Case Study: Enhancing Aged Care for Stroke Patients and Families

This case study focuses on Mr. McInnis, a 69-year-old stroke patient with left-side paralysis, and his wife Molly, his primary caregiver. The study outlines the challenges they face, including social isolation and refusal of support. It suggests various activities such as rehabilitation services, exercise strategies, counseling, community engagement, and self-care promotion. A nursing visit plan is proposed, emphasizing neurological assessment, lifestyle modification education, and encouragement of socialization. The study also explores transitioning from curative to palliative care, highlighting the importance of referrals and support services like ACAT, pastoral care, and pain management. The impact of personal values on care is discussed, along with the differences between curative and palliative care. Continuous improvement programs using technology and numeracy skills are also addressed, as well as issues facing older people and relevant referral mechanisms. This assignment provides comprehensive insights into aged care and stroke rehabilitation.

Running head: Aged Care
Aged Care
Name of the Student
Name of the University
Author Note

1Aged Care
Case File:
The case is about Mr McInnis, a 69 year old ,am, who suffered a stroke which caused
paralysis of his left side. His wife Molly (68 yesr old) is the primary caregiver, and thir
children lives overseas. Both the patient and his wife speaks with a thick Irish accent. The
couple migrated to Australia in 1965, and Mr McInnis used to work as a government
employee for 45 years, and Molly worked part time in schools, and then as a volunteer at a
local church. Before Mr McInnis had stroke, he used to work with a charity group for 3 to 4
days every week, and he loved travelling with his wife every fortnight. The also used to take
their dog for walk every day, and visit their children in Europe every Christmas. However
due to the stroke, Mr McInnis stopped socializing, and participate in any activities. He also
have refused all support, and his wife has become withdrawn since.
Role of Carer:
Molly is the primary carer of Mr McInnis, she takes care of preparation of food,
helping in cleaning, shaving and bathing and also assists him to the doctor’s appointments.
Activity List:
Different activities can be recommended in the given scenario:
1. Rehabilitation Service for the patient (Luvizutto et al. 2015)
2. Exercise and mobility improvement strategies for the patient (Billinger et al. 2014)
3. Counseling for patient and his wife (Liu et al 2018)
4. Encouraging community activities and socializing (English et al. 2014)
5. Promoting self care for patient (Parke et al. 2015)
6. Frequent nursing visits and neurological assessment
7. Provide social support and healthcare education (Wells and Bellamy 2017)

2Aged Care
Visit Plan:
The nursing visit plan can include the thorough assessment of the patient, to
understand the neurological function, the ability of the patient to communicate and move, as
well as supporting self care abilities of the patient. The plan also can involve educating the
patient and his wife on lifestyle modification and the need of physical activities to prevent
adverse effects of the condition on the mental and physical well being. Referrals can also be
provided depending on the need. The nurse can also encourage the patient to socialize more,
and support the patient to socialize.
The care can also involve continuous improvement plans (using technology and long
term care plans) and developing numeracy skills in the patient or caregiver.
List of Community Programs and Engagements to support client needs: 100 words
Different community programs and engagements can be suggested for the client, such
as: community transport, council community support (which can involve activities such as art
& craft sessions, education groups, advocacy services, legal education, mental health
services, companion groups, senior classes and leisure groups), home care support,
counseling services, allied services, independent living programs, day out services, duress
alarm services and mobile library services. These services can be helpful to address the needs
of the patient.
Empowerment programs can also be utilized for the patient in the form of support
groups which can help to develop the social well being of the patient. These programs can
help to provide education, health and housing referrals and support service
(empowermentprogram.org 2018).
Modification from Curative to Palliative Care:

