About the SeniorAdvisor.com 2014 In-Home Innovation Scholarship: We started the scholarship program to bring awareness of the unique benefits and challenges of in-home caregiving for seniors to younger generations. The questions posed by the scholarship encouraged our nation’s future caregivers to present solutions for improving home care in the United States. College-aged students were required to answer one of the three essay topics below and provide a short bio as part of their scholarship application. Read the winning essays here.
How can your major of study improve the lives of seniors receiving in-home care services?
Essay response by Tiffany Fraser
In-home care needs continue to increase as the older population continues to grow. Living at home alone can become extremely difficult when faced with multiple comorbidities, and disabilities increasing the risk of falls and injury. On the upside, there are benefits of being able to obtain care at home rather than in a nursing home. When seniors are in the comfort of their own home, they retain a sense of independence. They are more relaxed, and experience less anxiety than when receiving care in a strange environment.
In nursing, delivering care that is patient-centered is held in high regards. Simply stated, a nurse should not focus on the task alone but the patient, because the individual is most important. Building a relationship based on trust will lead to therapeutic communication. When nurses maintain therapeutic communication dialogue remains open. Seniors will be less hesitant to bring up any concerns or even share joyous events with the nurse. For the senior to know there is someone there to listen to them and not feel like a burden improves their day-to-day well-being. In order for nurses to improve the lives of seniors receiving in-home care services, nurses must continue to put them first in all decisions. Maintaining autonomy, providing assistance with activities, and ensuring safety are essential and improves the lives of seniors living at home. Autonomy is the right to make your own decision even if those decisions may not be in your best interest. A nurse may feel like they know what’s best but the senior has a right to refuse care, medication or any suggestion of care by the nurse. For example, a senior may be hypertensive and seem to not be taking their blood pressure medication. The nurse cannot force the senior to take their medicine. Instead, the nurse should investigate to find the reason they are refusing the medication to figure out how to intervene. Respecting a person’s autonomy shows respect for the person. It is important not to take away their ability to make decisions for their life. Maintaining autonomy enhances the quality of care received during in-home services.
Seniors are faced with the reality that they may require assistance for things that they have been doing independently for years. Providing assistance with bathing, dressing, eating, walking, and toileting are examples of activities of daily living (ADLs). Along with providing assistance, the nurse or caregiver in the home should always encourage the senior to do as much as they can on his or her own. For example, if the senior is recovering from a minor stroke and has left sided weakness, they should be encouraged to dress themselves using the stronger side (right side), and receive assistance with putting clothes on the left side. Monitoring activities that are done safely increases confidence and retains independence in the older adult.
When nurses deliver care in the home, there are safety concerns that need to be accessed similar to caring for a patient in the hospital. Older adults are at increased risk for falls and injury due to decreased strength, decreased sensory perception, and impaired mobility and balance. In order to improve the lives of seniors living at home, the environment must be assessed for safety and maintain a safe environment to prevent injury and falls. General measures to improve home safety include ensuring adequate lighting, remove throw rugs, install grab bars around toilets and in showers, provide non-skid bath mats for tubs and showers, and remove unnecessary clutter. Providing adequate safety measures decreases the likelihood of mishaps occurring.
Quality patient-centered care includes building a therapeutic relationship, respecting patient autonomy and ensuring safety in the home. These principles essentially put the older adult at ease and are more willing to welcome the nurse or care provider into their home. The aim is to maintain function and enhance quality of life for the older adult. The senior who is able to receive care in the home by a nurse gains peace of mind.
Tiffany is a registered nursing student at Pasadena City College.