Posted: July 12th, 2023

NURS 5163 – Comprehensive Care of the Older Person

NURS 5163 – Comprehensive Care of the Older Person

Assessment 3 – Portfolio

Your Name & Student Number

Table of Contents

1. Learning Activity 5 – Ageing Population 2
2. Learning Activity 19 – Policies & Guidelines 3
3. Learning Activity 22 – Recommendations from the Royal Commission 4
4. Learning Activity 23 – Physical Assessment 5
5. Learning Activity 27 – Spiritual Assessment 6
6. Learning Activity 33 – Health education & Health promotion 7
7. Learning Activity 34 – Quality use of Medicine 8
8. Learning Activity 35 – Best Practice- Reflection 9
9. References 10

1. Learning Activity 5 – Ageing Population
1. Do you believe that an increasingly ageing population poses a serious threat to the Australian government’s capacity to provide health and social care services to older Australians? If so, why? If not, why not?

2. What steps do you believe need to be taken in order plan for the future provision of health and social care to older Australians and their families?

3. In what ways do you think the health care system needs to change in order to better meet the needs of older Australians in the future?

4. How do you think population ageing will influence the roles and responsibilities of health professionals?

2. Learning Activity 19 – Policies & Guidelines
High-level strategic policies give effect to the visions and directions of the government and guide the whole direction and culture of the department or the portfolio. Policies inform staff of their working arrangements in terms of process, content, attitude, priority and urgency.
To Help in answering the following questions review the SA Health Policies and guidelines
1. Please review the title of each policy and identify which ones are specifically related to the older person and make a note of your findings.

2. After you have identified the policies that are applicable to caring for the older person which ones are you not familiar with? Identify those policies and list 3 key messages that are related to that policy.

3. In your opinion are there any policies or directives that are missing in the care of the older person, what are they and why do you think they are needed?

4. If you could change ONE thing about our health care system regarding caring for the older person, what would that be? And how could it be implemented?

3. Learning Activity 22 – Recommendations from the Royal Commission

This topic will examine: Reform agendas in aged care
Learning objectives
At the completion of this topic you should be able to:
1. Critically discuss key reforms that have occurred in caring for older people and aged care services in Australia.
2. Be aware of the recommendations that have been made from the Royal Commission in Aged Care Quality & Safety and how this will influence reform in the way we care for our older persons in Australia.

4. Learning Activity 23 – Physical Assessment

Bob Tomlinson sustained a hip fracture from a fall as he was taking his rubbish bin out.
After surgery, he is admitted to a surgical ward for recovery.
He is 90 years old and lives alone since his wife’s death three years ago.
He has a son who lives in Australia, with whom he seems to have little contact.
Mr Tomlinson desperately wants to go home.
He often talks about his 10-year-old Labrador, who is being looked after by neighbours.
He has started walking with a frame but has developed continence problems and it is likely that he will require support with activities of daily living after discharge.
You are one of the health care professionals looking after Mr Tomlinson on the ward and have been tasked with writing a care plan for him.
1. Which questions would you ask Mr Tomlinson regarding his physical health?
2. Which tools, tests or screening would you use to assess the physical domain?
3. What other domains of health need to be assessed to ensure holistic care?
4. How do Mr Tomlinson’s physical issues affect the other domains of health?
5. Which health professionals need to be involved in Mr Tomlinson’s care?
(Wiltjer & Kendall 2019a, p. 44)

5. Learning Activity 27 – Spiritual Assessment
Take a moment to reflect on practice – your own and/or that of other members of staff – to identify whether the spiritual needs of older people are met in your workplace. Consider the following questions:
1. How well is spiritual care assessed in your workplace?
2. What barriers prevent you or your colleagues from assessing the spiritual needs of the older people under your care?
3. What could be done to improve the assessment and Assessment process in terms of spiritual care provision?
(Wiltjer & Kendall 2019e, p27)

6. Learning Activity 33 – Health education & Health promotion
• Jeffery is a 76 years of age and lives in an outer Adelaide Southern suburb .

• He owns his own house and lives alone following the death of his wife 18 months ago.

• He has two dogs that are always with him.
• Jeffery is quite active and regularly walks for 10 kms three times a week.

• He states that he doesn’t seem to get lonely as he often catches up with people on his walks. He also swims at the local heated pool at least twice a week.
• His family is settled in other areas of the state and they usually visit each other monthly and ring each other regularly on the phone.

• Jeffery states that he has had increasing vertigo and intermittent hearing loss that he describes as annoying especially when he is ‘on the phone.’

