Case Analysis: Long-Term Care

Hello Dr. Ullom, majority of the long term care facilities are under staffed. There is usually one registered nurse in charge to manage a 240 bed facility, with LPN's  and nursing assistance. I feel that these patients would benefit from having one RN to every six -eight patients with a nursing assistance. Not only would this benefit the patient but the nurse as well. Patient are placed in long term care facility with a certain problem, but ends up with additional condition such as UTI, MRSA, pressure ulcers, and etc. These issues are related to poor care they receive because of unstaffing. I'm not placing blame on the LPN or nursing assistance, but with a RN and low nurse to patient ratio, they will receive better care.

Meeting Essential Care Needs Mrs Gale is a 70 year old widow and retired unskilled worker. The patient lives alone and relies on her son to provide basic care, medication and meals. Mrs Gale has a history of weight fluctuation owing to lifestyle but is currently at risk of malnutrition due to Parkinson’s disease. Mrs Gale shows signs of early dementia and suffers from poor mobility and pain caused by arthritis. Mrs Gale also has mild depression triggered by loss and has become socially isolated. All names have been changed as per the Nursing and Midwifery Council confidentiality guidelines (2008).

Learning Plan: Part 2 Susan Chan (500389854) NSE418-091 – Nursing Practice IV Faculty Advisor (FA): Akua Yirenkyi Primary Preceptor: Stephanie Dawkins Second Preceptor: Miranda Liu Placement Setting: Long-term care Monday, March 21, 2016 Assessment I chose a learning plan topic that would increase my nursing practice competency as a senior nursing student, would be relevant to my placement setting, would build on my knowledge obtained from completing NSE417 – Nursing Practice IV class and NSE407 – Nursing: Professional Issues and Trends class, and was approved by my Primary Preceptor and Faculty Advisor (FA). With a global trend of an increasing senior population and having a placement in a nursing home, it was important to choose a learning plan that focused on the challenges and trends in senior safety. My Overarching goal for my learning plan was to expand my knowledge and critical thinking skills related to expertly assessing and managing elder frailty in a long-term care setting by Tuesday, March 1, 2016. By completing this learning plan, I have fulfilled and demonstrated the College of Nurses of Ontario (CNO)’s Continuing Competency Standard by performing a self-assessment of my knowledge, developing and implementing a learning plan, and evaluating the outcomes of the plan (CNO, 2002). Ultimately, the goal is to enhance geriatric care at my placement setting and advance my competency in delivering safe, ethical, competent client-centred care.

Can I Get There From Here? Long-term Care (LTC) in Ontario. Imagine that you are a patient in an hospital in Ontario - you have undergone acute care and are now ready to enter a Long-term care (LTC) facility for additional care. Now imagine that you have entered a complex maze, like the Waterloo County County Corn Maze, only much trickier. Why?

A.C. is a 79-year-old man living in a long-term care facility. He has had multiple medical diagnoses, including congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), and stroke. He is bedridden and receiving enteral tube feedings. He has chronic diarrhea thought to be related to his tube feedings. He

IntroductionThere has been an issue with lack of care in long term care facilities. Some examples ofthese issues include the following: pressure ulcers, falls, dehydration, insomnia, abuse ofrestraints, etc. of the elderly residents. Therefore, there has been studies performed to determinewhat needs to be changed and what the effect these changes would have on the facility as well asthe workers or nursing assistants. These studies take place in two different facilities in Quebec,Canada. It is sad how the majority of the workers interviewed have the same complaints thatdirectly relate to the reasons why proper care is not provided, yet nothing has been done to fixthose issues.DevelopmentThe most important factor to the career of a nursing assistant and the care of the elderlyin facilities is time.

More than 5 million Americans currently have dementia in the United States and this number is projected to rise to between 8 and 13 million by 2050 (Alzheimer’s Association, 2015). Dementia is known to become more prevalent with age, increasing from 5 to 10 percent in people over 65 years of age to almost one half of people over the age of 85 (Alzheimer’s Association, 2015). Although family members provide the majority of care for people with dementia, increasing needs over time often lead to placement in a long-term care setting. Dementia is the most common reason for entry into long-term care facilities (Zimmerman, 2013) and nearly 90% of persons with dementia will have at least one stay at a nursing home in their lifetime (Grunier, 2007).

