Several years ago, I worked on a project with faculty from the Philadelphia College and some industry representatives called the “ACE project”. This stood for Advancing Care Excellence and was a project concerned with the care of elders in the U.S. To get a better idea of what it was all about please read the following excerpt:
Advancing Care Excellence (ACE)-S (senior):
Individualized Aging
Complexity of Care
Vulnerability During Transitions
The three variables of individualized aging, complexity of care and vulnerability during transitions are critical for care for the geriatrician. Meeting the needs of the elderly and providing the care that is really essential to their wellbeing. A nurse needs to know that each person is different, an individual with individual needs. An elder presents oftentimes with complex needs due to their conditions and syndromes of growing older that are part of the aging process or just a part of their medical history. As elders they are susceptible to periods of life where change becomes overwhelming but necessary. The nurse can be an important tool to serve the elderly patient making these periods easier with knowledgeable assistance.
The Advancing Care Excellence or ACE is a way to view the elder in a better light with knowledge about their life challenges and the individual ways they have found to adapt. When confronted with the issues of aging an elder finds the adaptations necessary to live their life in the most productive way. A nurse cannot treat the individual that does not have the tools yet to adapt to these challenges of aging without a personal knowledge to share with the elder patient.
Years later the National League for Nursing decided to put the entire project online. The next assignment is concerning the characters that were developed to exemplify the challenges that the elderly face in today’s society.
The following weblink is to the “Millie Larsen” story:
https://www.nln.org/education/teaching-resources/professional-development-programsteaching-resourcesace-all/ace-s/unfolding-cases/millie-larsen-a22fc65c-7836-6c70-9642-ff00005f0421
Review the three stages of the Millie Larsen story. Listen to or read the story about Millie. Then
Answer the following questions
- What functional challenges does Millie face?
- Look up Try this! https://hign.org/consultgeri-resources/try-this-series which is a website that has instruments or tools for evaluative functions. Consider which three instruments you will use in your paper for the Fall Prevention Program. List the three instruments here:
- Your paper should be:
Full Answer Section
Utilizing These Tools:
These three tools, along with a comprehensive assessment of Millie's individual needs and circumstances, can form the foundation for an effective fall prevention program. The TUG test will provide a baseline understanding of her mobility, while the BBS will offer detailed insight into her specific balance challenges. The 4-Stage Balance Test will help identify the level of balance intervention required.
By using these assessments, a healthcare team can develop a personalized fall prevention plan for Millie, addressing her specific challenges and incorporating strategies like:
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Environmental Modifications: Removing trip hazards, ensuring adequate lighting, providing assistive devices like grab bars, and modifying furniture placement.
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Exercise and Balance Training: Engaging in regular physical therapy and balance exercises to improve strength, flexibility, and balance.
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Medication Management: Working with Millie and her family to implement a safe and effective medication management plan.
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Education and Support: Educating Millie and her family about fall risk factors, recognizing signs of falls, and implementing strategies to prevent falls.
Millie's story highlights the importance of understanding the unique challenges faced by aging individuals. By employing comprehensive assessments and personalized interventions, healthcare professionals can play a crucial role in promoting the safety, independence, and quality of life for older adults like Millie.
Sample Answer
Millie Larsen's Journey: Exploring Functional Challenges and Fall Prevention
Millie Larsen's unfolding case story, found on the National League for Nursing website, depicts the complex challenges faced by many aging individuals. Her journey through three stages – "Pre-Admission", "Hospital Stay", and "Post-Discharge" – reveals the vulnerabilities and functional limitations that often accompany the aging process.
Functional Challenges Faced by Millie:
Millie's story showcases several functional challenges that impact her daily life and increase her risk of falls:
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Cognitive Decline: Millie experiences memory loss and confusion, particularly with new information and tasks. This cognitive decline significantly affects her ability to follow instructions, maintain personal safety, and make informed decisions.
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Mobility Issues: Millie has difficulty walking due to pain and weakness in her legs, relying on a walker for support. This impairs her ability to move around independently and increases her risk of falls.
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Vision Impairment: Millie experiences blurry vision, which affects her ability to navigate her surroundings and identify potential hazards. This further increases her risk of falls.
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Decreased Balance: Millie struggles with maintaining balance, especially when turning or transitioning between surfaces. This vulnerability makes her susceptible to falls, particularly when walking or standing.
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Medication Management: Millie's confusion makes it difficult for her to manage her medication regimen independently, leading to potential overdosing or missed doses.
Tools for Fall Prevention:
Three instruments from the High Intensity Geriatric Network (HIGN) website's "Try This" series, suitable for a fall prevention program for individuals like Millie, are:
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The Timed Up & Go Test (TUG): This test assesses mobility and balance by measuring the time it takes a person to rise from a chair, walk a short distance, turn around, walk back, and sit down again. It provides a quick and easy assessment of fall risk.
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The Berg Balance Scale (BBS): This scale evaluates balance and mobility through a series of 14 tasks, ranging from sitting to standing to walking on different surfaces. It helps identify specific areas of balance deficits and provides guidance on individualized interventions.
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The 4-Stage Balance Test: This test assesses an individual's ability to maintain balance in four progressively challenging positions: standing with feet together, standing with one foot in front of the other, standing with one foot in front of the other and eyes closed, and standing with one foot in front of the other and eyes closed on a foam pad. This test helps identify balance impairments and suggests appropriate interventions.