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Care for the Older Person

Role of the healthcare assistant in promoting positive attitudes to ageing and of statutory and voluntary agencies in promoting the wellbeing of older people

Healthcare assistants have a role of promoting positive attitudes towards ageing since they are in constant contact with older people, their family members and caregivers (Zahran et al., 2016 p.314). Besides, healthcare assistants (HCAs) have a higher likelihood of spending a significant amount of time with service users, particularly those who are highly dependent requiring 24 hour care service. Therefore, HCAs need to adopt a person-centred care approach in promoting the positive attitudes towards ageing. Essentially, person-centred care is described as the attitudes or behaviours of health and social care professionals when a service user is considered and treated like a conscious individual who has feelings (Nilsson et al., 2019 p.1251). Additionally, the service user is treated with a sense of dignity and self-worth and is considered to have a sense of self-hood, self-direction and self-knowledge. This implies that older persons should be treated as human beings irrespective of their age, illnesses, or levels of dependency. In providing care services, HCAs should formulate a partnership with service user, elicit a detailed narrative of the patient, and always document the partnership with the older person in their patient record (Zahran et al., 2016 p.318). The collaborative approach in healthcare service provision to older persons instills a sense of self-esteem and dignities the service users thus creating a positive attitude in them.

Additionally, HCAs can ensure older people develop positive attitudes towards ageing by maintaining open communication and preserving their identity (Baser and Cingil, 2018 p.57). Healthcare assistants should start by always calling older persons within their care by their preferred names and avoiding elder speak. Therefore, HCAs should ask the service users the name they would want to be addressed by as it not only helps in maintain their identity, but also creates a positive impression that the older persons have earned the attention of the HCAs. Open communication can also boost the patient’s attitudes, particularly where they are involved in the care plan and review, as well as in engagement in discussions of topical importance to them (Coffey and Whitehead, 2015 p.3). During communication, HCAs should actively listen to the older persons, maintain eye contact, and observe the tone of their voice and body language to avoid appearing dismissive (Burbank et al., 2018 p.101). Furthermore, HCAs can support the independence of older persons by only offering help where necessary to avoid creating the feelings of helplessness among the elderly service users. This can be achieved by focusing on the strengths and abilities of the service users.

Statutory and voluntary agencies have a considerable role to play in promoting older people’s wellbeing. According to O’Shea (2016 p.289), statutory agencies such as Health & Social Care Professionals Council (CORU), Health Service Executive (HSE), Health Information and Quality Authority (HIQA), and Health Safety Authority (HSA) are generally involved in formulation of policies that promote the wellbeing of older people, developing and enforcing standards of services, and ensuring access to care services for all older people, as well as funding the health and social care system. On the other hand, most voluntary organisations’ primary purpose is to facilitate positive attitudes to ageing as it increases their overall quality of life (Zahran et al., 2016 p. 320). They are involved in the provision of multiple services, including intellectual, social, emotional, and physical services. For instance, they can facilitate older people to participate in social groups or activities in their respective communities or provide education and lifelong learning, including computer training or other new technology that would help them become more self-reliant as equipment and technology advance.

Exploration of the role of the healthcare assistant in providing care for older people 

According to a 2017 national report review on Older Persons Services Working Group, HCAs offering services to older persons must work under the guidance and supervision of a Registered Nurse (RN) whom they report to (HSE, 2018 p.24). HCAs are integrated into a unit or ward team, which defines their specific tasks and duties. Usually, a registered nurse will apply professional judgement to delegate various roles based on the healthcare assistant’s professional competence and should not allocate any tasks that HCAs have not been trained. Notably, HCAs play a fundamental role in caring for older persons as they assist them with daily living activities based on the service users’ dependency levels (Drennan et al., 2018 p.18). Although HCAs should promote the independence of older persons by allowing them to perform various tasks within their capacity, they should help them in fulfilling various needs such as cleaning, toileting, feeding, bathing, dressing, and doing laundry (Cronin et al., 2020 p.22). However, these services should be offered respectfully while maintaining the service users’ dignity and privacy. HCAs must obtain the consent of the service users before offering them any assistance, entering their room, or touching their personal items, including clothes, bags and jewellery.

HCAs are tasked with the role of documenting and recording information on the patient’s record to ensure that all procedures, treatment, and drugs administered are reported. Patients will usually have a team of healthcare professionals offering treatment and care services (HSE, 2018 p.24). Therefore, proper recording of information will help in facilitating communication between the team, especially during change of shifts. However, confidentiality is critical in exercising this role as the privacy of the individuals is paramount. Besides, records can help healthcare workers in case of lawsuits. HCAs are also responsible for promoting autonomy of older people by engaging them throughout the care plan process, informing them of all the possible procedures, and allowing them to make decisions on their preferred plan of care (Zahran et al., 2019 p.1255). By giving them the autonomy to make choices, HCAs promote older persons’ dignity and instill a positive attitude towards ageing.

Issues related to an older person living with mental illness, dementia or any chronic illness

According to WHO (2017 paragraph 2), the proportion of older adults is expected to rise from 12% in 2015 to 22% by 2050 globally. The wellbeing of older people, including mental health is thus an important aspect of health in the society as more adults aged over 60 years are highly prevalent to neurological and mental disorders. Statistics from the World Health Organisation indicate that more than 20% of older persons suffer from a neurological or mental disorder and 6.6% of disability cases among older persons are associated with neurological and mental disorders (WHO, 2017 paragraph 3). Additionally, 3.8% of the group are affected by anxiety disorders, nearly 1% have substance abuse problems, and an estimated 25% of deaths through self-harm constitute of older persons (paragraph 3). Still, mental health problems continue to be under-identified by practitioners in the healthcare sector as well as the older people themselves while the stigma attributed to the conditions makes the individuals hesitant to seek for treatment and counseling services.

