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The elderly are a vulnerable population who are widespread all over the world. Apart from the general decline in life expectancy, research also indicates extensive increase in population ageing especially in low- and middle-income countries (Ho, & Hendi, 2018). Increased incidences of comorbid diseases and other health complications among the elderly is an indicator that there is need to develop better and less invasive treatment strategies for such patients (Itatani, Kawada & Sakai, 2018). There is a mass of evidence pointing towards poor supportive care intervention strategies and inappropriate treatment of elderly patients (Puts at al. 2021). This position paper focuses on how care improvement can be attained among elderly with chronicity issues. Position Paper.
Position Statement on Chronicity among the Elderly.
According to World Health Organization (WHO) cellular damage and molecular accumulation occur over time as an individual grows (“Ageing and health”, 2018). This means that the immune system is continuously weakened as age progresses. Diseases like diabetes, Chronic obstructive pulmonary disease, osteoarthritis and conditions like dementia and depression are common among the elderly. Consequently, due to the underlying factors, elderly individuals are at a higher risk of infection, disorders and other bodily malfunctions which collectively and if not well addressed could be chronic.
More than half of the hospitalized patients in Cedars Sinai are elderly. (“Cedars Sinai Frailty Project “, n.d.). The health institution has witnessed a number of readmissions of the elderly patients, with a percentage of the them having developed preventable complications as a result of the treatment they received. Being a population classified under the special category, a reduction in avertible medical errors, unnecessary readmissions and preventable complications and improvement in the quality of care among the elderly are some of the desirable outcomes of the institution.
To meet the desired outcomes, it is important for the institution to consider coming up with guidelines and policies on how elderly patients especially those with chronic illnesses. In addition, all caregivers attending to the elderly can be provided with further training on how to best handle them. It is also important to involve all major stake holders in caregiving programs if improvement has to be achieved. It is important to address the quality of care received by elderly patients suffering from chronic diseases so as to allow them to have a remarkable experience during their treatment without lengthening the period they are hospitalized and minimize cases or medical errors and readmissions. One assumption in this case is that the hospital, together with its stakeholders, has the capacity including the human and financial resources to support initiatives towards refining quality of care of the chosen population.
Role of the Interprofessional Team in Facilitating Improvements
Having health workers from diverse professional background is crucial in facilitating improvements in care delivered to elderly. Caring for elderly patients with chronicity can be challenging and thus requires maximum collaboration from all members involved in care provision, both the medics and family members or caregivers of patients. There are many medics involved in care of elderly patients including but not limited to social workers, pharmacists, physicians and nurses. Each plays their own unique role in ensuring the patient is well attended.
For improvements in caregiving to be realized, the interprofessional team has to have a shared goal, maintain constant communication among themselves as pertains to patient care and increase collaborations where required (Johnson, Hermosura, Price, & Gougeon, 2021). In addition, the interprofessional team is responsible for overseeing desired health care outcomes by ensuring medication errors are minimized or eliminated. An interprofessional team collaborating efficiently can easily identify an error, thus bridging the gap that arises, unlike when there is no collaboration. Elderly patients suffering from chronic illnesses require alertness and special attention from care givers. One way of delivering comprehensive and supportive patient care intervention is by having a collaboration of multiple health worker professionals attending to the patients.
Nevertheless, an interprofessional team is bound to be faced with challenges in the course of their work. The management of the organization may fail to appreciate the importance of some of the health care professions thus jeopardizing interprofessional efforts. At team level, the members may experience a conflict in their relation with the patient and apathy of the members of the team which may result to lack of commitment. Other challenges include reluctance of members to accept suggestions from other team members, competition and firmness of defensive attitudes among members. Poor team cohesion, skimpy documentation, and meagre referral strategies may pose a threat to interprofessional teamwork (Waggie & Arends, 2021). All in all, extensive training on interprofessional collaboration will be required to effectively facilitate realization of improvements.
