Audrey Williams is an 89 year old lady with a history of Diabetes Mellitus Type 2, obesity, and Peripheral Vascular Disease (PVD). Audrey lives in her own home with community nursing services who assist her with meals, blood sugar monitoring, medications and showers as she has chronic pain in her legs from the peripheral vascular disease causing decreased mobility. Recently Audrey has become increasingly debilitated and severely depressed and her family want to move her into a nursing home. However, Audrey is adamant she wants to stay in her own home. She has been asking her GP to increase her opioid medication and pleading with her doctor to ‘please just knock me off’. Audrey is already on maximum pharmacological therapy and her GP is reluctant to add further medications. Both Audrey and her family are becoming increasingly distressed.
Select EITHER Option A or Option B and answer and discuss the associated questions as a member of the community nursing team.
In both options you will need to apply understanding of integrated care concepts, as well as the principles of primary health care, person centred care, chronic disease self management, and clinical reasoning as you present your case study.
Audrey’s family are concerned for her safety and are unable to offer the necessary ongoing support so she is able to stay at home. They decide to move Audrey to a nursing home. In the home Audrey’s physical and mental health rapidly deteriorates. She becomes withdrawn and refuses to eat or take any medications resulting in increased pain, distress and malnutrition.
*Briefly discuss what assessments are necessary to enable Audrey to be admitted to a nursing home. Who does the assessments? What ongoing assessments are necessary to be conducted by the registered nurse in the aged care facility?
*Briefly discuss the loss and grief issues Audrey might encounter in moving to the nursing home. Identify and justify which model of care would be most useful to support Audrey to come to terms with her very changed life circumstances and help to improve her quality of life.
*Briefly outline issues Audrey’s family might face in this situation, what is the role of the aged care nurse in relation to Audrey’s family?
Structure and presentation
This assignment is a piece of academic writing and needs to be structured as such, with an introduction and conclusion. You may use sub-headings as needed. Use the marking criteria to guide you with respect to aspects of presentation and formatting of this assignment.
Marking Criteria (strong)
Content and Focus- Essay demonstrates professional reflection with only minor digressions. Essay sufficiently integrates current and relevant reviews
Analysis and clinical reasoning- Exhibits strong higher order clinical reasoning skills: synthesis and analysis, application, comprehension, knowledge
Development is logical and clear to reader; some points may be bunched together or not clearly linked