MACARAIG, MARIE KELSEY A.

BSN 3A
NCM 114: CARE FOR OLDER CLIENTS LECTURE AND LABORATORY

FINAL OUTPUT

I. Formulate or make your own “Home for the Aged” institution.

A. Formulate a name.
B. Create your own vision – mission for that said Institution of yours.
C. Create your own staff plan
D. Formulate your own rules and regulations

TAHANAN NA WALANG HANGGANAN FOUNDATION INC.

Name of the Institution for the home of the aged

ABOUT

In the Philippines, there is a home for the elderly that serves as a true home
for all of the country's abandoned, poor, sick, and homeless old.

VISION

To provide place and care for the elderly as to maintain and improve their
quality of life.

MISSION

To provide adequate and sufficient shelter and basic needs to old people and
combine them with love, attention, affection, and support in all aspects of life
in an environment that is homey.

Establish quality care for the frail, sickly, bedridden senior citizens in their own
homes through their family/kinship carers and homecare volunteers for the
abandoned and neglected senior citizens

SERVICES AND PROGRAMS

Care and Rehabilitation

Taking care of the health needs of each elderly through volunteer services
shared by physicians and medical staff.

Home Life
Striving to give the best care and support as our way of sharing God's love on
Earth to each rejected and abandoned elderly.

Spiritual Life
Finding respite in God's loving arms through regular prayers and reflection.
1-on-1 Counseling
Loneliness is a common problem that older people face. This problem is
heavier for abandoned and rejected elderly.

STAFF PLAN

This will be chaired by the P/C/MSWDO where this project will be

implemented with the following members:
• Representative from any existing senior citizens organization.
• Local Schools / Colleges / Universities.
• Local Government Units at all levels.
• Other government organizations - Local Health Department, TESDA; and
• Non-government organizations catering to older persons in their local unit.
ii. Functions of the Program Advisory Committee shall include:
• Planning and implementing community awareness campaign on older
persons issues.
• Generation and mobilization of community resources.
• Creation of opportunities in the community for senior citizens, carers, and
homecare volunteers to meet beneficiaries, know each other and integrate
with other beneficiaries;
• Provision of assistance in advocacy activities; and
• Facilitation of activities to sustain the project; and
• Act as resource person during capability building activities

RULES AND REGULATION

A. Primary beneficiaries {senior citizens):

 60 years old and above who are frail, sick, bedridden, or with disability
that has difficulty in performing activities of daily living due to physical
limitations and old age; and
 In need of care for a certain period of time due to physical and mental
conditions.

B. Secondary beneficiaries.
 Family Carers who lack skills/capacity to provide quality care to senior
citizens; and
 Home Care volunteers who are willing to share their time, skills, and
resources to care for the abandoned, neglected, frail, and disabled
senior citizens.
C. Identification and Assessment of Client and their Needs. This involves the
identification of the client and their family carers through the following:
 Gathering of primary and secondary data of the identified beneficiaries
from the municipal/city planning office, local health office, rural health
unit, barangay health centers, and barangay officials and from the
DSWD National Household Targeting System for Poverty Reduction
(NHTS-PR) database, etc.;
 Conduct of survey to identify target clientele in cases where there are
no existing data; and
 Validation and analysis of client’s information to be able to identify the
problems and needs.
II. Make a “Reaction Paper” for the following Ethic-Legal Considerations in the
Care of Older Adult

A. Laws affecting Senior Citizens/ Older Persons (RA 7432, RA 9257, RA

9994)

Laws affecting Senior Citizens/ Older Persons (RA 7432, RA 9257, RA

9994)

The concerned local government units have to conduct through the Office

of Senior Citizens Affair (OSFA), regular meetings, seminar, and re-

orientation about the privileges and benefits of the senior citizens stipulated in

RA 7432 and its amendments. Furthermore, consultations could be

periodically done to enhance the senior citizens’ knowledge about the said

privileges and benefits. The DSWD local government personnel could attend

seminars and trainings so that they can be updated on handling issues on the

curtailment of the privileges and benefits of the senior citizens. Moreover,

they could work programs in pursuance to the objective of the act. Increased

efforts in monitoring and reporting to the appropriate authorities - National

Monitoring and Reporting System

Through OSCA, the National Management Coordination Board (NMCB)

might be formed for efficiency, consistency, and uniformity. The law's

implementation Furthermore, the government might establish training and

other capacity-building initiatives for senior folks.  NMCB programs such as

leadership, given emphasis, livelihood, volunteerism, and social and self-

improvement program, allowing them to make the most of their rights and

rewards in order to increase their influence.

