week 4 lecture Continuum of care PartA: ContinuumofCare fortheOlderAdult NRSG266ContextsofAgeingWeek4 LearningOutcomes • OnCompletionofthisweek’slearningand...

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week 4 lecture Continuum of care PartA: ContinuumofCare fortheOlderAdult NRSG266ContextsofAgeingWeek4 LearningOutcomes • OnCompletionofthisweek’slearningand teachingactivitiesstudentswill: • Understandtheconceptof“ContinuumofCare” anditsimpactsonqualityoflifefortheolder person • Theroleofacommunitynurseassociatedwith ageing • TheimportanceofHealthyAgeing • ImplementingtheR-L-Tmodelforacommunity ageinghealthassessment • Introducingthemulti-disciplinaryteam(MDT) availabletoassisttheolderperson • TheimportanceofHealthyAgeing StudentThoughtsonAgeing • Duringweeks1&2weconsidered • Studentthoughtsonageingandwhatcaringfortheageingpopulationentailed • Weintroducedtheconceptsofageismandstereotypes • Qualityoflife • Hownursescanassisttheolderperson • Hereareonlysomeofyourresponses Student thoughts and responses on ageing Holland,K.&Jenkins,J.(Eds).(2019).ApplyingtheRoper-Logan-TierneyModelinpractice.Edinburgh:Elsevier, p.18 • Introducedduringweek2theR-L-Tconceptual frameworkconsidersa‘modelofliving’ • Itisessentialfornursestoconsiderallaspects ofaclient/patient’slifewhenundertakinga comprehensiveassessment • 12ActivitiesofLiving(ALs)wereintroducedas seeninthediagram • Comprehensivepatientcentred assessment shouldtakeintoconsiderationallALs • Assessment,PlanningandImplementationare allessentialwhensupportingthecontinuum ofcarefortheolderperson R-L-TModelinpractice ContinuumofCare Eachpersonthushasadependence/independencecontinuum Allaspectsoflivingareinfluencedbythefollowingcircumstances,whichultimatelyinfluencehealthcare Biological Psychological Socio=cultural Environmental Politico-economical Thelifespanisacontinuum TherearestagesofthelifespanwhenapersonisunabletoyetorcannolongerperformALsindependently Continuouschangeoccursaswemovethroughthelifespan FiveStagesofLife Infancy Childhood Adolescence Adulthood Oldage Thelifespanisacontinuumthatindividualsmovethroughfrombirthtodeath Roper,Logan&Tierney,(2019) QualityofLife • QualityofLifeis: • “Anindividual'sperceptionoftheirpositioninlifeinthecontextoftheculture andvaluesystemsinwhichtheyliveandinrelationtotheirgoals,expectations, standardsandconcerns”.(WorldHealthOrganisation,2019) https://www.who.int/healthinfo/survey/whoqol-qualityoflife/en/ • Qualityoflifeisdifferentforeachofus,andisdependentonthecomponentsthattheR-L-Tmodelidentifyas “factorsthatinfluenceourALs” • Biological • Psychological • Sociocultural • Environmental • Politicoeconomical • Aspectsofwhatisimportantforourindividualqualityoflifechangeaswemovethroughthelifespancontinuum TheimportanceofHealthyAgeing • Healthyageingisessentialtomaintainingagoodqualityoflife • Wediscussedinpreviousweeksthatthereare: • Normalphysiologicalchangesofthehumanbodyasweage • IndividualchoicesthatwemakethatmayimpactourageingandQOL • HowdoesanRNassistaclient/patientwiththeirQOL? • Communication? • Assessment? • Rapport? • Simplygettingtoknowsomeoneandwhatisimportanttothem? AgedCareinAustralia • AllRN’smustupholdourstandardsasoutlinedbyAHPRA(2016) • Standard1:ThinksCriticallyandanalysesnursingpractice • Standard2:Engagesintherapeuticandprofessionalrelationships • Standard4:Comprehensivelyconductsassessments • Standard5:Developsaplanfornursingpractice • Standard6:Provides,safe,appropriateandresponsivequalitynursingpractice • Standard7:Evaluatesoutcomestoinformnursing https://www.health.gov.au/health-topics/aged-care/about- aged-care/what-is-aged-care Whatisagedcare? 1. Supportforolderpeopleas theyage 2. Typesofagedcareservices 3. WhoisEligible 4. Whoprovidesagedcare? 