Community Nursing: Elderly Care with Health Complications

This report delves into the significance of community nursing for elderly individuals residing at home, emphasizing the challenges and considerations involved in their care. It focuses on a case study of a 70-year-old man with Down syndrome, a history of alcoholism, and complications from meningitis, illustrating the multifaceted health issues that often accompany aging. The paper discusses the rationale for community-based care, highlighting the crucial role of nurses in assessment, documentation, resource allocation, teamwork, and ethical considerations. Nursing considerations such as patient assessment, resource allocation, and communication strategies are highlighted. It emphasizes the importance of tailored care plans, family engagement, and adherence to safety and ethical standards. The report underscores the benefits of community care in promoting the overall health and well-being of both the elderly and the community, while also addressing the challenges of home-based care and the importance of addressing social determinants of health. It concludes by summarizing the key aspects of care management for elderly individuals with multiple chronic and mental disorders, emphasizing the collaborative efforts needed for effective care delivery.

Running head: COMMUNITY NURSING
COMMUNITY NURSING
Name of the Student:
Name of the University:
Author’s Note:

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Introduction
One of the vulnerable group that requires attention from medical, nursing and
community support are elderly people that stay at home. The elderly population in the world
is increasing at a dramatical rate because of the improved in medical technologies and
continuous research over time. According to the World Population Ageing 2019, this global
phenomenon indicates there are 703 million people that are above the age of 65 years in
2019. It is estimated that it will double to 1.5 billion by the end of 2050 (Un.org, 2020). The
ageing population is observed to increase at a fast rate in the Eastern and South-Eastern Asia
as well as in Latin America and the Caribbean. In order to take care of elderly people residing
at home, various factors need to be considered and thus, it becomes challenging and unique in
nature. Due to age factors as well as other health issues, the immune system, mobility and
mental status of an old person is found to be unstable and deteriorating in nature (Sungur,
2017). The aim of this paper is to discuss the significance of taking care of older people at
home and having issues such as Down syndrome, exposure to alcohol and complications
from meningitis with respect to understanding the role of the nurse in the care process.
Moreover, nursing consideration needs to be taken into account while taking care of such
patient to offer a healthy and independent life.
Discussion of Rationale for caring the patient in the community
Mr Henry Jones is a 70 years old man who lives with his son, his wife and their
teenage daughter. He has Down syndrome from childhood, he was alcoholic from a very
early age of his life and continue it for a prolonged period and recently, he had developed
from meningitis a year ago. The complex health issues of Mr Jones had limited his
movement; it was found that due to his intellectual disability, and he requires support in
conducting Activities of daily living (ADLs). According to Johansson et al. (2017), the vital

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contribution of the behavioural and mental disorder is important and it can be found that old
people having intellectual disabilities have a significant harmful impact on the affective,
cognitive and normal functioning of life as well as the quality of life. Thus, it necessitates the
need for taking care of the vulnerable group of people that support in enhancing the quality of
life as well as limiting the support of other people in leading a healthy life. This will, in turn,
helps in improving the overall health and well-being of the community and will help in
building a healthy population reducing the pressure of the healthcare sector on a national or
local context (Moffatt et al., 2017). Therefore, it can be stated that it is critical to address the
issues related to social determinants of health of the particular population that is old people
having several intellectual and physical disabilities thus, reducing the cost related to
healthcare in the country as well as global level.
Role of nurse and nursing considerations while caring
From the opinion of Engel et al. (2016), the geriatric care is stated to be complicated in nature
because it comprises of multifactorial impact on the individual, family member, healthcare
professionals and the society as a whole. Therefore, the role of the nurse in the care
management of old people such as Mr Jones is essential because of the development of care
programs. These are stated to enhance the coordination and integration of various care
services in the continuum of care, especially of weak old individuals. The use of various
models of care is taken into consideration that includes the cooperation of registered nurse
(RNs) and community workers for assisting in the care plan (Karlsson et al., 2020). The
nurses are to conduct different kinds of activities that include assessment, documentation,
allocation of resources, teamwork, data collection, referral, Occupation health and safety
(OH&S) practices, ethical challenges, family engagement and challenge in the care process.
The activities are stated to be critical while taking care of an old person with complicated
health and mental ability because an integrative approach is one of the healthcare frameworks

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that is stated to be fruitful in this case. The foremost tasks that need to be conducted by a
nurse in consideration of the nursing standards and ethics are assessment and documentation.
A thorough assessment of the patient and documenting each detail by the nurse is one of the
primary tasks in the nursing context. This is because it involves the identification of all the
possible issues that need to address by the team of healthcare professionals. Malegiannaki et
al. (2019) opined that Down syndrome among adults accelerate the ageing process as they
have the condition and physical features that affect the lives of ageing adults. The actual
reason for this is not understood; however, genetic or chromosomal influence is profound that
is associated with this. The impact of alcohol on the body for an extended period of time is
negative and detriment in nature. According to the study of Molina et al. (2018), ageing is
responsible for reducing the tolerance level of alcohol and thus, the sensitivity level of the
body. The adverse events that frequently occur among alcoholic adults are falls, unintentional
injuries and accident that may impair life-long effect on the body. The meningitis is a
bacterial infection, which is life threatening for elderly people because of low immunity.
According to Kohrman et al. (2020), many old people do not recover from this disease and
has several implications, such as brain damage and hearing loss. Therefore, it is crucial to
assess and record all the conditions that will allow in the development of an effective care
program to achieve the desired objective of living independently at home.
The resources that need to be taken into consideration for taking care of Mr Jones is a
critical understanding of the care setting. In this case, for caring for an older individual, it is
crucial to understand the hospital and home setting as the patient have an issue related to
adaptation in a new setting. Other requirements are medicines, equipment, community-
support care system and other related information that would appropriately address the issue.
Other than the care process, the aspects are essential in this case are communication
strategies, collaborative efforts of the healthcare professionals and family members and team

