Care Process for Elderly Home Care: Mental Health and Nursing Roles

This essay examines the care process for elderly individuals, particularly those with mental health disorders, focusing on the benefits and challenges of home-based care. It highlights the importance of nursing interventions, including risk assessment, communication strategies, and the involvem...Read More

Running head: CARE PROCESS FOR ELDERLY HOME CARE
Care Process for Elderly Home Care
Name of the Student
Name of the University
Author Note

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CARE PROCESS FOR ELDERLY HOME CARE
Introduction
The cases of mental health disorder are very common among the people of Australia
and it is reported that the cases of mental health illness has become a serious problem for the
elderly population in Australia. As per the data of the Australian Government, it can be
stated that almost 10-15 per cent of the older adults are suffering from the issue of mental
health disorder in the country. In this regard, it can be stated that the due to the mental health
disorder, those patients generally show suicidal behaviours as well and as a result, it has
become very important to take care of those people eagerly. Moreover, the report also stated
that the rate of the mental health problems is generally higher among the Australian
Aboriginal and Torres Strait Islander and under the age group of 55 year and above, the rate
of psychologically distress patients are almost 18 per cent in case of females and in case of
females it is almost 30 per cent (Australian Government, 2020). Therefore, the inventions of
various modern technologies also helps to enhance the overall life expectancy of the elderly
people in the country and caring the elderly people at their home environment has also
become mandatory. In various studies, it is stated that the application of home based care for
the elderly population has also helped to enhance the treatment outcome and the rate of
patient satisfaction as well. Hence, it can be stated that for the elderly people having the
problem of mental health disorder, the application of home based care is very important
(Zabalegui et al., 2014).
In this essay, the role of nurses in a home based care along with the importance of this
home based care for the elderly people is also depicted briefly.

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Discussion
Rationale for Caring Elderly having Mental Health Disorder at Home
The people with mental health disorder generally suffer from various type of health
related problems and as a result the quality of life of the patients gradually decreases with
time as well. As a part of the mental health disorder the patient can face the issue of poor
motor activity, social isolation, lack of support from the family members as well. Therefore,
the role of nurses is very crucial to support the individual at their home care. According to the
study of Yang, Hwang and Kwak (2014), it is stated that the people with different type of
mental health disorders such as Alzheimer’s disease, people show wandering behaviour and it
is very difficult to locate an individual with Alzheimer’s or other mental health disorder for
the nurses. It is important to be understood that the symptoms relates to dementia,
Parkinsonism and Parkinson as well and it is very much important that the diagnosis is done
properly in order to reach a community level as well as individual level diagnosis. Therefore,
it can be stated that those patients must be taken care by the nurses at their home as it is easier
to find someone at the house than that of a hospital care setting. As a consequence of the
wandering behaviour of the patients with mental health disorder such as Alzheimer’s disease,
the chances of having fall related accidents are also enhanced as patients have lowered level
of motor control and gait balance (Menant et al., 2014). As per the study findings of
Alzheimer's Association (2016), it is stated that the due to the altered gait balance among the
people with mental health disorder, it is quite obvious that the people are facing the issue of
fall cases in their own home and so it will quite effective to provide a home based care to the
patients suffering from mental health disorders such as Alzheimer’s, dementia, Parkinson,
amnesia ad memory issues that has been seen to affect the patients. The study of Alzheimer's
Association (2016), also reported that the fall cases are very common among the elderly
people due to their poor body balance and so they face different types of health related