3Aged Care
The healthcare services can be changed from the focus on curative to palliative
through the addition of several aspects to the care such as: a letter or referral as a
confirmation from the doctor (which confirms that the patient needs palliative care),
provision of extra care for the patient, inclusion of palliative care workers through the
inclusion of ACAT services (for aged care assessment), inclusion of pastoral care (for
emotional and spiritual support), involvement of the district nurses, involvement of pain
assessment nurses and general physicians (for understanding if the patient is suffering from
any pain), oncologist services and bereavement services (to help the patient cope up with
bereavement) (Gardiner et al., 2015).
Impact of my personal values:
My personal values dictates that one should be able to improve their well being
through self care strategies and seeking help when they are unable to. However such
understanding places a conflict with the values of MrMcInnis and Molly, who are exhibiting
social withdrawal instead of social interaction. However, it is important to maintain an
approach of not judging the client based on their choices, and instead the potential problems
should be noted and the concerns shared with the client (Holloway and Galvin 2016).
Curative vs Palliative care:
Curative care focuses on curing the medical or clinical condition, considering the
patient is suffering from a curable condition. Palliative care focuses on assisting the patient to
live with the condition and maintain the quality of life, considering the condition as non
curable and terminal
Continuous improvement programs (PDAC and Sustainability):

4Aged Care
Continuous improvement programs can include the use of technology and planning
for future care (Wang et al. 2015).
Numeracy skills:
Such skills can help to calculate disage of medicines, budgeting costs and performing
calculation.
Ageing demographics and impact:
Coverage for elderly care have steadily decreased over the years, resulting in more
expense in the healthcare for the elderly.
Addressing Devaluation:
Due to the increasing age and disabilities, the clients will have increased challenges
using technology.
Issues facing older people:
Different issues affects the wellbeing of the elderly, such as lack of support,
inactivity, lack of family or friends, lack of personal care service, environmental hazards at
home, transportation problems, lack of domestic assistance, social exclusion and lack of
exercise.
Referral Mechanisms:
The following referral services can be suggested: personal care service, mental
healthcare service and counseling, physiotherapy, transport service and home modification.

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References:
Billinger, S.A., Arena, R., Bernhardt, J., Eng, J.J., Franklin, B.A., Johnson, C.M., MacKay-
Lyons, M., Macko, R.F., Mead, G.E., Roth, E.J. and Shaughnessy, M., 2014. Physical
activity and exercise recommendations for stroke survivors: a statement for healthcare
professionals from the American Heart Association/American Stroke
Association. Stroke, 45(8), pp.2532-2553.
empowermentprogram.org., 2018., The Empowerment Program, retrieved on 23 May, 2018,
from: http://www.empowermentprogram.org/
English, C., Manns, P.J., Tucak, C. and Bernhardt, J., 2014. Physical activity and sedentary
behaviors in people with stroke living in the community: a systematic review. Physical
therapy, 94(2), pp.185-196.
Gardiner, C., Ingleton, C., Gott, M., & Ryan, T. (2015). Exploring the transition from
curative care to palliative care: a systematic review of the literature. BMJ supportive &
palliative care, 5(4), 335-342.
Holloway, I. and Galvin, K., 2016. Qualitative research in nursing and healthcare. John
Wiley & Sons.
Liu, W., Gong, Y. and Gong, Y., 2018. Effect evaluation of continuing care and
psychological intervention in convalescent phase of stroke. INTERNATIONAL JOURNAL OF
CLINICAL AND EXPERIMENTAL MEDICINE, 11(3), pp.2636-2641.
Luvizutto, G.J., Gameiro, M.D.O.O., Schelp, A.O., Braga, G.P., Ribeiro, P.W. and Bazan, R.,
2015. Characterization of patients treated by rehabilitation service after establishing of an
acute stroke unit in a Brazilian hospital. Journal of physical therapy science, 27(8), pp.2533-
2536.

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Parke, H. L., Epiphaniou, E., Pearce, G., Taylor, S. J., Sheikh, A., Griffiths, C. J., ... &
Pinnock, H. (2015). Self-management support interventions for stroke survivors: a systematic
meta-review. PLoS One, 10(7), e0131448.
Wang, H.F., Jin, J.F., Feng, X.Q., Huang, X., Zhu, L.L., Zhao, X.Y. and Zhou, Q., 2015.
Quality improvements in decreasing medication administration errors made by nursing staff
in an academic medical center hospital: a trend analysis during the journey to Joint
Commission International accreditation and in the post-accreditation era. Therapeutics and
clinical risk management, 11, p.393.
Wells, A. and Bellamy, L., 2017. Abstract TP389: Utilizing A Stroke Protocol to Improve
Stroke Prevention Education.