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meetings. These are important as based on these aspects; the entire plan of action will be
developed (Karam et al., 2018). The collaborative and integrative approach is crucial in
addressing multiple disorders, as it requires an alliance of different department of the medical
team in order to address the issue. For example, Down syndrome require a psychiatrist;
however, the disease is associated with other health issue and require a team effort of other
healthcare professionals. Lessard et al. (2019) opined that team meeting is one of the most
important for discussing the objectives of the patient from time-to-time in order to attain the
aim of the care plan. Communicating the plan to each of the caregiver, including a family
member, will ensure that the success rate of the care plan is optimised. This is because
communication is a key to sharing of information from time-to-time; thus, leading to increase
the level of efficiency in the care and management process.
The provision of data collection related to the issues of the patient that is Down
syndrome, meningitis and alcoholism is vital. This is because more data is collected from the
patient, family members and others will enhance the experience related to the old person
having three distinct diseases. More information will allow in getting more insight into the
case study, and thus, effective treatment can be administered. In addition to this, sharing of
information allows in exchange of vital stats and details related to the patient that will help in
identification of any other underlying issues that are critical in nature (Sawan et al., 2020).
The support from the healthcare practitioners in attaining an elevated outcome of health for
the older person and offering a health status involves allowing in independent living at home.
The nursing considerations that need to be undertaken by providing care to old people in their
home is the care setting which is at someone’s place. This is not a traditional care setting as a
result of which, various factors need to be taken into consideration. The use of the mobile
phone to continuously report about the patient or telemedicine can be a solution that could be
used in this case.

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The referral is stated to be health services that help in supporting and maintaining the
health and well being of old people at home. The help that can be taken in order to conduct
home and community services such as personal care, allied health service, equipment,
transport, shopping assistance and meals. The Australian government funds the Community
Aged Care Packages (CACPs) in order to offer care and support for being at home and living
in an independent manner (Sahealth.sa.gov.au, 2020). For vulnerable people such as Mr
Jones, referrals are important because of the multifaceted angles of the condition and varied
types of services required for caring. The use of the online referral system can be used that
specifically specialised in geriatric care offering support to people having multiple
conditions. In addition, there are various local care centre and community help services in
Australia that can be taken into consideration in the care management process.
The older people at home with multiple disabilities and chronic health condition need
to be taken care as it will improve the quality of life with the help and support of a trained
caregiver at home. While working at home, occupational safety and health legislation need to
be met in a sensitive manner by offering respect to the client and the care setting. According
to Danziger et al. (2017), the Safety, Health and Welfare at Work Act 2005 focuses on the
employer’s need of managing the safety and health aspect at work in order to mitigate the
possibility of any injuries or accidents. In this case, the PDCA (Plan, Do, Check and Act)
cycle can be used for ensuring that the nurse that is undertaking the care of the patient is safe
and healthy. The responsibility of ensuring this is entirely upon the family members (Hsa.ie,
2017).
While taking care of a patient, legal and ethical issue or dilemma are encountered on
several occasions. The legal and ethical implication of caring for an old patient with multiple
disorder is significant distress in the mental or physical health of the patient or even death

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(Levine, 2017). Therefore, it is important for the nurse to appropriately understand the
clinical implication of the issue that affects the care process.
One of the primary stakeholder in taking care of older people at home with multiple
disabilities and chronic physical distress is the family members. The family members are also
affected by the condition of the patient results in a variable impact on them. Therefore
engaging them in the care plan is stated to be more effective as their involvement will allow
in better attainment of the objective of care plan made initially for the older adult. However,
there are particular challenges in taking care of an old individual such as issues related to the
home setting, inappropriate community engagement, and irrelevant collection of data. These
need to be taken into account during the development of a care plan.
Conclusion
From the paper, it can be summarised that the care management procedure
undertaking for an older adult at home with multiple chronic and mental disorders include
benefits of taking care in the community. This involves the health and wellbeing of the entire
society as a whole. The different role of the nurse and considering the nursing practice in
offering care to the specified group of people is observed to be an important aspect. This
includes multiple factors that are taken into consideration for the development of an
appropriate care plan for Mr Jones, who has Down syndrome, alcoholism and a recent past
history of meningitis. The complication related to all these factors affects the health status of
him and his family. Therefore, a collaborative approach has established that help in
addressing the issue.

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