Availability of Adequate Training Programs to Reduce Elderly Abuse – Capstone Project

Benchmark – Capstone Project Change Proposal

Background

According to Hincapie, Gilmore, Lenox, and Stripling (2020), elderly abuse is defined as single or repeated acts or lack of satisfactory actions that lead to abuse or distress to elders aged 60 years and above. Acts that can lead to this elderly abuse can be classified into physical, sexual, psychological, and financial acts. Occasionally, elderly abuse cases go unnoticed, as they are not always reported (Moore, 2020). Therefore, elderly abuse remains a critical problem across the globe and in the United States. However, various interventions based on best research coupled with clinical expertise and patient values have been used to reduce elderly abuse cases. Thus, this paper aims to determine whether the availability of adequate training programs, policies, and wellness resources can reduce elderly abuse in six months.

Clinical Problem Statement

Elderly abuse in the home care environment has been identified as a significant problem affecting the aging population across the globe (Hincapie et al., 2020). According to Busso, O’Neil, and Volmert (2020), approximately one million elders and above are affected by elderly abuse. In the United States, the number of affected elders is projected to double within the next three decades (Hincapie et al., 2020). Therefore, this calls for efforts to deal with this type of abuse and get a long-lasting solution.

Purpose of The Change Proposal

This project aims to determine if the availability of adequate training programs, policies, and wellness resources are effective in reducing elderly abuse in home care settings in a period of six months.

 

PICOT Question

Does the availability of adequate training programs, policies, and wellness resources demonstrate a decrease in elderly abuse in the home care environment compared to before the availability of adequate training, policies, and wellness resources over six months?

Literature Search Strategy Employed

The study employed a two-search strategy to look for literature sources from various academic databases. Firstly, a search strategy was established for each academic database by using different search terms such as nursing homes, home care settings, residential care institutions, assisted living, elder abuse, abuse, verbal abuse, conflict, hostility, elder maltreatment, violence, elder neglect, elderly, aged, seniors, emotional abuse, sexual abuse, physical abuse, prevalence, and incidence. Secondly, the literature materials retrieved in the first step were screened to obtain relevant studies on training programs, policies, and wellness resources towards reducing the elderly abuse in home care settings. Eight articles were successfully obtained and were independently evaluated in areas. Inclusion criteria were (1) literature dealing with reducing elderly abuse; (2) recently published articles, not more than five years older; and (3) literature materials focusing on the availability of adequate training programs, policies, and wellness resources. On the other hand, all other articles were excluded from the selected literature if they did not meet the inclusion criteria.

Evaluation of The Literature

Schuster and Krahé (2016) state that there is an imbalance distribution of studies dealing with elderly abuse across the world, with numerous studies conducted in the United States. Moore (2016) found psychological abuse, physical abuse, and neglect to be the significant instances of undisclosed abusive practices. Apart from the types of elderly abuse mentioned above, Fenge and Lee (2018) affirm that the aging populations are also at risk of scam involvement and should be equipped with expertise and skills to understand such risks so that they can protect themselves. Moore (2020) found that there is inadequate reporting of acts of elderly abuse in home care environments. Moore also found that there are planned approaches to deter reporting of elder abuse cases to external agencies in care homes. Busso et al. (2020) found that dealing with and preventing elder abuse necessitates an integrated team of professionals and services. Breckman, Holt-Knight, Rachmuth, and Rivera (2020) found that multidisciplinary teams (MDTs) are a powerful tool in reducing elderly abuse and recommended its inclusion in elder abuse teams. Yi and Hohashi (2018), through the Knowledge-Attitude-Behaviour (KAB), found healthcare workers to have astute perceptions of elder abuse. They also noted that nurses and medical doctors incline towards not detecting and reporting elderly abuse out of the idea that elderly abuse is a family matter. On the other hand, Hincapie and colleagues (2020) state that there is a significant discrepancy between the available assessments and interventions, and the preparedness of mental health providers towards serving the aging population.

