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1. Concept of Individualized Care: Geriatric Case Study Paper
Concept of Individualized Care: Geriatric Case Study PaperThe traditional way of trying to
assess if a particular treatment or the clinical condition of a patient has changed, is by
running blood tests, clinical evaluation, and other laboratory tests. While these measures
undeniably give us certain levels of information about a patient, they tell us virtually
nothing about the disease process from a personal and social context. (Higginson et al
2001).Concept of Individualized Care: Geriatric Case Study Paper No illness exists in a
vacuum.ORDER A PLAGIARISM-FREE PAPER HEREThis essay is a discussion of the concept
of individualised care with particular reference to my recent placement on a geriatric ward.
I am going to discuss the case of Mrs.J., a 83 yr. old lady.Mrs J has been on the ward for two
weeks. She was originally admitted with a chest infection. She was very ill at the time of
admission and it was not easy to get a history from her. We could only establish that she
lived on her own and had been found by a neighbour who had called her General
Practitioner who had then arranged her admission. Her chest infection was treated and she
responded reasonably quickly.As she became more lucid, it became obvious that Mrs.J. had
had a mild stroke leaving her with an expressive dysphasia. It was not possible to ascertain
whether these changes had been present for a long time or had just come on, as she had not
seen the General Practitioner for nine months prior to this admission.Concept of
Individualized Care: Geriatric Case Study PaperWe also discovered that Mrs.J. had
developed a mild form of Type II diabetes mellitus as she was putting out small but constant
levels of sugar in her urine and her blood sugar levels were mildly elevated.In brief, her care
plan called for her to mobilise with the physiotherapist, to receive speech therapy for her
dysphasia, to see the dietician for advice regarding her dietary control of her Type II
diabetes mellitus and to see the social work team for assessment for discharge as it was
considered unlikely that she would actually be sufficiently self-caring to be able to discharge
to her home.The nursing profession, almost by definition, is a very personal and interactive
profession. (Yura et al 1998)In order to provide good individualised care there must be a
number of interactions in place.Concept of Individualized Care: Geriatric Case Study Paper
The nurse must have a good understanding of the medical elements of the case and also
have a good knowledge of the patient both as a person and of all their circumstances.
(Meleis 1991) This helps to allow the formulation of good individualised care without
making any inappropriate decisions that may be based on an incomplete understanding of
the situation.(Holzemer et al. 1994)The case of Mrs.J. is complicated because of her
expressive dysphasia. In a nursing context the “interpersonal processes” that are necessary

2. to establish rapport and empathy were made very much more difficult. (Platt et al 1999).
The verbal and motor cues that are a vital part of this essential process were not there by
virtue of her cerebro-vascular accident, and it made proper and meaningful conversation
very much more difficult. (Carpenito 1997).It was not helped by the fact that she did not
appear to have any close relative that we could use to get information. It was not simply a
matter therefore of deciding what was medically the best for her, but in order to try to
engage with her on the level of empowerment and education, we had to try very hard to
understand her feelings and situation in order to provide individualised care. (Woolhead et
al 2004)Concept of Individualized Care: Geriatric Case Study PaperIf we try to apply the
Roper Logan & Tierney model of nursing care (Roper et al 1983) to Mrs.J.’s situation of
needing dietary advice for her newly diagnosed Type II diabetes mellitus, the aim would be
to try to provide individualised care and to take into account the degree to which the
problems of her inability to communicate actually interferes with the other activities of
daily living. (Howe et al. 2003). It is in this respect that the concept of individualised care
becomes clearly apparent.ORDER A PLAGIARISM-FREE PAPER HEREFor the average
patient., it may simply be appropriate to fill out a dietetic referral slip and let the dietetic
department do the rest. If we wish to fully implement the concept of individualised care,
then we would need to establish that Mrs.J. needed and understood why she needed dietetic
advice, that she could adequately understand what was being said, (Kuhse et al. 2001), and
also make sure that the dieticians were fully aware of all aspects of the situation when they
were able to visit her and give advice. (Newell et al 1992)This approach allows us to make
an assessment of both the positive and negative aspects of the decision. We can also make
an assessment of whether Mrs.J. would eventually be in a position to take responsibility for
her own diabetic (or dietary) care in the long run. (Marks-Moran et al 1996)In
individualised care, it is important to be as empathetic as possible to the patients needs.
One must appreciate the fact that, in this particular case, the imposition of a diet may be
seen by the patient as yet another (iatrogenic) restriction imposed upon an already severely
restricted lifestyle. Concept of Individualized Care: Geriatric Case Study Paper Generally
speaking, concordance and explanation are better than dogma and enforced compliance
(Marinker 1997).Another important aspect of individualised care, is the process of
reflection (Gibbs 1998). It is generally comparatively easy to make clinical decisions, but the
key to ensuring that they are actually the correct decisions for that individual patient, is to
reflect upon them and consider all of the aspects of that particular patient’s case, which may
not have actually been impinging upon the original decision making process. (Taylor
2000).Concept of Individualized Care: Geriatric Case Study PaperFor example, it is almost
certainly the correct decision to invoke the help of the dietician to assist Mrs.J. in managing
her Type II diabetes mellitus. It is however, possible that, upon reflection, Mrs.J. might not
be able to adequately manage her diet because her motor problems now preclude her from
going independently to the shops, and the person who buys her food for her may have
absolutely no idea of the basic concepts behind the maintenance of a regular and restricted
sugar intake.Concept of Individualized Care: Geriatric Case Study Paper