Sample-3

5 Oct

Sample-3

  Blog

The elderly people awaiting for a package of care to find a suitable place for them after hospital admission.

  1. Introduction 

According to the British Geriatrics society if frail old people will be identified in the United Kingdom then they will be requiring a complete geriatric assessment and care (British Geriatrics Society, 2010).

Such multi dimensional diagnostic processes will focus on determining an old person’s medical, psychological and physiological capacity and thus maintain a long term follow up and care plan for the betterment of the person. As per the evidences from CGA it is very strongly pointed out that there is an increase in patients survival and betterment when they are taken care of in care homes, under special care or care packages. This is also associated with a decrease in cost of medical care for the elderly (Ellis et al, 2011).

The term population ageing is like a game changer for the services of healthcare and societal services. (David Oliver, 2013). In United Kingdom it is reported that a large section of the society is lying in the elder age group. Since old age accompanies with diseases a need of developing care packages arises. As it is recommended by practitioners that care is as important as a treatment in curing any disease so our paper is aiming at the need of care packages for elderly after hospital administration. A need of skilled, engaged and devoted staff is required for such care packages which are experienced in handling such cases of an old age group as the requirements and complications are variable with a certain age group. (Francis Report, November 2013)

The urge of setting up care packages is very clear from evidences like untimely intake of medications or timing errors in people suffering from Parkinson’s disease. They usually end up with worsening of disease by not receiving medication at right time. (Catananti, C, Liperoti, R,2009)

The specialist services were found to be more impactful in care packages of elderly. The aim of this proposal is to identify the health needs of diseased elderly people and to benefit them by nursing interventions and support, which will establish the nursing attributes for them (Jacobs, 2003).

As we know, the patterns of diseases have changed the in the last years. A lot of people are dying due to serious chronic diseases and acute illness, therefore, the care of old people must be taken up in some care home package after they are admitted to hospitals or discharged after some treatment.(Professor Janet Askham et al. WHO, Europe)

  1. Aims and objectives 

The main purpose of the proposal is to provide evidence-based recommendations for elderly people, waiting for an appropriate package of care and finding a suitable place for them after hospital admission.

Studies have been performed which focus on the health needs of the elderly in care homes, which proposed a nursing intervention of a requirement of a majorly committed package of care after hospital administration (Nolan et al, 2006). After searching databases like MEDLINE, CINAHL, BIDS, AgeInfo, Cochrane Library and British Nursing Index conclusions can be drawn that the elderly people who are unable to go back to their homes, need care packages after hospital administration. This is reflected in the NHS discharge statistics which show a waiting time of more than 100 days (NHS, 2016).

Needs and their Identifications:

The needs of old people who have been hospitalized vary as per the diseases they are suffering from and the condition or phase of the diseases. These diseases range from cardiovascular diseases, rheumatologic diseases, stroke, dementia, neurodegenerative diseases, depression etc.(Challis et al, 2000) all require a lot of care especially when they have targeted an elderly. Research shows that majority of elderly people undergoing treatment suffer from depression. This in turn, may have a detrimental effect on their recovery process (GodlhooveMozley et al., 2000)

The primary objective of the proposal is the need of setting up special care units in residential homes and nursing homes for the elderly, who have undergone or are undergoing treatment whilst waiting for a package of care. With the main objective of releasing hospital beds.

These homes will already have competent healthcare professionals, who can work in a multidisciplinary team, whilst delivering therapeutic and holistic healthcare needs. The research on nurses and primary care has identified that care, coordination of specialist care and other services altogether can predominately help the old age group.

Therefore all these researchers have emphasized on the importance of developing a care package for the elderly, which will help in boosting their recovery from diseases.

The aim of the service is to provide essential services like personal services like bathing, showering, dressing-up, toileting, mobility and communication facilities.

We will be providing services like nutrition, meal preparation, diet for the patient and hydration assistance and facilities. The care packages will include proper management services like urinals, catheter, urinary drainage appliances, bedpans and enema applications.

The aim of the care package is to provide a stress free environment and comfortable walking for the old. Therefore we provide lifts, bed rails, walking sticks etc. The nursing, healthcare services, speech therapy etc is also a part of the care package which will help in taking care of the patient in many diseased conditions. We will categorize two types of packages one for comprehensive or complete health services and the other for complex care for the individuals. The care packages will be chosen depending upon the condition of the patient.

The aim of the package also includes maintenance of skin integrity by using bandages, skin emollients, dressings etc.

  1. Time-frame and scale (how long will it last, which geographical are (s) will it cover)

The estimated time for the required setup will be based on the population we are targeting. According to the studies, we have information that there are approximately 11.6 million people who are aged above sixty-five years in the United Kingdom (Age U.K,2017)

It is also projected that the population of the elderly will be doubled in the next thirty years and may reach a huge number by 2040 which may make it so common that one in four people will be 65 years of age or over.(Age U.K, 2016)

Thus millions of people may need this care package thus the time frame setup has firstly been decided to start such programs in a specific location to cover some hundred people.

