The Older Person and Supportive Care

Running Head: THE OLDER PERSON AND SUPPORTIVE CARE
The Older Person and Supportive Care
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THE OLDER PERSON AND SUPPORTIVE CARE 2
The Older Person and Supportive Care
Introduction
Clinical decision making refers to a circumstantial, evolving and continuous process in
which there is a collection, evaluation, and interpretation of data to provide evidence-based
information on the bases of which a choice of action is determined. It frequently describes the
fundamental role of nurse practitioners who often make these clinical judgments (Tiffen,
Corbridge & Slimmer, 2014). Nurses draw from various sources such as the experience gained in
practice over time and their formal nursing education when making clinical decisions (Traynor,
Boland & Buus, 2010). The process also requires critical thinking which entails practicing
logical reasoning, information seeking, applying standards and discriminating, cognitive
analytical skills as well as forecasting and transmuting knowledge (Zuriguel et al., 2015). This
essay further discusses critical thinking as carried out by registered nurses caring for the elderly.
It brings to light the evidence-based decisions made by these nurses concerning the planning,
coordination, and provision of personal hygiene to the older people during an acute admission in
order to optimize their health outcomes. It also deliberates a gerontological condition,
highlighting its causes and effects on the health and wellbeing of the elder that impact his or her
personal hygiene care management.
Clinicians are faced by conflicting pressures on how to lessen diagnostic uncertainty,
reduce costs and minimize risks to the patient all at once and thus have to integrate a vast variety
of clinical data to come up with a course of actions (Malykh & Rudetskiy, 2018). The kinds of
assessments made include determining what data to gather, which tests to have conducted, how
to interpret and assimilate the info to draw diagnostic conclusions as well as the kinds of
treatments to give. Clinicians frequently make decisions informally in common situations

THE OLDER PERSON AND SUPPORTIVE CARE 3
whereby the diagnosis relies on disease patterns and customary practice is the basis for testing
and treatment. For instance, a healthy adult who has had a harsh cough, aches, and fever for 2
days during a flu epidemic is likely to be diagnosed as another case of influenza and offered
proper symptomatic relief just like other cases. However, the individual with these symptoms
might actually be suffering from bacterial pneumonia hence in need of antibiotics. In this case,
the error is made by failure to put other therapeutic and diagnostic possibilities into serious
consideration. This indicates that clinical decision making could be subjective and the necessity
of a History and Physical examination (H&P) cannot be emphasized enough.
Needs of the Older people
Older people attending acute medical units or emergency departments often have
complex needs caused by physical limitations, composite psychosocial issues, multiple
comorbidities, and enhanced functional dependence. Their advanced susceptibility and ease of
decompensation lead to increased frailty which makes clinical assessment difficult. The adverse
impacts of drugs, as well as the physical ailments, are more distinct resulting in delirium,
atypical presentation, cognitive decline and also the inability to carry out day to day activities.
Potential adverse outcomes for older frail inpatients include medical complications such as
hospital-acquired infections and pressure sores which may lead to continued deterioration. The
assessment for older people in hospitals also involves the valuation of their personal hygiene,
including skin condition and dental health. Generally, older people are at higher risks of
developing skin problems such as purpura, pressure ulcers, eczematous dermatitis, and venous
insufficiency (Singh, 2016). In addition, poor oral and dental hygiene can be observed among
older individuals. This is due to factors such as diminished functional dependence and physical
agility as well as impaired sensory functioning. Also, older people are taking multiple drugs