Geriatric Care: Challenges and Solutions

This assignment focuses on a collection of research papers exploring diverse challenges and solutions in geriatric care. Topics covered include mistreatment identification and measurement, surgical approaches for hip fractures, symptom management in dementia patients, early rheumatoid arthritis treatment, assistive technologies for toileting, the impact of staff attachment on dementia care, and interventions for depression in nursing home residents. The papers delve into clinical practices, psychological support, and multidisciplinary care models within geriatric settings.

Running head: CASE STUDY OF ROSA CALAPARI
CASE STUDY OF ROSA CALAPARI
Name of the Student
Name of the University
Author Note:

1CASE STUDY OF ROSA CALAPARI
It can be of great experience working with the elderly people, and interacting with
them can be quite knowledgeable, however, that work comes with its own unique sets of
challenges. Rosa Calapari is an 80 year old married woman, with 2 children and 5
grandchildren. She has a history of arthritis). Seven years ago, she suffered an intracapsular
hip fracture. I could also observe signs of irritability and anxiety and as she confessed to the
feeling of being neglected by her caregivers. As we see, that degenerative diseases like
arthritis can be common at old age (Innala et al., 2014). Also, weakening of bones, increases
the chances of fractures, like the intracapsular hip fracture suffered by the patient (Hartel et
al., 2016). A mini mental state examination showed a mild impairment of memory (Arevalo-
Rodriguez et al., 2015). The most frequent challenges I faced working with the elderly are
(Marksteiner et al., 2013) can be listed as below:
The biggest challenge I faced was an unwillingness to seek help at the right time:
This can be caused by a number of different reasons. In few instances they might feel they do
not need medical assistance, or may be too embarrassed to seek help. Sometimes they might
have preconceived notions about the treatment, and how it might adversely affect their lives,
and would neglect treatment, fearing that it would take away their freedom. It is important to
be gentle in such circumstances, and make the patient feel comfortable to seek help. I would
also clarify any doubts the patient might have about the treatment.
I also, faced challenges while dealing with mental health issues: Mental health
conditions which are generally associated with old age like Dementia, Parkinson’s or
Alzheimer’s can cause significant cognitive impairments (Birren et al., 2013). This causes a
great difficulty in providing help for them, since their condition might impair them of their
ability to take care of themselves, or even understand or accept the treatment given to them. I
have observed patients with Dementia, who often would forget to take their medications on
time, in such cases we can keep written notes for the patient to aid their memory (Hendriks et

2CASE STUDY OF ROSA CALAPARI
al., 2014). I would always strive to understand how the mental condition would underlie the
behavior, and that proved helpful in dealing with such situations.
I have also noticed an increasing need for personal care: Sometimes with advancing
ailment and age, the patient can get progressively debilitated, thereby needing more personal
help like to go to the bathroom or to clean them thereafter (King et al., 2017). We must
understand that it can be very embarrassing for the patient, and we ought to do all we can to
make them feel as comfortable as possible.
Forming emotional attachment: sometimes working with the elderly, I have formed
emotional attachments with the patients, and in some cases it helped me being more
empathetic, and helpful, but in other instances, it was a heartbreaking experience to see them
suffer. I learnt that an emotional attachment becomes an important tool to understand and
help the patient better (Kokkonen et al., 2014). The attachment can help to reduce the feeling
of loneliness and social isolation (Gierveld, Tilburg, & Dykstra, 2016). I have also seen that
pets can be a remarkable tool to create a bonding with the elderly (Cusack & Smith, 2014).
Mistreatment of the elderly: One of the biggest challenges is the mistreatment of the
elderly, which includes any harm done by caregivers by failing to provide the basic needs of
the patients. I have interacted with several patients who feel that they are mostly neglected,
and many showed confidence that they would feel much better, health wise, if the received
proper care (Giraldo‐Rodríguez, and Rosas‐Carrasco, 2013).
Challenges I faced while dealing with physical disabilities: Often with advancing age,
degenerative disorders (like arthritis) sets in, also fractures, or surgical procedures, can
reduce or even impair the mobility. This can place them at a great disadvantage, and in
constant need to help. Often these disabilities can lead to the feeling of being inadequate, and
can lead to mental stress, and depression (Dillon & Fernando, 2016). We must understand the

3CASE STUDY OF ROSA CALAPARI
change a patient goes through with progressive complexities of the advancing age (like
arthritis, dementia, diabetes, osteoporosis) to be able to empathize with their situation, and
help them. Managing geriatric depression hence requires a multidisciplinary approach
(Leontjevas et al., 2013).
I have also faced certain levels of difficulties when dealing with a grieving elderly,
like an elderly woman, who lost her husband. The psychological trauma, makes them more
prone to stress related disorders, and can adversely affect the health (Shear et al., 2014). In
such scenarios, it becomes important to provide an emotional support and a feeling of
comfort to the patient, which can foster good health and emotional well being (Walther &
Ehkert, 2016).
With hindsight, I can therefore infer that with proper understanding of the life of the
patient a proper way of dealing with a patient can be implement, through empathy and
compassion. I would keep in mind that ageing is not a disease, but a state of being, that we all
eventually arrive to, and providence of a proper care for the elderly is not just a professional,
but a social responsibility (Ardeljan & Chan, 2013).

