NR391 Transcultural Nursing

Introduction:

The paper discusses a case study regarding Karmenu, who is an 89 year old individual. Karmenu’s wife incidentally passed away six months ago and Karmenu has a daughter who lives in the United Kingdom. Karmenu has come in to the emergency room with a cut on his leg. Nurses have also observed badly dressed wounds all over his body which indicates that Karmenu has been dressing himself. The nurses then proceed to assess the needs of the patient and tries to provide him with the same. The case study then discusses the results from the assessment done on Karmenu and identifies the one that is causing the issue that brought him in to the emergency room. The main issue that is identified is of mobility and the issue is elaborately outlined and discussed. Lastly, the requirements for his holistic care needs are discussed and both the medical and non medical interventions that can be provided to Karmenu to improve his remaining quality of life is also discussed.

This paper aims to reflect and analyze the case study regarding the holistic requirements of an 89 year old patient Karmenu and discusses the concepts outlined in the case study more elaborately. Relevant scholarly books, articles and journals on this topic are also reviewed in order to understand these concepts in further depth. Finally, the paper provides its own recommendations and concludes itself.

Discussion:

Rationale for selection of case study:

The case study that has been chosen for this paper talks about Karmenu, who is an 89 year old individual who presented to the emergency room. The study talks about the holistic needs of Karmenu and his mobility issues. The reason why this case study was chosen is because it talks about holistic care which is an absolutely essential part of health care. This area of health care talks about the care requirements of elderly patients like Karmenu and their psychological, physical as well as emotional needs. The term elderly includes individuals who are above the age of 65 years, irrespective of their health or other physical conditions. In Australia, elderly people encompass 15 % of the total population and in the United States that number is even higher at a striking 16. 5 %. Thus, it can be said that elderly people constitute a major part of the total population and their health care needs should be treated with equal importance.

The reason for the development of a majority of the issues that falls under the category of holistic care develop because of mere increasing age and emotional stress. Though age is not treatable, the severe mental stress that can be seen in most elderly patients is because of loneliness or other forms of psychological trauma that disrupts their emotional balance. Children often live their parents alone after they grow up and start living their own lives. This is the source of loneliness for most older people. For some of them, the shock of their long time wife or husband’s death puts them in such a state of mental shock that they can not ever fully recover from the same. This social issue can be heavily seen in the society and impacts the quality of life of the elderly population significantly. However, owing to the significant development in the field of modern medicine and health care and variety of interventions have been developed to improve their quality of life. First and foremost, doctors suggest regular physical therapy sessions for elderly individuals to ensure that they remain fit and do not face any mobility issues.

Next, all individuals of the elderly population should be provided with regular mental screening sessions in order to ensure that they are not developing any mental disorders like anxiety, depression or post traumatic stress disorder (PTSD).  Medical check ups are also essential for members of the elderly group as certain diseases and chronic health disorders often develops only in older people. Further more, often they are placed in assisted living facilities where nurses can look after their well being all the time to ensure an improvement in their quality of life. Many more medical as well non medical interventions have been developed for the population of older people and their holistic care.  Thus, this case study was chosen as it would not only help analyze one of the most significant areas of research in modern day health care, but might help spread a little bit of awareness regarding the issue.

Analysis of Evidence based nursing care:

Mobility describes the ability of a person to move around and interact appropriately with the rest of the physical world. Mobility is one of the most significant requirements in the area of holistic care for elder people. The reason behind this is that with the increase in age the body begins to weaken and the different activities of the same are disrupted. This is why many older people complain joint pain, back ache as well as pain when standing or sitting in one position for two long. This pain is a part of the life cycle of human beings and can not be eliminated but the same can be managed with proper therapy and medication. But most research studies claim that the increment of these forms of pain occurs mainly progressively. This mean that the pain develops and increases gradually in stages and is there fore ignored by most older people.

In later stages, the pain becomes too unmanageable and is requires more intense or frequent interventions or might even put an individual in an assisted care facility. This further reduces their quality of life. The most significant medical problem that mobility issues cause in older people are falls. Pain along with other mobility issues can cause significant difficulty in a person to walk around and might increase the chances of hurting themselves. Bones become more fragile with age and there fore are more prone to breaking and the immune system also weakens with time. Thus, it takes a longer time for older people to heal. The combination of these issues often causes older people to hesitate when they move around. Thus, serious protocols are required to assess these issues in its early stages and implement necessary interventions to address them.

Appropriate methods should be implemented for the assessment of mobility issues among elderly people. The close ones, friends and family of an older individual should keep an eye out for indicative signs of mobility issues like persistent joint pain or back pain. If the concerned person does not want to go out for any reason on repeated occasions or lies down frequently during the day the that might indicate mobility issues as well. In these cases, the individual should be taken to an emergency room where his or her patient care needs would be assessed and a proper medical care plan would be prepared for them.; Following the said care plan would help further with their pain management and mobility issues and improve their quality of life significantly. One assessment test that the nurses use for analyzing the mobility issues in an individual is the timed up and go test. This test involves a stop watch and a trained nurse who asks the individual to get up from his chair walk up to a line that is 3 meters of 10 feet away from him, turn around and come back. While doing this the said individual may wear normal foot wear and may use walking aids as well. This are the basic methods of assessing the mobility issues in older people.

