Patient-centered care involves the provision of health care services which fit the needs of the patient. It is the process of engaging and informing the patient about his or her health. It also includes respecting the patient’s rights, decisions, and culture (Krau, 2015). Patient-centered care can be provided to the patient in the case by conducting assessments that focus on her needs and by evaluating her safety.
The focused assessments that should be completed on the patient include psychosocial. The social well-being and the mental health of the patient should be evaluated due to her condition. Patients with multiple chronic health conditions are more likely to report anxiety, stress and depression, all which can be diagnosed using a psychosocial assessment. The assessment can also be used to evaluate the social wellbeing of the patient since patients with multiple chronic conditions are also likely to report a low quality of life and low literacy levels. There is also a possibility that the patient might have a cognitive impairment which is also related to having many chronic conditions at the same time. The psychosocial assessment is essential in coming up with interventions that meet the needs of the patient (Tisminetzky et al., 2016). The nutritional assessment should also be completed. This evaluation is crucial in determining if the patient is suffering from malnutrition. The patient has various factors which increase the risk of malnutrition. One of them is living alone. Social isolation is a factor that influences dietary practices. The isolation is likely to affect the older adult as she may feel that the work involved in preparing a proper meal is too much for her to do by herself. Since she lives alone, there is a probability that she does not have a person who can prepare a meal for her. Another factor that increases the risk of malnutrition is chronic conditions.
Chronic diseases affect the functional ability and the ability to consume the food. These illnesses may lead to difficulties in swallowing and lack of appetite. The medicines used to treat the chronic diseases can also affect nutritional practices. The drugs may cause nausea, loss of appetite and diarrhea. The patient’s age also increases the risk of malnutrition since elderly individuals experience physiological changes in the body. The older adults may start preferring softer food due to loss of teeth. Old age also leads to an increase in fat mass and a reduction of muscle mass. This causes a reduction in the food consumed. An individual that is reducing his or her food intake may omit key nutrients from his or her diet (Leslie & Hankey, 2015).
The patient’s living situation also necessitates the need for the nutritional assessment. The patient lives on the second floor of an apartment. This may make it difficult for her to go shopping for some groceries especially if her physical ability is affected by her age or chronic conditions. The cultural assessment should also be completed. This evaluation is essential for the nurse to find out essential factors of the patient’s culture. Knowing the patient’s culture is crucial for communication. Effective communication is vital in the nursing practice as it enables the development of trusting relationships with the patient. Through communication the nurse can understand and empathize with the patient. Good communication is affected by culture. Culture makes individuals understand sickness or health differently. It also influences views about the type of information that can be divulged (Crawford, Candlin & Roger, 2017). The cultural assessment will enable the nurse to understand the patient better. There is a high possibility that the client belongs to a different culture since she speaks minimal English.
An environmental assessment should also be conducted. Environmental factors are increasingly causing diseases. The evaluation of the environment is crucial in determining if the environment has caused the patient’s chronic conditions or if it can make it difficult for her to manage her illnesses. For example, environmental factors which influence nutrition may affect the patient’s ability to maintain the diet needed to remain healthy. The environmental factors also influence the safety of the patient (Prüss-Ustün et al., 2017). The functional assessment should also be completed to determine the mental functioning of the patient. This evaluation is vital since old age is associated with poor mental functioning. The functioning of the brain is also influenced by various chronic conditions. The chronic illnesses that affect the patient may have caused damage to her mental functioning (Devi, 2018). This assessment is essential in the provision of patient-centered care as it will enable the nurse to consider the functional ability of the patient while designing and implementing care.
Various safety concerns should be considered. One of them is the risk of injury from a fall. The patient’s building does not have an elevator, therefore, causing a risk of her falling from the staircase. The chronic conditions that the patient suffers may affect her ability to move or see properly thus causing her to fall. The fall can also happen in the patient’s apartment or any other place. The patient lives by herself, and she is required to conduct all her necessary tasks without any assistance. This increases her movement inside and outside her house. Another risk that faces the patient is that of adverse drug events. The patient may obtain an injury from improper usage of her drugs. An adverse drug event may occur due to the confusion of her medicine. Her multiple chronic diseases may require her to take many medicines at once. This increases the probability of errors. The adverse drug events may also happen due to lack of understanding of the dosage instructions. The language barrier may lead to poor understanding of the dosage instructions and errors while taking medicine. The patient is also at risk of suicide or self-harm. Multiple chronic health conditions may lead to stress, anxiety, and depression which may cause suicide (Tisminetzky et al., 2016).
Crawford, T., Candlin, S., & Roger, P. (2017). New perspectives on understanding cultural diversity in nurse–patient communication. Collegian, 24(1), 63-69. doi:10.1016/j.colegn.2015.09.001
Devi, J. (2018). The scales of functional assessment of Activities of Daily Living in geriatrics. Age and Ageing, 47(4), 500-502. doi:10.1093/ageing/afy050
Krau, S. D. (2015). Patient-centered care and lifelong learning. Nursing Clinics of North America, 50(4), 11-13. doi:10.1016/j.cnur.2015.10.002
Leslie, W., & Hankey, C. (2015). Aging, nutritional status and health. Healthcare, 3(3), 648-658. doi:10.3390/healthcare3030648
Prüss-Ustün, A., Wolf, J., Corvalán, C., Neville, T., Bos, R., & Neira, M. (2017). Diseases due to unhealthy environments: An updated estimate of the global burden of disease attributable to environmental determinants of health. Journal of Public Health, 39(3), 464-475. doi:10.1093/pubmed/fdw085
Tisminetzky, M., Gurwitz, J., Mcmanus, D. D., Saczynski, J. S., Erskine, N., Waring, M. E., Goldberg, R. (2016). Multiple chronic conditions and psychosocial limitations in patients hospitalized with an acute coronary syndrome. The American Journal of Medicine, 129(6), 608-614. doi:10.1016/j.amjmed.2015.11.029