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.

By Day 3

Post 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.

References:

Resnick, B. (Ed.). (2016). Geriatric nursing review syllabus: A core curriculum in advanced practice geriatric nursing (5th ed.). New York, NY: American Geriatrics Society.

• Chapter 18, “Hospital Care” (pp. 134-145)

This chapter explores systems of care for assessing and managing hospitalized older patients. It also examines alternatives to hospital care and transitions from hospital care.

• Chapter 20, “Rehabilitation” (pp. 152-166)

This chapter describes essential components of geriatric rehabilitation, including sites of rehabilitation, roles of core health care providers on rehabilitation teams, and disease-specific care plans for older adults. It also explores mobility aids, orthotics, adaptive methods, and environmental modifications for older adults with disabilities.

• Chapter 21, “Nursing-Home Care” (pp. 167-174)

This chapter identifies the demographic and functional characteristics of older adults living in nursing homes as well as the availability of nursing homes in the United States. It also describes staffing patterns, quality issues, and legislation related to nursing home care.

• Chapter 22, “Community-Based Care” (pp. 175-180)

This chapter explores characteristics of care in communities, including home care, community-based services not requiring a change in residence, and community-based services requiring a change in residence. It examines older adult populations, health care issues, and the primary provider’s role in these sites of care.

• Chapter 23, “Outpatient Care Systems” (pp. 181-185)

This chapter describes current approaches that maximize patient outcomes in geriatric outpatient care systems. It also examines new approaches that may benefit older adults in outpatient care systems.