A variety of different challenges are faced by an individual who is suffering from mobility issues due to old age. First and fore most, it impairs the individuals ability to interact with his or her immediate physical world. Patients complain of not being enjoy social gatherings or family activities owing to their joint pain or back pain, which is unbearable. Other patients say, that they can not do their daily activities like morning walks or family game nights for the same reason. Lethargy is also a significant part of the mobility issues in older people and patients complain of feeling like lying down or sleeping all the time. Mobility issues are also some times associated with psychological stress which causes an individual to develop mental health disorders like anxiety and depression. Depression is very common among members of the older population and one of the most significant symptoms of depression is laziness or lethargy. Thus, it may be said that a variety of different factors contribute towards mobility issues in an individual. But, the problem that arises here is that mobility issues also prevents these individuals from doctor’s visits or physical screenings. This further disrupts any chances of diagnosing their issues at an early stage and resolving them to improve their quality of life.

A variety of different interventions may be provided to patients suffering from mobility issues. If the issues are manageable then doctor’s prescribe regular physical therapy and exercise with proper diet to manageable or at least control the pain. Patients are often asked to go on regular morning walks or invest in some free time stretching to improve their pain resistance and tolerance which helps them in their daily life.  However, in more severe cases patients are given high dose of pain medication or anti depressants, in cases of mental health issues, which causes them to become further lethargic and reduces their quality of life even further. Patients are over also brought in for non medical interventions like aromatherapy or animal assisted therapy to calm their nerves and help them relax. This is mostly done for patients with significant emotional trauma.

Older individuals who experience the death of their spouses or children suffer from severe debilitating grief which translates in actual physical pain according to some researchers. It also makes a person extremely vulnerable to depression, post traumatic stress disorder or mental health issues that might in turn cause mobility issues. Patients are given walking aids and are also provided with wheel chairs based on their holistic needs and this provides them with a little help while walking around. Trained dogs are also seen with elderly people who help them navigate the streets and do other daily activities with out too much effort.  The holistic needs for mobility issues vary on a wide range and there fore a trained medical professional should determine the care plan for the same.  Such patients who live with their family should always be kept under supervision and should be assisted in performing the day to day activities of their life. All these interventions along with pain medication will definitely help an individual manage his pain and mobility issues.

Long term implications for mobility issues:

Various different services are available for an older individual suffering from mobility issues to get along with their life and maintain the quality of the same. First comes the community nurses who are responsible for the care of the people living in their community. They will look after the medical needs and emergencies of the patient and will provide them with necessary medical interventions when necessary for managing the pain that they experience. These nurses are responsible for monitoring the diet and dedication time table of these individuals as well as encourage them to engage more with their immediate environment. Patients who are in an emergency situation or require a refill of their medication or food supplies, or just feel lonely and want to talk to some one, they can avail the tele care service.

This is essentially a help line number that is provided to these patients which is available all through out the say and they can contact the same at any time of the day to request any of the services mentioned above. The nurse, medical professional or social working sitting on the other side will immediately start working on the same and will deliver it to their door step. Further more, as discussed previously, older patients with mobility issues are prone to falls which results in a large number of wounds. This is where the skill set of the community nurses come in handy as they can treat these deep tissue wounds more precisely and help the, heal quickly. Other services are also available to help these individuals. Certain help line numbers allow these patients to contact services from social service organizations that note down the requirements of these individuals and delivers the same to the door step of the said individual, irrespective of their financial status.

Other help line numbers allow older patients suffering from depression, anxiety, post traumatic stress disorder or other mental health disorders to call there and talk to a counsellor or social worker on the other side. This helps them heal from their issues with the progress of time and provides some form of intervention to treat their loneliness problems. Nurses or social workers often come and visit these people and spend time with them to ensure that every thing is okay with these individuals. Holistic care is often provided to these individuals from the comfort of their homes so that they do not have the chance of having an accident on the way. Thus, it can be said that various services are available for such individuals and they have the support of community nurses. Community nurses are those who recognize and treat each patient differently. They nurture wholeness and healing by respecting each patient's unique physical, mental, emotional, spiritual and environmental strengths and challenges and honoring each patient's values, health beliefs and health experience.

Conclusion:

In conclusion, the paper talks about a case study about a 89 year old individual named Karmenu, who suffers from mobility issues and has reported to the emergency room with significant cuts on his upper calf and unruly bandages across his body. The case study discusses the different methods of assessment of mobility issues and provides an elaborate outline of the issue itself. It also discusses the different challenges faced by the patient Karmenu as well as the long term implications of his mobility issues. References and infographics are also provided in the case study for the better understanding of the topic. The paper provides a brief introduction where it outlines the case study elaborately.

Next, a reason or rationale is provided for the selection of the said case study and then one holistic need that was noticed in the patient was chosen and analyzed critically. The chosen holistic care issue for this paper is mobility. Finally, the paper talks about the long term implications of these issues and how they can be managed and controlled. The author of this paper concludes that holistic care is a very significant area in both the health care industry as well as the research world and with further advancements in technology and medicine, scientists will come up with new interventions that will eliminate mobility issues among the older population completely.

Bibliography:

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