Week 3 discussion

Models of Interdisciplinary Geriatric Care Teams

With the growing population of frail elders, there is an
increase of geriatric patients requiring ongoing care for multiple medical
conditions. This creates the need for interdisciplinary geriatric care teams.
Often, the dynamics and culture of these teams differ across various sites of
care, such as assisted living, home care, hospitals, long-term care, and
rehabilitation facilities. As an advanced practice nurse, it is important to
understand your role in the care team as well as your potential impact on
patient care. In this Discussion, you explore models of interdisciplinary
geriatric care teams for different sites of care and the varying roles of the
advanced practice nurse. Consider the following three case studies:

Case Study 1:

Mrs. Martinez is an 83-year-old Mexican American widow who
lives in her own home and is cared for by her adult daughter. Mrs. Martinez
owns the home, and her daughter lives with her and provides the care. Her
daughter brought her mother to the clinic today to ask to speak to the social
worker. She requests that her mother be placed in a nursing home. The daughter
states that her mother has nothing to do during the day. The television is on
The Weather Channel most of the day because Mrs. Martinez has limited English
capability and is unable to read closed-captioning. Mrs. Martinez also has two
sons who do not live in the local area, but they do call regularly and check in
with their mother and sister. The two sons are opposed to moving their mother
to a nursing home because they had promised her that they would “never put her
away.”

Case Study 2:

Mr. Williams, a 79-year-old African American widower,
resides in a foster care home. He has lived there for 4 years since his wife
died. He is a former minister. His medical history includes long-term diabetes,
high blood pressure, and benign prostatic hypertrophy. The home care provider
has requested a home visit to evaluate Mr. Williams’s ability to remain in the
home. The provider states that because Mr. Williams’s vision is seriously
compromised (he is nearly blind), and because he has been unable to get to the
toilet as quickly as necessary (he is very unsteady on his feet), his care is
becoming burdensome. According to the home care provider, for safety reasons,
Mr. Williams may not fit the criteria for remaining in the foster care home.

Case Study 3:

Mrs. Randall is a 77-year-old female who resides in a
long-term care facility. She has a history of frequent falls and is severely
cognitively impaired. The nursing staff at the long-term care facility called
the nurse practitioner at the medical home office to report the recent
development of productive cough and high fever. There have been cases of flu in
the facility; however, Mrs. Randall has had a flu shot. The nurse practitioner
in the office requests a chest x-ray in the long-term care facility. The nurse
on duty in the facility states that there is no portable chest x-ray equipment
available. She further requests that Mrs. Randall be transferred to the emergency
room of the local hospital. Mrs. Randall’s daughter has durable power of
attorney for health care decisions for her mother. The long-term care facility
has notified the daughter of the change in her mother’s condition. The daughter
says whatever the nursing home wants is fine with her.

To prepare:

Review this week’s media presentation, as well as the
American Geriatrics Society and Arbaje et al. articles in the Learning
Resources.

Research models of interdisciplinary geriatric care teams
that are used at various sites, such as assisted living, home care, hospitals,
long-term care, and rehabilitation facilities.

Consider the model used for the interdisciplinary geriatric
care teams at your current practicum site. Compare this model to models used at
other sites.

Reflect on how the role of the advanced practice nurse
differs according to the site of care.

Select one of the three case studies. Consider how care
should be facilitated for the patient in the case you selected based on the
model used for the interdisciplinary geriatric care teams at your practicum
site.

Post on or before Day 3 a comparison of the model used for
the interdisciplinary geriatric teams at your current practicum site to models
used at other sites. Then, explain how the role of the advanced practice nurse
differs according to the site of care. Finally, explain how care should be
facilitated for the patient in the case you selected based on the model used
for the interdisciplinary geriatric teams at your practicum site.

Read a selection of your colleagues’ responses.

Respond on or before Day 6 to at least two of your
colleagues on two different days in one or more of the ways listed below.
Respond to colleagues who selected different case studies than you did.

Offer and support an alternative perspective based on your
own experience and additional literature search.

Validate an idea with your own experience and additional
literature search.

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