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complications. Hence, the restriction in wandering behaviours of the patients due to the
mental health disorder may improve the condition of the patients and along with this, the
cases of fall related injuries may also be reduced if the nurses provide a home based care to
the patients.
In this regard the study findings of Stevens, Mahoney and Ehrenreich (2014), can be
mentioned and as per the study findings, it is observed that the cases of fall injuries are low in
number when the patients are kept in a small area such as in a room. Therefore, it can be
stated that the in case of home based care patients are generally kept within a small amount of
area and so it can be stated that if the patients are given a home based care, then the chances
of getting fall cases can may reduce and so it is important to give home based care to the
patients suffering from mental health disorders. On the other hand, the self-harm behaviour is
also very common among the patients of mental health disorder and it is very difficult to care
a huge number of people at a same time in a mental health care facility. Therefore, it will be a
wise decision to provide a home based care process to those patients suffering from the
problem of mental health disorder. In a home base care, the nurse will only be responsible for
taking care of one patients and he or she easily can prevent any type of adverse incidents
related to the self-harm behaviour of patients suffering from mental health disorder. Another
important reason that is associated with the care process of the mental health disorder patients
is poor support from the family members and along with this, in some cases the family
members also are not ready to provide proper support to the patients of mental health
problems (Nielsen et al., 2017). In this regard, it can be stated that the application of the
home based care for the mental health disorder will allow the nurse to be with patients at their
home and thus it may possible that the patient can share his or her feelings with the nurse and
thereby the issue of isolation can be reduced to some extent.

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Moreover, mental health disease like Alzheimer’s disease and Parkinson’s disease is
common at and after the age of 65 years, and the same is associated with lack of support from
the family members that it becomes very difficult for them to cope up with these problems of
mental health disorder. As per the study findings of Alzheimer's Association (2016), it is
stated that support from the family members can improve the health outcome of the patients
suffering from mental health disorder. Moreover, presence of family members also help the
nurse to take opinions of the family members during taking decision about the treatment
process as the due to the disease condition of the patient, he or she is unable to take decisions
regarding his or her health condition. So, it is very important to provide a home based health
care process as a part of the family centred care process. While staying with the family
members of the patients, it can be stated that participation of the family members can enhance
the treatment satisfaction and treatment outcome in a positive manner as well.
Role of Nurses in the Care Process
The role of nurses in the care process at the home for the elderly people is very crucial
and as a part of this, the nurse have to play multiple roles in the home based care process for
the patients suffering mental health problem such as Alzheimer’s disease. As a part of
maintain safety of the patients, the nurse should assess the risks present in the house itself and
it will help the patient to avoid cases of slip trip and fall due to presence of obstacle in the
house. Moreover, the nurse should write down the everyday routine of the patients, calendar
and other required things in front of the patients so that he or she can easily call up his or her
essential things of everyday life. According to the study of Rangasamy et al. (2015), it is
stated that the forgetfulness is a major symptom of Alzheimer’s disease and in order to
maintain the quality of life of the patients, the nurse can take this initiatives. It is important to
understand that Parkinson, dementia and Alzheimer’s forms a complex and the signs in
addition to the symptoms overlaps with each other. Under these circumstances the

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assessments must be done properly to reach a differential diagnosis and then a provisional
diagnosis. Even in a case where the cases are comorbid, the treatment plan must be started
and given likewise in order to manage the symptoms holistically. Therefore, the study also
indicated that management of the Alzheimer’s disease has shown better result when, such
kind of initiatives have been taken by the nurses. As per the study findings of Klimova et al.
(2015), it is stated that the patients of Alzheimer’s disease face the problem of poor
communication and in order to do so, the nurse can use non-verbal communication strategy
as it has proven to be effective in communicating with Alzheimer’s person. Along with this,
presence of multidisciplinary team in the treatment process of the patient suffering from
dementia will also be very helpful. The presence of multidisciplinary team in the treatment
process of Alzheimer’s disease will help the patient to gain maximum outcome from the
treatment process. In a multidisciplinary team, the presence of social worker,
neuropsychologists, and physiotherapist will help the patient. The social worker will work on
reducing the issue of isolation and on the other hand neuropsychologists will be responsible
for managing the depressed condition of the patients. Along with this, the inclusion of
physiotherapist will help to improve the body balance and muscle strengths of the patients as
it is observed that during Alzheimer’s disease, the patients have problem in walking and so it
is important to improve the muscle strengths and gait balance of the patients (Mollon et al.,
2016).
Therefore, it can be stated that the family members of the person with Alzheimer’s
disease can be referred to a health educator so that they can have proper knowledge reading
the disease condition. The improved level of knowledge of the family members will also help
the family members to support the patients psychologically and emotionally. As a part of the
safety maintenance during the home based care process of the Alzheimer’s patient, the nurse
should take care about the removal of hazardous tools, prevention of wandering process,

