University Aged Care: Clinical Integration Specialty Practice Report

This report delves into the critical role of nurses in aged care rehabilitation, focusing on interventions to maintain the functional status of elderly individuals. It evaluates various methods, including physical activities, exercise programs (resistance, endurance, balance training, and multi-component pr...Read More

Running head: CLINICAL INTEGRATION: SPECIALTY PRACTICE
Clinical Integration: Specialty Practice
Name of the Student:
Name of the University:
Author’s Note:

1CLINICAL INTEGRATION: SPECIALTY PRACTICE
Table of Contents
Introduction......................................................................................................................................2
Critical Evaluation...........................................................................................................................2
Critical Observation.........................................................................................................................4
Conclusion.......................................................................................................................................6
References........................................................................................................................................7

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Introduction
With age, people tend to lose their ability to function properly due to physical disability.
The nurses in the care help the elderly people to complete the daily activities due to the
functional disabilities that set in with age. Therefore, the nurses in the care settings use various
methods to help the elderly people maintain their functional status in terms of preventing falls,
malnutrition, poor self-care and skin integrity.
This report emphasizes on the methods or activities undertaken by the nurses in aged care
rehabilitation to help elderly people to maintain their functional status. Peer-reviewed journals
are used for critically analysing and observing the methods used by the nurses in for the elderly
people in the rehabilitation centre thereby, keeping them functional.
Critical Evaluation
As mentioned by (Gillespie, et al., 2012), one of the most important interventions used by
the nurses for helping the elderly people in maintaining the physical activity is helping them
doing physical activities by motivating them. As seen the rate of physical activities in the elderly
people decreasing, as they tend to move frequently. As a result, the bones and muscles of the
elderly people tend to function slowly thereby, making them mostly dependent on others. With
time, the elderly people also lose confidence to work independently. Therefore, the nurses in the
rehabilitation centre help the elderly people in motivating the elderly people to continue the
physical activities. As a result, the elderly people are able to maintain physical mobility thereby,
helping them live independently. However, as argued by (Reid & Fielding, 2012), increasing the
skeletal muscle power of the elderly people helps in effective maintenance of the physical

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activity. With age, due to lack of calcium and drying of the cartilages, muscle movement of the
elderly people gets extremely difficult. Skeletal movement for the elderly people is very painful
that prohibits them from maintaining effective physical movement. Therefore, the nurses at the
rehabilitation centres ensure that the elderly people are continuing physical activities to maintain
physical activities. The physiotherapists conduct physiotherapy sessions with the elderly patients
to help them maintain comfortable physical activities. Physiotherapy sessions for the elderly
patients help them in smooth and comfortable physical movement thereby, allowing them to
maintain the physical activities smoothly. The physiotherapy sessions conducted by the
physiotherapist in presence of the nurses that helps in improving strength for the elderly people
along with enduring correct postural and muscular balance.
According to (Cadore, Rodríguez-Mañas, Sinclair, & Izquierdo, 2013), the nurses in the
care settings use exercise programs such as resistance training, endurance training, and balance
training and multi-component programs help in maintaining physical mobility for elderly people.
Balance training is an intervention that nurses teach the elderly people aiming at preventing falls.
The exercises of the balance training include heel-toe walking, stepping practice and throwing or
catching a ball. All the aforementioned activities help in ensuring skeletal and muscular
movement for the elderly patients thereby, maintaining physical mobility. However, on the
contrary, the nurses for improving the overall health status of the elderly people consider multi-
component exercise programs the most effective. The nurses use different types of stimulus in
order to improve the balance of the elderly people. Therefore, the nurses promote independence
to the elderly people and ability to perform daily activities. However, as argued by (Windle &
Bennett, 2012), the nurses in the clinical settings helps in preventing poor self-care for the in the
context of care giving, by psychologically motivating the elderly people helps in building

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confidence thereby, enabling physical movement. The motivation provided by the nurses helps
the elderly people in gaining confidence and taking good care of them individually. This helps
the elderly people maintain physical health and move muscles and skeletal comfortably.
Psychological motivation provided by the nurses helps in encouraging the elderly people in
taking appropriate good care of them thereby, preventing issues such as malnutrition, falls and
skin integrity. However, on the contrary, this leaves chances of falling and injury for the elderly
patients, as they lack physical support.
Critical Observation
According to the article written by (Gillespie, et al., 2012), it can be concluded that more
than 70% of the elderly people have been benefitted by practicing the physical activities daily.
The training provided by the nurses at the rehabilitation centre makes the movement of muscle
and skeletons smooth. With age, as the liquid between the skeletons gets dry, the elderly people
feel pain in moving normally. Therefore, physical activity enforced by the nurses helps in
maintaining regulatory movement of the muscles for the elderly people. However, as argued by
(Robinovitch, et al., 2013), the physical activities enforced by the nurses for the elderly people
making it hectic for them. This is because due to old age, the elderly people require inputting
more energy in completing the physical activities thereby, making it tiring. At certain instances,
the physical activities conducted by the nurses have a detrimental impact on the elderly people.
According to the findings of (Reid & Fielding, 2012), it can be concluded that the nurses help in
increasing the skeletal muscle power of the elderly people by using isokinetic or isometric
dynamometry. It has been seen that more than 60% of the elderly people have been able to
maintain functional status due to the implementation of isometric dynamometry. However, as
argued by (Trampisch, Franke, Jedamzik, Hinrichs, & Platen, 2012), implementation of

