NURS3101 Foundations of Professional Practice

The purpose of this paper is critically analyzing the literature related to the risk of diabetes in elder people, and how it can be managed in the community. This paper also includes the rationale for caring in community, and role of nurse such as responsibilities, coordination, risk assessment and ethical consideration. It has been found that more the type-2 diabetes is the fastest growing chronic disease in Australia and 1 out 20 people in Australia has diabetes, and more impact can be seen in old people (Davis et al., 2018). Kathryn is a 70 years old female who has been suffering from type-2 diabetes from last 10 years. Kathryn has a history of having atrial fibrillation and chronic kidney disease, and recently she has also developed the heart issues. However, burden of diabetes is greater that weakened her. Kathryn has been taking required dose of insulin and glucose; however, recent months has not gone good for her in terms of health. Kathryn’s husband has died recently since then she has been living alone, and experienced more frequent health issues including increased diabetes. This paper includes the nursing condition required for Kathryn to deliver quality care (Shubrook, 2019).

It has been observed that old people with diabetes have more complex issues in care, also, with the growing age, people become more sensitive, thus, there are chances that Kathryn might develop hospital complications. Depression is also one of the major challenges that diabetes patients face. Hence, it is necessary to provide care to Kathryn at her home within the community settings (Weinger, Beverly & Smaldone, 2015). Community care is the help and healthcare services provided to people at their homes. Old people are required more support and assistance due to the disabilities caused by aging. It has been also found that caring the old people at home or in the community is more feasible than in hospitals. Community health care provides peace of mind for diabetes patients. The caregiver provides assistance to old people more efficiently at home including medication monitoring, identification of symptoms, regular monitoring of blood sugar levels, and providing physical assistance in daily tasks. In the case of Kathryn who has been living alone, it is essential to have social support that can be provided to her in community care. Also, Kathryn has been diagnosed with kidney problems that may cause trouble for her to move from one location to another more frequently, thus caregivers at home might provide the best assistance and care. With the growing age risk of social isolation increases. Research shows that 28% of people of age 65 and above lived alone. These people have reported a heavy decline in mobility, loss of driving ability, also it is difficult for old people to maintain relationships with these disabilities thus, the risk of isolation increases more. However, social interaction can benefit the senior in terms of health and wellbeing (Geller, 2017). Several studies have shown that patient such as Kathryn improve more frequently when the care provided at home or in community care (Payne, 2016).

With the growing age and disabilities, Kathryn may have the risk of injuries that can become complicated due to diabetes. Thus, the accommodation provides in community care will be best for Kathryn. Community-based care promotes food health and prevents sickness of the elderly. The main objective of community care is to prevent old people from getting sick, maintaining their health, and effective approach for quick recovery. Community Care will be a good option for Kathryn that can provide independent care to her (Bulmer, 2015). For Kathryn it is important to have a person who can take care of the hospitalization, that can be provided in community care. It is important to know that an old person may need any kind of support at any time. Thus, community care is essential for Kathryn to have 24x7 support (Payne, 2016). In addition, care can identify the need of Kathryn and can help to educate her in self-management, problem-solving, decision making, and working collaboratively with caregivers to achieve the health goal (Berta et al., 2013). There are the basic examples where community care can provide support to Kathryn such as in food preparation as she has lost the ability to perform the daily tasks, making a diet plan for her, supporting and motivating Kathryn for exercise that can be essential for the physical fitness. It has been found that the care at home or community health is much cheaper than hospital expenses that is good for Kathryn as being alone she might not have the capabilities to pay huge hospital bills (Knapp et al., 2016).

The medical knowledge, support, and compassionate patient care provided by nurses are vital, hence, community care has relied on nurses for better care for old people. It has been found that nurses have a huge impact on patient’s health and recovery. Since nurses become standard in hospitals healthcare has evolved and seen a huge development in different care plans such as palliative care, and community care (Ismail & Saiboon, 2012). For community care, the nurses have a special role that they know as Community Health Nurses (CHN) or public health nurses who focus on their primary objective of improving the health of the population and reducing disease and disabilities (Yuan, Peng & Jiang, 2012). A study revealed that social determinants of health such as low income and poverty are the main cause of health issues that prevent people to look for treatment. Hence, to address these issues holistic approach is needed that can be possible in community health care. In community healthcare nurse Kathryn can follow the process of health prometon, disease prevention, and disease management in the following ways including risk assessment, data collection, referrals, and ethical consideration in care. (WHO, 2017).

