There are several troubling factors that need to be addressed with this client. The client openly verbalized that he feels like he is a burden to his daughter. The client’s daughter is the primary caregiver and has complete control of the client’s finances. With the client feeling that he is already a burden to his daughter, he is less likely to verbalize his needs or concerns to her in an attempt to not place further stress on her. It is clear that the client cares for his daughter greatly, as he still puts her needs ahead of his own even in his old age. The nurse practitioner would need to approach the subject of inquiring about the quality of care provided to the client by his daughter. The nurse practitioner needs to ensure that client is in a safe environment with adequate care, safety, and supervision, without offending the client by questioning the care provided by his daughter. The client must be questioned regarding any concerns he may possibly have with his living arrangements and ensure that the client feels safe living with his daughter or if he is interested in making other living arrangements. It is also imperative that the nurse practitioner place great emphasis on providing culturally competent care. Culturally competent care requires that healthcare providers be sensitive to the patient’s heritage, sexual orientation, socio-economic situation, ethnicity, and cultural background (Ball et al., 2019). A great way to show the client that you care about his culture is to ask him what aspects of his culture can be incorporated into his plan of care. The client’s daughter must also be included, if possible, to ensure that she has a voice as her father’s caregiver, and to give her the opportunity to voice any concerns she may have. This is also an excellent opportunity to offer any assistance to the daughter whether it be counseling services, financial assistance, etc (Rezende et al., 2017). Is it important to also assess the caregiver’s mental health status. Results suggest that satisfactory mental health status plays an important role in limiting family caregivers’ burden (Miura et al., 2005). Five specific target questions that would aid in assessing the client’s health history and health risks are as follows: “Is your daughter always home to help you around the house when you need assistance?”, “Does your daughter ensure your daily medications are taken and at the appropriate times?”, “Does your daughter monitor your blood pressure at home daily?”, “You mentioned not wanting to be a burden to your daughter, is there some reason that you feel like you might be a burden to her?”, “Can you tell me a little bit about your culture? I want to incorporate any customs or preferences you may have into your plan of care”.

Resources

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.

Miura, H., Arai, Y., & Yamasaki, K. (2005). Feelings of burden and health-related quality of life among family caregivers looking after the impaired elderly. Psychiatry and Clinical Neurosciences, 59(5), 551–555. https://doi.org/10.1111/j.1440-1819.2005.01413.x

Rezende, G., Gomes, C. A., Rugno, F. C., Eva, G., Lima, N. K. C., & De Carlo, M. M. R. P. (2017). Burden on family caregivers of the elderly in oncologic palliative care. European Geriatric Medicine, 8(4), 337–341. https://doi.org/10.1016/j.eurger.2017.06.001

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Solution

Introduction

I have read the discussion posted and I can confidently say that I agree with it. Almost all elderly patients have to be in the care of an adult caregiver. This is important for the reasons that I will discuss in this paper. Furthermore, there are many considerations to be taken to ensure both the health of both the patient and the caregiver. This is as follows.

When assessing a geriatric patient, it is important to factor in issues like culture so that the patient feels safe enough to report their problems to the NP (Solomon et al., 2021). This will enable the nurse to make patient-centered decisions appropriate for the patient. It is also important to understand their culture in case one needs to make living arrangements for the patient (Givler et al., 2021). Incorporation of cultural aspects into the patient care makes them feel welcomed and more at home, which improves their quality of life (Givler et al., 2021).

The history taking session should be done in a setting where the patient feels open to talk. You should ask the patient whether he is getting the recommended care from the caregivers such as taking all prescribed medications on time. If for example the patient feels like he is becoming a burden to the caregiver, this should be addressed (Rezende et al., 2017). The NP should assess the caregiver’s mental and physical health for capability and availability to carry on care for the patient (Stajduhar & Dionne-Odom, 2019). If this is not possible, they should both be and advised on considering living care for the patient. The caregiver should be reassured that it does not mean that they have failed in taking care of the patient, rather, the NP should encourage them that this will be better for the patient who will be getting all the care they need from professionals.

References

Givler A., Bhatt H., & Maani-Fogelman, P. A. (2021). The Importance Of Cultural Competence in Pain and Palliative Care. NCBI. https://www.ncbi.nlm.nih.gov/books/NBK493154/

Rezende, G., Gomes, C., Rugno, F., Eva, G., Lima, N., & De Carlo, M. (2017). Burden on family caregivers of the elderly in oncologic palliative care. European Geriatric Medicine, 8(4), 337-341. https://doi.org/10.1016/j.eurger.2017.06.001

Solomon, B. S., Dains, J. E., Ball J., Stewart, R. W., & Flynn, J. A. (2021). Seidel’s Guide to Physical Examination An Interprofessional Approach (10th ed.). Elsevier.

Stajduhar, K. I., & Dionne-Odom, J. N. (2019). Supporting families and family caregivers in palliative care. Oxford Textbook of Palliative Nursing, 405-419. https://doi.org/10.1093/med/9780190862374.003.0032