HLT54115 - Aarti and Mangal Case Study - Capacity to Perform Daily Living Activities - Stereotypes Associated With Ageing - Nursing Assignment Help

Assignment Task

Case Study 1:

Arti is an 88- year–old woman living with her youngest daughter in western Sydney. Aarti’s health has declined over the last 10 years with a history of poorly controlled type 2 diabetes for which she takes metformin 500mg BD and recently she has developed incontinence and pain in the middle of her back. Aarti is carrying weight around her abdomen and does not pay much attention to her blood sugar levels or her diet and leads a relatively sedentary lifestyle. Lately, Aarti noticed her ankles are swelling all the time and her vision is blurring. After a visit from the GP, it was noted that Aarti’s blood pressure is elevated and she has protein and glucose in her urine, the GP suggested further investigations which lead to Aarti being diagnosed with Chronic Kidney Disease. Aarti’s GP would like to discuss some functional assessments to determine her level of care requirements. Aarti’s family has been informed of her acute care needs and that she would need to be admitted to a suitable acute care facility. They would like her to stay at home with them for as long as possible with home care support.

Question 1. What are the levels of care that can be accessed by the aging community, and what functional assessment tools would be used to assess Aarti to make a determination on how you would prioritize her health care needs?
Question 2. What are Aarti’s health care needs and how would you prioritize them?
Question 3. What are some age-related effects of medications on Aarti, and are there any complementary therapies that might assist her with some of her health issues?
Question 4. What information can you provide to Aarti and her family to assist their understanding of the following:
a) impacts of age-related pathophysiology
b) impact on the person’s capacity to perform daily living activities
c) Primary Health Care support services
d) implications of admission of Arati into an acute care facility
Question 5. What are some common myths or stereotypes associated with aging that could adversely impact Aarti’s health care?

Case Study 2
Mangal is a 78-year-old man with vascular dementia and partial deafness in both ears and has been admitted to St Andrews Aged Care service, as attempts to support him to remain in his own home were unsuccessful due to his failing memory, disorientation and lack of understanding of risks which is increased by his partial deafness. 
On physical examination, it was assessed that Mangal had been neglecting himself for some time; he had lost his dentures and hearing aid and was very frightened and angry. Mangal did not understand why he was not able to remain in the unit that he had lived in for over 20 years. 
The interdisciplinary care team collected as much information as they could about Mangal’s life history, the cause of his partial deafness and significant events from friends and medical health services. 
The nursing team adopted ‘helping techniques’ recommended for managing behaviors that are the result of the person feeling uncomfortable and fearful at this stage of the vascular dementia illness. These techniques include; staff trying not to expose the person’s weaknesses, working with all feelings expressed including anger which can be frequent and sudden in onset, keeping our distance until invited to get closer, acknowledging and validating feelings rather than ignoring them or taking things personally. Most importantly the team acknowledged Mangal’s many years of experience as a nurse, requesting that he would understand the importance of having his dentures and hearing aid replaced, asking his opinion on simple issues where the staff knew he would be able to feel that his input was valued and helpful. 
Within 3 weeks Mangal’s behavior started to change in a way that suggested our dementia care strategy was having a positive impact on him and was helping to make him feel more secure and comfortable. Mangal started to confide in two staff he now trusted, he admitted that he was frightened of not being in control and of having memory difficulties.  12 months later Mangal deteriorated quickly and is now receiving a palliative approach with advanced care directives to assist his end of life care needs.

Question 7. Briefly describe the stages of Mangal’s vascular dementia as a progressive neurological condition, and list some strategies and nursing interventions that can be used with people with dementia? 
Question 8. When caring for people with dementia with difficult behavior, what would be the legal ramifications if the staff had used any physical, chemical and psychological restraints on Mangal?
Question 9. Why is it important to provide Mangal with a safe, physical, social and emotional environment, appropriate to his gender, culture, and age and reflecting his individual likes and dislikes?
Question 10. How would you assess and manage Mangal’s oral health care, taking into account his complex health and behavioral issues associated with his dementia?
Question 11. What is the difference between end-of-life care and the palliative approach to nursing care Mangal will receive? What are Advanced care directives?
Question 12. What are the steps in the procedure for nurses undertaking the care of a deceased person 
Question 13. Briefly describe the following psychosocial interventions and medication groups used to manage the following presenting problems or challenging behaviors of an older person in a residential aged care setting

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