Analysis of Case Study on Multidisciplinary Healthcare for Elderly Patients

This essay analyzes a case study of an elderly patient with gastrointestinal bleeding and other health problems, discussing the role of multidisciplinary healthcare members, effective communication strategies, integrated care management, advocacy skills, and ethical considerations.

Running head: CASE STUDY
Analysis of Case Study
Name of the Student
Name of the University
Author Note

1CASE STUDY
Analysis of the Case Study
There is a need to identify the complex needs of elderly patients and monitor their health
patterns to watch and prevent problems that are most common among the elderly. In this case
scenario, the patient P.W is aged 77 years and suffers from gastrointestinal bleeding, in addition
to facing problems that involve hand swelling, muscle weakness and urinary incontinence. The
essay will discuss the role of multidisciplinary healthcare members who are integral to caring for
this patient, and will also advocate for the patient, while discussing the major ethical concerns.
Effective communication strategies
Use of healthcare approaches that encompass multidisciplinary team have been identified
crucial in managing the health status of elderly patients. In the case study presence of
gastrointestinal bleeding and other presenting complaints would require the patient P.W to
interact frequently with different healthcare professionals, with a particular emphasis on primary
and secondary care providers. The knowledge and skills of a range of professionals belonging to
healthcare disciplines is required to conduct her comprehensive health assessment. The team
members will be involved in determining her physical, emotional, social and functional status,
with the aim of enhancing health outcomes (Shaw et al., 2014). The team will be comprised of a
rehabilitation therapist, nurses, physicians, social workers and physiotherapists. Caring for the
elderly patient will require establishment of a successful relationship with the patient and will
have to utilise effective communication strategies and skills. Effective communication forms an
essential aspect of healing and makes patients show an increased likelihood to the treatment and
intervention. Effective communication strategies that can be employed by the patients include

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beginning with an appropriate body language. Seating in a position that is directly opposite to the
patient P.W will improve communication (Cooper et al., 2014).
Extra time must be allowed to the elderly patient due to her increased need for
information and poor communication skills. Distractions should be avoided to make the patient
feel that an appropriate willingness is being demonstrated by all healthcare professionals to listen
to her preferences and demands (Almeida & Ciosak, 2013). Maintaining eye contact should also
be employed as essential non-verbal communication skills by the multidisciplinary team. This
will establish trust and a foster an effective therapeutic relationship. Furthermore, the healthcare
professionals should speak slowly, in short sentences and use simple words to make the patient
P.W understand the benefits of medication. Demonstrating active listening skills will also help
the patient to clearly state her wishes and demands, depending on which the care plan can be
adjusted accordingly (Williams, Kemper & Hummert, 2016).
Integrated care management service
Integrated care refers to the delivery of coordinated and comprehensive seamless care to
all patients, regardless of the health abnormalities that the patients are suffering from (Martínez-
González et al., 2014). One unique need of the case is related to presence of symptoms that are a
direct manifestation of gastrointestinal bleeding. This mainly occurs due to hemorrhoids, cancer,
esophageal varices or peptic ulcers (Villanueva et al., 2013). Hence, the integrated care
management will involve use of a lavage or gastric aspiration, which will involve insertion of a
tube into the stomach, through the nose to determine presence of blood in stomach (Mennigen,
Senninger & Laukoetter, 2014). Comprehensive laboratory testing that includes hemoglobin,
hematocrit, electrolyte balance, and platelet is also crucial. Furthermore, the healthcare staff
should also conduct imaging for determining the exact location of bleeding in the gastrointestinal

3CASE STUDY
tract. Other unique needs of the patient encompass muscle weakness, loss of functioning, urinary
incontinence, and hand swelling.
Care management approaches should involve measuring the vital signs of the patient,
followed by providing physiotherapy assistance to the patient to participate in a range of simple
exercises. These will help in improving limb strength. Bedside comfort should be provided, in
addition to assisting the patient to conduct daily activities such as, showering, and feeding,
dressing and medication management. Another management approach will focus on use of
indwelling catheter for the patient P.W that will help in addressing the urinary incontinence
(Nademanee et al., 2015). Efforts will also be taken to avoid catheter associated bloodstream
infections. Moreover, the care management will also comprise of administration of proton pump
inhibitors such as, omeprazole, lansoprazole, and ranitidine bismuth citrate, to reduce rates of GI
bleeding (Liu et al., 2013).
Advocacy skills
The primary need of the patient is the fact that she wants to shift to an assisted living
facility that will act as housing facility for the patient. This can be attributed to the fact that the
patient finds it difficult to live independently. These facilities will help in conducting activities
that are associated with daily living (Jang et al., 2014). The patient requires companionship and
extensive assistance in her day-to-day living. Owing to the fact that the patient P.W is facing
difficulties related to her complicated medical problems, noncompliance to medications and
functional decline, there is a need to understand her perceptions and ensure proper patient care.
Hence, the basic right of the patient related to autonomy confers her right to make necessary
decisions about her medical care, without being influenced by others (Josse-Eklund et al., 2014).

4CASE STUDY
Owing to the fact that she has sound problem solving skills that indicate a sound
cognitive state, her son will not be allowed to impose his decisions regarding shift to assisted
care centre. Thus, she will be given the provision to exercise her rights related to shift to the
long-term senior care option that will provide personal care support services (Chernbumroong et
al., 2013). However, in addition to considering her rights, efforts will be taken by the
multidisciplinary team to make her adhere to medications, for an easy recuperation.
Ethical consideration for the given case
Ethical issues are one of the major challenges for providing healthcare service to aged
individual. In the given case, the major ethical issue is due to the conflict of wish between the
patient and her family. The patient being aged wants her treatment to be done in assisted living
facility, where she will be comfortable with her daily routine. Nevertheless, due to the past poor
experience, the patient family is not able to support the decision. The patient also has the right to
refuse medication, which is more applicable for the aged individual suffering from critical
disease. The heavy medication given to the patient of gastrointestinal disease has higher levels of
side-effects that increase the mental stress of the patient. Hence, in the given context it is
essential that the nurse or the patient family do not enforce the patient to take up forced
medication (Teng et al., 2016).
It is also one of the company ethical duties to respect the wish of the aged patients by
taking their prior consent while recommending intervention strategies (Brazier & Cave, 2016).
This has been clearly violated in the given cases as the patient family is not able to fulfill the
patient desire. This is one of the major issues as the patient is not aware about the consequence
of the chosen healthcare intervention strategy. Hence, is the ethical duty of the knots and the

5CASE STUDY
patient family to properly inform about the outcome of every intervention and treatment
strategies that are implemented for the given case.
Institutionalized care that is given to the aged patients has limited opportunity due to lack
of Healthcare resources. In the assisted healthcare facility, it is the ethical duty to provide
individual care to the patient depending upon their personal needs. This will provide both
physical and mental support to the critically ill aged patient (Teng et al., 2016).
Conclusion
Thus, it can be stated that then management of the patient will involve a
multidimensional, multidisciplinary and comprehensive approach that will work towards
improving the health outcome of the patient. Advocating for the rights of the patient, while
implementing an integrated care management service will lead to enhancement of the overall
health and wellbeing, thereby improving the health related quality of life.

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References
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