Nursing - Improvement in Health Care Service

Running head: NURSING
Nursing
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1NURSING
With the improvement in health care service, the life expectancy of people has increased
leading to increase in ageing population. Elderly people are challenged by age related physical
limitation and multiple co-morbidities. As they have diverse health needs, specialized field of
nursing called gerontological nursing which aims to promote good aging and providing support
to meet diverse health needs of client. Good understanding of diverse challenges is important too
so that nurses can apply gerontological competencies appropriately (Boscart et al., 2017). With
this context, the main purpose of this paper is to review indicator 1.2 and 3.6 from the Canadian
Association of School Nursing (CASN’s) entry to practice gerontological competencies and
discuss about the challenges to older people related to this indicator. The paper will also explore
how nurses can use their skills and knowledge to meet the selected indicators. The significance
of the entry to practice gerontological competencies is that it can give direction to nurse about
implementing inclusive and integrated care for older people.
One of the CASN’ entry to practice gerontological competencies includes collaboration
with older people and their families to promote their health and well-being and prevent illness
and injury. The indicator 1.2 of the CASN’s competency states engaging in therapeutic
relationship with the older people and their value and recognizing their values and diversities
(CASN, 2017). However, some of the challenges for older people related to this indicator is that
they fail to receive culturally sensitive care leading to care dissatisfaction. Such experiences of
older people has been defined by Kelly, Mrengqwa and Geffen (2019) which gave an overview
of the experiences of care for community dwelling older adults in Cape Town, South Africa. The
participants reported difficulty in accessing quality care and had poor care experience as their
needs were overlooked. Because of this issue, they lacked trust in health care professionals.
Brooks, Manias and Bloomer (2019) argue that lack of culturally sensitive care leads too poor

2NURSING
adherence to treatment and increased prevalence of adverse events too. The main reason for such
challenge is difference in cultural values and expectations of elderly client and health care staffs.
From the above evidence, it is clear that nurse must pay attention to holistic needs of older
persons. Having therapeutic communication competency can support nurse to eliminate negative
attitude towards complex needs of elderly and use empathy fulfill cultural and professionals
expectations of elderly (Arnold & Boggs, 2019).
A nurse who aims to engage in therapeutic relationship with elderly client must have
good communication skills and they must respect the values and beliefs of the elderly patient.
They can meet their cultural needs during care delivery by using person-centered approach to
care. This will involve being compassionate, being respectful and considering the patient’s point
of view before providing any service or nursing actions. This can involve asking for cultural
preferences or other inputs while providing care to patient (Brooks, Manias and Bloomer 2019).
Certain communication skills like active listening and responding to verbal and non-verbal cues
of patient are important at this stage to attain cultural sensitivity. Other strategies that nurse can
use to collaborate with the patient and family includes interacting with the patient’s family to
understand beliefs and values and ensure continuity of care. In case of language differences,
nurse can also utilize interpreter service to better engage with elderly patients (Lundin,
Hadziabdic & Hjelm, 2018).
Another indicator specified in the CASN’s entry to practice gerontological competencies
is the indicator 3.6 that states that providing comfort and support to the older person who is
dying that is consistent with their wishes, spirituality and culture. This is related to the
competency of collaborating with older person to provide competent and respectful end of life
care (CASN, 2017). The challenges to the older adults related to this indicator is that they