HP 626 week 7 assignment aging service provider interview and paper

Sample Answer

For this assignment, I interviewed a female Adult-gerontology primary care nurse practitioner (AGPCNP) who works in a Long-term care (LTC) facility. The AGPCNP supervises and provides care and treatment to older adults recovering from an illness or injury in the long-term care facility.

Besides, the AGPCNP has a role in improving the quality of life and promoting the wellbeing of older adults through education, research, and application of interdisciplinary knowledge of the aging process and aging population. The service provider has been an AGPCNP for seven years and has worked in the facility for three years.

She has a Master’s degree in Nursing with an Adult-gerontology primary care nurse practitioner specialization. Before becoming an AGPCNP, she worked as a registered nurse for eight years. The purpose of this paper is to summarize the interview with the AGPCNP and reflect on how the interview has expanded my understanding of service providers.

Overview/Summary of Interview

The AGPCNP’s primary role is to assess, diagnose, and plan for the health needs of older adults in the LTC facility. She is an autonomous NP with independent practice and thus is involved in obtaining patients’ medical histories, performing physical examinations, ordering screening tests, interpreting diagnostic tests, and administering age-appropriate

pharmacological and non-pharmacological treatments. Furthermore, the AGPCNP mentioned that she addresses the cultural, psychological, and social aspects of aging alongside treating and preventing illnesses and injuries in older adults.

This comprehensive approach to health enables the AGPCNP to deliver a care plan that the patient will understand and that family members and caregivers can support.

She states that she assesses older adults to identify the physical, social, economic, psychological, and spiritual factors that may influence the health of patients and educates the patients on how to improve health outcomes. Moreover, the AGPCNP is tasked with managing transitions of patients between care settings, providing patient and caregiver education during transition, and evaluating caregiver competence.

The AGNP’s job and the LTC facility she works in significantly impact the health and wellbeing of aging adults. The facility provides a wide range of services to assist older adults over prolonged periods to compensate for loss of function caused by chronic illnesses, injury, or physical or mental disability.

The care provided to older adults in the facility varies based on a patient’s needs and includes hands-on, direct care and general supervisory assistance. The facility supports older adults in two aspects activities of daily living (ADLs) and instrumental activities of daily living (IADLs).

ADLs include eating, bathing, dressing, getting in and out of bed or a chair, and using the toilet. IADLs include additional tasks needed to maintain a patient’s independence, like managing medications. The organization is under community-based care.

Social, political, and economic factors impact the day-to-day running of the long-term care facility. Social factors include the social isolation of older adults by their families, which leads to increased levels of depression and anxiety.

Besides, older adults fear being dependent due to the social stigma associated with being fully dependent on others for ADLs. This makes them reluctant to accept help from another person to carry out ADLs or make decisions about finances and health care. Political factors relate to policymakers having a role in determining which type of care is most suitable for whom.

Existing policies influence service delivery and financing in long-term care facilities, and policymakers affect the organization’s scope, mix, quality, and financing of services. Economic factors that impact service delivery at the LTC facility include financial retrenchment and budgetary pressures. The costs of LTC include direct costs of care as well as costs such as resource utilization and family burden.

However, policies are primarily concerned with reimbursement costs but fail to consider the other costs, which are equally important.
The AGPCNP mentioned that almost all patients present with at least two comorbidities. Consequently, the organization has adopted an interdisciplinary and multidisciplinary approach to help meet all the patients’ needs.

According to the AGPCNP, the facility employs a patient-centered, multidisciplinary approach, whereby goals are set for and with the patient and often involves the family. This is followed by assigning duties to the different disciplines needed to support the patient’s goal.

An interdisciplinary and interpersonal approach goes hand-in-hand, and the holistic assessment approach with the older adult drives the team.

The AGPCNP reported being a leader who approaches problem-solving and decision-making through critical thinking, effective communication, and having an analytical mindset. The service provider stated that since health complexities increase with age, an AGPCNP must critically think through their care plans, continuously evaluating patients’ health status and recommending solutions to treat and prevent illness and injury.

Critical thinking is vital in making clinical decisions that best meet a patient’s health needs. In addition, she mentioned that an AGPCNP must possess strong analytical skills to assess patients’ health needs. She utilizes analytical skills to thoroughly examine patients’ health status, including scrutinizing their medical history and assessing environmental factors that may impact their health, like home care and social activities, before developing a care plan.

Furthermore, the AGPCNP reported that positive nursing leadership is essential in problem-solving and decision-making. As the interdisciplinary team leader, she needs to steer the team’s direction through a clear vision, support other providers, promote their personal development, attentively listen to the team members, and act accordingly.

The AGPCNP mentioned that health informatics and technology have helped improve care delivery and patient outcomes at the LTC facility. For instance, the EHR has improved the quality of care by reducing medication-related errors and improving clinical documentation and decision-making. Patients, providers, and the organization have realized the benefits of adopting EHR.

Furthermore, the adoption of the EHR has been linked with key qualities of efficiency and effectiveness through improved data analysis and audits, coding and links to billing, and retention and proper safeguarding of clinical records. Health informatics has supported using the Health Information Exchange (HIE).

HIE allows electronic transmission of healthcare-related data among healthcare facilities and is particularly applicable to the facility owing to the number of transfers and medical handoffs linked with the care of older adults.

