The Need for Patient Education with Older Patients: An Observation Study
According to nurse practitioner and health care educator Geralyn Ochs, RN, BSN, MSN (1997), “Aging is not a simple physiological progression…there is no theory that can predict and explain the complexities of older adults” (p. 168). Consequently, patient education is vital to the health care process…, “and the cognitive, physical and psychosocial status” and lifestyle of older adults “should serve as the basis for planning individual care” (p. 171). This paper will recount the observations of Marretta Latimer, the daughter and primary caretaker of Johnnie Latimer, Jr., an 84-year-old African-American male with the following diagnoses: dementia, dysphagia and arteriosclerosis. According to Ms. Latimer, her father’s health care experiences have involved the following during his hospitalizations: 1.) unnecessary surgery, 2.) unnecessary medication, 3.) neglect.
Mr. Latimer has been hospitalized repeatedly since the rupture of his aorta in August 2008. Because of the patient’s dementia and a delay in the swallow reflex, speech therapists made the judgment that Mr. Latimer needed a peg-tube insertion. They also said he would never consume food orally and would not benefit from speech therapy. A gastroenterologist previously indicated that Mr. Latimer had mild dysphagia and could have a soft diet. This recommendation was ignored by the speech therapists. A new team of speech therapists have re-evaluated Mr. Latimer using swallow studies, and he is enjoying a soft diet by mouth.
Another experience during Mr. Latimer’s hospitalizations has been unnecessary medication. Following his peg-tube placement, Mr. Latimer was automatically prescribed insulin. Following the intervention of Mr. Latimer’ family, the doctor stopped the insulin. Mr. Latimer’s “sugar levels” have continued to remain in the normal range without the use of insulin. The physician assumed that given his age and peg-tube, Mr. Latimer would require insulin. He did not consult the patient’s primary care physician (because of the hospital where the surgery took place) or the patient’s medical history.
Neglect was another of Mr. Latimer’s experiences during his hospitalizations. The nursing staff at the hospital would not attempt conversation or allow him to assist with his personal care. Physical therapists did not order physical therapy, assuming he was bedbound. Mr. Latimer’s family visited daily and demonstrated his ability to walk, brush his teeth, comb his hair and enjoy some level of conversation. Eight months following his surgeries, Mr. Latimer remains at home, is ambulatory with the use of a walker, and performs some personal care tasks daily.
Patient Education and Patient Outcomes
In conclusion, Ms. Latimer’s observations about her father’s experiences during his hospitalizations indicate that health care practitioners must be trained to understand that all older patients don’t require the same level of care. Each patient has a unique medical, social and psychological history. Health practitioners must be sensitive to the needs and problems often associated with the aging process. They must also take the time to familiarize themselves with a patient’s physiology and experiences to offer the best possible health care and produce the best patient outcomes.
Fagerberg, S., Lafferty, G., Shreve, K., & Siders, K. (1985). Medical terminology: a descriptive
body systems pictorial approach with programmed vocabulary instruction. Minneapolis:
Burgess Publishing Company.
(M. Latimer, personal communication, April 4, 2009)
Ochs, G. (1997). Fundamentals of nursing: concepts, process and practice. St. Louis: Mosby.
Tradewell, G. (1998). Beare-Myers’ adult health nursing. St. Louis: Mosby.