QUESTION
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Critically analyse the role of an Australian registered nurse in empowering the older adult.
Paper:
The Final Report: Recommendations published by the Royal Commission into Aged Care (2021) contains Key Principles underscoring a new Aged Care Act due to replace the current 1997 Act in July 2023.Using the context provided in the following statement, critically analyse the role as an Australian registered nurse in empowering the older adult.
Statement:
One key principle is “older people should be supported to exercise choice about their own lives and make decisions to the fullest extent possible, including being able to take risks and be involved in the planning and delivery of their care” (Aged Care Royal Commission (2021) Final Report: Recommendations, March 1st 2021, p207)Paper structure:
Use the following headings for the paper: introduction, section one, section two, section three, conclusion, references.
Please don’t waste the word count including explanations of the headings, just stick with “section one.”Referencing: APA 7th Edition
Purpose: is to synthesise literature on the topic of healthy ageing, and critically analyse the role of the Australian registered nurse in empowering the older adult in their care.
- critically analyse the concept of healthy ageing and its promotion at an individual and community level
- Experiences of ageing and how these are impacted by biopsychosocial, spiritual, and cultural factors
Word Count: 1000 words or + 10%
Task: The Final Report: Recommendations published by the Royal Commission into Aged Care (2021) contains Key Principles underscoring a new Aged Care Act due to replace the current 1997 Act in July 2023.
One key principle is “older people should be supported to exercise choice about their own lives and make decisions to the fullest extent possible, including being able to take risks and be involved in the planning and delivery of their care” (Aged Care Royal Commission (2021) Final Report: Recommendations, March 1st 2021, p207)
Using the context provided in the statement above, critically analyse the role of an Australian registered nurse in empowering the older adult.
Paper structure:
Use the following headings for the paper: introduction, section one, section two, section three, conclusion, references.
Please don’t waste the word count including explanations of the headings, just stick with “section one.”
Introduction
(Estimate up to 100 words)
- Articulate accurate, and clearly raised main discussion points.
- Detail the flow of the discussion.
- Use of high quality and relevant background information and/or statistics to strongly support the writing.
Section 1
Knowledge and understanding of how healthy ageing aligns with the key principle.
(Approx. 400 words)
- Analyse how the key principle contributes to healthy ageing.
- The concept of healthy ageing is analysed and linked to the key principle clearly as it relates to older people.
- The key principle is clearly broken down into all its component parts and analysed.
- Supported by comparing and contrasting current research studies and literature.
Further explanation/assistance for the writer:
- Why the key principle noted above is important for healthy ageing.
- The first step is to understand why the royal commission was so important.
This will give an understanding of what this paper is trying to achieve.
There is a good summary from the ABC - https://www.abc.net.au/news/2021-03-02/aged-care-royal-commission-final-report-key-takeaways/13203508
- Next, figure out what the key principle actually means – think about why empowering the older adult to choose their own fate is important.
- Look at concepts of healthy ageing, empowering the older adult, and person-centred care to inform the critical analysis.
- Explain what the principle means, why it is important in the care of the older adult. This article might give some insight: https://www.magonlinelibrary.com/doi/full/10.12968/nrec.2017.19.9.515
- Keep in mind this paper is not just about older adults who are in aged care – you can discuss acute care and community care.
Section 2
Discuss how ACQS 1 and 2 support the key principle provided?
(Approx. 200 words)
- Well-articulated discussion of the components of ACQS 1 and 2 and draw explicit links to all aspects of the key principle and to healthy ageing.
Further explanation/assistance for the writer:
- How the Aged Care Quality Standards, in particular Standards 1 and 2 support the key principle above. https://www.agedcarequality.gov.au/providers/standards
- These are the consumer outcomes for the age care quality standards 1 and 2
Aged Care Quality Standard 1 - https://www.agedcarequality.gov.au/providers/standards/standard-1
Consumer outcome: I am treated with dignity and respect and can maintain my identity. I can make informed choices about my care and services and live the life I choose.
Aged Care Quality Standard 2 –
https://www.agedcarequality.gov.au/providers/standards/standard-2
Consumer outcome: I am a partner in ongoing assessment and planning that helps me get the care and services I need for my health and well-being.
- Think about how the standards link to the principle.
- You might want to again explain these standards, and discuss why these changes are important (i.e. what the care of the older adult used to look like and why it needed to change to improve the care of the older adult).