Evidences For and Against team’s approach
Increasing pervasiveness in chronic illnesses among older people calls for collaboration among professionals. Waggie et al. (2021) reveal that an interprofessional team approach is important in handling complex health complex health care needs especially in recent times that there has been a dramatic shift in universal health landscape. The study further reveals that such a team’s approach is useful in provision of holistic patient centered care which consequently leads to improvement in the quality of care given. Elderly patients together with their families enjoy high quality care from a well-coordinated team approach. If well implemented, elderly patients with chronic illnesses stand to benefit from all aspects. A position paper by Miller et al. (2019) on interprofessional education can act as a framework for developing this position and general implementation of the strategies to address chronicity among elderly patients. However, there is a gap on interprofessional guidelines which need t be developed to facilitate proper coordination of professionals.
Evidences against the team’s approach
Despite the known advantages, of an interprofessional team approach, there are scholars who have critiqued the adaptability of this method. As much as collaboration is important, integration into already existing systems may be a setback (Grosser, Bientzle, Shiozawa, Hirt, & Kimmerle, 2021). Since interprofessional collaboration is an evolving phenomenon, its integration into the current systems is bound to be challenging. Nevertheless, the advantages of the an interprofessional team’s approach outweigh the challenges. In bid to improve quality care of the elderly, especially these with chronic illness, it is important to adopt the proposed technique.
Conclusion
Chronicity has alarmingly become prevalent in recent times. Interprofessional team work is an important technique that can be used to improve quality care among the elderly. With proper guidelines and policies, teamwork can successfully be implemented and result to improved healthcare outcomes.
References.
Ageing and health. Who.int. (2018). Retrieved 22 September 2021, from https://www.who.int/news-room/fact-sheets/detail/ageing-and-health.
Cedars Sinai Frailty Project Program | Elderly Hospital Readmission. Programsforelderly.com. Retrieved 22 September 2021, from http://www.programsforelderly.com/nursing-cedars-sinai-frailty-project-program.php.
Grosser, J., Bientzle, M., Shiozawa, T., Hirt, B., & Kimmerle, J. (2021). Observing interprofessional collaboration: Impact on attitude and knowledge acquisition. Anatomical Sciences Education. https://doi.org/10.1002/ase.2007
Hintenach, A. M., & Howe, J. L. (2020). Interprofessional Care: Why Teamwork Matters. In Geriatric Practice (pp. 491-500). Springer, Cham. https://doi.org/10.1007/978-3-030-19625-7_39
Ho, J. Y., & Hendi, A. S. (2018). Recent trends in life expectancy across high income countries: retrospective observational study. bmj, 362. doi: https://doi.org/10.1136/bmj.k2562
Itatani, Y., Kawada, K., & Sakai, Y. (2018). Treatment of elderly patients with colorectal cancer. BioMed research international, 2018. https://doi.org/10.1155/2018/2176056
Johnson, J. M., Hermosura, B. J., Price, S. L., & Gougeon, L. (2021). Factors influencing interprofessional team collaboration when delivering care to community-dwelling seniors: A metasynthesis of Canadian interventions. Journal of interprofessional care, 35(3), 376-382. https://doi.org/10.1080/13561820.2020.1758641
Miller, R., Scherpbier, N., van Amsterdam, L., Guedes, V., & Pype, P. (2019). Inter-professional education and primary care: EFPC position paper. Primary health care research & development, 20.
Puts, M., Strohschein, F., Oldenmenger, W., Haase, K., Newton, L., Fitch, M., … & Kenis, C. (2021). Position statement on oncology and cancer nursing care for older adults with cancer and their caregivers of the International Society of Geriatric Oncology Nursing and Allied Health Interest Group, the Canadian Association of Nurses in Oncology Oncology & Aging Special Interest Group, and the European Oncology Nursing Society. Journal of Geriatric Oncology, 12(7), 1000-1004. DOI:https://doi.org/10.1016/j.jgo.2021.03.010
Waggie, F., & Arends, N. E. (2021). Exploring interprofessional teamwork at a tertiary public hospital in South Africa. Journal of Interprofessional Care, 35(5), 672-681. https://doi.org/10.1080/13561820.2020.1803225
