Vulnerable Population and Self Awareness
One of the most common vulnerable populations are those individuals with a cognitive disorder such as Alzheimer’s disease. People with advanced AD are more challenging to assist in a health care setting because of their difficulty with expressing their needs. Health care professionals must use their strong assessment skills to determine what the persons needs are. My personal experience in working with patients with AD has rarely been the best. When I knew that I would be assigned a patient that has Alzheimer’s disease, I would immediately become frustrated because of the high demands.
I recall them climbing out of their beds and I would fear them falling due to their unsteady gaits. Attempting to get the patients to take their medications as ordered would sometimes take hours. The other nurses would often have to help hold the patient due to their combative behavior if an IV or a catheter would need to placed. I felt that they always required more attention than the other patients. Once I started getting more patients with AD, I started to better understand their behaviors and it became easier to anticipate their needs.
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After a while, I recognized the other nurses felt the same way. Eventually I would start volunteering to take these patients because I didn’t see them the way that I used to. I noticed a huge stereotype had been placed on this population of people. After volunteering to care for these patients, doctors and nurses told me they couldn’t do it because they were a handful. I would always tell them that they aren’t all the same and they have different levels of needs. The attitudes towards the cognitively challenged patients remained the same.
The lab technicians would come to ask for help holding the client so they could draw blood and they would ask for help before they even saw the patient. This population is prejudged and labeled as “difficult” or “crazy”. Patients with cognitive impairment can sense the attitudes of healthcare workers, which may cause them to reject care given or become combative. According to the Centers for Disease Control, an estimated 5. 1 million people over the age of 65 are currently living with Alzheimer’s disease in the United States. The number could rise to at least 13. million by the year 2050 (“Cognitive Impairment: A Call For Action, Now! ” 2011). Knowing the numbers of cognitive impairments are increasing, more research should be done to increase the public’s knowledge so that we can better prepare ourselves for what may come. A better understanding could help healthcare professionals better serve this population and increase the amount of education to families of this population. Also, increasing the knowledge of healthcare professionals could help them to change their attitudes about caring for the cognitively impaired population.
Many times, negative attitudes are developed through fear. Increasing your own personal knowledge may eliminate fears, which in turn could reduce the negative attitudes. “To make nursing staff aware of how their attitudes influence their actions in relation to the people with dementia it is important to focus on nursing practice and nurse education. ” (Norbergh, Helin, & Dahl, 2006). Lydia Ocampo is a 69 year old Philippino female who has been diagnosed with Alzheimer’s disease. She fell a few months ago and fractured her hip.
She has been in a rehabilitation hospital due to her postoperative complications of anemia, wound infection, nutritional deficits, and increased confusion. She has had some improvements but the confusion continues. Mrs. Ocampo requires continuous assistance with ambulation, toileting, bathing, and eating. She requires frequent verbal cues. Mrs. Ocampo’s husband, Danilo comes to visit her every day and he plans to take his wife home next week due to his niece is coming to take care of her. Mrs. Ocampo may benefit from being at home to continue her healing process.
From my experience, Alzheimer’s patients do better in a familiar environment, like their home, as opposed to a hospital environment that is constantly changing. Also, due to staffing shortages and hospital cuts, Mrs. Ocampo may need more one-on-one help that she could not get in the hospital that she could get at home with her niece taking care of her. It is important before Mrs. Ocampo is discharged home that her family are educated thoroughly on how to care for her. This can be done by giving them literature to read and review, invite them in to be a part of the care rovided in her remaining days in the hospital so they can gain knowledge through demonstration, and always encourage them to ask questions. Follow up phone calls should be done once she has been discharged to check the status of how she and her family are doing and offer additional time to ask any questions. According to Janet Y. Shagam, PhD , at one point or another, all caregivers report a time of feeling burnt out or overwhelmed (Shagam, 2009). She may also benefit from home health visits in the beginning to assess how she is doing at home.
Encouraging Mrs. Ocampo’s husband and niece to seek counseling would be beneficial to them because of the challenges they will face. “Caring for a cognitively impaired senior is generally time consuming and often traps the caregiver in his or her home while trying to manage the needs of the impaired senior. ” (“The Caregiver’s Journey Part 3: When Behavior Matters,” 2005, para. 1). Before learning about this vulnerable population, I became frustrated easily because I feared I would not be able to care for them properly.
Caring for the cognitively impaired is challenging because you do not receive very much feedback from them due to their inability to communicate. It was time consuming and almost always put me behind in my caring for other patients. Once I started to learn how to pick up on nonverbal cues it became easier and less fearful for me to care for them. I began reading literature to increase my knowledge and I would almost always bombard more experienced nurses with questions.
It is still a challenge to work with this population, but it is easier to cope with those challenges now that I have more knowledge of what they need. In closing, one of the most common vulnerable populations are those individuals with mental/cognitive challenges. Healthcare workers often avoid this population due to the challenges that they know they will face. My personal experiences caring for this population have proven that. With the reduction of my fears of caring for this population, I now have a better understanding on how to care for them.
A stereotype has been placed on this population, which has caused many people to develop a premature bias towards them. With numbers increasing in this population of people, we need to increase our knowledge of their illnesses so we may better serve them and change this stereotype placed upon them. This can be done with continuing to study them and their illnesses, developing better education for the public to be more aware, and increasing the amount of services offered to this population. Fear is what fuels us as a society to turn our backs on those in need and create these vulnerable populations.
1) Shagam, J. Y. (2009, November). The Many Faces of Dementia. Radiological Technology, 81(2), 154-168. http://ehis.ebscohost.com/eds/pdfviewer/pdfviewer?sid=3ecb6afa-2a57-4279-a7ba-cafff8281f16%40sessionmgr111&vid=3&hid=23.
2) The Caregiver’s Journey Part 3: When Behavior Matters. (2005, May). Clergy Journal, pg 26-28. http://ehis.ebscohost.com/eds/pdfviewer/pdfviewer?sid=ae35a725-e7eb-4bcc-8498-75e26d9f040e%40sessionmgr15&vid=5&hid=116.
3) Norbergh, K., Helin, Y., & Dahl, A. (2006, May). Nurse’s Attitudes Towards People With Dementia: The Semantic Differential Technique . Nursing Ethics, 13(3), 264-272. Retrieved from http://ehis.ebscohost.com/eds/pdfviewer/pdfviewer?sid=e27e8175-d6a1-408d-aae8-93b60bc735b4%40sessionmgr12&vid=8&hid=6
4) Cognitive Impairment: A call for action, now!. (2011). Retrieved from http://www.cdc.gov/aging/pdf/cognitive_impairment/cogImp_poilicy_final.pdf