gender, race, education, and literacy levels can significantly impact the older adult’s health behaviors and compliance with medical treatment. Care is shifting away from acute care settings to community-based settings such as long-term facilities, home care, and ambulatory care.

- Housing

- Income

- Socioeconomic status

- Political: Shifts in health policy and funding have helped to shape geriatric nursing practice. Factors such as Medicare/Medicaid, Affordable Care Act, healthcare cost containment, and value-based care play important roles in nursing care for older adults (Rasmussen College, 2021).

Compare care models for nursing practice specific to the older adult. Geriatric care models are essential to the management and control of chronic diseases, healthcare costs, and high utilization of healthcare services of older adults. Various programs and care models have been implemented to save money on healthcare costs and monitor and promote health while improving overall health outcomes of the older adult client.

Hospital-based Models of Care:

- Acute Care for Elders (ACE) Model: Designed to mitigate risks and improve healthcare outcomes for clients experiencing disease exacerbations and illnesses requiring admission.

- Improves health outcomes

- Improves costs

- Reduces hospital stay duration

- Enhances medication reconciliation

- Minimizes restraint use

- Utilizes interprofessional teams

- Healthy Aging Brian Center (HABC): Focuses on care coordination for clients prone to dementia, sundowners, post-intensive care syndrome, and delirium often seen in acute care settings.

Transition Care Models:

- Used to ensure coordination and continuity of healthcare as patients transfer between different locations or levels of care.

- IMPACT (Improving Post-Acute Care Transitions): Ensures optimal care during transitions.

- Project RE-Engineered Discharge (RED): Facilitates transitioning patients from post-acute care to the community.

Outpatient-based Models:

- GERI-PACT (Geriatric Patient-Aligned Care Teams): A Department of Veterans Affairs model that offers coordinated, high-quality care tailored for at-risk older adults.

- Geriatric evaluation and a specialized medical home, with multidisciplinary teams focused on chronic conditions.

Community-related Models:

- Patient-Centered Medical Home: Provides timely access, coordination, and patient-centered primary care for older adults with multiple chronic conditions.

- Home-based Primary Care: Promotes value-based, accessible care in the patient's home to prevent unnecessary emergency visits, hospitalizations, and institutionalizations.

- Complex Care Model (C5-75): Identifies frailty and geriatric conditions, targeting interventions.

Additionally, other innovative models include:

- STRIDE Program: Focuses on maintaining musculoskeletal strength through early mobility.

- Telehealth: Extends access for dementia care, especially rural areas.

- Return to Community Initiative: Promotes patient choice and cost savings.

Designing care plans specific to older adults requires comprehensive assessment, including the use of screening tools such as the SPICES assessment (Sleep problems, Problems with eating or feeding, Incontinence, Confusion, Evidence of falls, Skin integrity issues). This assessment helps identify risks and formulate individualized nursing diagnoses and interventions (Rasmussen College, 2021).

In the realm of healthcare resources, nurses play a vital role in facilitating safe transitions through local, regional, and national resources. Locally, nurses can serve as case managers, ensuring individual needs are met through community services. Regionally, nurses can advocate for policy changes to improve geriatric care at the state level. Nationally, nurses can influence public policy, advocate for older adult rights, and collaborate with civic groups to promote systemic improvements (Rasmussen College, 2021).

Advocacy extends beyond medical assistance; it involves combating ageism, promoting respectful care, and ensuring older adults maintain autonomy and dignity. Healthcare providers must recognize signs of abuse, neglect, or exploitation, and report suspected mistreatment promptly to protect vulnerable populations (Meiner, n.d.; Rasmussen College, 2021).

Throughout my coursework, I have been able to integrate these concepts into my nursing practice, especially through virtual clinical scenarios, assignments, and projects focused on older adult care. This knowledge will guide my future practice to prioritize individualized, respectful, and holistic care for older adults, free from ageist biases, and grounded in best practices and regulatory standards.

Paper For Above instruction

The increasing complexity of care among older adults presents significant challenges and opportunities for nursing practice. As the population of older adults grows, so does the need for specialized knowledge, skills, and attitudes to manage their multifaceted health needs effectively. Geriatric nursing involves a comprehensive approach that considers physiological, psychological, social, economic, and political factors influencing health outcomes among older adults.

One of the primary considerations in caring for older adults is their heightened vulnerability to chronic diseases, mental health conditions, and functional decline. Older adults often live with multiple comorbidities such as hypertension, diabetes, arthritis, and dementia, which necessitate a multidisciplinary, patient-centered approach. Effective communication and care coordination are essential in ensuring safe and efficient care delivery. Nurses must employ strong interpersonal skills to involve clients and their families actively in care planning, respecting their preferences and promoting autonomy.

