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Article One Literature review
The article highlights the fragility nature of the old people in Australian aged care facilities. Old people are faced by several physical health challenges attributable to their deteriorating fitness caused by aging. For example, the article indicates that they have general structure weaknesses and deterioration of their sensory system. The aged in residence facilities are faced by a constant risk of falling because of poor balance and general body weakness. The treatment offered to the victims is of low quality compared to the high risk of bone fractures they face. Researchers have proposed some possible methods of prevention of fractures and treatment of osteoporosis among the aged. The treatment processes involve consultations between a multidisciplinary team, the family, and the patient.
A normal profile of the old people in the institutions includes multiple medications; low bone mineral density, poor muscle strength, cognitive disorders, fecal and urinary incontinence. Nursing home Residents are entirely dependent on the staff to assist them with their daily activities. They receive medical administration at specific intervals from the support staff. On the other hand, hostel residents are assisted by support staff but most of the times they are left unsupervised for long periods.
According to Parikh, Avorn and Solomon (2009), studies indicate that 85% of residents in nursing homes have osteoporosis with 40% of hip fractures. A study by Chen et al. (2008) conducted a study to infer fracture and falls risk among the elderly population in the residential homes compared to those living in the community. Although institutionalized people face high risk of osteoporosis, treatment in the residential homes is considerably low (Wright, 2007).
The existence of the treatment gap can be attributed to limited access to diagnostic methods to help in the identification of fractures and quantification of bone marrow density, little knowledge of osteoporosis interventions in residential nursing homes, assumptions about the victim’s length of stay and patients and family’s concerns about potential side effects of the medication.
Fall is a major cause of fractures in nursing homes. Studies show that screening residents for fall risks within the nursing homes reduces injuries, leading to an agreement that residents should be screened for ascertain their stability. Pharmacists should perform annual medication review to identify medical related problems and prescribe medication accordingly. Other factors to prevent falling include strength and balance training. Studies have been conducted to determine the efficacy of hip protectors in the prevention of hip fractures. A Bayesian Meta-analysis of the hip protector effect on reduction of injuries reported that they reduce the hip fracture risk among the elderly in nursing homes (Wright, 2007).
Medical treatment of osteoporosis is possible and cost-effective among the elderly when the assessments are based on bone marrow density. Physicians choose a treatment method after consultation with multidisciplinary team, patients, and their families. Physicians also result to use of vitamin D and calcium supplements. The dosage has been proven to increase vitamin D levels consequently better patient compliance.
Bisphosphonates are used to prevent fractures in the general population. Studies have shown that its use among institutionalized old people improves bone marrow density (Wright, 2007). Oral administration of the treatment can be creating burden on patients and nursing staff because of complex directions (Gustavo et al., 2010).
In conclusion, people living in residential aged facilities face a higher risk of fall and bone fractures. Staff training and participation in determining possible intervention measures to minimize injuries, and treatment to the injured is important. However, factors that affect the aged like inability to self administer medication and poor cognition mount pressure on the staff and patients assisting them to take their medication. Prevention of falls and bone fractures among the elderly living in residential homes facilities should focus on both pharmacological and non-pharmacological methods pf risk prevention and treatment. Decision making on treatment should include the staff, family members and the patient to avoid friction.
Article Used
Gustavo, D. et al. (2010). Treatment for osteoporosis in Australian residential aged care facilities: consensus recommendations for fracture prevention. The Medical Journal of Australia, 193(3), 173-179.
Article Two Literature Review
This article discuses the importance of teamwork between the Residence Aged Care Facility and the family in formation of relationships and effective care delivery to the resident. Teams enable participants to share information and reveal their expectations. The roles of every member should be specified and there should be sharing of responsibilities during the process of implementation of care strategies. The nature of the relationships formed between these two parties affects the quality of care the resident is likely to receive while in the facility.
Old people who have been moved into aged care facilities need to maintain the relationships existing between them, families and friends. This article examines how the patient’s family and the care staff can collaborate to ensure that the patient receives good care at the residential center. Due to continuous involvement with the person being moved to the care center, it’s important for family members to continue caring for the patient actively. This entails forming new relationships with care givers and sharing information about the person in residential center to make the care process meaningful to all parties.
Care staff is trained to respect patient’s individuality. Although individual expression of this might be hard because they are caring for several people, involving the family to find out how this can be done is important. The family can express appreciation for the care provided in different ways; it’s advisable not to favor some staff members over others.
Families feel guilty for moving their relatives into residential facilities. Diagnosis of dementia in the patient can be devastating; consequently affecting the quality of care they give to the patient in the facility. For example, strained visiting patterns. The family should reveal to the staff the uncertain aspects of care they have in mind. They should also talk about how the family would like to be involved in taking care of their relative.
The family should be informed about its responsibilities and those of the facility in the provision of health care to their relative. They should also reveal if the patient has special health professionals whom he or she would like to maintain contact with. Medical information about diagnosis and arising issues can be obtained from the doctor in the facility. Good communication can be established through clear discussion on the staff roles and the expected input in the exercise from the care giver, based on the care plan of the residence. The family has the right to get correct information concerning care issues in the facility (Fetherstonhaugh & Garratt, 2008).
Family members are allowed to participate actively in care delivery to reduce friction which arises when the staff feels like they just being monitored and reported to the organizations management for poor delivery. Establishing trust between the family, the patient and the staff takes time, understanding, and tolerance; to realize long term expectations in the care settings.
Management style influences the relationships formed in care facility. Care models, level of training, and staff workloads can either promote or discourage collaborative care. The staff and family should work as a team; consider each other’s opinions in making decisions. The older person should also be involved in the decision making process. Communication failure in the team leads to competition; the aged person in dire need for care suffers due to lack of agreement between the two parties whose tug of war is very detrimental.
In conclusion, building harmonious relationship between the support staff and the family serves to improve the quality of care given to the old person in the residence center. Poor communication leads to friction and as a result suffering of the person who needs care the most. Open communication should be used to avoid disruption of care by strong independent personalities. Teamwork is the gateway to successful delivery of care to make the residents life more comfortable. Care staff in the institutions cannot work single handedly without the family’s input. On the other hand, family members cannot give the care scheduled to be provided by the skilled caregiver efficiently.
Article Used
Fetherstonhaugh, D. & Garratt, S. (2008). Supporting families and friends of older people living in residential aged care. International Journal of Evidence-Based Healthcare, 7, 1-16.
References
Chen, S., Simpson, M. & March, M. (2008). Fracture risk assessment in frail older people using clinical risk factors. Age Ageing, 37, 536-541.
Fetherstonhaugh, D. & Garratt, S. (2008). Supporting families and friends of older people living in residential aged care. International Journal of Evidence-Based Healthcare, 7, 1-16.
Parikh, S., Avorn, J. & Solomon, H. (2009). Pharmacological management of osteoporosis in nursing home populations: a systematic review. Journal of the American Geriatrics Society; 57(2), 327-334.
Wright, R. (2007). Use of osteoporosis medications in older nursing facility residents. American Medical Directors Association, 8(7), 453-457.
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