The Continuum of Long-Term Care Lukita Wilson November 28, 2010 David Olsen Long-Term Care A variety of services that provides medical and non-medical needs toward individuals who are suffering from chronic illness, disability or old age is known as long-term care. Long- term care meets the needs of individuals who are no longer able to

Acute care and long-term care are both continuum care, but there are many differences between these types of facilities. When people are severely injured or ill, they seek treatment at an acute care facility. “Acute care is medical care designed to treat and/or cure an acute condition, for example, a heart attack or stroke” (http://eldercarehelper.com, 2016). Acute care facilities usually release patients before the 30th day and treatment is provided by a physician. In long-term is provide for patients that need continuum care, but less intensive treatment. “Long-term care facilities offer medical care to patients who need…less intensive level then that provided at an acute care facilities” (Gartee, 2011). The patients usually stay longer

The transitioning to a long-term care facility can be scary and stressful for residents, and some may find it difficult to adjust. I agree with you that the enabler role can be of great assistance to the resident and their families to help reduce the stress of entering a new facility. The frequent visits and encouragement from the social worker will let both the patient and their family know they will not be alone during this transition. Have you ever had to utilize the services of a social worker? In my current position, I come into contact with patients who require the support of a social worker typically for help with resources that they need to attain. Being a social worker is a demanding position since they are there to assist the patient,

The long-term care system consists of an integrated continuum of many institutional and non-institutional providers who deliver extended care when needed. Long-term care providers distribute a variety of care to individuals with chronic, mobility and/or cognitive impairments/limitations. These providers include: nursing facilities, subacute care, assisted living, residential care, elderly housing options and community based adult services (CBAS) (Pratt, 2010). CBAS is broken down into subdivisions, which include: home health care, hospice care, adult day care and adult day health care (ADHC). ADHC’s falls under the category of non-institutional care, allowing individuals to be independent, stay within their community, live at home, and age in place, while being of high quality and low cost. The ultimate goal of ADHC’s is to keep individuals out of hospitals and nursing homes (institutional care), and allow them to live their life comfortably, independently and in their households with their loved ones (Alteras, 2007).

Case management is a discipline within the Long Term Care system. Case managers help and give guidance in the planning process of developing a care plan for individuals with different health needs. The case manager assesses an individual, plans the care, assists with communication between all members of the team, coordinates appropriate care, evaluates the individual, and acts as an advocate for proper communication between the patient, family members, and the interdisciplinary team (Marion et al., 2010). Case managers are individuals who have specialized in a field within the human and health services, receiving higher education, a license or certification. This education allows case managers to be able to perform assessments on their

As a MSW student at a long term care home, I get an opportunity to take on many duties and activities. For starters, I get to do a lot of administration work including filing, faxing, photocopying, writing thank you letters for those who came for the tour of the home,

Growing up with your grandparents has its benefits. I remember waking up to freshly baked biscuits and fried sliced ham on Saturday mornings just before cartoons. Riding to the pharmacy with my grandfather to pick up his medicine was one of my favorite trips. We would always stop for ice cream before we returned home. Soaking in the knowledge that streamed from the lips of your elders can go unappreciated until you are an adult. Watching people age gives you an understanding of what is important to seniors as they transition to retirement and lonIg-term care. Seniors value the ability to live and enjoy a life that includes independence, family, and home. In today's economy, there is a shortage of health care professionals. Home healthcare services are vital due to the aging US population and need for increased continuum of care.

The long-term care system is aimed at providing continued care to individuals both in facilities and at home. Many people associate long-term care specifically with nursing and assisted living facilities, but long-term care is so much more. This care can be provided to an individual whether they are home or in a specialized facility (National Institute on Aging, 2017). In essence, the system of long-term care involves the coordination of facilities, providers, and case manager support to provide the best quality of care for individuals.