• he had recently had a bout of gastroenteritis which made him quite dehydrated and he required a short stay in the local hospital.

• Jefefry keeps mentally active by reading, completing, crosswords, brain games and using the Internet.
• At time he is concerned that he is getting dementia as he forgets things easily.

• The GP is concerned that there is a degree of dementia and wants to send Jeffery for more tests.

• This is frightening for him as he has always been mentally active and managed a large business until his retirement at 70.

• Jeffery believes that he has excellent health and does not take any medication.
1. Please discuss: The interventions that will be applied in this situation (from a Health education & Health promotion perspective) that will help manage, improve, and maintain Jeffery’s health.

7. Learning Activity 34 – Quality use of Medicine

Please review the following resources on:
1. Medications & Older Adults
2. Medications and Adverse Outcomes in Older Adults
Once you have reviewed these resources you will be in a good position to undertake the following case study:

Mrs AB is 95 years old and has a past medical history of osteoporosis, ischaemic heart disease and atrialfibrillation. She has spent the last couple of years in a care home. Her current medication is

1. aspirin 300mg daily,
2. bisoprolol 2.5mg daily,

3. alendronate 70mg weekly,

4. AdcalD3 1tablet twice daily,
5. simvastatin 40 mg at night

6. and paracetamol 1g four times daily.
Questions:
1. Please rationalise Mrs AB’s medications
2. What are some of the barriers to implementing strategies to limit the potential harms due to polypharmacy?
3. Provide some strategies that you could use in your role as a health care professional to overcome the barriers that you identified?

8. Learning Activity 35 – Best Practice- Reflection

Leaders play an essential role in the health care of older adults. Please read the following article: Senior manager leadership competencies for quality residential aged care: an Australian industry perspective, Do you agree with the authors findings that The differences of views of leaders’ role and competence, and especially the increased focus on personal characteristics may have an impact on the health care provided to older adults?Please justify your response.

9. References

Learning Activities High Distinction 85% + Distinction 75-84% Credit 65-74% P1 55-64% P2 50-54% F1 40-49% F2
0-39%
Learning Activity Five (5) – Week Two (2)

Ageing population (250 words)
5 Marks As for D plus stimulates new thoughts/perspective s on the topic in response to the questions posed in the Learning Activity. Excellent level of critical analysis Comprehensively answers all the questions posed in Learning Activity. Responses are conveyed clearly, succinctly & concisely.
Very good level of critical analysis. Clearly answers all the questions posed in the Learning Activity. Responses are synthesised & non- repetitive in manner.
Evidence of critical analysis. Adequately answers most of the questions posed in the Learning Activity.
Some evidence of critical analysis. Information is not clearly presented in response to the questions posed in the Learning Activity. Responses are mostly descriptive with limited evidence of critical analysis. Minimal attempt to answer the questions Posed in the Learning Activity Responses are simplistic with limited to no evidence of critical analysis. incorrect and unstructured or absent response to most of the questions posed in the Learning Activity
No evidence of critical analysis

Learning Activity Nineteen(19) – Week Four (4)

Policies & Guidelines

(500 words)

10 Marks As for D plus stimulates new thoughts/perspective s on the topic in response to the questions posed in the Learning Activity. Excellent level of critical analysis Comprehensively answers all the questions posed in Learning Activity. Responses are conveyed clearly, succinctly & concisely.
Very good level of critical analysis. Clearly answers all the questions posed in the Learning Activity. Responses are synthesised & non- repetitive in manner.
Evidence of critical analysis. Adequately answers most of the questions posed in the Learning Activity.
Some evidence of critical analysis. Information is not clearly presented in response to the questions posed in the Learning Activity. Responses are mostly descriptive with limited evidence of critical analysis. Minimal attempt to answer the questions Posed in the Learning Activity Responses are simplistic with limited to no evidence of critical analysis. incorrect and unstructured or absent response to most of the questions posed in the Learning Activity
No evidence of critical analysis

Learning Activity Twenty Two (22) – Week Five (5)
Future Needs (500 words)
10 Marks As for D plus stimulates new thoughts/perspective s on the topic in response to the questions posed in the Learning Activity.
Excellent level of Comprehensively answers all the questions posed in Learning Activity. Responses are conveyed clearly, succinctly &
concisely. Clearly answers all the questions posed in the Learning Activity. Responses are synthesised & non- repetitive in manner.
Evidence of critical Adequately answers most of the questions posed in the Learning Activity.
Some evidence of critical analysis. Information is not clearly presented in response to the questions posed in the Learning Activity. Responses are mostly descriptive
with limited evidence Minimal attempt to answer the questions Posed in the Learning Activity Responses are simplistic with limited to no evidence of
critical analysis. incorrect and unstructured or absent response to most of the questions posed in the Learning Activity
No evidence of critical analysis

Learning Activities High Distinction 85% + Distinction 75-84% Credit 65-74% P1 55-64% P2 50-54% F1 40-49% F2
0-39%
critical analysis Very good level of
critical analysis. analysis. of critical analysis.

