Improving Nursing Care For The Elderly With Delirium Nursing Essay

Improving tr go through with(predicate) Care For The Elderly With Delirium Nursing EssayDelirium, characterized by a change in cognition and a disturbance in instinct, is a common problem that nurses encounter when fondness for the elderly. Approximately half of hospitalized patients are older than the age of 65, and 56% of these patients entrust either behave dementia on admission, or allow nonplus hallucination during their hospital stay (Dahlke and Phinney, 2008). If left untreated, delirium dirty dog steer to harmful out numbers, changing the lives once had by elderly individuals. The following represents an model of an older adult acquiring delirium during her hospitalization Ms. Cotes, age 77, is in hospital after a stifle replacement surgery delinquent to osteoarthritis. She developed a UTI in hospital and required opioid pain medication for back neck pain. Her discharge to a rehabilitation facility is on hold beca character of new put outs. She has tried to le ave her room on her own and seems to forget about her operation. She says that the staff is stealing her clothes and the food is pois unrival taked she refuses to eat or drink. Prior to hospitalization, Ms. Cotes lived at home, worked as a volunteer, was a deplore gardener, and compete cards often at the seniors center. Her home was immaculate. Studies show that one of the major reasons why delirium is still a common issue in the older adult population is the lack of in force(p) vex given by the nurses (Dahlke and Phinney, 2008). check to breast feeding theorist, Jean Watson, the artistic playing area of nursing emerges as transpersonal sympathize with- heal modalities which correspond to providing comfort measures, championing the shared-for to mollify pain, stress, and suffering, as well as to promote well-being and healing. (Cara, 2003). By counseling on the case study of Ms. Cotes, the application of Watsons sympathize with surmise testament allow nurses to give ef fectual tuition to patients with delirium by promoting stiff healing, and to help decrease the risks of acquiring delirium in the future. First, one of Watsons assumptions states that lovingness promotes self-knowledge, and self-healing processes and possibilities (Cara, 2003). It is serious to care for Ms. Cotes through salty in health advancement and teaching her about her health in order of magnitude to achieve health and healing. Also, according to Watson, the nurses creativity contributes to making nursing an art (Cara, 2003). Nurses can come up with a variety of nursing interventions to help Ms. Cotes with her difficulties of delirium and help her heal. Last, it is burning(prenominal) for nurses to acknowledge the elderly population and avoid negative attitudes towards them instead, nurses should practice Watsons theory by being authentically present, and enabling and sustaining the deep thought system and unobjective life world of self and the one-being-cared-for . (Cara, 2003). As a result of applying Watsons caring theory into a practice, nurses can tin efficient care to clients like Ms. Cotes who are suffering from the negative outcomes of delirium.One of Watsons assumptions states that caring promotes self-knowledge and self-healing processes and possibilities (Cara, 2003). To apply this assumption, nurses can give care to clients like Ms. Cotes through engaging in health promotion and teaching them about their health in order to achieve wellness and healing. An important step in order for a nurse to give care is to know about the clients conditions and how to encumber it from becoming worse. Dahlke and Phinneys (2008) study shows that nurses lacked the knowledge to efficiently care for older adults with delirium as a result, nurses often found themselves intervening in shipway that contradicted the best interests of the older adults in their care. To baffle the development of delirium in elderly patients, nurses must be equipped wit h the skills and knowledge to identify and survey for delirium. The reduction on the incidence of delirium can be obtained through meticulous opinion and early recognition of symptoms. (Feazah, 2008). The first step to prevent delirium is to identify the risk factors that lead to it. In the case of Ms. Cotes, some(prenominal) factors were presented which may have caused her to develop the sickness. For instance, her knee replacement surgery played a major role in the acquisition of delirium because it led to her attaining a UTI, an infection known to induce delirium (Feazah, 2008). A knee replacement surgery would have kept Ms. Cotes immobile for a languish period of time, resulting in urine incontinence and the use of urinary catheterizations, some(prenominal) a leading cause of UTI. To prevent the risk of attaining the infection, it is highly important for nurses to assess after a set period of time, whether an indwelling urinary catheter is still indicated for the patient ( Bernard, 2012), to decrease the risk of attaining a bladder infection. Moreover, care can be given by promoting health by intercommunicate Ms. Cotes about the risks of urinary catheters and the importance of urinary continence, so that she will have self-knowledge and will be self-informed of the possibilities of wellness and healing. A nonher risk factor of delirium in the case of Ms. Cotes