Friday, September 6, 2019
The organizational structure of an Alzheimer’s nursing home Essay Example for Free
The organizational structure of an Alzheimer’s nursing home Essay INTRODUCTION Pathophysiology            Alzheimer’s disease (AD), also known as dementia, is a chronic, progressive, degenerative disease that accounts for 60% of the dementias occurring in people older than 65 years of age. It may also be seen less commonly in people in their 40s and 50s, which is referred to as early dementia, Alzheimer’s type, or presenile dementia. It is characterized by loss of memory, judgment, and visuospatial perception and by a change in personality. Over time, the client becomes increasingly cognitive impaired; severe deterioration takes place and death occurs as a result of complication and immobility. Administration and organizational structure  Imagine being in a large room with 40 or so people who are wandering, talking to themselves or talking gibberish, yelling, crying, staring into space or sleeping. Some are looking for their parents; some ask how to get home; one person, who appears to be lost, is repeatedly hollering keeps trying to stand up and sets off a chair alarm. The television is on. Nursing staff is in and out of the dayroom, to ensure that everyone is safe, telling residents to sit down, and calm down taking some to the bathroom or comfort room, passing medication or just observing. An activities aide is trying to hold the attention of a few residents who can cut and paste decorations for the unit. Other residents are sitting at tables with unopened magazines in front of them. This is a typical dementia unit. Coping with restlessness and wandering. The Alzheimer’s disease Association estimates that almost two thirds of clients will wander and become temporarily lost in the community. The client should always wear an identification badge or bracelet when at home. The badge should include how to contact the primary caregiver. In an inpatient setting, the client is checked frequently and placed in a room that can be monitored easily. The room may need to be close to the nurses’ station ( if the noise level in the nurses’ station can be managed ) and away from exits and stairs. Some health care agencies place large stop signs or red tape on the floor in front of exits. Others have installed alarms systems to indicate when a client is opening the door. The Federal Nursing Home Reform Law (OBRA 87)          The Federal Nursing Home Reform Law of 1987 (OBRA 87) requires that each nursing home â€Å"care for its residents in such a manner and in such an environment as will promote maintenance or enhancement of the quality of life of each resident.†This requirement emphasizes dignity, choice, and self-determination for residents. Every nursing home is also required by law to â€Å"provide services and activities to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident in accordance with a written plan of care which†¦is initially prepared, with participation to the extent practicable, of the resident, the resident’s family, or legal representative.†This means that a resident should not decline in health or well-being as a result of the way a nursing home provides care. At its heart, culture change is about changing the culture of nursing homes so that they fully reflect these requirements. The culture change movement aims to de-institutionalize the environment of nursing homes. It involves the transformation of nursing homes from the traditional model to a more resident-centered model. Culture change nursing home structure look like. Care is truly resident-centered: tailored to each resident to meet his/her needs as an individual, based on the individuals needs and preferences; Care is delivered by caregivers who have a meaningful and valued role in the residence; The environment is truly home-like, with residents having privacy of their own room and bathroom and the functioning of the nursing home such as nurse stations, resident lounges and dining rooms being small in scale and close in proximity to the residents room; Residents truly participate in life at the nursing home, making decisions for themselves regarding dressing, dining, bathing and partaking in activities, taking part in the functioning of the nursing home to the extent they wish to be involved, etc Conclusion:            When the client can no longer be cared for at home, referral to an assisted-living or long-term care facility may be needed. Early in the course of the disease, advise the family that placement might be needed in the late stage of the disease. This allows the family to begin the search process for an appropriate facility before a crisis develops and immediate placement is needed. A number of facilities specialize in the care of the clients with AD and other dementias. These units generally have a high staff- to-client ratio and architecturally design to meet the special needs and attention of this type of client. Reference: Cummings, J.L., (2002). Guidelines for managing Alzheimer’s disease, American Family Physician Nussbaum, R.L., (2003). Alzheimer’s disease and Parkinson’s disease. New England Journal of Medicine Rowe, M.A (2003). People with dementia who became lost, American Journal of Nursing http://www.princeton.edu/~ota/disk1/1992/9234/923407.PDF
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