Learning Activity Twenty Three (23) – Week Seven (7)

Physical Assessment & Assessment

(500 words)
10 Marks As for D plus stimulates new thoughts/perspective s on the topic in response to the questions posed in the Learning Activity. Excellent level of critical analysis Comprehensively answers all the questions posed in Learning Activity. Responses are conveyed clearly, succinctly & concisely.
Very good level of critical analysis. Clearly answers all the questions posed in the Learning Activity. Responses are synthesised & non- repetitive in manner.
Evidence of critical analysis. Adequately answers most of the questions posed in the Learning Activity.
Some evidence of critical analysis. Information is not clearly presented in response to the questions posed in the Learning Activity. Responses are mostly descriptive with limited evidence of critical
analysis. Minimal attempt to answer the questions Posed in the Learning Activity Responses are simplistic with limited to no evidence of critical analysis. incorrect and unstructured or absent response to most of the questions posed in the Learning Activity
No evidence of critical analysis

Learning Activity Twenty Seven (27)
– Week Seven (7)

Spiritual Assessment & Assessment – Reflection
10 Marks The reflection is thoughtful & exceptionally well organised. It clearly explains the student’s own thinking about the question posed The reflection is comprehensive, it clearly explains the student’s own thinking about the question posed The reflection is clear, it explains the student’s own thinking about the question posed The reflection is adequate, it summarises the student’s own thinking about the question posed The reflection is identifiable, but not clearly presented. it is vague and/or unclear about the question posed The reflection does not articulate any connection to the question posed The reflection is absent/ or not relevant and does not address the student’s thinking about the question posed

Learning Activity Thirty Three A (33A) – Health Education & Health Promotion As for D plus stimulates new thoughts/perspective s on the topic in response to the Comprehensively answers all the questions posed in Learning Activity. Responses are Clearly answers all the questions posed in the Learning Activity. Responses are synthesised & Adequately answers most of the questions posed in the Learning Activity.
Some evidence of Information is not clearly presented in response to the questions posed in the Learning Activity. Minimal attempt to answer the questions Posed in the Learning Activity
Responses are incorrect and unstructured or absent response to most of the questions posed in the Learning

Learning Activities High Distinction 85% + Distinction 75-84% Credit 65-74% P1 55-64% P2 50-54% F1 40-49% F2
0-39%
(500 words)
10 Marks questions posed in the Learning Activity. Excellent level of critical analysis conveyed clearly, succinctly & concisely.
Very good level of critical analysis. non- repetitive in manner.
Evidence of critical analysis. critical analysis. Responses are
mostly descriptive with limited evidence of critical analysis. simplistic with
limited to no evidence of critical analysis. Activity
No evidence of critical analysis

Learning Activity Thirty-Four (34) – Week Ten (10)

Quality Use of Medicine

(500 words)
10 Marks As for D plus stimulates new thoughts/perspective s on the topic in response to the questions posed in the Learning Activity. Excellent level of critical analysis Comprehensively answers all the questions posed in Learning Activity. Responses are conveyed clearly, succinctly & concisely.
Very good level of critical analysis. Clearly answers all the questions posed in the Learning Activity. Responses are synthesised & non- repetitive in manner.
Evidence of critical analysis. Adequately answers most of the questions posed in the Learning Activity.
Some evidence of critical analysis. Information is not clearly presented in response to the questions posed in the Learning Activity. Responses are mostly descriptive with limited evidence of critical
analysis. Minimal attempt to answer the questions Posed in the Learning Activity Responses are simplistic with limited to no evidence of critical analysis. incorrect and unstructured or absent response to most of the questions posed in the Learning Activity
No evidence of critical analysis

Learning Activity Thirty-Five (35) – Week Twelve (12)