- The ACQS has a Guidance and Resources for providers to support the aged care quality standards, that may help with an understanding of what these standards look like in practice. https://www.agedcarequality.gov.au/sites/default/files/media/Guidance_%26_Resource_V14.pdf
Section 3
Provide examples of evidence-based nursing interventions that promote ACQS 1 and 2 in the care of older people.
(Approx. 300 words)
- Evidence of both depth and breadth of high-quality reading.
- A well-articulated discussion containing relevant and comprehensive examples of evidence-based nursing interventions.
- Each intervention is seamlessly linked to promotion of ACQS 1 and 2.
- Interventions are supported with research studies and literature.
Further explanation/assistance for the writer:
- Analysis of the Australian registered nurse role – examples of how a registered nurse will incorporate ACQ Standards 1 and 2 into their care of older people in order to realise the key principle mentioned above. Older people residing in the community or in supported accommodation can be considered.
- Choose a way that you can empower the older adult to make decisions about their own fate in clinical practice. This may be something like advocating for an advance care plan, changing the way shift planning is undertaken, or strategies that increase a patients understanding, like medication lists. There are a million other things you could choose – these are just examples. Outline how these strategies support empowering the older adult.
- Look at the NMBA standards and find where the above empowering actions fit in – don’t just describe or list the standards here; choose one and link to section 1 and 2 with research to support your ideas. https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards/registered-nurse-standards-for-practice.aspx
Conclusion
(Estimate up to 100 words)
- Articulate and return to what was stated in the introduction.
- Include all of the main discussion points of the paper and reflect on the larger implications of the topic.
- Use of expert quotes to support the writing. Leaves the reader with something to think about.
Referencing:
- Comprehensive use of credible, contemporary, and relevant references.
- References relevant to Australian nursing and older people
- Sources to be no older then 5 years ideally, or a maximum of 10 years where applicable
- Accurate use of APA 7th Edition referencing style.
- In text citations are provided where required in all instances.
What is Critical Analysis?
Critical analysis is a process of deconstructing what you read, write, and listen to in a rational and logical manner (Brown & Keely, 2012). It requires you to move beyond describing and analysing to evaluating and postulating on what you process. This means you need to think how the concepts in section one, two and three go together. Just listing multiple bits of the NMBA standards will miss out on ‘critical analysis’– you must drill down and make links between the principle, the standard being discussed, the nurse’s role, and the ultimate aim of empowering the older adult.
This is a list of texts and references that the writer can use for gaining a greater understanding of the topic.
The list contains some sources that are applicable as academic references for the paper.
Bernoth, M. & Winker, D. (2017). Healthy ageing and aged care. South Melbourne, Oxford University Press
Brown, D., Edwards, H., Seaton, L., & Buckley, T. (2020). Lewis’s medical-surgical nursing. assessment and management of clinical problems (5th ed.). Chatswood, N.S.W.: Mosby/Elsevier Australia.
Bullock, S., & Hales, M. (2019). Principles of pathophysiology (2nd ed.). Frenchs Forest, N.S.W.: Pearson.
Bullock, S., & Manias, E. (2017). Fundamentals of pharmacology (8th ed.). Frenchs Forest, N.S.W.: Pearson.
Holland, K., Jenkins, J., Solomon, J., & Whittam, S. (2019). Applying the Roper-Logan-Tierney Model in practice (3 rd ed). London: Churchill Livingston.
Hunter, S., & Miller. C. A. (2016). Miller’s nursing for wellness in older adults (2nd ed.). Sydney, N.S.W: Wolters Kluwer/Lippincott, Williams & Wilkins.
Jarvis, C. (2020). Jarvis’s physical examination and health assessment (3rd Australian and New Zealand ed.). Chatswood, N.S.W: Elsevier Australia.
Johnson, A., & Chang, A. (2017). Caring for older people in Australia: Principles for nursing practice. Brisbane, QLD: Wiley.
Levett-Jones, T. (2018) Clinical reasoning: Learning to think like a nurse (2nd ed.). Frenchs Forest, NSW: Pearson.
https://doi.org/10.1016/j.colegn.2015.05.003
(https://www.sciencedirect.com/science/article/pii/S1322769615000475)
Bernoth, Maree, and Denise Winkler. Healthy Ageing and Aged Care, Oxford University Press, 2016. ProQuest Ebook Central, https://ebookcentral.proquest.com/lib/acu/detail.action?docID=4941721.
Bennett, C. (2019). Caring for patients with delirium. Nursing, 49 (9), 17-20. doi: 10.1097/01.NURSE.0000577772.92256.8a.
