Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Consideration Paper

Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Consideration Paper

Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Considerations Paper

Dementia is a progressive and chronic syndrome caused by various brain disorders that affect a person’s thinking, memory, behavior, and ability to carry out everyday activities. One of the common causes of dementia is Alzheimer’s disease (AD). AD dementia is overwhelming for affected individuals and their caregivers and families (Griffin et al., 2020). Besides, there is limited awareness and understanding of AD dementia globally, causing stigma and barriers to diagnosis and treatment.AD dementia significantly affects caregivers, families, and communities physically, psychologically, and financially. The purpose of this paper is to discuss the

Patient, Family, or Group I Intend To Work With

Seniors are the selected patient population that I purpose to work with. They include adults from the age of 65 years and are usually one of the most vulnerable populations in our communities. The Administration for Community Living (ACL) 2020 statistics revealed that there were approximately 54.1 million seniors in the US in 2019. This represents 16% of the US population. Of this population, 30 million were females, while 24.1 million were male. Senior citizens represent one in every seven Americans. Seniors are the most affected population by AD dementia, with approximately 6.5 million Americans aged 65 and above living with AD in 2022 (ACL, 2020). Of this population, 73% are 75 years or older. It is projected that seniors with AD will reach 12.7 million by 2050.

Senior citizens with AD live in the community (living alone or with a spouse) or in long-term care facilities. For senior citizens living in the community, 61% lived with their spouse in 2020, while roughly 27% lived alone (20% of senior men and 33% of senior women). The number of senior Americans has shot up by 14.4 million (36%) since 2009 (ACL, 2020). States with the highest population of seniors as of 2019 include Florida, Maine, West Virginia, and Vermont. The population of seniors is projected to continue to increase significantly and is estimated to reach about 94.7 million in 2060.

What I Hope To Learn

Older adults living with AD experience a wide range of challenges, which most people are unaware of since they rarely express themselves. Therefore, I hope to interact with seniors and learn the challenges that individuals with AD experience in their day-day lives in the physical health, mental, social, and economic aspects. I hope to learn about the common comorbid conditions among seniors and the factors that impact their health outcomes. I also hope to learn about the social factors that affect seniors’ mental health and the challenges that make them vulnerable to poor health outcomes. In addition, I hope to learn the level to which seniors with AD access social services and how these services help them to manage their health. I also hope to learn about seniors’ access to health insurance and how their insurance status influences their access to healthcare services and the quality of care they receive for AD. Furthermore, I hope to learn how disability and limitations in physical functioning affect their functioning and the degree of difficulty they experience in their day-to-day activities.

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The Rationale for Choosing This Particular Group

I selected seniors because they are among the most vulnerable populations in the U.S. Factors contributing to their vulnerability include poor health status, cognitive deficits, and social isolation. There are various dimensions of vulnerability among seniors, including Poor mental and physical health; Limitations in physical mobility; Food insecurity; Economic insecurity; Social isolation; Inadequate and unaffordable housing; Inaccessible transportation and built environments; Marginalized identities and cultures; Language barriers and lack of multi-lingual services (Cabral et al., 2019). Besides, seniors are greatly vulnerable to exploitation by other individuals, including relatives and institutions, owing to their worsening health and cognitive functioning and the weakening social support system over time.

In addition, seniors are a population of interest since they face many socio-economic challenges. Poverty among seniors is usually due to a buildup of disadvantages over their lifetime, gender and racial differences, and structural issues. Access to social services and benefits is usually a great challenge for low-income seniors (Griffin et al., 2020). The groups of seniors most affected by vulnerabilities include women above 85 years; Visible minority seniors; Single-income seniors; Aboriginal seniors; Recent immigrant seniors; Seniors with low education levels; Seniors with chronic conditions and limitations in mobility.

Presenting Ideas About The Problem To The Group And Convincing Them Of Its Significance

Effective communication is crucial when dealing with seniors and can help to strengthen the patient-provider relationship and promote better health outcomes. I will present ideas about AD dementia to the seniors by using the appropriate form of address and using formal language to establish respect. In addition, I will take some time to create a rapport by introducing myself and the purpose of the meeting (Jack et al., 2019). I will also use active listening skills to keep the discussion focused and let the group know that I understand their concerns. Furthermore, I will demonstrate empathy and avoid medical jargon when talking to the seniors. The teach-back method will be used to ensure patients understand the health issue, what they need to do, and the importance of taking action (Jack et al., 2019). When applying the teach-back method, I will instruct the older adults to explain what they have learned about AD dementia using their own words and its impact on their health and overall well-being. Besides, I will present statistics on AD dementia and examples of how AD patients are managed.