Best Practice- Reflection

(500 words)
10 Marks The reflection is thoughtful & exceptionally well organised. It clearly explains the student’s own thinking about the question posed The reflection is comprehensive, it clearly explains the student’s own thinking about the question posed The reflection is clear, it explains the student’s own thinking about the question posed The reflection is adequate, it summarises the student’s own thinking about the question posed The reflection is identifiable, but not clearly presented. it is vague and/or unclear about the question posed The reflection does not articulate any connection to the question posed The reflection is absent/ or not relevant and does not address the student’s thinking about the question posed

Use of scholarly
literature to support Extensive use of
scholarly literature Comprehensive use
of scholarly literature) Sound use of
scholarly literature to Adequate use of
scholarly literature to Limited use of
scholarly literature to Inadequate use of
scholarly literature to No/inappropriate use
of evidence to

Learning Activities High Distinction 85% + Distinction 75-84% Credit 65-74% P1 55-64% P2 50-54% F1 40-49% F2
0-39%
key ideas (10 Marks) throughout paper. Demonstrates high- level ability to critically analyse, evaluate & synthesise literature
& apply information to the topic to support discussion Demonstrates sound ability to critically analyse, evaluate & synthesise literature &apply information to the topic support discussion. Demonstrates some ability to critically analyse, evaluate & synthesise literature &apply information to the topic. support discussion. Uses some secondary sources that are less scholarly but relevant to the topic support discussion. Overuse of secondary sources of evidence &/or some references that have limited relevance to the topic support discussion. Over reliance on secondary sources/ minimal references used/references of poor quality support discussion. References all secondary sources of poor quality

Referencing & Academic Integrity Adherence to APA 7 referencing guidelines
( 5 Marks) Extensive quality sources correctly referenced as per APA 7 referencing guidelines. In-text references very well integrated. The reference list conforms to the APA 7 referencing guidelines Multiple quality sources correctly referenced as per APA 7 referencing guidelines. Many in-text references very well integrated. The reference list conforms to the
APA 7 referencing guidelines. Range of quality sources correctly referenced as per APA 7 referencing guidelines. Some in- text references very well integrated. The reference list conforms to the APA 7 referencing guidelines. Mostly quality sources cited, but some of lesser quality. Correct use of APA 7 referencing guidelines. The reference list mostly conforms to the
v. Mostly correct use of APA 7 referencing guidelines, with no evidence of plagiarism. The reference list mostly conforms to the APA 7 referencing guidelines. In-text referencing is insufficient/incorrect. Reference list incorrect or incomplete. OR Some evidence of plagiarism.
Possible referral to AIO No references in text. No reference list.
OR
Evidence of extensive plagiarism Refer to AIO

Overall writing & presentation
(10 Marks) Adheres to all guidelines.
Exemplary: sentence & paragraph structure,
grammar, vocabulary, spelling, punctuation,
use of 3rd person, Adheres to all guidelines. Excellent: sentence & paragraph structure, grammar, vocabulary, spelling, punctuation, use of 3rd person,
use of inclusive Adheres to all guidelines re: sentence & paragraph structure, grammar, vocabulary, spelling, punctuation, use of 3rd person,
use of inclusive Adheres to most guidelines re: sentence & paragraph structure, grammar, vocabulary, spelling, punctuation, use of 3rd person,
Use of inclusive Some problems with: sentence & paragraph structure, grammar, vocabulary, spelling,
punctuation, use of 3rd
person, inclusive Paper poorly written re: sentence & paragraph structure, grammar, vocabulary, spelling,
punctuation, use of 3rd and 1st person
was not appropriately Very poor writing & presentation with inadequate sentence & paragraph structure, grammar, vocabulary, spelling, Punctuation, No
distinction between

Learning Activities High Distinction 85% + Distinction 75-84% Credit 65-74% P1 55-64% P2 50-54% F1 40-49% F2
0-39%
use of inclusive language. First person only used when providing a reflection,. Word limit met; Discussion well- sequenced with logical flow. language. First person only used when providing a reflection,
Word limit met; Discussion well- sequenced with logical flow. language, First person only used when providing a reflection,
Word limit met; Discussion clear & logically sequenced. language, First
person only used when providing a reflection,
Word limit met; discussion mostly logically sequenced language, First
person only used when providing a reflection,
Word limit met, discussion not always logical or well sequenced used
Below or above word limit, poorly sequenced, poor logical flow First and Third person usage evident.
Well below/well above word limit, not sequenced, no logical flow.
100

Feedback:

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Learning Activity 5 – Ageing Population

The increasing ageing population does pose a serious threat to the Australian government’s capacity to provide health and social care services to older Australians. This is primarily due to the following reasons:

Increased demand for healthcare services: As the population ages, there is a higher prevalence of chronic diseases and age-related conditions, leading to an increased demand for healthcare services. This puts strain on the healthcare system in terms of resources, workforce, and infrastructure.