5. OurAgedCareSystemin Australia Roleofacommunityagedcarenurse CaseScenario2:KarlandFrancis OurnextCaseScenarioonKarlandFrancisissetinthecommunityhoweverbemindfulthatthese discussionsarerelevanttoallaspectsofagedcarenomatterthesetting • AcommunitynurseshouldbeabletoimproveandmaintainthequalityoflifeofolderAustralians • Amongstotherssomeimportantkeyskillsforanagedcarenursetopossesswhenworkinginthecommunityinclude: • Collaboration • Assessment • WorkingIndependentlyandaspartofateam • Communication • Advocacy • Healthpromotion • Education CommunityAgedCareServices • Thecommunitynurses • Workinvarioussettingsandarefocusedonassistingclientswithexistinghealthconditions,tomaintainand/orimprove theirqualityoflife • Referralsaremadetoaccessacommunitynursingservice • Assessmentsaremade • Resourcesareaccessed • Ongoingassessmentandsupportscontinue AgedCareservicescaninclude Homecare,District, DayCaree.g.GPvisits,outpatients,surgical Respite(dayonlyorforanagreedlongerterm) TransitionalCare Longtermcare Hospice,palliativecare ImplementingtheR-L-Tmodelforacommunity ageinghealthassessment • Comprehensivepatientassessment • NowthatweareawareoftheRLTALs,wecanbegintothinkcriticallyabouthowtheyareusedforanagedcare assessmentforacouplelikeKarlandFrancisforexample • YoumayhaveheardofsomeoftheresourcesavailableintheAustralianHealthcaresystembothataFederaland atthevariousStateandTerritorylevels • AcommunityRNcanreviewaclient/patientintheirownhome,GPClinicorHospitalSettingforaninitial assessment • Aswithanynursingassessmentitmustbepatientcentred,toensurethisusethe12ALsashighlightedintheR-L-T model ImplementingtheR-L-Tmodelforacommunity ageinghealthassessment • AcommunityRNwillundertaketheirowninitialassessmentoncetheyreceiveareferral • OncethishasbeenundertakentheRNisabletoascertainifanACATassessmentwillhelp • ThisinitialassessmentwillbethoroughwhenutilizingtheR-L-Tmodel QuestionsaboutAssistanceandAccess HowdoIgethelp? Whathappensatan assessment? Isanassessmentforahome carepackagefree? Icareformyhusbandonmy own…Iamexhaustedand feelingstressed.CanIget help? Theimportanceofenhancingthequalityoflifeforclients/patientswhoareageingwithintheir homeandthecommunityenvironmentisundeniable www.myagedcare.gov InformationandhelpforallAustralians https://www.myagedcare.gov.au/assessment/prepare-your-assessment AnACATAssessment Whatisan ACAT assessment? 1 Whatisan ACATteam? 2 Howmuchwill itcost? 3 Iam frightenend 4 myagedcare.gov Timetowatchhowmyagedcare.gov canhelpAustralians https://www.youtube.com/watch?v=PQtsUgeLVWI Referrals • Inthepasthealthcareprofessionalsworkedin individualprofessionalsilosforexample; 1. Medicine 2. Nursing 3. Physiotherapy 4. Dietician 5. OccupationalTherapist • Sharingknowledgeimprovesthelivesofour patients/clientsandassistshealthcare professionals • Multidisciplinaryteam(MDT)workand accessingotherprofessionalsassistsclients, ourselvesandoutcomes Introducingthemulti-disciplinaryteam(MDT) availabletoassisttheolderperson • Whoworksinagedcare? • Nurses • Doctors • Surgeons • Podiatrists • WoundCareSpecialists • ContinenceSpecialists • Physiotherapists • Dieticians • OccupationalTherapists • Socialworkers • PatientCareAttendants • CouncilAidWorkers • Volunteers • Canyouthinkofanyothers? ChoicesinHomeCare • https://www.youtube.com/watch?v=Jqj5Gj2sWE4 • Reducerestrictions • Providesupport • BuildRapport • ProvideTransport • MobilityOptions • MealsonWheels • DomesticAssistance • Livingathome • AgedCareAssessment • AskforhelpTessfromCanberra https://www.youtube.com/watch?v=a-3F1BYMgE0 DianaandIgnattius https://www.youtube.com/watch?v=dmHBolAJOPk ApplyingtheR-L-TmodelinAssessment • LookingatCaseScenario2ofacoupleresidingintheirownhomewecanworkthroughthe12ALsas outlinedbyR-L-Tintheirmodelofassessment • Thiswillprovidecommunitynursingteamandotherhealthprofessionalswithvaluableinformationto assistKarlandFranceswiththeirneeds • ThisthoroughassessmentbeganwiththeGPandthecontinuumofcareforKarlandFranceswillbe ongoing • Itislikelythatotherhealthprofessionalswillassistandbeinvolvedintheircare CaseStudy2 • CommunityRNvisitingacouple(KarlandFrances)intheirownhome • SubjectiveandObjectivedataneedtobeobtainedtoascertaintheirneedsboth currentandpotential • WorkingthroughtheClinicalReasoningCyclewillassistwiththeestablishmentof SMARTgoalsprovidingthemwithsupportneededtostayathomeforaslongas theycan Clinical ReasoningCycle • Howcanwebest helpKarland Frances? MovingForward • Sharingknowledgeimprovesthelivesofourpatients/clientsand assistshealthcareprofessionals • Inthepasthealthcareprofessionalsworkedinindividualprofessional silosforexample; 1. Medicine 2. Nursing 3. Physiotherapy 4. Dietician 5. OccupationalTherapist • Thelistisendless,togetherwecanmakeadifferenceinthequalityoflives ofourclients/patients,theirlovedones,ourcolleaguesandpeers NRSG 266 Principles of Nursing: