Antonio is a 85 years old person who lives in the city center of Alicante (South east Spain). He has been a very sportive man as he was a professional football player since he was young. He was infected by COVID-19 as he refused to be vaccinated and spent 1 month in intensive care unit due to severe COVID infection. He was prone to suffer severe COVID infection as he is HIV positive since 2005. His husband is his main caregiver. After that, he was discharged to a care home in order to improve deterioration from being hospitalized during 3 months. He has been followed up by an interprofessional team focused on cognitive stimulation, physical stimulation and wellbeing since he was hospitalized.
Remind the goals.
Emotion phase:
• Ask about the feelings during the exercise: first the patient, then the caregiver and then the nurse.
Fact phase
• What happened – describe what happened step by step?
• What went well?
• Feedback from observers on verbal and non-verbal interaction and critical activities.
Analysis phase
• Why specific decisions were made?
• How it should / could be done (ideas are generated by students, the tutor leads to the conclusions)?
• What to do to make it better?
• Students’ questions.
• What do you remember from the exercise (each student says 1 item – preferably everyone should say something different)?
• What should happen (select 3-4 items here that should always be discussed with students regardless of whether they happened or not)?
• Point out step by step what the students’ behavior should look like – exemplary.
• Motivate students to think reflectively while deceiving strengths and correct paths.
Cultural competencies/Social and Cultural aspects to reflect about:
At this point please reflect and discuss on the cultural similarities and differences with your context according to the items exposed at the general introduction of this document keeping in mind what “culture” and “cultural aspects” are.
• How would you ideally think this situation should happen?
• Is there any type of resource that you would include?
• What kind of individualized support would you advise Antonio to search for?
• Is there any initiative in your country for HIV population?
• What would you say to him as he has rejected to be vaccinated? What about his main caregiver?
• What would you advise your colleagues if you see that some of them are arguing with him in order to make him understand the importance of being vaccinated?
• Do you think that he could help other people with HIV with his experience after suffering COVID19?
TOPIC
Interprofessional collaboration towards fostering older person safety and functioning
PREBRIEFING
In this session we will see how Antonio is discharged due to COVID19 infection.
The nurse has the opportunity to directly influence the patient’s and other healthcare staff actions empowering him and his caregiver with tools and knowledge in order to make him as less dependent as possible. For this to be effective, the acquisition of knowledge, skills and competencies is essential.
REFERENCES, MATERIALS FOR CLASSES
- Moncatar, T. J., Nakamura, K., Siongco, K. L. L., Seino, K., Carlson, R., Canila, C. C., … & Lorenzo, F. M. E. (2021). Interprofessional collaboration and barriers among health and social workers caring for older adults: a Philippine case study. Human resources for health, 19(1), 1-14.
- Chau, J. P. C., Lo, S. H. S., Lee, V. W. Y., Yiu, W. M., Chiang, H. C. Y., Thompson, D. R., & Lau, A. Y. L. (2020). Fostering gerontology students’ competence in Interprofessional collaborative practice. BMC Medical Education, 20(1), 1-8.
- Baxter, P., & Markle-Reid, M. (2009). An interprofessional team approach to fall prevention for older home care clients ‘at risk’ of falling: health care providers share their experiences. International journal of integrated care, 9, e15.
- Riquelme-Galindo, J., & Lillo-Crespo, M. (2021). Developing a dementia inclusive hospital environment using an Integrated Care Pathway design: research protocol. PeerJ, 9, e11589.
- Riquelme-Galindo, J., & Lillo-Crespo, M. (2021). Designing Dementia Care Pathways to Transform Non Dementia-Friendly Hospitals: Scoping Review. International Journal of Environmental Research and Public Health, 18(17), 9296.
- Brew, B. J., & Chan, P. (2014). Update on HIV dementia and HIV-associated neurocognitive disorders. Current neurology and neuroscience reports, 14(8), 1-7.
- Valcour, V. G., Shikuma, C. M., Shiramizu, B. T., Williams, A. E., Watters, M. R., Poff, P. W., … & Sacktor, N. C. (2005). Diabetes, insulin resistance, and dementia among HIV-1–infected patients. Journal of acquired immune deficiency syndromes (1999), 38(1), 31.
PREREQUISITES
The student has the knowledge and ability:
- To know and to understand the experience of suffering from a chronic process (or disease) and living with dependency.
- To base the interventions of Health Sciences professionals on scientific evidence and available means.
- To lead, manage and work within a team.
- To establish evaluation mechanisms, considering scientific, technical and quality aspects.
- To apply the necessary methods and procedures in your field to identify health problems.
The student has the skills:
- To carry out nursing care techniques and procedures, establishing a therapeutic relationship with patients and their families.
- To select care interventions aimed at treating or preventing health problems and their adaptation to daily life through proximity resources and support for the elderly.
- To provide care, guaranteeing the right to dignity, privacy, intimacy, confidentiality and decision-making capacity of the patient and family.
- To individualize care considering age, gender, cultural differences, ethnic group, beliefs and values.
- To know palliative care and pain control to provide care that allleviates the situation of advanced and terminally ill patients.
- Goal setting with older patients.
INTRODUCTION
Antonio is a 85 years old person who lives in the city center of Alicante (South east Spain). He has been a very sportive man as he was a professional football player since he was young. He was infected by COVID-19 as he refused to be vaccinated and spent 1 month in intensive care unit due to severe COVID infection. He was prone to suffer severe COVID infection as he is HIV positive since 2005. His husband is his main caregiver. After that, he was discharged to a care home in order to improve deterioration from being hospitalized during 3 months. He has been followed up by an interprofessional team focused on cognitive stimulation, physical stimulation and wellbeing since he was hospitalized.
CURRENT CLINICAL CONDITION
Antonio is a 75 years old. His main disease is HIV positive since 2005, now he is suffering from long COVID19 effects. He had very good physical condition as he was practicing sport daily. However, at this moment he has difficulties with soft sports as he feels tired and short of breath with low intensity exercise. This situation makes him frustrated as he has drastically changed in less than one year and his quality of life has worsened from his perspective. At this moment the most relevant score scale is 40 (moderate dependent) as he has been sedated during 20 days in intensive care unit. A group of healthcare professionals are trying to adapt a plan for him once he is going to be discharged to his home with the support of his husband in order to make him feel comfortable and satisfied stablishing realistic goals for the next months following his preferences in terms of healthy habits, physical and mental training.
INTERVIEW
The student should analyze the patient situation and caregiver situation and know more about the patient in order to guide the rest of the team that will manage him after discharge from hospitalization. The student needs to address the future guideline that Antonio will follow after discharge in order to adapt their needs and wills to his current situation at home focusing in keeping him safe and as autonomous as he can.