In a research performed by (Yousaf 2012) in Newcastle upon 85 and over aged population suffering from left ventricular heart failure out of 376 patients ventricular dysfunction or isolated moderate dysfunction also along with difficulty in breathing. Therefore we would like to set up our elderly care home in Newcastle to help the people suffering from cardiovascular diseases. This will also help them to reduce the adjuvant problems faced by them like breathing problems etc.

The time frame will be for three years as it would require firstly setting up of the committee who will work on the volunteer work. Then will be planning a map with the help of an architect for the special care home. The landscape has to be approved by the government authorities, and then we will have to file an application for setting up out proposed work.

Meanwhile, we will have to collect the patient data from the neighborhood as well as the district hospitals nearby in Newcastle. Our aim would be to cover all hospitals and priority will be given who are in most need of such services.

A prior research will have to be done for identifying the elderly people in Newcastle and what is the majority disease affecting the people. We will have to create a previous list of the percentages of people who are suffering from severe diseases and group them by the ages. As the requirements vary therefore each group will have a slot ranging five years.

Such centre will cover elderly people who have a medication course running for six months to one year. We would be admitting patients who have recently met with prolonged hospitalization and are suffering due to lack of care required for the cure or betterment of disease. A selection criteria format will have to be set up to get the patients admitted.

  1. Resources required, including staff 

The special care home will need some essentials like a first aid box, basic medication supply, a general practitioner, one nurse for each patient and some government funding agency support for the welfare of the elderly. For such proceeding, we will have to contact some Old age associations and welfare clubs who would be ready to donate to some charity.

In our construction process, we will add relaxing rooms which will provide a light ambience to the people using care packages. An ambulance facility has to be strictly kept in mind for easy travel of the old age people while visiting their hospitals for regular check-ups or emergency conditions. A team will also be appointed to take care of the repair or construction work as per the need of the time. We will appoint teams who will be responsible for managing food in the house as per the diet prescribed to the patient. A house help will also be appointed to marinating sanitation in the house including toilets and discarding the medical waste of the person.

  1. Funding /costs 

We have planned our funds by approaching various organizations. A proper format of the application has been prepared, and we are applying in organizations like Help care International, which is an international agency and sanctions, funds for the needs of the elderly. We will also in the process of applying in United Kingdom’s various organizations like Age international.org.uk, Age Concern.org.uk  and many such organizations will have an excellent record of helping the elderly people. Such agencies, organizations and Non-governmental organizations will help in building the structure of the care center. These funds will help in creating a nursing atmosphere and the supply of basic medications.

People enrolling in such programs will have to pay some basic amount which will make up for the cost of their medications or basic household needs. The costs which we have estimated will stand somewhere about £70,000 for a lifetime residence for the elderly above the age of 65 years.(OECD, United Kingdom,2013). The nursing care team will work on charity basis or will be paid wages if funded by us or a government body support that is willing to support or endeavors. 

  1. Monitoring Evaluation of project

We will set up parameters for evaluating health records of the people who have enrolled in our programs. We will plan daily, weekly and monthly health check-ups by doctors who will compare the records and results of the people who are living in the care home with the people who are not availing any such facilities.

Time and again it has been proven that the nursing care support and regular care the patients have helped them in recovering very quickly as compared to the once no provided with any such care. (Cramp and Bennett, 2013)

The parameters on which we will evaluate any person’s recovery will be based on the medical history of the person and its complications. It is very well known that the medication along with psychological healing processes helps in the speedy recovery of patients, therefore, counseling sessions, interaction with people of the same age group living with them will boost the enthusiasm and remove the concepts of misery in solace.(Caroline Nicholson,2017)

  1. Proposed outcomes: Conclusion 

The main aim of this proposal is to identify the need for the elderly who are undergoing treatment. Such supportive care homes are supplied with proper nursing and medical help to take care of a certain section of the society. The intention of setting up such homes is to collect evidence that the special care can boost up the enthusiasm in people who are majorly affected by diseases. The timely care has also served as an important parameter in speedy recoveries.

The model of care of this elderly care home was to enhance relationship and communication between the patient and its families, doctors, specialists, with people of the same age group. (Morrow and Nicholson, 2016)  These initiatives will be taken up by the nursing staff accompanying the patient or by the staff members who will be running the elderly homes. This will help the patients who are gravely ill and getting palliative care services (Gardiner et al., 2011; Zhi and Smith, 2015).

As a coordinator, my role will be to create a team who are willing to work on such a project. We will discuss the capabilities and interest of people in my team like record keeping, application process, talks with Government and Non-government agencies, etc. I will assign roles to people of my team as their mentor with perfect suitability to their work profile. I will keep a record on the time slot, and a timetable will be created for every person who is in-charge for taking care of one patient. A buffer staff will be appointed to work under increased demand of work or emergencies.