B. Medications of Older Adults (Polypharmacy)

According to the World Health Organization, one elderly person, defined

as someone aged 60 or older, exists for every nine persons. By 2050, this

figure is predicted to rise to one in every five individuals, accounting for over

half of global population growth.

Multiple chronic diseases such as hypertension, diabetes mellitus,

arthritis, chronic heart disease, renal disease, and others are related with

advancing age, posing a substantial problem for health authorities around the

world. As a result, elderly persons are more likely to take many drugs per day,

a condition known as polypharmacy. Polypharmacy is a source of concern for

the elderly for a variety of reasons. Because of the metabolic changes and

slower drug clearance associated with aging, elderly adults are at a higher

risk for adverse drug reactions (ADRs); this risk is worsened by increasing the

number of medications used. The risk of drug-drug interactions is heightened

when many medicines are used. Polypharmacy was found to be an

independent risk factor for hip fractures in a case–control study of elderly

people.3 Polypharmacy can also lead to "prescribing cascades."4 A

prescribing cascade occurs when signs and symptoms (multiple and

nonspecific) of an ADR are misinterpreted as a disease, and a new

treatment/drug therapy is added to the previously prescribed treatment to

treat the condition. This has the potential to cause even additional adverse

effects, resulting in a prescription cascade

C. DNR issues

Many elderly individuals choose to have a do-not-resuscitate (DNR) order

placed on them when they are admitted to the hospital. However, few

research have examined older patients' perceptions of their chances of

surviving cardiopulmonary resuscitation (CPR) if it is required during their

stay.

CPR, which is known to be effective, is expected to be used. widely used

throughout the world, will have to be with the changing times, adopted more

and more structure of the people This will create even more questions.

frequently about the circumstances in which CPR is used should be

implemented. The health-care team, in this regard, patients, relatives of

patients, and surrogates for patients hold significant tasks This decision as

much difficulty as possible. As vital as it is, there are a lot of obligations. It's

because can put health care providers in a bind. In terms of moral and ethical

principles, as well as legal obligations. High-probability circumstances in the

elderly, such as cognitive impairment and a lack of mental competency to

offer these instructions, stand out against the health care team as a backdrop

to other issues.
III. What are the different trends/ Issues and Challenges on the Care of Older
Persons specifically on home care, hospice facilities, drop-in/ Day Care
Centers and Retirement Living? Discuss each briefly but substantially.

The social safety net for the elderly is dwindling. The government's
support for the elderly remains substantial, although it is dwindling. Currently
under attack. Expense pressures at the federal and state levels Cutbacks
affect everyone, especially the elderly. Rollbacks Medicare and Social
Security are likely to be affected. Corporate support for retirement through
pensions and retiree health care benefits is fading. Smaller families, more
geographically distant cannot provide the care in the same way as large,
close extended families did in the past. Yet, older persons feel healthier than
ever, live longer, and have fantastic opportunities to remain vibrant members
of society.
As home-based care grows in use and acceptance, it is crucial to consider
patient preferences for home-based care vs. care in traditional brick-and-
mortar settings. A study of older persons’ preference for a treatment site
revealed that 54% of surveyed participants preferred treatment for acute
illness in the hospital rather than at home. There are several challenges that
can deter clinicians from participating in home-based care. Compared to the
hospital or office environment, caring for patients at home requires longer
visits and therefore a smaller panel size (the number of patients for whom a
care team is responsible). Home-based care clinicians see, on average, just
five to seven patients a day. Physicians spend more time understanding and
addressing the social and economic conditions that impact health — such as
remedying medication discrepancies, identifying home safety issues, and
connecting patients with social services — but are disadvantaged under
traditional fee-for-service models that tie payment to number of patients seen
and procedures performed. Another challenge is clinician safety. Clinicians
are understandably disinclined to visit homes in areas with high rates of
crime, making it difficult to embed home-based care programs in some
medically underserved areas. Attracting clinicians to home-based care
requires measures that prioritize clinicians’ safety. he lack of supporting
infrastructure, including life-sustaining and assistive durable medical
equipment (DME), makes it challenging to manage patients’ acute care needs
at home. here are specific risks to patient safety in the home setting. These
include: environmental hazards such as infection control, sanitation, and
physical layout; challenges with caregiver communications and handoffs; lack
of education and training for patients and family caregivers; the difficulty of
balancing patient autonomy and risk; the different needs of patients receiving
home-based care; and lack of continuous health monitoring. Home-based
care is governed by a patchwork of regulations that are not uniformly applied
or monitored. There are no national or state requirements for the quality of
home-based care, with the exception of care provided under the Medicare
home-health benefit, and limited regulation of the education, training, and
licensure of home-based care professionals further endangers patient safety.