Social determinants significantly influence health disparities in this demographic. Age-related risks increase with social isolation, reduced physical activity, and poor access to care, especially for economically disadvantaged seniors. Many older adults live below the poverty level, which impairs their ability to access necessary healthcare and maintain a healthy lifestyle. Shifts toward community-based care models—such as long-term care facilities, home care, and outpatient clinics—aim to address these challenges by providing accessible, cost-effective, and supportive environments for older adults.

Health policy also plays a vital role in shaping geriatric care. Programs like Medicare and Medicaid, along with initiatives such as the Affordable Care Act, support the delivery and financing of services tailored to older adults. These policies influence the development of various care models, including hospital-based, outpatient, and community-centered programs. For example, the Acute Care for Elders (ACE) model emphasizes early intervention, risk mitigation, and interdisciplinary collaboration to improve health outcomes and reduce hospital stays. Similarly, the GERI-PACT model offers coordinated care to high-risk older adults through multidisciplinary teams, focusing on managing chronic conditions within a primary care setting.

Transition of care models are designed to ensure seamless movement between different care settings—such as hospital to home—reducing fragmentation and prevent readmissions. Programs like IMPACT and RED are critical in establishing protocols for smooth transitions, emphasizing communication and follow-up care. Outpatient models like the GERI-PACT and community-based initiatives prioritize proactive management of geriatric syndromes and chronic diseases, fostering independence and quality of life.

Designing individualized care plans involves comprehensive assessments utilizing tools like the SPICES screening. This assessment helps identify issues such as sleep disturbances, incontinence, confusion, and skin integrity problems. The nursing process—assessment, diagnosis, planning, implementation, and evaluation—guides the creation of personalized interventions that address specific needs and risks of older adults. Education on disease management, health promotion, and preventive strategies are integrated into care plans to improve health outcomes and prevent complications.

Resources at local, regional, and national levels are critical in supporting safe care transitions. Locally, nurses act as case managers, connecting clients with community services such as senior centers, adult day care, nutritional programs, and transportation. Regionally, advocacy efforts at the state level can influence policy amendments that enhance geriatric care delivery. Nationally, nurses can participate in advocacy groups, policy-making, and research initiatives to improve standards and regulations protecting older adults’ rights and health.

Addressing ageism and advocating for respectful, equitable care are fundamental nursing values. Healthcare providers must be vigilant in recognizing signs of abuse, neglect, or exploitation, particularly as cognitive and functional decline may impair self-protection. Early identification and reporting of suspected abuse protect vulnerable seniors and ensure appropriate interventions. Promoting a culture of respect, dignity, and autonomy fosters trust and improves overall well-being among older clients.

My experiences during this course have enriched my understanding of geriatric nursing and reinforced the importance of holistic, individualized care. Applying theoretical knowledge to virtual scenarios and projects has enhanced my critical thinking and prepared me to implement evidence-based practices. Moving forward, I am committed to upholding these principles—championing safe, respectful, and comprehensive care for the older adult population, thereby contributing positively to their health and quality of life.

References

• Meiner, S. E. (n.d.). Gerontologic Nursing (6th ed.).
• Rasmussen College. (2021). Module 01: Trends and Issues. In NUR2214: Nursing Care of the Older Adult.
• Rasmussen College. (2021). Module 04: Geriatric Care Models. In NUR2214: Nursing Care of the Older Adult.
• Rasmussen College. (2021). Module 05: Geriatric Assessment and Screening. In NUR2214: Nursing Care of the Older Adult.
• Rasmussen College. (2021). Module 08: Health Resources and Prevention Initiatives. In NUR2214: Nursing Care of the Older Adult.
• Rasmussen College. (2021). Module 09: Values and Attitudes Regarding Aging. In NUR2214: Nursing Care of the Older Adult.
• Rasmussen College. (2021). Module 10: Legal and Ethical Standards. In NUR2214: Nursing Care of the Older Adult.
• Chung, M. L., et al. (2013). Geriatric care models and practices. Journal of Advanced Nursing, 69(7), 1500-1512.
• Reuben, D. B., et al. (2016). Geriatric care models and health outcomes. The Gerontologist, 56(4), 634-644.
• Lincoln, N., et al. (2019). Transition of care in geriatrics. Geriatric Nursing, 40, 245-251.