Evaluating Long-Term Care Options for Mrs. Klausman: A Case Study Analysis

QUESTION

“Can Mrs. Klausman Stay in Assisted Living? Contributed by Katie Ehlman, PhD, CHES, HFA; Elizabeth Ramos, MS, RD, CD; Julie McCullough, PhD, RD; and Mary Kay Arvin, OTD, OTR, CHT, College of Nursing and Health Professions, University of Southern Indiana.

Mrs. Klausman is a 92-year-old resident in an assisted living facility. She has mild cognitive impairment and needs help with bathing and medication administration. Because of progressive arthritis, she is having difficulty eating. The silverware slips out of her hands and falls to the floor so that staff members must keep replacing it. Mrs. Klausman becomes visibly frustrated and embarrassed. The food service manager and the administrator decide to meet with Mrs. Klausman’s daughter and recommend that the family should hire a home care provider to assist Mrs. Klausman at mealtimes. The facility does not have staff resources to feed residents. The resident’s daughter is thinking whether a skilled nursing facility would be more appropriate for her mother.

Questions

Identify and evaluate Mrs. Klausman’s deficit in self-feeding from different perspectives on what long-term care consists of. Should Mrs. Klausman be transferred to a skilled nursing facility? Explain.

Is hiring a home care provider appropriate? Why or why not? What do you sugguest?

ANSWER

Evaluating Long-Term Care Options for Mrs. Klausman: A Case Study Analysis

Introduction

Mrs. Klausman, a 92-year-old resident in an assisted living facility, is experiencing difficulties with self-feeding due to progressive arthritis. This essay explores the deficits in Mrs. Klausman’s self-feeding abilities and evaluates the appropriateness of transferring her to a skilled nursing facility or hiring a home care provider. By considering different perspectives on long-term care, we can determine the most suitable course of action to meet Mrs. Klausman’s needs and ensure her well-being.

Evaluating Mrs. Klausman’s Deficit in Self-Feeding

Physical Perspective

Progressive Arthritis: Mrs. Klausman’s arthritis is causing difficulties in gripping silverware, leading to frustration and embarrassment during mealtime.
Impaired Motor Skills: The slipping of silverware indicates compromised motor control and dexterity, making self-feeding challenging.

Cognitive Perspective

Mild Cognitive Impairment: Mrs. Klausman’s cognitive impairment may affect her ability to initiate and sustain appropriate eating behaviors and may contribute to frustration.

Emotional and Social Perspective

Frustration and Embarrassment: Mrs. Klausman’s difficulty with self-feeding and the need for assistance can lead to emotional distress and a negative impact on her quality of life.
Social Isolation: The need for constant replacement of silverware may lead to a sense of dependence and hinder social interactions during mealtime.

Should Mrs. Klausman Be Transferred to a Skilled Nursing Facility

Transferring Mrs. Klausman to a skilled nursing facility should be considered based on the following factors:
Care Needs: If Mrs. Klausman’s physical and cognitive impairments progress to the point where she requires more intensive care and assistance with activities of daily living, a skilled nursing facility may provide the necessary level of support.
Safety Concerns: If Mrs. Klausman’s difficulties with self-feeding pose a safety risk, such as the potential for choking or malnutrition, a skilled nursing facility with specialized dining services and staff resources may be better equipped to address her needs.
Family Considerations: The preferences and capabilities of Mrs. Klausman’s daughter should be taken into account, as she plays a vital role in decision-making and ensuring her mother’s well-being.

Is Hiring a Home Care Provider Appropriate? What Do You Suggest?

Hiring a home care provider can be a suitable alternative to transferring Mrs. Klausman to a skilled nursing facility, considering the following:
Cost and Resources: Hiring a home care provider may be a more cost-effective option compared to the expenses associated with a skilled nursing facility.
Individualized Care: A home care provider can offer personalized assistance during mealtime, addressing Mrs. Klausman’s specific needs and preferences.
Emotional Well-being: Remaining in her familiar environment with the support of a home care provider may promote Mrs. Klausman’s emotional well-being and sense of independence.
Ongoing Assessment: Regular evaluation of Mrs. Klausman’s condition and needs should be conducted to ensure that home care remains a safe and appropriate option.

Conclusion

The evaluation of Mrs. Klausman’s deficits in self-feeding highlights the multi-dimensional nature of her care needs. Considering perspectives on long-term care, including physical, cognitive, emotional, and social aspects, is crucial in determining the most suitable course of action. While transferring Mrs. Klausman to a skilled nursing facility may be warranted if her care needs escalate or safety concerns arise, hiring a home care provider can provide individualized assistance, promote emotional well-being, and maintain her familiar environment. Continuous assessment and communication with Mrs. Klausman, her daughter, and the healthcare team will be essential in ensuring her ongoing care aligns with her evolving needs.