Contexts of Ageing NRSG 266 Principles of Nursing: Contexts of Ageing Week 3 Lecture: • Psychosocial theories of ageing • Non-physical changes associated with ageing Learning outcomes week 3: On completion of this week’s learning and teaching activities the student will: • Recognise that ageing may effect psychosocial health status • Describe how age-related changes influence psychological health, social interactions and socio-economic status and belief systems • Describe the main psychosocial theories of ageing and explain their effect Psychosocial theories of ageing: • Represent ideas about psychological and social changes resulting from or influenced by the ageing process • Attempt to explain the factors influencing how individuals manage such behavioural, cognitive and emotional change • Attempt to explain the interrelationship between older adults and the social environments in which they live • May predict outcomes Mrs Anna Maria Morteno is 70 years old. She is … • Second generation Greek-Australian • Married to Alec, a retired factory worker, for 53 years. • Anna Maria has a close relationship with her siblings and their families • Her grown adult children and her siblings live within the same suburb and are close knit. • Her parents passed away 3 years ago, within a few months of each other. (What ages would they have been?) • Anna Maria retired from her role as a senior librarian two years ago, and now enjoys caring for, and playing with, her seven grandchildren whenever she can. ROLE THEORY: Based on the belief that roles define us, our identity and self-concept, and shape our behaviour. As we age we take on new roles and complete others • Context: Anna Maria was a Librarian, how do you think this influences her interactions with her grandchildren? Age norms – “culturally constructed expectations of what is deemed acceptable behaviour in society” (Touhy & Jett, p. 41). Successful ageing means that each new role holds similar value through adjustment to the new role. However … • This theory does not consider influence on social factors such as class, education and income on the ageing process. Mrs Anna Maria Morteno is 70 years old. She is … • Second generation Greek-Australian • Loves to spend time in her garden • Enjoys cooking for large family gatherings • Has a strong faith and attends church each week. • She attends a dance class every Wednesday with a group of friends. • Walks three kilometres a day no matter what the weather. ACTIVITY THEORY: That the continuation of activities carried out during middle age is necessary for successful ageing. Successful ageing is dependent on the individual maintaining an active lifestyle. According to Hunter and Miller (2016 p. 58), older people may remain both psychologically and socially fit if they can continue with some kind of active engagement in life. • Context: Anna Maria loves to work in her garden and walks three kilometres every day no matter what the weather is like, she walks with Alec. • She likes to cook for her family, particularly large family gatherings. Within this theory it is believed that activity, interest and involvement should not diminish with ageing. When you look at some of the research in this area, new and continuing social interests and roles are important to the older person’s sense of identity, life satisfaction and well being. While Anna Maria and her lifestyle/lifespan choices seem to align with Role Theory and Activity Theory, consider DISENGAGEMENT THEORY: That ageing is a process where people turn away from active involvement with others and turn inward, people may become more self-focused or preoccupied in a way that produces gradual withdrawal from social roles (Johnson & Chang, 2017). Within this theory there is a move between society and the individual where the individual draws back of disengages from other people – at times to their mutual satisfaction and benefit. • The individual may be more focused on self once free of social expectations • Society benefits from the orderly transfer of power across generations. Does this fit with Anna Maria and her choices? Have you encountered what seems like a disengagement from society within older people? Some residents in RACF’s may align with disengagement