About the SeniorAdvisor.com 2014 In-Home Innovation Scholarship: We started the scholarship program to bring awareness of the unique benefits and challenges of in-home caregiving for seniors to younger generations. The questions posed by the scholarship encouraged our nation’s future caregivers to present solutions for improving home care in the United States. College-aged students were required to answer one of the three essay topics below and provide a short bio as part of their scholarship application. Read the winning essays here.
How can your major of study improve the lives of seniors receiving in-home care services?
Essay response by Lauren Catlett
Living in the basement apartment of his daughter’s house, Mr. V sits in his wheelchair with light from the television flickering over his gaunt frame. He has not eaten or bathed recently: he has been alone since early this morning when his daughter brought him a few pancakes before leaving for work. His arms tremble with Parkinsonian tremors and ache from the fall he took as he teetered from the bed to his chair. His briefs are soiled, and his clothes are unkempt. His playful personality has melted into somnolence.
His caregivers at the adult day center he attends a few times a week have noticed a decline in his weight and his energy. They call for help from his healthcare team, and nurses set out to Mr. V’s home to identify lapses in his care. Soon after these visits begin, his health improves, his weight stabilizes, his grooming resumes, and the life in his blue eyes returns. Where his nurse-coordinated team has found neglect, they have cultivated an environment of safety, healing, and compassion that restored Mr. V’s vitality.
As one of Mr. V’s caregivers during his time at the adult day center, I tell his story to illustrate conditions all too common in American elder care and to highlight opportunities for change. Witnessing the impact of nurses on restoring Mr. V’s health and wellbeing was one factor in my decision to apply for the Clinical Nurse Leader program at the University of Virginia. The Clinical Nurse Leader (CNL) is a master’s prepared registered nurse who coordinates patient care on a microsystem level. With leadership and clinical skills, the CNL is in a position not only to provide quality health services to seniors but also to act as a coordinator for home-based care. Hospices already employ nurses as team managers to support patients at home, and innovative programs, such as Health Quality Partners (HQP) in Doylestown, PA, rely on nurse coordinators to assist at-risk older adults with managing chronic conditions and preventing health crises. On a weekly or monthly basis, nurses visit patients in their homes, giving patients the opportunity to inquire about medications and physician orders while allowing nurses to assess and report lifestyle factors impacting patient health and to adapt care plans as needed. Nurses trained as CNLs have the potential to expand these models to improve patient access to quality care, promote interprofessional collaboration, and reduce costs by prioritizing coordination of care.
The University of Virginia CNL program draws applicants with a wide variety of degrees and work experiences. This unique feature encourages students to merge skills gleaned from their past experiences with clinical nursing skills. My baccalaureate degree in art and my role as program manager for a creative arts program for persons with dementia have revealed opportunities to improve quality of life for seniors living at home in my future nursing practice. Creative activities complement medical care to fulfill patients’ physical, social, emotional, and even spiritual needs. Additionally, they provide opportunities for in-home caregivers to engage with patients in meaningful ways. By tapping into Mr. V’s artistic and architectural talents at the adult day center, I helped spark his creativity and improve his mood. Integrating these activities into his home care would have augmented the nursing services he received. As a nurse visiting seniors at home, I would have the opportunity to educate patients and caregivers not only about healthcare management but also about methods for improving quality of life through simple creative projects.
Quality in-home care relies on synchronization of health services and focus on wellbeing of the whole person. With preparation to provide care within the context of physical, social, emotional, and spiritual circumstances of the patient, the nurse leader plays a vital role in maintaining the long-term sustainability of in-home care for older adults. Mr. V’s nurses encouraged his social engagement at the adult day center while responding to the challenges of his health condition and neglect in his home life with efficiency, skill, and compassion. Applied on a larger scale, this approach to in-home patient care for seniors would call on nurse leaders to coordinate care from daily caregivers, physicians, and therapists and to incorporate alternative therapeutic modalities with traditional nursing skill sets to meet the needs of the whole person. As a future Clinical Nurse Leader, I plan to join the team of clinicians changing the lives of seniors like Mr. V by strengthening the aging-in-place movement and supporting safety, compassion, and creativity in home care.
Lauren is currently pursuing a graduate degree in nursing at the University of Virginia.