PROBLEM/ISSUE

GOAL OF CARE

NURSING INTERVENTIONS

RATIONALE

INDICATORS PLAN IS EFFECTIVE

PHYSICAL

Mechanical fall and risk of harm

Prevention of fall for promoting independence, enhancing physical movement and providing safe environment

Appointing a support worker to Mr. Lee. Assessment of his vision and physical ability

Balance assessment- for promoting his muscle strengthening

Assessing his eyesight is the primary intervention for Mr. Lee to reduce his fall risk because the blurred or impaired vision is general symptoms in older adults of his age. The blurred or impaired vision enhances the risk of fall and chances of physical injury (Morgan & Yoder, 2012). As he has a history of fall from tool during gardening, reducing the risk of fall is necessary.  Appointing a support worker would be helpful for Mr. Lee because the support worker would enhance his ability to complete his ADLs. the support worker can assess his mobility and physical ability regularly and based on the reports proper interventions can be recommended (Reuben & Tinetti, 2012).

Mr. Lee participated in a 12 week program for enhanced balance and muscle strengthening. The support worker reduced the harmful and hazardous materials from Mr. Lee’s house. Mr. Lee showed empowered behaviour and improved mobility

Physical exercise including aerobic and walking interventions

Physical exercise is necessary with age the normal muscle strength declines with increased risk of falling. It would also enhance his abilities of movement and completing ADLs (Rosemond et al., 2012)

Eliminating hazardous materials from his surrounding areas within his home

As Mr. Lee stays alone at his home, the chance of falling enhance along with risk of physical harm. The support worker would reduce harm through the elimination of hazardous elements including acids, knife, chemical strippers and fire extinguishers (Brownie & Nancarrow, 2013).   

Enhanced mobility

Gardening interventions

Onder et al., (2012) analysed the role of gardening in mental and physical wellbeing of older adults. It enhances the hand strength and pinch force. Positive results from gardening would enhance the self-esteem level. Along with the exercise program. Gardening can be both energetic and relaxing for him

MENTAL

Deterioration in mental health, Loss and grief, Risky behaviour

Enhancing mental relaxation decrease sympathetic outputs

Tai chi intervention

Tai chi is a traditional Chinese exercise which is used as martial arts for health benefits. The practice involves sequences of flowing movements along with changed mental focus, coordination, breathing and relaxation. It would help Mr. Lee to improve her mental health. The intervention has been reported as the ‘meditative movements for enhancing mental functioning (Gillespie et al., 2012)

Tai chi and person-centred care were useful for their enhanced recovery of mental health. After attending a 8 week counselling session, he showed enhanced self-confidence and decreased hesitation.

Enhancing self–confidence

Person-entered Health counselling

Person-centred health counselling and therapeutic communication stimulation can be the best intervention for Mr. Lee to enhance his self confidence. Upon assessment, the person-centred counselling would help him to deal with his loss and grief for his wife and dear ones (Cameron et al., 2012)

Making him aware of his status and promoting self-help

Individual Health promotion

Health promotion is necessary for Mr. Lee for enhancing his knowledge about his actual health status. In this health promotion, Mr. Lee would be provided all the necessary information about his health assessment, counselling and other health intervention along with their importance (Takahashi et al., 2012). It would help him to build sufficient knowledge to promote self-management and self-management is important at this age.

Aged And Community Services Australia (ACSA) (www.agedcare.org.au, 2016/ 0396001988/ Blackburn North Victoria) is another organization which provides care to the patients by developing adequacy and development in both political and public areas. they are always ready with their legal advices for the patient whenever needed. They also provide different kinds of information like the eligibility and conditions for the location by giving the pamphlet. They also give design employment to the unemployed people by creating social clubs also provide home furnishing to the immigrants.

Lee is excited to use this services as his friend has given positive feedback about this services.

SOCIAL

Social isolation,

Less involvement with others, silent most of the time,

Decreased self-confidence

Enhanced social involvement

Involvement with catholic groups at St. Pauls church regularly

Mr. Lee has a background of migration from China to Australia at the age of 12 and he has lost his father at early age. Therefore, there was a cultural issue identified and at his end of life stage. Therefore, his involvement with his society can improve his health and well being (Smith et al., 2012). Therefore, the nursing intervention would be targeted towards his enhanced involvement with catholic church. Decreased social isolation would reduce the risk of depression

Attending creative workshops and his involvement with his catholic society friends at St. Paul church enhanced his negative thinking towards his life as well as enhanced his creative thinking

Enhanced interaction with others and mental wellbeing

Group creative education

Creative interaction with others is a great way to engage older people in community> it also helps to enhance their self confidence and the urge of living. Creative education would include art and craft education which is a well known recreation activities suitable for aged care services. Creative practices like painting, participating in art and craft workshops and creation of art and craft would promote the critical thinking and judgement skills, thereby enhancing positive interaction with others (Zarit & Zarit, 2012). 

EMOTIONAL

Anxious nature

Behavioural and communication improvement

Behavioural activation and pleasant events, cognitive training

The behavioural activation programs through the therapeutic communication stimulation can be helpful for Mr. Lee to improve his current health status. The therapeutic stimulation would initially need the establishment of positive relationship within the nurse and Mr. Lee (Wright & Leahe, 2012). It would enhance his cognitive thinking and positivity which would be sufficient for his emotional well being. The support from the positive relationship with the nurse would promote his positive judgment and wellbeing.

Carers Australia (www.carersaustralia.com.au, 2016/+61 262790200) is the foundation of the old aged homes.  One of the Australia’s integral health care system. it is mainly responsible  for the medication management. It provides social, financial and emotional support to the elderly patients. Mr. Lee is looking forward to this service to improve social connectedness. The organization help the patients to get organized, remind them with the dates of their appointments and with the dealing of the emergency.  They also provide transportation assistance in case of medical urgency. They also look after the Holocaust elderly survivors.

The sessions of therapeutic communication stimulation helped Mr. Lee to improve his communication and interaction which reduced his risk of anxiety. The relaxing and supportive exercise helped in improving his emotional wellbeing

Decreased mobility and related depression

Improving physical disability and related emotional wellbeing

Exercise and walking

Relaxing exercise and regular walking has been reported to enhance the emotional well being of geriatric patient. The physical disability is one of the most common causes of emotional issues. A walking programme for three times a week over six months can improve the mental and emotional well being (Li et al., 2012). It has been also reported that relaxing physical exercise improve the hormone regulation in the body and thereby controlling depression and anxiety related symptoms. Engagement in regular exercise and walking program would also help him to reduce his loss and grief related depression symptoms.

Decreased sense of emotion

Emotional health boost

Computer games and brainstorming

It has been proved that older adults, who are involved in computer games and brainstorming activities, have been shown to have positive results in recreation programs. It can also enhance his social involvement with others who plays videogame, thereby reduction of his loneliness and social isolation problem would also be resolved.  

The Aged And Care Assessment Team (www.myagedcare.gov.au, 2016/1800200422) is an independent multi disciplinary organization, which provides free care to the people with age above 65 years. It relates to respite and transition care, aged care of residential and packages of home care. The respite care is like an emergency or temporary care, which is given to the elderly people who have an intellectual disability. This care provides a positive feeling to the patients receiving this.

Lee is excited to use this services as her friend has given positive feedback about this services

ACAT gives continuous services by doing their daily tasks and looking after their personal care 24×7. They try to make the patients feel at home and comfort them in every means.