theory. This theory does not account for cultural diversity, sociocultural context or individual preference and choice. • While it can be difficult not to stereotype Anna Maria – it is well known that the Greek community are excellent cooks and have wonderful variety within their food and culture. • Anna Maria loves to garden, cook and spend time with her grandchildren. She remains active by walking everyday. She does not align with disengagement theory. Consider what has been presented here, that these are theories. They are Psychosocial theories of ageing. • They represent ideas about psychological and social changes influenced by ageing. • They attempt to explain factors that influence how individuals manage behavioural, cognitive and emotional change while ageing. • They can predict social and emotional outcomes of actions, decisions and behaviours, however … • They are not absolute. They are theories. Here are a few more. Continuity theory “Aging, as an extension of earlier life, reflects a continuation of the patterns of roles, responsibilities and activities.” (Touhy & Jett, 2018, p.42) Successful ageing is determined by how well the older adult maintains this continuity (Johnson & Chang, 2017) Internal continuity – personality traits, attitudes, beliefs, values External continuity – social interactions, relationships, sociocultural context, environment • Assumes older adults rely on their past (experiences, decisions, behaviours, coping strategies) to inform their future; and that ageing is a smooth transition in which abrupt changes do not occur, change is gradual, which allows the older person to adapt • Problems - • considered to be simplistic; not accounting for the complexity of factors influencing ageing Johnson, A. & Chang E. (2017.) Caring for older people in Australia (2nd ed.). Milton, Qld: Wiley; Touhy, T. & Jett, K. (2018) Ebersole and Hess’ Gerontological nursing and health aging (5th ed.). St Louis Missouri: Elsevier. Theory of Gerotranscendence (Tornstam 1989, 1994) • Builds on disengagement theory • “A positive, lifelong continuous development towards gerotranscendence” (Johnson & Chang, 2017, p.37) - a shift from materialistic rational view to cosmic transcendent view which is accompanied by an increase in life satisfaction • Increased feelings of peace and contentment • Changed perception and experience of space and time • Enhanced interest in spiritual, mystical aspects of living and ageing • Decreased fear of death • Greater focus on meaningful relationships (Johnson & Chang, 2017) • Emphasises the transcendent aspects of old age, that is, the person experiences a redefinition of self and fundamental shift in the way the world is experienced • Places focus on inner self as positive characteristic of old age • Problems: - • too egocentric in focus • Does not consider sociocultural economic and environmental factors that may prevent such introspection and contemplation Johnson, A. & Chang E. (2017.) Caring for older people in Australia (2nd ed.). Milton, Qld: Wiley. Approximate Age Psychosocial crisis Existential question Infancy Trust vs. Mistrust Can I trust the world? Toddlerhood Autonomy vs. Shame/Doubt Is it okay to be me? Early childhood Initiative vs. Guilt Is it okay for me to do, move, and act? Middle Childhood Industry vs. Inferiority Can I make it in the world of people and things? Adolescence Identity vs. Role Confusion Who am I? Who can I be? Early adulthood Intimacy vs. Isolation Can I love? Middle Adulthood Generativity vs. Stagnation Can I make my life count? Late Adulthood: 60 and above Ego Integrity vs. Despair Is it okay to have been me? Theory of psychosocial development (Erikson, 1963) Hunter, S. and Miller, C. (2016). Nursing for wellness in older adults, 2nd Australian and New Zealand Edition. North Ryde, NSW: Lippincott, Williams and Wilkins; Johnson, A. & Chang E. (2017.) Caring for older people in Australia (2nd ed.). Milton, Qld: Wiley. Theory of psychosocial development Proximity of death in old age leads to - • questions • “What has my life meant?” “ Is it OK to have been me? ”What have I to grieve, to be proud
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Answer To: week 4 lecture Continuum of care PartA: ContinuumofCare fortheOlderAdult...

