The impact of physiological changes on older people : implications for nursing practice

The focus of this chapter is the physiological changes that occur as people age. Even though the chapter is dominated by physical changes, it is acknowledged that we are complex beings with biopsychosocial, cultural and spiritual aspects that contribute to our individuality. As you learnt in Chapter 4, although changes happen as ageing occurs, when they occur and the speed with which they occur, depend on the individual. The meaning and significance of the changes are similarly individual experiences. Being aware of age-related changes enables registered nurses and other health professionals to work collaboratively with individuals in initiating programs that retard and/or prevent deterioration, pathology and trauma, and support the older person to live the life they aspire to. Knowledge of age-related changes enables astute assessment and helps with being able to differentiate between an age-related change and pathology. Age-related changes underpin different responses to the external environment and challenges to health for the older person. As this is essential knowledge for a registered nurse and other health professionals, the chapter is presented in a way that makes the information readily accessible and articulates that, although ageing is universal, it is also individual. It emphasises the significance of assessment and outlines the particular role of the registered nurse in prolonging functionality, enabling the maintenance of connections with family, friends and the community and supporting the older person to adapt to their ageing journey

‘I’d rather die happy’: residents’ experiences with food regulations, risk and food choice in residential aged care. A qualitative study

Background: Food regulations exist to protect older people in residential aged care, leading to the restriction of potentially hazardous foods. The impacts of malnutrition, resident centred care and the importance of maintaining individual autonomy for older people are well documented. By contrast, there is scant literature describing residents’ perceptions of food regulations and food risks in the residential aged care setting. Aims: The aim of this study is to explore resident perceptions of food choice and food restrictions in residential aged care. Methods: Using a qualitative, hermeneutic phenomenological design, semi-structured interviews were conducted with six participants recruited from two residential aged care facilities. Interviews were audio-taped, transcribed verbatim and thematically analysed. Results: The following key themes emerged in this study: participants were largely unaware of food regulations and risks, yet expressed the desire to make their own choices. Participants provided contradictory accounts of their experiences with food in residential aged care, which emphasises the ongoing challenge of meeting individual preferences. Conclusion: These themes warrant further investigation, particularly in relation to the impact of food regulations on food choice and the meaning of risk to older people in residential aged care. This research provides new insight into the perceptions of residents regarding their individual autonomy and independence against legislated risk minimization strategies

Factors influencing the development and implementation of advanced radiographer practice in Australia:A qualitative study using an interpretative phenomenological approach

INTRODUCTION: The purpose of this study was to explore the factors influencing the implementation or the lack of implementation of advanced practitioner role in Australia. METHODS: This study uses an interpretative phenomenological approach to explore the in-depth real life issues, which surround the advanced practitioner as a solution to radiologist workforce shortages in Australia. Research participants are radiographers, radiation therapists and health managers registered with the Australian Institute of Radiography (AIR) and holding senior professional and AIR Board positions with knowledge of current advanced practice. RESULTS: In total, seven interviews were conducted revealing education, governance, technical, people issues, change management, government, costs and timing as critical factors influencing advanced practice in Australia. CONCLUSIONS: Seven participants in this study perceived an advanced practice role might have major benefits and a positive impact on the immediate and long-term management of patients. Another finding is the greater respect and appreciation of each other's roles and expertise within the multidisciplinary healthcare team. Engagement is required of the critical stakeholders that have been identified as ‘blockers’ (radiologists, health departments) as well as identified allies (e.g. emergency clinicians, supportive radiologists, patient advocacy groups). The research supports that the AIR has a role to play for the professional identity of radiographers and shaping the advanced practice role in Australia

The older person in acute care

As registered nurses we have the capacity to enhance the quality of life of older members of our communities and ensure they are living in an environment that provides optimum support, so that they are living the satisfying lives we all want to enjoy. A registered nurse can build rapport, assess care needs, implement strategies to address those needs and refer appropriately to other health professionals, with the outcome being an older person and their family who are supported and who can live in optimal health. Underpinning this is a registered nurse with the attitudes, skills and knowledge to orchestrate this outcome. Appreciating that all older people are adults and individuals who deserve respect, whose pathologies present differently and often present as cognitive impairment, and that hospitals can negatively affect their health, is essential in working with older people and their families in acute care hospitals

I am Looking for My Truth: a Hermeneutic Phenomenological Study Focusing on Undergraduate Nursing Students\u27 Journeys in Indigenous Australian Cultural Competence

This paper will present the initial findings of a study aimed at creating meaning from students\u27 lived experiences and journey towards Indigenous Australian cultural competence across a three-year Bachelor of Nursing degree. The participants of this study were undergraduate students who enrolled in a cultural competency subject within the Bachelor of Nursing Course and the subsequent journey of students in this cohort through their second and third year of university. Truth seeking was a major overarching theme found in the data of year one students. This paper will explore this theme and how the interdependent sub themes of previous truths, new knowledge, critical thinking and confirming the new truth, played a role in students\u27 journey of Indigenous Australian cultural competence

Enhancing connectedness through peer training for community-dwelling older people: A person centred approach

Social interaction and connectedness is important to the mental health and wellbeing of older people. The aim of this research study was to facilitate and increase opportunities for social connectedness for older people living in regional areas through the use of technology training. Weekly technology training sessions were conducted at a Seniors Citizen's Club with a peer trainer (an experienced, retired computer teacher) and sessions were attended not only by the six study participants, but also by other club members, with up to 15 club members participating in sessions. Data analysis involved all documents generated by the project, including the individual interviews, researcher observations of training sessions, reports from the peer trainer and weekly diaries maintained by participants. Findings demonstrated that computer training at the Senior Citizens Club helped participants build group cohesion and to form tiered connections with partners, family, and friends with whom they no longer live. When the trainer is seen as a peer, and training is person-centred, older people are more receptive to learning, exploring, and experimenting with technology. Although only six people were involved in the in-depth evaluation part of the study, voluntary training with the trainer in the absence of any funding continues even to this present time. The outcome of this research reinforces the potential for technology facilitated tiered connectivity to enhance the quality of life for older people living in regional and rural Australia

The impact of a participatory care model on work satisfaction of care workers and the functionality, connectedness, and mental health of community-dwelling older people

This study describes and evaluates an innovative program designed to reduce functional decline among seniors, using a participatory care approach and integrated health teams. The evaluation provides older people and community support workers (CSWs) with the opportunity to share their experiences of being involved with an innovative program to reduce functional decline (mobility, skin integrity, nutrition, mental health, continence) of older, community dwelling adults implemented by a Nursing Service in a major capital city in Australia. As part of the program, CSWs were trained to provide care that aimed to reduce functional decline, and improve the quality of life for the care recipients. Data were collected through in-depth interviews with older people receiving care and a focus group (FG) was conducted with CSWs. Seven themes emerged during data analysis: 1) functionality/independence; 2) prevention; 3) confidence; 4) connection; 5) the approach; 6) care plans; and 7) the role of the CSWs. The relationship built between care giver and receiver and the mutual respect facilitated through adopting a participatory care approach was crucial. This relationship-focused care contributed to improved functionality and consequently quality of life for the older person, and for the CSW professional it contributed to their development, improved satisfaction with their role, and increased pride in the difference they make in the lives of their clients. Opportunities for improvement of the program included ensuring that participants understood the rationale for all aspects of the program, including regular reminders, as well as the use of regular reviews of individual outcomes