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machines and utensils and medication process of the patients. Moreover, the nurse should
take care about the proper lighting of the home environment so that the patient can avoid slip
trip and fall incidents. However, during providing care to the patients with Alzheimer’s
patient, it can be stated that the nurse may face various challenges as the patient is developing
the symptom like forgetfulness (Alzheimer's Association, 2016). As a result, it may possible
that the patient may not recognize the nurse and also may refuse to take treatment from the
nurses. In such condition, the nurse should empathy to the patients and tries to take help from
the family members of the patient as the patient may recognize his or her family members. As
a part of should follow the concept of beneficence and non-maleficence so that during the
care process, the nurse can take opinions from the patients as a part of the person-centred
care. Beneficence refers to the ethical principle that states that the action of the nurses should
promote the good of the patients all the time and in case of caring an Alzheimer’s disease at
their home, the nurse should follow this ethical principle. On the other hand, no maleficence
refers to the ethical considerations of not harming others and thereby also helps the patient to
have positive treatment outcome. However, as the patient is unable to take decisions
regarding his or her health condition and so the nurse can take opinions from the family
members as well (Casey, 2016).
Conclusion
Therefore, it can be concluded that the issue of mental health disorder such as
Alzheimer’s is one of the major area of concerns for the older people around the different
countries of the world. In case of Australia, the condition is not at all different and so it is
very important to give care to those patients who are residing at their own home. During the
disease condition, the patients may face various adverse health outcome and as a consequence
providing care to the patients of Alzheimer’s disease at their home has become very
significant and relevant. During providing care to the patients the nurses must follow safety

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guidelines and ethical guidelines so that they can provide a safe home based care to the
patients.

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References
Alzheimer's Association. (2016). 2016 Alzheimer's disease facts and figures. Alzheimer's &
Dementia, 12(4), 459-509.
Australian Government (2015). Australia’s welfare 2015. Australian Institute of Health and
Welfare. Retrieved from- https://www.aihw.gov.au/reports/mental-health-services/mental-
health-services-in-australia/report-contents/summary/prevalence-and-policies [Accessed
on 6th March 2020]
Casey, P. (2016). Beneficence and non-maleficence: confidentiality and carers in
psychiatry. Irish journal of psychological medicine, 33(4), 203-206.
Klimova, B., Maresova, P., Valis, M., Hort, J., & Kuca, K. (2015). Alzheimer’s disease and
language impairments: social intervention and medical treatment. Clinical interventions
in aging, 10, 1401.
Menant, J. C., Schoene, D., Sarofim, M., & Lord, S. R. (2014). Single and dual task tests of
gait speed are equivalent in the prediction of falls in older people: a systematic review and
meta-analysis. Ageing research reviews, 16, 83-104.
Mollon, J., David, A. S., Morgan, C., Frissa, S., Glahn, D., Pilecka, I., ... & Reichenberg, A.
(2016). Psychotic experiences and neuropsychological functioning in a population-based
sample. JAMA psychiatry, 73(2), 129-138.
Nielsen, R. E., Lolk, A., Rodrigo-Domingo, M., Valentin, J. B., & Andersen, K. (2017).
Antipsychotic treatment effects on cardiovascular, cancer, infection, and intentional self-
harm as cause of death in patients with Alzheimer's dementia. European Psychiatry, 42,
14-23.

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Rangasamy, S. B., Corbett, G. T., Roy, A., Modi, K. K., Bennett, D. A., Mufson, E. J., ... &
Pahan, K. (2015). Intranasal delivery of NEMO-binding domain peptide prevents memory
loss in a mouse model of Alzheimer’s disease. Journal of Alzheimer's Disease, 47(2),
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Stevens, J. A., Mahoney, J. E., & Ehrenreich, H. (2014). Circumstances and outcomes of falls
among high risk community-dwelling older adults. Injury epidemiology, 1(1), 5.
Yang, Y., Hwang, I., & Kwak, Y. T. (2014). Neuropsychological characteristics of wandering
in patients with drug-naïve Alzheimer's disease. Dementia and Neurocognitive
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Zabalegui, A., Hamers, J. P., Karlsson, S., Leino-Kilpi, H., Renom-Guiteras, A., Saks, K., ...
& Cabrera, E. (2014). Best practices interventions to improve quality of care of people
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