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Running Head: NRSG266                                    1
NRSG266                                            6
Table of Contents
Introduction    3
Healthy Ageing    3
Role of Registered Nurses in Healthy Ageing    3
Registered Nurse Facilitating Quality of Life in Older Adults.......................................................3
Evidence Based Approaches to Promote Healthy Ageing    4
Impact of Psychosocial Factors on Healthy Ageing.....................................................................6
Conclusion    5
References    6
This essay analyses the role
of registered nurses in order to promote and encourage healthy ageing in older individuals as well as talks about some evidence based practices followed in Australia to encourage the process of healthy ageing. Healthy ageing has a significant impact in generating the opportunities and suitable environment that assists people in doing and being the person that they appraise all the time in their lives. However, staying free from any sort of disease is not a basic obligation for healthy ageing since majority of elderly people are subjected to one or more health conditions, which if controlled and managed well, could have little impact on the wellbeing of the elderly people.
Significance of Healthy Ageing
The World Health Organisation explains healthy ageing as the mechanism of developing as well as preserving the functional capability in elderly people that facilitates wellbeing at older age. Functional ability entitles the elderly people with capabilities to build and sustain relationships personally and in the society, to grow in life and take decisions. A healthy ageing helps older people to fulfil their basic needs stay mobile as well as contribute efficiently to the society (World Health Organisation, 2020).
Role of Registered Nurses in Healthy Ageing
    A registered nurse possesses key skills to achieve healthy ageing in older adults. They work efficiently in order to enhance and maintain the quality of life in elderly people of Australia. They play a crucial role in collaborating with the care services as well as communicating with the older people who need the aged care. Registered nurses work individually and even as a part of team in order to work in the community.
In order to empower old individuals about healthy ageing, registered nurses also work in the area of promoting good health as well as educating people about healthy living in older adults (Australian College of Nursing, 2019). Registered nurses work in different settings and usually focus on helping elder people with prevailing health conditions in order to maintain and enhance the quality of life in older adults.
Registered Nurse Facilitating Quality of Life in Older Adults
Registered nurses play a crucial role in encouraging individualised quality of life in the older adult with healthy ageing. They follow few steps in order to facilitate the process of healthy ageing in older adults. They make some referrals to acquire community-nursing services and perform various assessments on the elderly people of Australia. As analysed by Campisi et al. (2019), the registered nurse from a community tackles the health condition of the older adults once they achieve a referral from the community nursing service. As soon as the referral is received, registered nurses perform their own primary assessments on the older people, after which they would be able to discover whether an ACAT assessment would be of any help to the older person. The initial or primary assessment is expected to be in depth and meticulous when it is employed by the R- L- T model (Holland & Jenkins, 2019).
    Registered nurses assists the older people with a safe, secure, evidence based as well as patient centred care practice for the better health. They associate with the elderly person and encourage decision-making skills as well as delivery of care practices between the older person and the family, partners, friends or the health care professionals of the elderly person (Australian College of Nursing, 2019). Registered nurses are also involved with each older people in a respectful as well as safe manner in their cultural aspect. They build strong relationships with the elderly people that are quite honest, loyal and open, sticking to their obligations related to their secrecy and privacy (Australian College of Nursing, 2020).
    Registered nurses help the older individual in understanding the process as well as significance of healthy ageing. They further encourage the health and wellbeing of the elderly people as well as their families, friends and the entire community in a certain manner that helps in confronting and tackling health inequality (Hiam et al., 2020). They also promote education and awareness about healthy ageing and the importance associated to it. Registered nurses help in achieving the aim of maintaining the health and wellbeing of elderly people of Australia.
Registered nurses utilise their expertise in profession as well as individual personalities in order to be nice, calm, thoughtful, sensitive as well as assertive to identify and implement beneficial ideas to enhance the care system of older adults. They make sure that older adults are having enough access to the beneficial care services as well as the utilisation of long term, healthy, safe and secure care services which should be incorporated as well as coordinated in order to meet the requirements of the older adults (Maatouk et al. 2018).
Registered nurses assist in the availability of assertive technologies as well as appropriate medicines that...

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