TASK INSTRUCTIONS: 

You will need to describe the issues in your case study, and then undertake a process of analysis in order to generate a comprehensive nursing plan of care. Practising this process of analysis will help you to feel more confident in providing nursing care to an older person in the clinical setting.

Your case study must:

1. Reflect upon the impact that various stereotypes of older people may have on the older person and their nursing care;
2. Recommend the nursing requirements for older people diagnosed with, or at risk of, complex health conditions and/or cognitive decline; and
3. Evaluate the outcomes for nursing care of older people

For this task you need to prepare a 2500 word written assignment in a case study format. There are two parts to this assignment. Part 1 is a case study (750 words) and Part 2 is a plan of care for the person (1750 words).

Part 1 – Case Study (750 words)

• Introduce the purpose of the case study.
• Briefly outline the main problems as you recall and reflect on the care of an older person (over 65 years or over 55 years if Australia's First Peoples) who has at least two (2) co-morbidities which impact on their functional status in an acute care (hospital) setting. 
• Write a case study based on this experience. In the case study:
• describe the impact that specific stereotypes of older people may have on the person, and
• identify a specific, and recent environmental change impacting this older person. 

Part 2 – Care Plan (1750 words)

Develop a plan of care for the person. In your plan you must:

• Identify and justify the top five objectives for nursing care,
• Describe and justify evidenced-based nursing interventions to achieve each objective, and 
• Create and describe the evaluation criteria that you will use to judge whether the plan addressed the identified objectives.

Throughout your care plan it must be clear how your decisions have been informed by a critical analysis of the case, applying concepts (stereotypes, nursing requirements, outcomes) raised in modules 1 and 2. No fewer than 10 different sources from the scholarly literature should be sourced. NOTE: It is important that you maintain confidentiality as per University guidelines and include no identifying demographic information about patients, colleagues or institutions. 

 Part – 1 (Case Study)

The purpose of this case study attributes to the identification of healthcare challenges experienced by the elderly patients in the nursing care settings. Patients affected with traumatic conditions and co-morbidities require the administration of person-centered and holistic interventions in the context of improving their quality of life and treatment outcomes. Mrs. Ruby, 86 years old female was brought into the hospital after experiencing a fall and subsequent bilateral hip fracture at the nursing home. She eventually underwent open reduction and internal fixation of her hip fracture. Mrs. Ruby was a widow who lived alone in a self-owned apartment for several years. She remained entirely dependent on her 39 years old son who lived at a nearby location with his spouse and two children. Mrs. Ruby had a clinical history of dementia, obesity, and hypertension over the past 7 years. Mrs. Ruby was also affected by polypharmacy and symptoms including generalized body pain, hip pain, weakness, depression, confusion, and tiredness. Mrs. Ruby faced a lot of problem in undertaking the activities of daily living (ADL) and personal care. Mrs. Ruby's co-morbidities significantly deteriorated her quality of life and wellness outcomes across the community environment. She remained entirely dependent on her son in relation to her daily living requirements. Most of the time Mrs. Ruby ordered and consumed junk food because of her incapacity to handle the kitchen work. Mrs. Ruby's son managed to provide fresh food items for dinner; however, at times she had to manage her daily meals from outside resources. Mrs. Ruby undertook a limited physical activity and encountered frequent falls in the home under the sustained impact of co-morbidities.     

Mrs. Ruby received limited social support after dementia development due to limited human resources and socioeconomic constraints. She experienced cognitive decline and memory loss due to her incapacity to cope against the developing psychosomatic complications. Mrs. Ruby received Aricept – 5mg initially followed by the maintenance dose of 10mg once daily. However, Mrs. Ruby's dementia symptoms did not improve much due to her worsening psychological complications that substantially deteriorated her medication compliance and problem-solving skills. Mrs. Ruby exhibited limited coping skills and experienced disorientation under the impact of dementia complications. Furthermore, communication challenges barricaded the escalation of Mrs. Ruby's individualized needs and personal healthcare challenges. Mrs. Ruby also experienced difficult motor coordination, anxiety, paranoia, agitation, irritation, and hallucination that substantially increased her safety challenges, the risk of inadequate nutrition, and death. Mrs. Ruby's obesity, physical inactivity, and depression substantially impacted her self-esteem and self-care pattern. She eventually experienced an elevated risk for diabetes and cardiovascular diseases. Mrs. Ruby's hypertension resulted in complications including irregular heartbeat, chest discomfort, and severe headache. Her primary care physician prescribed a maintenance dose of amlodipine-5mg per day for blood pressure control. However, treatment non-compliance badly impacted Mrs. Ruby's health and wellness outcomes in the nursing care environment. The lack of appropriate management of Mrs. Ruby's co-morbidities and their treatment challenges resulted in her health intricacy that required evidence-based nursing management through multidisciplinary coordination. Mrs. Ruby's limited responsiveness and incapacity to coordinate with the nursing care team elevated her vulnerability and isolation in the treatment setting.          

(Some parts of the solution has been blurred due to privacy protection policy)