In community care nurse Kathryn could provide her required care and support in terms of coordination. Nurses can be coordinators in care who can compile the patient’s data and observation to provide the best intervention and care to improve the health status. In order to make a referral depending on the patient’s need CHN collects the data from the patient. In the community care setting risk assessment is essential for Kathryn as a home risk assessment to identify the potential risk and challenges. In addition, risk assessment help to evaluate the risk in the living environment. This helps both patient and nurse to conclude whether the environment is good for health or not. Risk assessment for Kathryn can be done using the risk assessment method by filling the risk assessment form. A physical assessment must be included for Kathryn to measure if she has to face any physical challenge. For the risk assessment, Kathryn required to have a machine to measure the glucose level of the body, blood glucose test strips, and insulin. Further community care assessment focuses to provide the health information of clients t their families that also help nurses to obtain important information about the client’s past history. It has been found that having a patient’s history is more beneficial in community care (Osuala Eunice, 2017).

In the case of Kathryn, it is not possible to obtain any information from family members as he has been living alone, nurses in community care can collect these data from their own observations and from friends, or neighbors of Kathryn. Hence, Kathryn’s nurse can identify the multiple determinants of health to provide a solution for addressing the common issues such as the physical, biological, and environmental cause of illness (Williams et al., 2014).

Basis on the data collection and observation nurse Kathryn can follow the referrals. It has been observed that Kathryn has a type- 2 diabetes and recent incidents have increased the risk of diseases with other the risk of other mental health issues such as dementia. Thus, Kathryn’s nurse can refer her to a diabetes specialist or an educator. A diabetic educator can play a huge role in the care of Kathryn who can guide her on how to negotiate with the situation of high and low glucose levels. The educator can guide Kathryn to take the required diet and level of glucose to maintain sugar level in the blood (Mian, Koren & Rukholm, 2012). For Kathryn, it is important to maintain blood sugar as any injury or would lead to serious trouble for Kathryn. A diabetic educator also educates the patient about the risk of injuries, prevention, and impact of injuries in case of diabetes. Thus, Kathryn must be provided with basic instructions to prevent injuries and health safety so that she can avoid such problems. For Kathryn, it is also important to take the required insulin done with proper guidance, with help of an educator it can be possible to know the complications of insulin with improper diet, and these issues can be prevented with timely monitoring of the patient by a nurse (Toledo, Costa & Silva, 2016). It has been found that diet is crucial in diabetes mellitus. Diabetes patients have the risk of developing various diseases such as cardiovascular disease, however, a diabetes-specific diet can prevent the risk of such diseases. Hence, a nurse in community care can provide a healthy diet plan for Kathryn including low carbohydrate, and low sugar foods (Armstrong, Harskamp & Armstrong, 2013).

Elderly people have the risk of environmental hazards; however, nurses can make community care more effective by preventing these risks. Nurse Kathryn can use the methods of occupational therapies to save her from these risks. The home environment includes the risk of slippers mats, carpet, slippery surfaces, the height of stairs, and many other such things. Hence, Kathryn must be provided instructions and guidance to prevent these risks at home, similarly, these are also occupational health and safety concerns for the nurse as she visits Kathryn (Kuschel, Laflamme & Möller, 2015). Apart from this risk of nurses, may include the violence from Kathryn’s neighbor, their inappropriate behavior, and threats from Kathryn’s friends. Hence, Nurse must follow the policy and regulations of community care including zero-tolerance violence. However, these challenges can be minimized for nurses as Kathryn lives alone, and most of her relatives talk only on phones. Nurse community care also has the risk of patient’s negative behavior and attitude, and old people do not get satisfied easily with the services. Hence, Kathryn’s nurse must follow the occupational ethics and provide the necessary support to her. In addition, a collaborative approach by nurses improves the effectiveness of community care. Thus, Kathryn’s nurse can help her by providing collaborative support (Danielsen et al., 2018).

Basis on the above analysis it can be concluded that community care is an effective way for the treatment and care of the elderly that allow an independent environment and social support for them as most of the old people live alone or more isolated. Community care is more effective in Kathryn’s case as she lived alone, thus her nurse in community care can work as a care coordinator who can promote health, prevent the risk, manage the care plan a can refer her to the diabetes specialist basis on the health condition. Being alone with chronic health diseases such as diabetes and kidney problems it is important for Kathryn and other elderly to seek community care rather than hospitalization where they might have hospital complications. Basis on the patient’s health condition community health nurses provide support, care, refer the patient to the required consultant or doctors. It has been found that care in the community also comes with lots of challenges for nurses such as workplace environment, home condition of the patient, ethical issues in delivering the care, and risk of environmental hazards at the workplace. Thus, nurses must follow the policies and guidelines while delivering community care to improve the care quality.

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