Question

For this assessment, you are an advanced practice nurse working on an inpatient rehabilitation unit. You care for many patients after they experience strokes, paralysis after spinal cord injuries, severe burn injuries, and amputations after illness or injury. The patients stay for 3-8 weeks depending on the severity of their illness and their baseline level of strength. Each patient participates in at least 3 hours per day of a combination of physical, occupational, and/or speech therapy in order to speed recovery. To be eligible for admittance to the unit, the admitting doctor or APN must feel that the patient will be capable of this intensive therapy--so many times, the patients are on the younger end of the spectrum.

You are the leader of the nursing team, whose goal is to support therapy goals and to address the psychosocial needs of patients and families. Because of this, nurses are the team member most likely to identify which patients are exhibiting adaptive patterns that will promote a healthful new pattern after the disorganization of this injury; and which patients are exhibiting patterns that indicate poor coping. The unit recognizes how important family caregivers are and the nursing team also assesses and intervenes to support the family's psychosocial needs.

You and your team have identified that a subset of caregivers that most often seem to struggle with achieving health patterns before discharge is younger (20's-40's) male caregivers of spouses/partners.

Using the themes identified in the research by Macleod (2011) as salient to the development of healthy patterns for caregivers, development an assessment that can help the nursing team best identify which caregivers in this group are likely to move toward healthy patterns/expanded consciousness and which may need a referral for further intervention. Nurses will use these assessment questions to check progress of expanding consciousness each week before the multidisciplinary team meetings so the nurse can advocate for a referral if necessary. Remember to keep the theoretical definitions from Newman's Health as Expanding Consciousness Theory in mind as you develop the assessment.

Answer 1

Upholding domestic caregiver purpose has main insinuations for the being with Alzheimer’s illness (AD), the caregiver, and civilization as a complete. When domestic caregivers purpose well, care headsets knowledge reduced interactive indications of dementia, better-quality care and excellence of life. Family caregiver’s attitude to advantage by feeling minus strain and higher heights of mental and physical fitness. Once caregivers assess their condition more definitely, they are more probable to institutionalize their qualified and more probable to last as long as in-home upkeep. This can interpret into inferior long-term upkeep prices to civilization, as nursing home assignment establishes a main constituent of public health maintenance prices credited to AD; and since our present long period care scheme is powerless to engross the worth of voluntary care if by family members, which methods 350 billion dollars yearly.

A sequence of emphasis collections and discrete interviews were showed with scientific and outreach operate for the determination of purifying the notion of caregiver ability with a main emphasis on caregiver services about interactive indications of dementia. Social indications of dementia were designated since these indications have steadily been revealed to make utmost suffering for family caregivers and if relentless, principal to previous nursing home assignment.

The decisive influences to recognizing accomplished against fewer accomplished caregivers attentive on whether caregivers deliver Person Centered Care, Accomplish their own Feelings, and Accomplish Family and Community Capitals. Person Centered Maintenance (PCC) was labeled as concentrating on the reduced family associate’s requirements somewhat than the illness or the chore, fortes slightly than confines, and the procedure somewhat than the consequence. PCC could be if by the domestic caregiver or others and contains a comprehensive range of logical methods and involvements. It speeches not only Maslow’s pyramid of wants emphases on the actualization in the instant.

The insinuation was that PCC would prevent and stop problematic performances related with dementia. Interferences that maintained PCC encompassed a broad range of methods such as: interactive, movement, conservational, delivery of straight physical maintenance, and consideration to medicinal requirements. Attention group members recommended that accomplished caregivers know their reduced family associate, are more possible to inducement upon confident caregiver potentials, deliver just right tests for the reduced family associate, purpose as an investigator, have convinced values, and receive the reduced family associate as is. They measure their lessened family associates’ fortes, set truthful prospects, and work about their limits. They distinguish when to step in and do not generate additional incapacity. They contemplate of upkeep as a movement against a chore; they regularize doings and include their family member in everyday life. Less accomplished caregivers are additional probable to attention on the sickness slightly than the person, what their family associate can’t do slightly than what they can do. They are supplementary probable to deliver task positioned, planned upkeep, and have more trouble setting suitable bounds.

Three another methods to measuring family caregiver skill/efficiency were industrialized: caregiver self-report, clinician assessment, and in-person straight observational calculation. Attention group information, current works and events were used to current content and stipulate methods for each amount. Constant separate meetings and a third emphasis collection was showed with medical operate. By means of their contribution, events were sophisticated over a retro of four months. Planned events and procedures were authenticated with domestic caregiver investigators.