Front. Aging Neurosci., 30 April 2021 | https://doi.org/10.3389/fnagi.2021.626127
Smith, S. G., Jackson, S. E., Kobayashi, L. C., & Steptoe, A. (2018). Social isolation, health literacy, and mortality risk: Findings from the English Longitudinal Study of Ageing. Health Psychology, 37(2), 160–169. https://doi-org.ezproxy2.acu.edu.au/10.1037/hea0000541.supp (Supplemental)
https://doi.org/10.1016/j.euroneuro.2020.06.010.
(https://www.sciencedirect.com/science/article/pii/S0924977X20302091)
Michelle E. Mlinac, Michelle C. Feng, Assessment of Activities of Daily Living, Self-Care, and Independence, Archives of Clinical Neuropsychology, Volume 31, Issue 6, September 2016, Pages 506–516, https://doi-org.ezproxy2.acu.edu.au/10.1093/arclin/acw049
Weil, J., & Smith, E. (2016). Revaluating aging in place: from traditional definitions to the continuum of care. Working with Older People, 20(4), 223-230. http://dx.doi.org.ezproxy2.acu.edu.au/10.1108/WWOP-08-2016-0020
https://doi.org/10.1016/j.cger.2017.03.006.
(https://www.sciencedirect.com/science/article/pii/S0749069017300204)
Ofori-Asenso R, Chin KL, Mazidi M, et al. Global Incidence of Frailty and Prefrailty Among Community-Dwelling Older Adults: A Systematic Review and Meta-analysis. JAMA Netw Open. 2019;2(8):e198398. doi:10.1001/jamanetworkopen.2019.8398
https://www.safetyandquality.gov.au/standards/nsqhs-standards/partnering-consumers-standard
https://www.safetyandquality.gov.au/standards/nsqhs-standards/comprehensive-care-standard
Adverse drug reactions in special populations – the elderly
https://doi-org.ezproxy2.acu.edu.au/10.1111/bcp.12596
https://doi.org/10.1016/j.cnur.2017.04.007.
(https://www.sciencedirect.com/science/article/pii/S0029646517300580)
Medication use and potentially inappropriate prescribing in older adults with intellectual disabilities: a neglected area of research
https://doi.org/10.1177/2042098618782785
Integrate healthcare to provide multidisciplinary consumer-centred medication management: report from a working group formed from the National Stakeholders’ Meeting for the Quality Use of Medicines to Optimise Ageing in Older Australians
https://doi-org.ezproxy1.acu.edu.au/10.1002/jppr.1434
Influence of caregiver burden on well-being of family member caregivers of older adults
https://doi-org.ezproxy1.acu.edu.au/10.1111/psyg.12421
Padmaja, G., Vanlalhruaii, C., Rana, S., Nandinee, D., & Hariharan, M. (2016). Care givers’ depression, anxiety, distress, and somatization as predictors of identical symptoms in cancer patients. Journal of Cancer Research and Therapeutics, 12(1), 53–57. https://doi-org.ezproxy1.acu.edu.au/10.4103/0973-1482.146088
Karl Pillemer, PhD, David Burnes, PhD, Catherine Riffin, PhD, Mark S. Lachs, MD, MPH, Elder Abuse: Global Situation, Risk Factors, and Prevention Strategies, The Gerontologist, Volume 56, Issue Suppl_2, April 2016, Pages S194–S205, https://doi-org.ezproxy1.acu.edu.au/10.1093/geront/gnw004
Elder Abuse - A National Legal Response
https://www.alrc.gov.au/wp-content/uploads/2019/08/elder_abuse_131_final_report_31_may_2017.pdf
Elder abuse Key issues and emerging evidence
https://aifs.gov.au/cfca/sites/default/files/publication-documents/51_elder_abuse_0.pdf
Recognising elderspeak and how to avoid its use with older people
Mental Health Practice (2014+); London Vol. 23, Iss. 5, (Sep 2020): 22-27. DOI:10.7748/mhp.2020.e1472
Recognising elderspeak and how to avoid its use with older people. (2020). Mental Health Practice (2014+), 23(5), 22-27. http://dx.doi.org.ezproxy1.acu.edu.au/10.7748/mhp.2020.e1472
LETTERS. (2009). Nursing Standard (through 2013), 23(18), 32-33. https://www-proquest-com.ezproxy1.acu.edu.au/scholarly-journals/letters/docview/219888820/se-2?accountid=8194
Understanding Elderspeak from the Perspective of Certified Nursing Assistants
Tracy M. Grimme, MA, Jeffrey Buchanan, PhD, and Shelby Afflerbach, MA
Published Online:October 15, 2015
https://doi-org.ezproxy1.acu.edu.au/10.3928/00989134-20151015-05
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| Subject | Nursing | Pages | 12 | Style | APA |
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Answer
Analysing Current Aged Care and Principles in Australia
Introduction
For many ageing people, old age can be synonymous with ill health. This is partly the reason why it is important that their health is taken seriously. In the first section of this paper, the key principle that concerns healthy ageing developed by the Aged Care Royal Commission will be discussed. The section looks at how the Aged Care Quality Standards 1 and 2 support the key principle. Eventually, section three discusses examples of evidence-based nursing care interventions that promote the Aged Care Quality Standards mentioned in the care of older people.