Evidence from Peer-Reviewed Literature and Professional Sources That Describes and Guides Nursing Actions Related To AD in Seniors

There are currently no disease-modifying interventions for AD, and the existing pharmacological treatments for AD symptoms have limited efficacy and significant side effects. Zucchella et al. (2018) explain that non-pharmacological interventions may play a role in alleviating AD. The non-pharmacological interventions that can guide nursing actions include cognitive rehabilitation, exercise, motor rehabilitation, psychological therapy, and occupational therapy. In addition, new technologies have been recommended to help in managing AD patients, such as virtual reality, assistive technology and domotics, gaming, and telemedicine. Abraha et al. (2018) explain that behavioral and psychological symptoms of AD can be alleviated through approaches such as environmental redesign, reminiscence therapy, validation therapy, light therapy, aromatherapy, massage, and sensory-based interventions, music therapy, pleasant events, activity engagement, and caregiver training.

How State Board Nursing Practice Standards and Organizational or Governmental Policies Could Affect Seniors With AD

The state board of nursing practice standards and government policies direct how nursing care should be provided and the quality of care for patients with AD. Nursing practice standards guide nurses on ways to deliver quality patients that will improve AD symptoms and the quality of life for AD patients. Various residential care and assisted living (RC/AL) policies influence the quality of life for patients with dementia. For instance, all states have policies mandating RC/AL settings to evaluate residents to establish if their needs can be met and organize activities that meet their needs and preferences (Carder, 2018). Patients with dementia can benefit from practice standards and policies that account for particular behaviors and needs associated with dementia, making states’ regulations on RC/ALs addressing dementia care a crucial policy topic.

There are state government policies that dictate the building design of RC/ALs to address the safety and quality of life of patients with dementia. Besides, some required design features may improve behavioral symptoms like cognitive limitations, exit seeking, and pacing (Carder, 2018). These policies include having simple floor plans to accommodate seniors with difficulties finding their way, locking systems that prevent seniors from leaving a building unsupervised, and having small separate dining areas for patients with dementia.

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Leadership, Collaboration, Communication, and Change Management Skills

The leadership skills needed to work with the seniors effectively include interpersonal skills, patience, time management, and empathy. Besides, I will need persuasion skills to change the seniors’ existing attitudes and behavior and build trust (Claesson et al., 2020). Collaboration skills will be essential to bring together seniors from different backgrounds and convince them to focus on the identified health problem. Crucial collaboration skills when working with seniors include open-mindedness, adaptability, and organization. Furthermore, excellent communication skills are crucial, and they include active listening, confidence, exhibiting empathy, responsiveness, positive nonverbal cues, and giving feedback (Jack et al., 2019). Additionally, change management skills will be essential to promote change that will promote better health outcomes among seniors. They include effective communication, active listening, strategic thinking, strong research skills, measurement, and analysis.

Potential Barriers In Presenting The Problem To Seniors

Potential barriers that may transpire when presenting information on AD dementia to seniors include privacy, time, obligation, and willingness to change. Privacy may be a barrier since the facility includes a missionary home where seniors live. It might be challenging to have a one-to-one interaction with each individual to inform them of their health problems. Time might also be a barrier because each older adult has a schedule, and it might be difficult to have a joint meeting. Besides, seniors have various obligations in their social and occupational lives, resulting in a limited commitment to taking appropriate interventions to address the health problem. Furthermore, seniors may be reluctant to honor the meeting or put the proposed health promotion interventions into practice. Willingness to change is yet another barrier to addressing the health problem of AD dementia. Lifestyle changes will be a major intervention in preventing or delaying the progression of AD among seniors. However, some seniors may be reluctant to effect these changes, which will greatly affect the attainment of the desired outcomes.

Change Management Strategies To Overcome These Barriers

            Change management strategies that will help overcome the above barriers include proper planning, inviting participation, and monitoring and measuring. Before presenting the problem to seniors, I will create a clear plan on how the health problem will be presented, including resources needed and how to address potential concerns (Tappen et al., 2018). In addition, I will ensure that I communicate clearly about the purpose of the project and how addressing AD will help improve the target population’s quality of life and health outcomes, which will overcome barriers of change resistance. I will also invite participation from the group to ensure their concerns are addressed and thus reduce resistance to change (Tappen et al., 2018). Lastly, I will monitor and measure members’ participation in the project to determine the level of resistance to change and the factors causing the resistance.

Conclusion

Alzheimer’s disease is the selected health problem for this project, and the target population is older adults 65 years and older (seniors). This group was chosen because it is one of the most vulnerable populations attributed to poor health status, cognitive deficits, and social isolation. I hope to learn about the health, social, and financial challenges senior citizens with AD experience. However, leadership, communication, and collaboration skills are needed to work with older adults effectively.