Rising healthcare costs: Older adults generally require more healthcare services, medications, and long-term care, which can result in higher healthcare costs. The government may struggle to allocate sufficient funds to meet the growing healthcare needs of the ageing population.

Workforce shortage: The ageing population also impacts the healthcare workforce. There is a shortage of healthcare professionals specialized in geriatric care, leading to a potential lack of adequately trained professionals to meet the needs of older Australians.

To plan for the future provision of health and social care to older Australians and their families, the following steps can be taken:
Increase funding: Allocating adequate funding to healthcare services for older Australians is essential to meet their needs. This includes funding for healthcare facilities, home-based care, community support services, and training programs for healthcare professionals.

Enhance geriatric education and training: Investing in education and training programs focused on geriatric care can help prepare healthcare professionals to effectively address the unique needs of older adults. This includes providing specialized training in geriatric medicine, gerontological nursing, and other relevant disciplines.

Promote preventive care and healthy ageing: Emphasizing preventive care and promoting healthy ageing can help reduce the burden of chronic diseases and improve the overall health outcomes of older Australians. This can be achieved through health promotion campaigns, access to regular health screenings, and lifestyle interventions.

The health care system needs to change in the following ways to better meet the needs of older Australians in the future:
Integration of care: Enhancing coordination and collaboration among healthcare providers, community support services, and aged care facilities is crucial to ensure seamless transitions of care for older adults. This includes implementing care coordination models, promoting interdisciplinary teamwork, and utilizing technology for effective information sharing.

Person-centered care: Shifting towards a person-centered care approach is essential to meet the individual needs and preferences of older Australians. This involves involving older adults in care planning, respecting their autonomy and dignity, and providing culturally sensitive and inclusive care.

Expansion of community-based care: Strengthening community-based care services, such as home care and community health centers, can facilitate ageing in place and reduce the reliance on institutional care. This requires adequate funding, workforce support, and infrastructure development in community settings.

Population ageing will influence the roles and responsibilities of health professionals in several ways:
Increased demand for geriatric specialists: There will be a greater need for healthcare professionals specialized in geriatric care, including geriatricians, gerontological nurses, and allied health professionals. These professionals will play a crucial role in assessing, managing, and coordinating care for older adults.

Focus on chronic disease management: With a higher prevalence of chronic conditions in older adults, health professionals will need to place greater emphasis on chronic disease management, including regular monitoring, medication management, and lifestyle interventions.

Interdisciplinary collaboration: Given the complexity of healthcare needs in older adults, health professionals will need to work collaboratively in interdisciplinary teams to provide comprehensive and holistic care. This may involve coordinating with social workers, pharmacists, physiotherapists, and other professionals to address the multiple dimensions of health and well-being.

Advocacy and policy development: Health professionals will have an important role in advocating for policy changes and initiatives that support the needs of older Australians. This includes influencing healthcare policies, promoting healthy ageing programs, and advocating for the rights and welfare of older adults.

Learning Activity 19 – Policies & Guidelines

To review the SA Health Policies and guidelines related to the older person, you would need access to the specific policies and guidelines of SA Health. These documents can typically be found on the official website of SA Health or obtained through relevant healthcare organizations.

Without access to the specific policies and guidelines of SA Health, it is not possible to identify the policies related to the older person or provide information about unfamiliar policies and their key messages.

Similarly, identifying any missing policies or directives in the care of the older person would require a detailed review of the existing policies and guidelines of SA Health. It is recommended to consult the official documents and assess whether there are any gaps or areas that need further attention.

Without knowledge of the current state of the health care system regarding caring for the older person in Australia, it is challenging to suggest a specific change. However, potential areas for improvement could include:

Increasing funding for aged care services and resources to meet the growing needs of older Australians.

Enhancing coordination and integration of care between healthcare providers, community support services, and aged care facilities.

Improving access to quality and affordable home care services to enable ageing in place.

Strengthening workforce training and development in geriatric care to ensure healthcare professionals are adequately prepared to meet the needs of older adults.

Promoting person-centered care approaches that prioritize the individual needs and preferences of older Australians.

The implementation of these changes would require collaboration among various stakeholders, including government bodies, healthcare organizations, professional associations, and community groups.

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