EDUH1006 Identifying Health Determinants

EDUH1006 Identifying Health Determinants

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EDUH1006 Identifying Health Determinants

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EDUH1006 Identifying Health Determinants

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Course Code: EDUH1006
University: The University Of Sydney is not sponsored or endorsed by this college or university

Country: Australia


Discuss About The Challenging Dealing With Elderly Patients?


This write-up is a reflection of lifespan stage and health related concepts that happen to be most challenging when dealing with elderly patients. It discusses how a health care worker can modify his/her perception and behaviour when dealing with the elderly patients to minimise potential challenges and provide effective health care. The essay follows the case study of Dorothy, a 71-year old Greek widow who had been presented to the emergency unit following a broken arm as a result of fall at her home. The primary contributing factor for this incident is alcohol due to isolation from friends, family and her late husband. The patient experiences memory loss, forgetfulness fatigue, depression and has aggressive behaviour which she attributes it to the feeling of being judged by others. Although the patient had been diagnosed with dementia, there is a concern she might forget to take her medication to relieve pain in the broken arm. Also, the patient is verbally aggressive and non-compliant at the hospital something which makes it hard for the physicists to monitor her situation effectively. All these problems caused her; falls, loss of memory, black out and not being able to stand for long, things which make it hard for the patient to be discharged since she may return to her drinking routine.
Factors Influencing Interaction between Elderly Patients and Healthcare Providers
There are a myriad of factors that determine the quality of service delivered by a physicist in regard to his interaction with the patient, but in this write up we will look at the two most common healthcare constructs.
Patient behaviour/ cooperation; from the case scenario, it is evident that the patient did not cooperate fully with the service being provided. At time, the healthcare provider was worried that the patient could be discharged only to go home to resume her drinking. The patient also attributes her verbally aggressive behaviour to the feeling of being judged by others.
Provider’s level of competence; from the case scenario, we can point out that the healthcare provider is competent in his work. He understands that opioids and alcohol have adverse effects on the body, hence the need for alcohol withdrawal program. Throughout the case scenario, it is well presented that the doctor is versed in his work and his level of competence high.
Why the above constructs are most challenging?
First, the patient’s cooperation and involvement are very challenging since it helps in determining the quality of healthcare service delivery. Clinical outcome depends entirely on the behaviour of the patient and ability to give information or cooperation with the healthcare providers (Drenth-van Maanen et al., 2009). Even if a nurse does her job well and the client does not follow medical orders, the objective will not be achieved. For example, non-compliance of Dorothy at the hospital will make it hard for the physicist to provide effective, quality care for the patient. Patient’s trust is also significant in achieving the desired results. Ekdahl et al., (2010) assert that providing more information about a disease or a condition can not only help improve patient/doctor interaction but also ease the process of treatment.
Second, the practitioner’s knowledge, competence and technical skills are also challenging since they determine the quality of healthcare service (Lerolle et al., 2010). Hence, health experts need to improve their competencies to deliver standard services. If a health care provider is not competent enough or does not have the required skills, it will be hard to provide effective health care, especially for the aggressive and non compliant elderly patients.
Modifying Perceptions/ To Ensure Effectiveness in Health Care Delivery
First, health care providers should provide options whenever possible; According to Mangin (2007), a vast number of elderly patients desire to keep a sense of independence. Whenever possible, provide choices to choose from since it is through the ability to exercise choice where a patient can have a greater sense of confidence, security and esteem. For the case of Dorothy insisting on going back home, the doctor should provide an alternative if he feels that the patients will go back home to resume her drinking habit.
Second, health care providers should be provided with enough training or education on how to deal with different types of clients, especially the elderly.  It should be noted that effective healthcare delivery involves a decision by both the client and the provider; hence patients should be given a chance to make rightful decisions or be involved in decision making (Ruiz et al., 2013).
Lastly, providers should exercise patience and compassion; slow movements, aggressiveness, neediness and apathy are some of the challenges or behaviours that might be experienced when dealing with the elderly (Stuijt et al., 2008). During these times, it is prudent to consider the adults you are dealing with and provide the needed care.
Although providing care for the elderly is rewarding as well as enjoyable when dealing with some patients /clients, a vast number of physicians find it hard and time-consuming especially when dealing with aggressive, difficult, manipulative and angry patients. Nurses alone cannot meet a wide range of needs of such clients in the current practice setting. However, with changes in healthcare policy, practice organisation, medical sensitisation for the elderly and health policy, health workers can be in a better position to handle elderly patients and ensure effective healthcare is provided. Dealing with elderly patients is not a profession that can be learned only in college, but it is a practice that needs commitment, perseverance, compassion and the willingness to provide healthcare. Although dealing with older patients is difficult compared to other patients, it is of great paramount to exercise the above tenets to ensure smooth sailing in the health service delivery.
Drenth-van Maanen, A. C., van Marum, R. J., Knol, W., van der Linden, C. M., & Jansen, P. A. (2009). Prescribing optimization method for improving prescribing in elderly patients receiving polypharmacy. Drugs & aging, 26(8), 687-701.
Ekdahl, A. W., Andersson, L., & Friedrichsen, M. (2010). “They do what they think is the best for me.” Frail elderly patients’ preferences for participation in their care during hospitalization. Patient education and counseling, 80(2), 233-240.
Lerolle, N., Trinquart, L., Bornstain, C., Tadié, J. M., Imbert, A., Diehl, J. L., … & Guérot, E. (2010). Increased intensity of treatment and decreased mortality in elderly patients in an intensive care unit over a decade. Critical care medicine, 38(1), 59-64.
Mangin, D., Sweeney, K., & Heath, I. (2007). Preventive health care in elderly people needs rethinking. BMJ: British Medical Journal, 335(7614), 285.
Ruiz, M., Cefalu, C., Reske, T., & Estrada, J. (2013). Management of elderly and frail elderly cancer patients: the importance of comprehensive geriatrics assessment and the need for guidelines. The American journal of the medical sciences, 346(1), 66-69.
Samaras, N., Chevalley, T., Samaras, D., & Gold, G. (2010). Older patients in the emergency department: a review. Annals of emergency medicine, 56(3), 261-269.
Stuijt, C. C., Franssen, E. J., Egberts, A. C., & Hudson, S. A. (2008). Appropriateness of prescribing among elderly patients in a Dutch residential home. Drugs & aging, 25(11), 947-954.
Valiyeva, E., Herrmann, N., Rochon, P. A., Gill, S. S., & Anderson, G. M. (2008). Effect of regulatory warnings on antipsychotic prescription rates among elderly patients with dementia: a population-based time-series analysis. Canadian Medical Association Journal, 179(5), 438-446.

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