Advanced Practice NURS 6540 Week 1: Caring for Frail Elders 

NURS 6540: Advanced Practice Care of Frail Elders | Week 1

As you get older, change is inevitable and it’s not going to get easier. So if you’re thinking about it, go for it. It’s not for everyone, but it was the right decision for me.

—Gail Joy, geriatric patient

Gail Joy is expressing her feelings about changing her site of care. After Joy suffered from falls, she and her daughter realized that living alone was no longer an option for Joy. Joy’s needs had changed, and she required continuous care and assistance with many activities of daily living. She and her daughter explored a couple of options but felt that an assisted living retirement community would be the best site of care (Rubin, 2011). While Joy agreed that she needed to change her site of care, many geriatric patients struggle with accepting this decision. As an advanced practice nurse, you must be able to support these patients and facilitate necessary changes in their sites of care.

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This week, as you begin exploring the care of frail elders, you examine the impact of changes in sites of care on geriatric patients. You also consider the impact of finances on site placement and treatment decisions. Then, in preparation for your Practicum Experience, you examine aging theories and geriatric competencies to guide the development of your practicum goals and objectives.

Learning Objectives – Advanced Practice NURS 6540 Week 1: Caring for Frail Elders 

By the end of this week, students will:

• Evaluate the impact of changes in sites of care on elderly patients
• Analyze the impact of financial issues on site placement and treatment decisions
• Analyze aging theories in nursing practice*

Discussion: Changes in Sites of Care

Since the culture and practices of care settings are inherently different, changes in sites of care are often difficult for geriatric patients. Efforts should be made to limit changes to only those necessary; however, sometimes a patient’s situation might require multiple changes in sites of care. When selecting sites of care, such as home, assisted living, rehabilitation facilities, and hospitals, many factors must be considered by patients, their families, and their health care providers. Health status, ability to perform self-care, financial limitations, and patient preferences are all factors that might influence a patient’s site placement. As an advanced practice nurse who recommends sites of care and facilitates changes, you must evaluate factors and consider sites that limit the impact of these changes on geriatric patients.

To prepare:

• • Review this week’s media presentation, as well as Chapters 3 and 8 of the Resnick text.
  • Reflect on your personal experiences, observations, and/or clinical practices from the last 5 years. Select a case from the last 5 years that involves an elderly patient who has been in two different sites of care such as home, assisted living, hospital, etc.

Note: When referring to your patient, make sure to use a pseudonym or other false form of identification. This is to ensure the privacy and protection of the patient.

• Reflect on issues that occurred because of the change in the patient’s sites of care. Think about the impact of differences in the settings themselves, inherent cultures of the settings, and ethical practices of these sites on the patient.
• Consider whether the patient had an advanced directive in place at the time of the change in sites of care. Reflect on whether any difficult treatment decisions had to be made as a result.
• Think about the impact of financial issues on site placement and treatment decisions.

By Day 3

Post a description of a case from your personal or clinical experiences in the last 5 years that involves an elderly patient who has been in at least two different sites of care. Explain the impact of differences in the settings themselves, inherent culture of the settings, and ethical practices of these sites on the patient. Then, explain whether the patient had an advanced directive in place at the time of the change in sites of care, and if so, whether any difficult treatment decisions had to be made as a result. Finally, explain the impact of financial issues on site placement and treatment decisions.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days in one or more of the following ways:

• Suggest community resources that may assist with related cases in the future.
• Recommend appropriate alternative site placements for your colleagues’ patients based on your geographic location.
• Provide insights on policy implications of your colleagues’ cases (i.e., Medicare, Medicaid, Veteran’s Affairs, etc.).Advanced Practice NURS 6540 Week 1: Caring for Frail Elders