In every stage in a person’s life, there are several risk factors that may cause mental health issues. In particular, older adults do not battle with the common stressors that affect each person in life, but also undergo other stressors that specifically affect people in late life, including the extreme and continuous loss of functional capacity, independence and capabilities (Greenwood et al., 2018 p.39). Older folks, for instance, may experience chronic pain, diminished mobility, frailty, or other health problems that require long-term care. Additionally, incidences like bereavement or decreased socioeconomic position caused by post-retirement effects are likely to impact on the social, physical, psychological, spiritual, and economic status of older persons. Such stressors might lead to isolation, psychological anguish, or loneliness in older people, thus requiring long-term care. The state of a person’s mind impacts on their physical well-being. For instance, older persons with physical illnesses like cardiovascular disease are more predisposed to depression than those in good health (Vigo et al., 2016 p.174). Untreated depression can cause an adverse impact on the wellbeing of older individuals who suffer from a heart attack. Besides, older people are more prone to elder abuse, which can include financial, verbal, sexual, physical, and psychological cruelty, as well as neglect, abandonment, and loss of respect and dignity. Current statistics indicate that one in six elderly people is abused (WHO, 2017 paragraph 7). Elder abuse has devastating effects on older persons, including physical injuries and long-lasting psychological effects like anxiety and depression.

Arthritis

Arthritis is the degeneration or inflammation of joints characterized by swelling, stiffness, redness, tenderness, and pain, as well as reduced range of motion (Nelson and Churilla, 2017 p.665). The disease mostly affects a person’s hands, hips, feet, lower back and knees. The condition is diagnosed through physical examination, lab tests, and x-rays (Martinez-Calderon et al., 2020 p.24). Notably, commonly occurring types of arthritis include rheumatoid arthritis, gout, osteoarthritis, juveline arthritis, thumb arthritis, psoriatic arthritis, and ankylosing spondylitis. There are various risk factors are likely to cause arthritis, including family history, sex, age, previous joint injury, and obesity. Various studies indicate that some forms of arthritis are inherited among families, implying that a family member is at an increased risk of developing the condition if a sibling or parent has the disorder (Kaeley et al., 2020 p.3). In relation to age and obesity, research has found that the susceptibility to arthritis increases with age while obese individuals are at a greater risk of developing the disorder due to the pressure exerted on joints by excess weight, especially on the spine, knees and hips. Additionally, previous injuries on the joints are predisposed to the condition. Interestingly, studies indicate that sex is a huge determinant on the type of the disorder likely to occur between genders as most men suffer from gout than women while females increasingly develop rheumatoid arthritis than males (Nelson and Churilla, 2017 p.667).

References

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Burbank, P.M., Burkholder, G.J. and Dugas, J., 2018. Development of the Perspectives on Caring for Older Patients scale: Psychometric analyses. Applied Nursing Research43, pp.98-104.

Coffey, A. and Whitehead, N., 2015. Healthcare assistants’ attitudes towards older people and their knowledge about ageing. Nursing older people27(1).

Cronin, U., McCarthy, J. and Cornally, N., 2020. The Role, Education, and Experience of Health Care Assistants in End-of-Life Care in Long-Term Care: A Scoping Review. Journal of gerontological nursing46(1), pp.21-29.

Drenann, J., Hegarty, J., Savage, E., Brady, N. and Murphy, A., 2018. Provision of the Evidence to Inform the Future Education, Role and Function of Health Care Assistants in Ireland. [online] Health Service Executive. Available at: <https://www.hse.ie/eng/staff/resources/hrstrategiesreports/health-care-assistant-literature-review-2018.pdf> [Accessed 4 December 2021].

Greenwood, N., Mezey, G. and Smith, R., 2018. Social exclusion in adult informal carers: A systematic narrative review of the experiences of informal carers of people with dementia and mental illness. Maturitas112, pp.39-45.

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Kaeley, G.S., Bakewell, C. and Deodhar, A., 2020. The importance of ultrasound in identifying and differentiating patients with early inflammatory arthritis: a narrative review. Arthritis research & therapy22(1), pp.1-10.

Martinez-Calderon, J., Meeus, M., Struyf, F. and Luque-Suarez, A., 2020. The role of self-efficacy in pain intensity, function, psychological factors, health behaviors, and quality of life in people with rheumatoid arthritis: a systematic review. Physiotherapy theory and practice36(1), pp.21-37.

Nelson, N.L. and Churilla, J.R., 2017. Massage therapy for pain and function in patients with arthritis: a systematic review of randomized controlled trials. American journal of physical medicine & rehabilitation96(9), pp.665-672.

Nilsson, A., Edvardsson, D. and Rushton, C., 2019. Nurses’ descriptions of person‐centred care for older people in an acute medical ward—On the individual, team and organisational levels’. Journal of clinical nursing28(7-8), pp.1251-1259.

O’Shea, E., 2016. Rural ageing and public policy in Ireland. In A Living Countryside? (pp. 289-306). Routledge.

Vigo, D., Thornicroft, G. and Atun, R., 2016. Estimating the true global burden of mental illness. The Lancet Psychiatry3(2), pp.171-178.

World Health Organisation (WHO). December 12, 2017. Mental health of older adults. https://www.who.int/news-room/fact-sheets/detail/mental-health-of-older-adults (accessed December 4, 2021).

Zahran, Z., Tauber, M., Watson, H.H., Coghlan, P., White, S., Procter, S., Addis, G. and Norton, C., 2016. Systematic review: what interventions improve dignity for older patients in hospital?. Journal of clinical nursing25(3-4), pp.311-321.

 

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