Section 1
The Royal Commission into Aged Care Quality and Safety is a vital Commission that spearheaded a raft of reforms that eventually recommended the need for Australia to have a new Aged Care Act that would be the backdrop of any meaningful reform. Besides the rights-based Act, the commission also found it necessary to advocate for funding based on need with a much stronger regulation and transparency (Ducket & Stobart, 2021).
The key principle discussed in this section forms part of the Key Principles that the Aged Care Royal Commission suggested. The key principle is instrumental with regard to the provision of quality care to older adults. Ducket and Stobart (2021) explain that this principle has varied elements, including the vitality of personal choice, patient-centred care and empowering the aged adults to be more involved in their care decisions.
This key principle is an improvement on the key provisions of the 1997 Act as it goes beyond the simple notion that the aged ought to receive quality care and incorporates elements of evidence-based interventions including the aspects of empowering the patient by getting them more involved in the care decisions (Royal Commission into Aged Care Quality and Safety, 2021).. This principle then aims at improving the quality of care provided through the strict application of tested interventions and not just as a matter of addition of more equipment or personnel (Henderson & Willis, 2020; Hunter & Miller, 2016)). By altering the core decision-making process that informs care, the principle directly influences the care process.
In the past, the failure to make older adults more responsible for their life choices has negatively impacted on the quality of healthcare delivery that they receive (Michelle & Michelle, 2016). Poulos et al. (2021) affirm that the key principle takes this fallacy apart, recommending a more patient-centred approach, with the older adults more involved in decision-making. Some of the interventions that are recommended for older adults are life-changing. These older adults have to be ready and even more so, willing to engage in these decisions that would greatly impact on their overall health. When the older adult is empowered, they would take part in deciding their fate and then would be more willing to participate in the care plans that are designed to improve their condition (Smith, 2019).
Section 2
The very first standard of the Aged Care Quality (ACQ) Standards is the factor of treating the patient with dignity and respect and the importance of personal choice. In connection to the key principle, this standard reinforces the element of choice. When the older adult can make free choices from the available care options, then the standards would generally improve. Whether the decision is about undergoing a certain surgical procedure, designing a given plan of care or using a particular medical scheme, the option of having the older adult make the choice help to preserve their dignity as rational beings and thus not lose their identity in the process (Weil & Smith, 2018; Levett-Jones, 2018). This principle is also important as it would eliminate incidences where older adults were forced to undergo some procedures under the pretext that they were incapacitated to fully understand the consequences of their disapproval.
The second standard concerns the consumer as a partner in the ongoing assessment and planning for their own care. This standard also highlights the need of patient-centred care as outlined in the key principle. Making the consumer a partner in the process means that he or she becomes the most important person in the design and delivery of care, meaning that in every step of care along the way, their input is valued and integrated (Holland et al., 2019). This eliminates the prospect of emotional distress and needless hesitancy that were the results of a less patient-centred model adopted before (Cousins, 2020; Dyer et al., 2020).
Section 3
One of the key things that a nursing unit ought to properly invest in to promote elderly care is to have a formal guide for their nursing assessment and history. This tool ought to be developed by the input of all nurses (Bennett, 2019; Brown et al., 2020). The tool ought to incorporate good communication skills with possibly mostly open-ended questions that can help the old adults express themselves freely. The assessment should be less direct that may make the old adults shy from giving their full answers. In addition to what they say, it would also be essential to pay attention to what the older adults do (Henderson et al., 2017; Harrison et al., 2020). Their body language, facial expressions and muted response to some questions may be pointers of deeper problems that cannot be found from a casual oral interview.
The fourth Nursing and Midwifery Board standard deals with comprehensively conducting assessments (NMB, n.d.). What the nursing practitioner has to understand with regards to this standard is that for older adults, the assessment cannot consist mainly of what other close family members or other doctors say. The patient himself or herself has to be given the freedom to communicate their feeling, pain, opinions and generally have their voices heard (Jarvis, 2020). This improves their dignity in line with the first ACQ Standard and makes them valuable partners in line with the second standard.