The organization considers a diverse workforce as fundamental to providing high-quality care to patients from diverse cultures and backgrounds, given that the patient population in the facility is not homogeneous. A diverse workforce has the advantages of having access to different perspectives and improving the organizations’ ability to ideate, problem-solve, and empathize with patients.

However, the organization has encountered challenges in developing a diverse, qualified workforce since finding qualified staff from different backgrounds is difficult. Besides, there have been challenges of cultural misunderstandings among employees, discrimination, and communication issues due to language barriers, different communication styles, and preferences.

The AGPCNP’s work is affected by social challenges like ageism, a type of social discrimination arising from age. The AGPCNP mentioned that society purposely excludes certain age groups from opportunities or resources based on chronological age, which leads to social inequality.

Older adults perceive aging as negative, which leads to aging anxiety and affects how they accept the care given to them. Ethical and legal challenges are also prevalent when caring for older adults. The AGPCNP mentioned that many patients refuse treatment, and this poses ethical challenges related to respect for autonomy and beneficence.

Patients tend to refuse interventions aimed at improving their health outcomes. Treating older adults with dignity and allowing them to make autonomous decisions is an essential part of quality medical care. According to the AGPCNP, her biggest challenge at work relates to advanced directives.

Many patients lack clear advance planning for their health care, contributing to conflict between physicians, patients, and family members. It also leads to medical interventions that the patient would not have desired or withdrawal of interventions that would have met a patient’s wishes.

Analysis

The interview analysis shows that service organizations for aging adults face social, political, and economic factors that affect their day-to-day activities. The organizations are addressing this by proposing and advocating for policies that improve care delivery and reimbursement in LTC facilities.

Organizations have identified that they need effective policies to bridge the gaps between public health, health care, and other sectors of the economy, focusing on social determinants of health and preventive measures to reduce the burden of chronic disease in older adults (Fulmer et al., 2021).

Gaps in the current management practices include poor care coordination across health systems. Multiple care transitions contribute to medication errors, lack of follow-up care and referrals, and disruptions in care planning and treatment, leading to substandard care for older adults (Fulmer et al., 2021).

The challenge can be addressed by establishing transitional care approaches, using advance directives, and honoring older adults’ wishes for end-of-life care.

Regarding social issues, the organization lacks a policy to address social isolation and loneliness among older adults in LTC. This can be addressed by lobbying for policies that will direct the development of innovative housing options, recreational opportunities, and improved transportation and public safety measures to reduce isolation (Boamah et al., 2020).

However, this comes with the challenge of finances to fund housing models that promote equity and address social issues. Future concerns that should be addressed include limited access to technology, low digital health literacy, and design barriers in patient portals and apps that disproportionately affect older adults, particularly those in underserved communities.

The principles of strategic leadership and management skills can benefit a service provider of aging adults by fostering highly effective approaches to decision-making, transparency, and innovation.

A leader of a service care organization can push power downward across the organization to empower employees at all levels to make decisions.

This can increase the organization’s collective intelligence, adaptability, and resilience (Singh et al., 2023). The leaders can also create a working environment that allows the employees to be creative, try new things, and even fail so that they can learn from their errors.

Furthermore, leaders can create opportunities for experience-based learning (Singh et al., 2023).

For instance, the leader can encourage employees to come up with a solution to a problem in patient care or design a new intervention to improve care delivery. The current political environment helps to shape policies affecting healthcare organizations and the communities they serve as advocates lobbying for healthcare policies.

There has been an increase in advocacy initiatives to enact or change policies related to insurance coverage for older adults and low-income persons. Besides, advocacy activities aim to improve the healthcare environment to improve healthcare delivery to communities.

Personal Reflection

The interview with the AGPCNP enlightened me on the unique needs of service providers for aging adults, which include social, economic, and political factors. I learned that healthcare professionals working with older adults not only address the physical issues patients present with but also have to provide holistic care focusing on social, economic, psychological, and spiritual factors.

I was surprised to learn that although aging is a natural change everybody experiences, many older adults see aging as negative. This leads to aging anxiety that often affects their psychological wellbeing and determines peoples’ attitudes and behavior toward older adults.

The interview experience will affect how I approach my career and profession as I have learned to prioritize identifying the healthcare setting and programs that meet the preferences of older adults while best serving their healthcare needs.

Conclusion

I interviewed an AGPCNP working in an LTC facility. Her role is supervising registered nurses in the facility and ensuring patients are provided with a well-rounded approach to care.

The AGPCNP reported that social, political, and economic factors affect their work, and they include social isolation of older adults, policymakers determining care delivery, financial retrenchment, and budgetary pressures.

Ageism is a major social challenge that affects older adults in LTC facilities and impacts their psychological wellbeing. Policies are needed to improve reimbursement in LTC and mitigate social isolation in older adults.

References

• Boamah, S. A., Weldrick, R., Lee, T. J., & Taylor, N. (2020). Risk factors for social isolation among older adults in long term care A scoping review. https //doi.org/10.20944/preprints202012.0779.v1
  
• Fulmer, T., Reuben, D. B., Auerbach, J., Fick, D. M., Galambos, C., & Johnson, K. S. (2021). Actualizing better health and health care for older adults. Health Affairs, 40(2), 219-225. https //doi.org/10.1377/hlthaff.2020.01470
  
• Singh, A., Lim, W. M., Jha, S., Kumar, S., & Ciasullo, M. V. (2023). The state of the art of strategic leadership. Journal of Business Research, 158, 113676. https //doi.org/10.1016/j.jbusres.2023.113676