References

Abraha, I., Rimland, J. M., Trotta, F. M., Dell’Aquila, G., Cruz-Jentoft, A., Petrovic, M., … & Cherubini, A. (2018). Systematic review of systematic reviews of non-pharmacological interventions to treat behavioural disturbances in older patients with dementia. The SENATOR-OnTop series. BMJ open, 7(3), e012759. http://dx.doi.org/10.1136/bmjopen-2016-012759

Administration for Community Living. (2020). 2020 Profile of Older Americans. ACL Administration for Community Living. https://acl.gov/sites/default/files

Cabral, J. F., Silva, A., Mattos, I. E., Neves, Á. Q., Luz, L. L., Ferreira, D. B., Santiago, L. M., & Carmo, C. (2019). Vulnerability and associated factors among older people using the Family Health Strategy. Vulnerabilidade e fatores associados em idosos atendidos pela Estratégia Saúde da Família. Ciencia & saude coletiva, 24(9), 3227–3236. https://doi.org/10.1590/1413-81232018249.22962017

Carder, P. C. (2018). State regulatory approaches for dementia care in residential care and assisted living. The Gerontologist, 57(4), 776-786. https://doi.org/10.1093/geront/gnw197

Claesson, M., Jonasson, L. L., Lindberg, E., & Josefsson, K. (2020). What implies registered nurses’ leadership close to older adults in municipal home health care? A systematic review. BMC nursing, 19, 30. https://doi.org/10.1186/s12912-020-00413-1

Griffin, S. C., Mezuk, B., Williams, A. B., Perrin, P. B., & Rybarczyk, B. D. (2020). Isolation, not loneliness or cynical hostility, predicts cognitive decline in older Americans. Journal of Aging and Health, 32(1-2), 52-60. https://doi.org/10.1177/0898264318800587

Jack, K., Ridley, C., & Turner, S. (2019). Effective communication with older people. Nursing Older People, 31(4), 40–48. doi:10.7748/nop.2019.e1126

Tappen, R. M., Wolf, D. G., Rahemi, Z., Engstrom, G., Rojido, C., Shutes, J. M., & Ouslander, J. G. (2018). Barriers and Facilitators to Implementing a Change Initiative in Long-Term Care Using the INTERACT® Quality Improvement Program. The health care manager, 36(3), 219–230. https://doi.org/10.1097/HCM.0000000000000168

Wei, M. Y., Levine, D. A., Zahodne, L. B., Kabeto, M. U., & Langa, K. M. (2020). Multimorbidity and cognitive decline over 14 years in older Americans. The Journals of Gerontology: Series A, 75(6), 1206-1213. https://doi.org/10.1093/gerona/glz147

Zucchella, C., Sinforiani, E., Tamburin, S., Federico, A., Mantovani, E., Bernini, S., … & Bartolo, M. (2018). The multidisciplinary approach to Alzheimer’s disease and dementia. A narrative review of non-pharmacological treatment. Frontiers in neurology, 1058. https://doi.org/10.3389/fneur.2018.01058

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In a 5-7 page written assessment, define the patient, family, or population health problem that will be the focus of your capstone project. Assess the problem from a leadership, collaboration, communication, change management, and policy perspective. Plan to spend approximately 2 direct practicum hours meeting with a patient, family, or group of your choice to explore the problem and, if desired, consulting with subject matter and industry experts. Document the time spent (your practicum hours) with these individuals or group in the Core Elms Volunteer Experience Form.
Introduction

Nurses in all professional roles work to effect positive patient outcomes and improve organizational processes. Professional nurses are leaders in problem identification, planning, and strategy implementation—skills that directly affect patient care or organizational effectiveness.

Too often, change agents jump to a conclusion that an intervention will promote the envisioned improvement. Instead, the ideal approach is to determine which interventions are appropriate, based on an assessment and review of credible evidence. Interventions could be patient-facing or involve a change in policy and process. In this assessment, you’ll identify and make the case for your practicum focus area, then explore it in depth from a leadership, collaboration, communication, change management, and policy perspective.

This assessment lays the foundation for the work that will carry you through your capstone experience and guide the practicum hours needed to complete the work in this course. In addition, it will enable you to do the following:

Develop a problem statement for a patient, family, or population that’s relevant to your practice.
Begin building a body of evidence that will inform your approach to your practicum.
Focus on the influence of leadership, collaboration, communication, change management, and policy on the problem.

Preparation

In this assessment, you’ll assess the patient, family, or population health problem that will be the focus of your capstone project. Plan to spend approximately 2 hours working with a patient, family, or group of your choice to explore the problem from a leadership, collaboration, communication, change management, and policy perspective. During this time, you may also choose to consult with subject matter and industry experts about the problem (for example, directors of quality or patient safety, nurse managers/directors, physicians, and epidemiologists).

To prepare for the assessment, complete the following:

Identify the patient, family, or group you want to work with during your practicum The patient you select can be a friend or a family member. You’ll work with this patient, family, or group throughout your capstone project, focusing on a specific health care problem.
Begin surveying the scholarly and professional literature to establish your evidence and research base, inform your assessment, and meet scholarly expectations for supporting evidence.

In addition, you may wish to complete the following:

Review the assessment instructions and scoring guide to ensure that you understand the work you’ll be asked to complete and how it will be assessed.
Review the Practicum Focus Sheet: Assessment 1 [PDF], which provides guidance for conducting this portion of your practicum.