Applicable Change

The number of elderly individuals undergoing elder abuse is considered to increase in the United States (Hincapie et al., 2020). Hence, there is a need to have reliable interventions to address this problem in the form of adequate training programs, policies, and wellness resources while offering culturally competent effective care. Evidence suggests that efforts to quantify abuse occurring to the aging population are expected to have led to wrong approximations to inadequate reporting (Moore, 2020). This calls for the need to educate older adults on how to report abuse without fears or doubts adequately. Also, there is a need for home care agencies to report elderly abuse according to specified policies. Also, nurses need to be educated on how to identify signs of elderly abuse. Educating elderly individuals on how to report abuse and training nurses to recognize signs of abuse will ensure that the most effective care with any abuse is practiced in the home care settings in addition to enhancing the reporting of instances of abuse. Breckman et al. (2020) recommend the inclusion of MDT’s in elder abuse teams. This will improve the utilization of their expertise, aiming at increasing safety and reducing the suffering and risk of harm to the aging population as early as possible.

Busso et al. (2020) argue that communication strategies yield results. Therefore, free-thinking, as well as public discourse, can be molded in the right direction through effective communication strategies to establish a better understanding of the issue of elderly abuse. Moore (2020) insist on the provision of wellness resources to care staff in Home Care environments as they can be perpetrators of abuse. This will help nurses to deal with their frustrating circumstances that could result in unintentional abuse. The KAB model can be valuable in predicting healthcare workers’ views of elder abuse in addition to the training of nurses. Finally, financial abuse is considered to be the second most common type of adult abuse. However, research has paid a lot of attention to the abuse that happens due to families’ relationships (Fenge & Lee, 2018). Therefore, this project will utilize education to prevent financial abuse in the Home Care environment.

Proposed Implementation Plan with Outcome Measures

The intervention plan will involve alerting the public members on measures to prevent elderly abuse through Evidence-Based Disease and Disability Programs. Under this plan, all forms of elderly abuse will be reported to the National Research Council (NRC), which will provide interventions and prevention measures regarding reported abuse cases. Also, this plan will involve policies that ensure regular check-ups of the elderly daily and those that ensure that home-based care staff is well trained on how to provide the best care to the elderly. Regarding wellness resources, the elderly population will receive individual empowerment, which will give tactical measures to help them evade the incidences of abuse.

Additionally, they will be engaged through personal-centered training to acquire inspirational values on how to recognize early signs of any form of abuse. Also, the intervention plan will involve health care agencies that will provide guidelines on how to treat elders. The health care agency will also strictly oversee the empowerment of the elders towards promoting their rights. Besides, health care agencies will ensure and involve public and professional awareness campaigns to inform family caregivers about avoiding elderly abuse. The plan will also ensure that all nurses are well trained on how to detect early signs of abuse and neglect. Additionally, nurses will be urged to report any incidences of abuse to law agencies.

Evidence-Based Practice Towards Creation of the Intervention Plan

Evidence-Based Disease and Disability Programs inform the public’s members on measures to prevent elderly home care settings (Moore & Browne, 2017). Schuster and Krahe (2016) state that policies that are tailored to ensure that home-based caregivers are well trained can provide the best care to the elders. Moore and Browne (2017) affirm that patient person-centered training instills inspirational values to the elderly in detecting early signs of abuse from the caregiver. They also highlight that health care agencies can be used to ensure close supervision towards empowering the elderly on how to form a union to advocate for their rights. On the other hand, there are various early signs of abuse and neglect that can be used by home-based care staff and elders to prevent elderly abuse (Storey, 2020; Mion & Momeyer, 2019).

 

Evaluation of The Proposed Nursing Intervention

The proposed nursing intervention plan will be evaluated through a review. Monthly patient reports, nurses’ post-tests, and quarterly audits associated with all aspects of education and elderly abuse will be analyzed six months after implementation of the nursing intervention. The results of the analysis will be compared with the results of previous months before the implementation of nursing intervention to determine its effectiveness.

Potential Barriers to Plan Implementation and How to Overcome Them

Yi and Hohashi (2018) found that a sample may not fully reflect the entire population, which may affect the generalizations of the results. Also, Fenge and Lee (2018) reported a limitation of small sample size, while Schuster and Krahé (2016) reported lacking a conceptual and methodological consistency. Thus, to avoid such a problem, adequate sample size and appropriate methodology must be considered for the project. Another potential barrier is the current outbreak of Coronavirus disease (COVID-19), which was reported in December 2019. The disease is infectious and spread mainly through droplets of saliva or discharge from the nose when an infected person coughs or sneezes. Thus, those involved in the implementation will be required to wear masks and observe general cleanliness, as well as adhering to all other measures described by WHO and the state. Also, it will be hard to provide education to patients with cognitive impairment, which will demand the family or professionals to be involved in their education.

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