Question

1. Nursing models for the care of older adults (Discuss at least three models in detail at least with 1000 to 1500 words).

Answer 1

NURSING MODELS FOR THE CARE OF OLDER ADULTS

Older people are often defined as 65 years of age and older using definition by swedish statistics but other age limits are also used. The aging demographic shift occuring world wide is creating an opportunity for innovative care models to address the burgeoning care needs of the expanding population of older adults. Nursing and advanced practice nursing as well as interprofessional models past and present hold insights into how to meet the needs of older adults acrosss the continuum of care. The models across settings emphasize maximizing the role of nurses and advanced practice nurses.

The models reviewed include: on Lok and programs of all inclusive care for the elderly (PACE), Community Aging in Place, Advancing better Living for Elders (CAPABLE), Teaching Nursing Homes, Interventions to Reduce Acute Care Transfers( INTERACT) ;Missouri Quality Initiative(MOQI), Nurses Improving Care for Health System Elders(NICHE)

On Lok: Programs of All Inclusive Care of the Elderly(PACE)

The programs for All inclusive care of the elderly (PACE), a capitated managed care program was started by On Lok Senior Health services in 1971 based on the british day hospital model by Dr. william gee, a dentist and marie louise ansak, a social worker.

On lok senior health services was created to provide an interprofessional community based system of LTSS.

Nurses are an integral part of this model of care for persons in need of chronic diseases management.

Currently 8% of PACE organizations are for profit. Evaluations have shown that PACE successfully integrates acute and long term care and reduces hospitalizations thereby decreasing costs.

CAPABLE

Like PACE, the CAPABLE program focuses on impoverished older adults and implementing person - centered interprofessional interventions to maintain older adults living safely in the community.

The growing awareness that drivers of health fall largely outside the health care system and are found in places where people live, work and play has created a need to address social determinants of health in the communities where people live. This program bring together a registered nurse, occupational therapist, and handyman team to address the health and functional care needs of older adults.

CAPABLE provides a person directed approach focusing on individual goals and this intervention has increased functional outcomes and decreased disability.

Teaching nursing home

The teaching nursing home program was funded by the Robert Wood Johnson for five years from 1982 through 1987 to improve the quality of care provided in nursing homes.

This program was a collaboration between 11 academic nursing programs and nursing homes to improve clinical care, educate nursing programs, and foster research in long term care settings.

It was modelled after the ongoing medical school medical center partnerships.

The quality outcome from the teaching nursing home program were superior to the comparison homes in hospitalization, continence of bowel and bladder, functional parameters of dressing and transferring and limitations of restraint use

This was due to the pooled resources of the schools and nursing homes, the presence of advanced practice nurses and faculty practice within the nursing homes.