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isometric dynamometry for muscle strengthening for the elderly people prevents the flow of
blood to the muscles. As a result, the speed of muscle response in decreased largely.
Additionally, the elderly people have also complained to the nurses of being easily bored, as they
have to continuously press against the same object for a long time. As mentioned by (Harbo,
Brincks, & Andersen, 2012), isometric dynamometry might also increase the flow of blood
suddenly thereby, leading to an irregular heartbeat or ruptured blood vessels for the elderly
people. Therefore, the nurses in the rehabilitation centre need to conduct isometric dynamometry
for muscle strengthening appropriately.
According to the article written by (Cadore, Rodríguez-Mañas, Sinclair, & Izquierdo,
2013), it can be concluded that balancing training, multi-component exercise programs and
resistance training helps in maintaining the functional status for the elderly people. It can be said
more than 50% of the elderly people have been able to maintain proper balance due to attending
balancing training conducted by the nurses. The training has provided the opportunity of
maintaining proper balance in the old age and perform physical activities independently.
Additionally, endurance training also helps in enhancing in cardiovascular functions within the
elderly people. However, as argued by (Furuta, et al., 2013), increased cardiovascular functions
has an adverse impact on the elderly people, as they have a weak heart due to old age. Therefore,
the nurses in the rehabilitation centre need to be extremely careful while providing training to the
elderly people in order to maintain functional state. According to the article written by (Windle
& Bennett, 2012), it can be concluded that psychological motivation provided by the nurses
helps in encouraging the elderly people to maintain functional state. Continuous motivation
provided by the nurses helps the elderly people in performing the physical trainings and perform
their daily activities independently. However, as argued by (Zimmermann, et al., 2014), only

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care provided by the nurses makes the elderly people more incompetent as they tend to rely
largely on the support of the nurses rather than having confidence in them.
Conclusion
In this report, it can be concluded that the nurses in the rehabilitation centre play a
significant role in maintaining functional status for the elderly people. The nurses conduct
various physical exercises, training such as balancing training, endurance training for ensuring
that the elderly people remain in the functional state. Additionally, the nurses in the rehabilitation
centre helps in psychologically motivating the elderly people in taking good self-care. Ensuring
good self-care for the elderly people will prevent malnutrition, skin integrity along with
preventing falls. As a result, the elderly people in the rehabilitation centre are able to live a
physically sound life due to the support of the nurses.

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References
Cadore, Rodríguez-Mañas, Sinclair, & Izquierdo, &. (2013). Effects of different exercise
interventions on risk of falls, gait ability, and balance in physically frail older adults: a
systematic review. Rejuvenation research, 105-114.
Furuta, Komiya‐Nonaka, Akifusa, Shimazaki, Adachi, Kinoshita, & Yamashita, &. (2013).
Interrelationship of oral health status, swallowing function, nutritional status, and
cognitive ability with activities of daily living in Japanese elderly people receiving home
care services due to physical disabilities. Community dentistry and oral epidemiology,
173-181.
Gillespie, Robertson, Gillespie, Sherrington, Gates, Clemson, & Lamb, &. (2012). Interventions
for preventing falls in older people living in the community. The Cochrane Library.
Harbo, Brincks, & Andersen, &. (2012). Maximal isokinetic and isometric muscle strength of
major muscle groups related to age, body mass, height, and sex in 178 healthy subjects.
European journal of applied physiology, 267-275.
Reid, & Fielding, &. (2012). Skeletal muscle power: a critical determinant of physical
functioning in older adults. Exercise and sport sciences reviews, 4.
Robinovitch, Feldman, Yang, Schonnop, Leung, Sarraf, & Loughin, &. (2013). Video capture of
the circumstances of falls in elderly people residing in long-term care: an observational
study. The Lancet, 47-54.

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Trampisch, Franke, Jedamzik, Hinrichs, & Platen, &. (2012). Optimal Jamar dynamometer
handle position to assess maximal isometric hand grip strength in epidemiological
studies. The Journal of hand surgery, 2368-2373.
Windle, & Bennett, &. (2012). Caring relationships: How to promote resilience in challenging
times. In The social ecology of resilience . New York: Springer.
Zimmermann, Swami, Krzyzanowska, Hannon, Leighl, Oza, & Donner, &. (2014). Early
palliative care for patients with advanced cancer: a cluster-randomised controlled trial.
The Lancet, 1721-1730.