Challenges in Elderly Patient Care: Chronic Conditions, Ethics, and Evidence-Based Practices - Free Report

Eighty-five-year-old Mr. Bale is oxygen-dependent due to being diagnosed with Chronic Obstructive Pulmonary Disorder. This is due to smoking at least two packs of cigarettes for the past 50 years of his life. Apart from his condition, he also suffers from two chronic conditions: congestive heart failure and loss of hearing ability (Salmon, 2020). He lives with his wife at his eldest son's house, with two more of his children living close to them. He migrated from Mexico fifteen years ago and has since become an American citizen. However, he does not fully understand English since he is proficient in Spanish, and therefore his family translates most of the communication that happens in English to him. Mr. Bale uses Western healthcare as well as traditional remedies prescribed for his conditions ( Salmon, 2020). His family is concerned that despite his conditions and the interventions given to manage them, he continues to smoke cigarettes, which puts him at more risk of suffering from the consequences of the complications he faces. His family is concerned that despite signing an agreement not to smoke when he was put under oxygen therapy, he continues to smoke, which is an ethical concern since they feel that they should notify the relevant authorities or at least try to make him stop the act.

Is your time best spent reading someone else’s essay? Get a 100% original essay FROM A CERTIFIED WRITER!

Order now

The three complications that Mr. Bale experiences have different risk factors associated with them. First, COPD has the risk factors of being exposed to cigarette smoking. The smoking that he engages in puts him at risk of suffering from congestive pulmonary disorders since the blood vessels are obstructed by the deposits of the smoke that he inhales. The risk factors for heart failure that he experiences come from the different aspects he is exposed to. The first one is the smoking that he engages in, which constricts his blood vessels and makes breathing and blood circulation difficult. The blockage from the smoke deposits from cigarette smoking also results in high blood pressure from the heart's attempts to pump sufficient blood to the body. COPD also results in the patient being at risk of heart failure since his heart is overwhelmed by the need to supply blood to the body, yet the blood vessels are insufficient in the supply.

The identified problems represent a danger to both Mr. Bale and his family. First, all the conditions identified represent a tragic end for Mr. Bale since they may all lead to suffering and death (Baker, 2019). Additionally, given that he is an older adult, it is likely that he may be at extra risk of suffering from the consequences of the complications since his body is unable to recover from the challenges and results associated with the difficulties mentioned above. His family is at risk of being passive smokers since he smokes from the house, and this means that he may put them at risk of suffering from the consequences of smoking even if they do not actively participate.

The chronic care model would help Mr. Bale manage his conditions and lead a more productive life free of struggles from the consequences of the conditions. The model provides practical solutions to the problems experienced and therefore considers the different issues that the patients experience and provides workable solutions (Baker, 2019). The supportiveness of the model also ensures that the patients are supported in their attempts to manage their conditions despite the different challenges they experience, such as Mr. Bale's addiction to cigarettes. Therefore, the model will help the patients manage their conditions through the informed interactions between the patients and the team taking care of them.

The evidence-based practice that I would apply is oxygen in patients with COPD and other heart-related conditions. Through the provision of sufficient oxygen, the patients concerned will overcome any breathing challenges that may come as a result of the blockage of their respiratory system, which will, in turn, lead to heart complications. I would build a personal relationship with the patient, which would establish trust and mutual respect, which would result in the ability to convince them to quit or reduce their smoking so that they can not worsen their conditions ( Boehmer, 2018). By establishing personal relationships, I will have found a way to persuade and influence the patients to quit smoking without sounding invasive and making it seem like I am forcing them to take up smoking. Therefore, the relationship will open up a leeway through which I can openly communicate with the patient and make the right decision.

The ethical dilemma is when the patient signed an agreement not to smoke when given oxygen therapy. Yet, they continue to do so, putting their family in the dilemma of reporting him and getting the oxygen treatment withdrawn or breaking the law by not reporting the issue. The ethical principle in the issue is the need to divulge information whenever the patient is putting themselves or others at risk. To solve the dilemma, I would suggest that the family talk to Mr. Bale to convince him to quit smoking since it worsens his health condition and violates the agreement they signed (Boehmer, 2018). Secondly, I would suggest that Mr. Bale be put through programs that will help him quit smoking since making him quit without being put through therapy, and other programs would end up hurting him. I support the second suggestion since it is a proven way, and it is the only way that would not harm the patient due to the use of counseling to help the patients quit addictions.

References

Boehmer, K. R., Abu Dabrh, A. M., Gionfriddo, M. R., Erwin, P., & Montori, V. M. (2018). Does the chronic care model meet the emerging needs of people living with multimorbidity? A systematic review and thematic synthesis. PLoS One, 13(2), e0190852. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0190852

Salmon, V. L. (2020). Care Management and Readmission among Elderly African American Patients with Chronic Illnesses. https://scholarworks.waldenu.edu/dissertations/8576/

Baker, E., & Fatoye, F. (2019). Patient perceived impact of nurse-led self-management interventions for COPD: a systematic review of qualitative research. International Journal of Nursing Studies, 91, 22-34. https://www.sciencedirect.com/science/article/pii/S002074891830258X