Case study of an older person with complex care needs

Intent: This assessment will provide an opportunity to develop knowledge on the complex care needs of older persons that arise due to the ageing process, life circumstances and chronic conditions that intersect to impact on their level of functioning and quality of life. Students will demonstrate their ability to apply a person-centred approach, identify issues affecting an older person and develop evidence-based nursing recommendations. Students will also demonstrate their academic writing skills.

Instructions: In this assessment task, you will complete a case study analysis of an older person with complex care needs due to the ageing process, life circumstances and chronic conditions that intersect to impact on their level of functioning and quality of life. You will consider the older person's bio-psycho-socio-environmental context, research professional and scholarly evidence, and outline a plan of care using a person-centred approach.

Background:
Every individual is unique and to support healthy ageing, it is important to focus on the person and what they can do, not their condition or disability. The individual should be supported to achieve their aspirations and support should be tailored to their needs and unique circumstances.
Using a person-centred approach helps to deliver personalised and tailored care to the individual.

This involves:

• Supporting the person to be involved in making decisions about their life
• Considering the individual's life experience, age, gender, culture, heritage, language, beliefs, and identity
• Utilising flexible services and support to suit the person's wishes and priorities
• Using a strengths-based approach, where the individual is acknowledged as the expert in their life; focussing first on their abilities and then any support they would need
• Including the individual's support networks as partners

Step 1: Selection

Select one case study from the list below (see UTS Canvas for full details of each case study).

1. Claire Gill
2. Maria Vestina
3. Michael Pretor

Step 2: Examining the case study

Read through the case study you have selected for your assessment.

Step 3: Strengths-based approach

Describe strengths-based approach within the context of care of older persons. Explain why this approach is important by drawing an example from your selected case study. (400 words)

Step 4: Critical reflection

Critically reflect on the selected case study and explain two key issues from the older person's perspective that could impact on their independence and/or healthy ageing. (300 words)

Step 5: Nursing care plan

Discuss two nursing recommendations addressing each of the identified key issues.
Make reference to the individual's strengths and/or abilities that you would use to support them in their care. (400 words)

Step 6: Nursing care plan

Discuss the multidisciplinary team involvement and resources that you would consider in supporting healthy ageing for this person in their current residential location. (300 words)
Referencing:
Intext references should be used where appropriate using APA7 referencing style. A complete reference list is to be included on a new page at the end.
A minimum of ten (10) peer-reviewed journal articles published since 2018 is necessary for this assessment.
Presentation:
No introduction or conclusion is required. Structure your writing using the following headings in the given order:

1. Strengths-based approach (400 words)
2. Critical reflection (300 words)
3. Nursing care plan (700 words)
   • Nursing recommendations (400 words)
   • Multidisciplinary services and resources (300 words)

Age, sex, domestic, social  and vocational status: 

Mrs Gill is a 66 year old self-funded retiree who  recently retired after working for 35 years in television  production. She lives with her second husband and  their adult son Richard in a modern and comfortable  home in Annandale. Richard studies at the University  of Sydney but he has become depressed recently after  experiencing some bullying while studying. Mrs Gill’s  63 year old husband still works full-time as a senior  account manager for a large merchant bank. There has  been a long-standing tension in their relationship  because of what Mrs Gill perceives as his bossiness,  but she is confident in confronting him and maintaining  her independence. Increasingly Mrs Gill spends her  time outside the home with her friends, geting together  for coffee or to go the art gallery or theatre. 

Health status: 

Mrs Gill is 155cm tall and weighs 82 kg and she  smokes about fifteen cigarettes a day - she would like  to stop smoking but has been unable to do so. She  becomes somewhat breathless if she has to walk more  than about 500 metres, so she generally chooses to  drive or use public transport to get around, even to  nearby for shopping. Mrs Gill has also recently been  diagnosed with moderate osteoporosis and she now  walks with a lopsided gait because of increasing pain  in her right hip. 

Reason for Referral: 

Mrs Gill has been having problems with sleep and loss  of energy, and she is becoming despondent about her  son’s depression, her problems with mobility and her  hip pain. One of Mrs Gill’s friends recommended that  she contact the physiotherapy department of Royal  Prince Alfred Hospital. The physiotherapist then made a  referral to the community aged care team for follow up.

Religion, culture and  language: 

Mrs Gill is proud to admit she is an atheist and  has been since she was twelve. She was  brought up in Annandale (a few streets away  from where she lives now) by her grandmother  as her own mother abandoned her. She found  her grandmother strict and quite resentful, and  Mrs Gill was very happy to eventually leave  home and live with a group of friends. She  studied journalism at university and travelled  the world for six months on her own at age 19.  She met and married her first husband aged 21  but the relationship only lasted for two years.  She married her second husband aged 26. She  speaks only English.  

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