Care Management of Elderly Patient with Multiple Comorbid Chronic Diseases at Home Rationale | Nursing Assignment

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Introduction
According to the report, older people comprise a significant proportion of the
population of Australia, where 1 out of 7 people in the country was aged 65 years or more in
2017 (Australian Institute of Health and Welfare, 2018). Therefore, 3.8 million people
contributing 15% of the total population in Australia were above the age of 65 years. It had
drastically increased from 319000 in 1927 to 1.3 million in 1977. Community care involves
helping people in order to live a dignified and independent life within society. The care of an
elderly person at home requires consideration of a number of factors because they have
complex needs due to age-related issues; thus, it is important to increase the amount of home
support to elderly people. The common condition that is prevalent among the over-65
population is hypertension, arthritis, diabetes, pulmonary disease, osteoporosis and cancer.
Thus, it is exceeding important to offer community care to elderly people with multiple
comorbid chronic diseases to live independently at home. The aim of the paper is to critically
analyse the literature related to the care of elderly people suffering from multiple chronic
diseases at home in order to support them to live independently.
Care Management of Elderly patient with multiple comorbid chronic diseases at home
Rationale
A patient is an 85-year-old man living in Sydney with his son and his family. He has
been diagnosed with diabetes, hypertension and arthritis that affected his health and
movement. Due to this age factor, his family decided to recruit a caregiver to take care of his
needs and demands. In geriatrics, the most concerning factors are offering optimal care to
older people that have multiple chronic conditions or multimorbidity. It is associated with a
high number of deaths, institutionalisation, and disability, use of healthcare resources,
adverse impact and poor quality of life. As per the opinion of Tinetti et al. (2019), there are

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appropriately 50% of the older adults that have at least three or chronic diseases that have a
distinctive effect on the individual. The older people are found to be heterogeneous because
of the severity of illness, prognosis, and functional status, risk of a negative impact and
personal choices that are diagnosed with similar patterns of conditions. This leads to a
difference in the treatment options; thus, necessitating the need for more flexible approaches
of care to the target population. The advantage of taking care of the patient suffering from
multimorbidity is numerous; it will allow in improving the health condition, decreasing
dependence on family or support care, reduction in the cost of treating the patient and
allowing to live a respected and dignified life at the end of his life.
Nursing role and considerations
One of the primary carers of the elderly patient with multiple diseases at home is a
nurse. The role of nursing is critical because they help in offering appropriate care in
alignment with the demands and needs of the patient. The educative role of nurses intends to
focus on the importance of having an active life and teaching self-care activities such as
continence promotion, self-medication and health screening. By focusing on the aspect of
treating and management of chronic conditions, the nurses will be able to improve e the
quality of life of the assigned patient. Halvorsen et al. (2016) opined that the supportive role
of nurses includes offering emotional and psychosocial care, which enhances the relationship,
lifestyle, thus, facilitating the aspects of self-expression and cultural diversity. The
therapeutic role of the nurse in case of offering care to the elderly patient with multiple
chronic diseases is most vital in this case. Lavan, Gallagher and O’Mahony (2016) argued
that this is because it helps in maximizing the independence level as well as functional
ability, which prevents any further deterioration or disability. Since this involves caring at
home, the provision of family members needs to be taken into consideration by assisting
them in receiving knowledge and skills related to caring.

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According to Danielsen et al. (2018), the home care setting is stated to be a
challenging working environment for patient safety due to a number of reasons. The foremost
risk is the household-related hazards that include lead paint, poor indoor quality of air and the
presence of toxic substances that have a negative impact on health. There are well-defined
hazards in relation to healthcare that involve the spread of nosocomial infection, medication
errors and the development of resistant organisms that are prevalent at home. In addition,
there can be some uncontrollable condition factors, limitation of training of the healthcare
providers in working at home-based setting, as each home is different and pose different
issues. Therefore, the case of elderly patients needs to conduct a thorough assessment of the
patient’s home and undertake documentation to critically evaluate the risks, factors and
working conditions that need to be taken into account.
The management of an elderly patient suffering from multiple conditions is stated to
be a new stage in the patient’s and family’s life. As per the study of Kälviäinen and
Reinikainen (2019) opined that the critical decision of care arises that involves anxiety and
uncertainty that affects the future care approach. The foremost aspects that need to be
conducted in such cases is a thorough evaluation that will notably include the community
care options that include informal care, information and referral, services related to care
management, transportation services, legal counselling, respite care, nutritional programs and
adult day care.
An integrative approach that involves collaboration, communication and team
meeting is crucial for the sharing of vital information among the stakeholders and enhancing
the quality of life of the patient. The aim of the care management is to offer a caring approach
to the elderly patient at home with multiple diseases, thus allowing living independently. As
stated by Wu et al. (2017), the multiple diseases and age factor complicates the treatment and
recovery status. It is often found that patients above the age of 65 years do not recover