I will be keeping records on the vehicles needs and the inbuilt medical supply needs of the home. Different mangers will manage the food and basic requirements, and the financial advisory board and team will monitor all the bills generated. I will coordinate with specialists and organize visits by Doctors and their team.

The purpose of this work is to provide a good place for the elderly who are undergoing medical treatments. Such people require special benefits, and there are insufficient care and supply in the old age homes. They need serious medical care, nursing attention and emergency medical treatments; therefore, a specialized home build for a specific purpose can be a great help.

A home which has been specially designed for taking care of the ill elderly people will be a great solution for our requirement which remains the same of provides special care and recovery to a certain section of the society. 
This theory can be used meaningfully used here as it projects and points out at the need of emotional help, psychological help, medicinal help and most importantly nursing help to the elderly people for recovery early or giving them strength to deal with the sufferings of the diseases.

It can help to raise questions about the medical patterns we are following which can be modified if each patient gets an individual care throughout the day. Such interventions will prove to improve the quality of life for people suffering from chronic and fatal diseases.

References:

  1. style=”text-align:justify”Challis, D., Mozley, C.G., Sutcliffe, C., Bagley, H., Price, L., Burns, A., Huxley, P. &Cordingley, L. (2000) ‘Dependency in older people recently admitted to care homes’, Age and Ageing, 29 (3), pp.255-260.
  2. Goodman, C., Robb, N., Drennan, V. & Woolley, R. (2005) ‘Partnership working by default: district nurses and care home staff providing care for older people’, Health & Social Care in the Community, 13 (6), pp.553-562.
  3. Jacobs, S. (2003) ‘Addressing the problems associated with general practitioners’ workload in nursing and residential homes: findings from a qualitative study’, The British Journal of General Practice: The Journal of the Royal College of General Practitioners, 53 (487), pp.113-119.
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  6. Professor Janet Askham et al,World Health Organisation,Better Palliative Care for older people, Europe
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  11. Later Life in the United Kingdom January 2017, Age U.K
  12. Age UK (2016) Later life in the United Kingdom: June 2016. London: Age UK
  13. Yousaf, F., Collerton, J., Kingston, A., Kenny, A., Davies, K., Jagger, C., Robinson, L, Kirkwood et al 2012. Prevalence of left ventricular dysfunction in a UK community sample of very old people: the Newcastle 85+ study. Heart, 98, 1418- 1423.
  14. The United Kingdom A Good Life in Old Age © OECD/European Commission June 2013
  15. Cramp, F., Bennett, M., 2013. Development of a generic working definition of ‘supportive care’. BMJ Support. Palliat. Care 3 (1), 53–60. doi:http://dx.doi.org/ 10.1136/bmjspcare-2012-000222.
  16. Caroline Nicholson, Elizabeth M. Morrow, Allan Hicks, Joanne Fitzpatrick, International Journal of Nursing Studies, Science Direct,66 (2017) 60–71
  17. Morrow, E., Nicholson, C., 2016. Career involvement in the hospital care of older people with frailty: an integrative review. Int. J. Older People Nurs. 11 (4), 298– 314. doi:http://dx.doi.org/10.1111/opn.12117.
  18. Gardiner, C., Cobb, M., Gott, M., Ingleton, C., 2011. Barriers to providing palliative care for older people in acute hospitals. Age Ageing 40 (2), 233–238. doi:http:// dx.doi.org/10.1093/ageing/afq172.\
  19. Zhi, W, Smith, T., 2015. Early integration of palliative care into oncology: evidence, challenges and barriers. Ann. Palliat. Med. 4 (3), 122–131. doi:http://dx.doi.org/ 10.3978/j.issn.2224-5820.2015.07.03.
  20. Catananti, C, Liperoti, R, Settanni, S, Lattanzio, F, Bernabei, R, Fialova, D, Landi, F & Onder, G 2009, ‘Heart failure and adverse drug reactions among hospitalized older adults’ Clinical Pharmacology and Therapeutics, vol 86, no. 3, pp. 307-310. DOI: 10.1038/clpt.2009.89
  21. ‘Hard Truths, the Journey to Putting Patients First’, Government response to the Francis Report, November 2013
  22. Professor David Oliver, Consultant Geriatrician President-elect British Geriatrics Society King’s Fund Senior Visiting Fellow Visiting Professor, Medicine for Older People, City University, London
  23. British Geriatrics Society (2010) Comprehensive Assessment of the Frail Older Patient. Accessed at: http://www.bgs.org.uk/index.php/topresources/publicationfind/goodpractice/195-gpgcgassessment
  24. Ellis, G., Whitehead, M.A., Robinson, D., O’Neill, D., Langhourne, P. Comprehensive geriatric assessment for older adults admitted to hospital: meta analysis of randomised controlled trials. BMJ 2011 Oct 27;343:d6553.doi 10.1136/bmj.d6553

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