Conclusion
Many older adults struggle with the ever-piling healthcare needs. Their struggles summarize why ageing healthcare as a concept is still relevant today. The recommendations for a new Aged Care Act by the Royal Commission are an example through which care for this section of the population can be prioritized. In addition to the key principle that stresses on the need for a more patient-centred approach to care and the importance of offering freedom of making choices, the two ACQ Standards provide examples of how patients can be more involved in decision-making and retain their dignity and respect. The fourth NMBS standard that stresses on the need for comprehensive assessments can be applied to the key principle and the two ACQ standards as the assessments ought to reflect the needs and feelings of the patient rather than other ideas.
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References
Bennett, C. (2019). Caring for patients with delirium. Nursing, 49 (9), 17-20. doi: 10.1097/01.NURSE.0000577772.92256.8a.
Bernoth, M. & Winker, D. (2017). Healthy ageing and aged care. South Melbourne, Oxford University Press
Brown, D., Edwards, H., Seaton, L., & Buckley, T. (2020). Lewis’s medical-surgical nursing. assessment and management of clinical problems (5th ed.). Chatswood, N.S.W.: Mosby/Elsevier Australia.
Cousins, S. (2020). Experts criticise Australia's aged care failings over COVID-19. The Lancet, 396(10259), 1322-1323.
Ducket, S., & Stobart, A. (2021). Four Takeaways from the aged care royal commission’s final report, from https://www.abc.net.au/news/2021-03-02/aged-care-royal-commission-final-report-key-takeaways/13203508
Dyer, S. M., Valeri, M., Arora, N., Tilden, D., & Crotty, M. (2020). Is Australia over‐reliant on residential aged care to support our older population? The Medical Journal of Australia, 213(4), 156.
Harrison, F., Cations, M., Jessop, T., Aerts, L., Chenoweth, L., Shell, A., ... & Brodaty, H. (2020). Prolonged use of antipsychotic medications in long-term aged care in Australia: a snapshot from the HALT project. International psychogeriatrics, 32(3), 335-345.
Henderson, J., & Willis, E. (2020). Chapter Twelve: The Marketisation of Aged Care: The Impact of Aged Care Reform in Australia. In Navigating private and public healthcare (pp. 249-267). Palgrave Macmillan, Singapore.
Henderson, J., Willis, E., Xiao, L., & Blackman, I. (2017). Missed care in residential aged care in Australia: an exploratory study. Collegian, 24(5), 411-416.
Holland, K., Jenkins, J., Solomon, J., & Whittam, S. (2019). Applying the Roper-Logan-Tierney Model in practice (3 rd ed). London: Churchill Livingston.
Hunter, S., & Miller. C. A. (2016). Miller’s nursing for wellness in older adults (2nd ed.). Sydney, N.S.W: Wolters Kluwer/Lippincott, Williams & Wilkins.
Jarvis, C. (2020). Jarvis’s physical examination and health assessment (3rd Australian and New Zealand ed.). Chatswood, N.S.W: Elsevier Australia.
Levett-Jones, T. (2018) Clinical reasoning: Learning to think like a nurse (2nd ed.). Frenchs Forest, NSW: Pearson.
Michelle E. Mlinac, Michelle C. Feng, Assessment of Activities of Daily Living, Self-Care, and Independence, Archives of Clinical Neuropsychology, Volume 31, Issue 6, September 2016, Pages 506–516, https://doi-org.ezproxy2.acu.edu.au/10.1093/arclin/acw049
Nursing and Midwifery Board. (n.d.). Registered Nurse Standards for Practice, from https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards/registered-nurse-standards-for-practice.aspx
Poulos, R. G., Boon, M. Y., George, A., Liu, K. P., Mak, M., Maurice, C., ... & Parker, D. (2021). Preparing for an aging Australia: The development of multidisciplinary core competencies for the Australian health and aged care workforce. Gerontology & geriatrics education, 42(3), 399-422.
Royal Commission into Aged Care Quality and Safety (2021). Final Report, adapted from https://agedcare.royalcommission.gov.au/publications/final-report
Smith, C. (2019). Navigating the maze: An overview of Australia's current aged care system.
Weil, J., & Smith, E. (2016). Revaluating aging in place: from traditional definitions to the continuum of care. Working with Older People, 20(4), 223-230. http://dx.doi.org.ezproxy2.acu.edu.au/10.1108/WWOP-08-2016-0020