4CASE STUDY OF ROSA CALAPARI
REFERENCES:
Ardeljan, D. and Chan, C.C., 2013. Aging is not a disease: distinguishing age-related macular
degeneration from aging. Progress in retinal and eye research, 37, pp.68-89.
Arevalo-Rodriguez, I., Smailagic, N., i Figuls, M.R., Ciapponi, A., Sanchez-Perez, E.,
Giannakou, A., Pedraza, O.L., Cosp, X.B. and Cullum, S., 2015. Mini-Mental State
Examination (MMSE) for the detection of Alzheimer’s disease and other dementias in people
with mild cognitive impairment (MCI). BJPsych Advances, 21(6), pp.362-362.
Birren, J.E., Cohen, G.D., Sloane, R.B., Lebowitz, B.D., Deutchman, D.E., Wykle, M. and
Hooyman, N.R. eds., 2013. Handbook of mental health and aging. Academic Press.
Cusack, O. and Smith, E., 2014. Pets and the elderly: The therapeutic bond. Routledge.
de Jong Gierveld, J., Van Tilburg, T. and Dykstra, P., 2016. Loneliness and social isolation.
Dillon, C. and Fernando, E.T., 2016. Special Issue: Activity and Lifestyle Factors in the
Elderly: Their Relationship with Degenerative Diseases and Depression. AIMS Medical
Science, 3(2), pp.213-216.
Giraldo‐Rodríguez, L. and Rosas‐Carrasco, O., 2013. Development and psychometric
properties of the Geriatric Mistreatment Scale. Geriatrics & gerontology international, 13(2),
pp.466-474.
Hartel, M.J., Mandani, S.M., Nuechtern, J., Stiel, N., Lehmann, W., Rueger, J.M. and
Grossterlinden, L.G., 2016. On-table decision-making in intracapsular hip fracture surgery:
mid-term results of a pilot study. Archives of orthopaedic and trauma surgery, 136(7),
pp.913-919.

5CASE STUDY OF ROSA CALAPARI
Hendriks, S.A., Smalbrugge, M., Hertogh, C.M. and van der Steen, J.T., 2014. Dying with
dementia: symptoms, treatment, and quality of life in the last week of life. Journal of Pain
and Symptom Management, 47(4), pp.710-720.
Innala, L., Berglin, E., Möller, B., Ljung, L., Smedby, T., Södergren, A., Magnusson, S.,
Rantapää-Dahlqvist, S. and Wållberg-Jonsson, S., 2014. Age at onset determines severity and
choice of treatment in early rheumatoid arthritis: a prospective study. Arthritis research &
therapy, 16(2), p.R94.
King, E.C., Boscart, V.M., Weiss, B.M., Dutta, T., Callaghan, J.P. and Fernie, G.R., 2017.
Assisting frail seniors with toileting in a home bathroom: approaches used by home care
providers. Journal of applied gerontology, p.0733464817702477.
Kokkonen, T.M., Cheston, R.I., Dallos, R. and Smart, C.A., 2014. Attachment and coping of
dementia care staff: The role of staff attachment style, geriatric nursing self-efficacy, and
approaches to dementia in burnout. Dementia, 13(4), pp.544-568.
Leontjevas, R., Gerritsen, D.L., Smalbrugge, M., Teerenstra, S., Vernooij-Dassen, M.J. and
Koopmans, R.T., 2013. A structural multidisciplinary approach to depression management in
nursing-home residents: a multicentre, stepped-wedge cluster-randomised trial. The
Lancet, 381(9885), pp.2255-2264.
Marksteiner, J., Jagsch, C., Psota, G., Rainer, M., Ruepp, B., Singewald, E., Fellinger, M. and
Wancata, J., 2013. Geriatric psychiatry in Austria: Current status and new perspectives.
Geriatric Mental Health Care, 1(4), pp.82-87.
Shear, M.K., Wang, Y., Skritskaya, N., Duan, N., Mauro, C. and Ghesquiere, A., 2014.
Treatment of complicated grief in elderly persons: A randomized clinical trial. JAMA
psychiatry, 71(11), pp.1287-1295.

6CASE STUDY OF ROSA CALAPARI
Walther, A. and Ehlert, U., 2016. Emotional support, depressive symptoms and age-related
alterations in male body composition. Psychoneuroendocrinology, 71, p.24.