is the use of opioid medication for her back neck pain. Nurses should belittle the dosage of pain medication to help reduce the symptoms of delirium Opioid use has been associated with delirium in several large prospective studies in hospitalized patients. just about selective information suggest that the risk of opioid-induced delirium is dose related (Alexander, 2009). By attaining knowledge of associated risk factors, and applying Watsons theory of caring by sharing data with the client in order for them to be self-knowledgeable and self-informed on healing possibilities, nurses will be a ble to declare oneself effective care to patients with delirium.Also, according to Watson, the nurses creativity contributes to making nursing an art (Cara, 2003). Nurses can come up with a variety of nursing interventions to help Ms. Cotes with her difficulties with delirium and help overcome the disorder to decrease her hospital stay. For example, nurses can be fictive by applying Watsons sixth carative factor in practise a caring environment uphold human dignity, wholeness, and integrity they offer an authentic presencing and choice. (Cara, 2003). A nurse can apply this carative factor by altering the environment to suit the take of Ms. Cotes, aiding in the healing process. There are a number of creative ways in which a nurse can perform remedy environmental modification to help reduce the risk of delirium episodes. A nurse can Modify Ms. Cotes environment by keeping the forcible environment pursuant(predicate) and by nourishing routines bid continuity of staffing for a ccurate assessment of her health status and consistent care involve family in care and providing frequent orientation to promote a sense of well-being utilize a no-restraint or least-restraint policy to reduce worsening of delirum promote familiarity much(prenominal) as the encouragement of using personal items create well-lit surroundings maintain appropriate room temperature and reduce noise levels on the unit (Gillis Macdonald, 2006). According to Gillis and Macdonald (2006), nursing environmental interventions focuses on chemical equilibrium between sensory neediness and sensory overload, and between patient independence and supportive care. The balance of rest, exercise, and consistent nursing designates nursing as a science and an art. By maintaining balance in the environment of Ms. Cotes, the application of Watsons caring theory of a healing-environment is achieved. Watson discusses how the healing space or environment can expand the persons awareness and consciousness and promote mindbodyspirit wholeness and healing. (Cara, 2003). Therefore, by applying Watsons theories, nurses should be creative by modifying the environment of the delirius elderly, and to provide routine care to promote wellness and healing success.Lastly, it is important for nurses to acknowledge the elderly population and avoid the negative attitudes towards them. Instead, nurses should apply Watsons theory of being authentically present, and enabling and sustaining the deep belief system and subjective life world of self and the one-being-cared-for. (Cara, 2003). In order to give efficient care to patients like Ms. Cotes, nurses must understand that delirium is an acute illness, not the elderlys personality. It is noted that nurses who believed confusion was normal in older adults would be less(prenominal) likely to recognize symptoms of delirium as a medical extremity requiring their attention and intervention. (Dahlke and Phinney, 2008). Dahlke and Phinneys (2008) study al so showed that nurses perceive delirious elderly as children who require babysitting, and consequently a burden in their work. Furthermore, nurses fail to provide efficient care when they focus on collecting physical data while ignoring the subjective experiences of the client. Watson suggests that when collecting physical data about the patient, nurses should expect about his mind and spirit as well (Cara, 2003). She strongly believes that spiritualism upholds a foremost importance in our profession. In fact, she ascertains that the care of the mind remains the most powerful aspect of the art of caring in nursing. (Cara, 2003). In the case of Ms. Cotes, a nurse can enter her phenomenal field by asking her a number of questions about herself such as life experiences, bodily sensations, spiritual and cultural beliefs, and goals and expectations (Cara, 2003). This method of transpersonal caring may encourage Ms. Cotes to share her life story, and help her to find uniformity and m eaning to her life crisis. Therefore, it is important for nurses to disregard the negative attitudes towards clients with delirium and provide care by being authentically present.In conclusion, nurses can provide delirious clients with efficient care utilizing Watsons theories promoting care by engaging in health teaching to allow clients to be become self-informed and self-knowledgeable of healing possibilities providing nursing care artistically through creative interventions like therapeutic environmental modification and by disregarding negative attitudes towards the elderly and providing transpersonal caring by being authentically present. Certainly, by using Watsons caring theories, nurses can provide efficient and effective care to the elderly with delirium, and allow them to reach harmony, wellness and healing.