Discussion Question #1
Topic: Diabetes Management in the Frail Older Adults
The prevalence of diabetes is expected to increase as the number of older adults increases. Treatment goals of diabetes in older adult is similar to younger adults: management of hyperglycemia and reduction of the risk of complications. Due to comorbid conditions, the management of diabetes in the frail older adult should be individualized.
For the frail older adult, discuss the following:
- Glycemic targets for the frail older adult
- Medication selection to avoid adverse drug reactions
- Recommendations for lifestyle modification taking into consideration functional status.
Discussion Question #2
Topic: Advance Directives
For many Nurse Practitioners, it is difficult to tell a patient they have a terminal illness or that a “body system has just worn out.”
Frail elderly patients often know when they are having a health issue or medical diagnosis they cannot overcome based on their functional status or decline in functional capacity and activities of daily living. One of the major roles of the nurse practitioner working with frail elderly patients is to assist them in designing an advance directive that tells their loved ones and family members what their autonomous wishes are for end-of-life and palliative care. For example, many frail elderly patients may opt for quality of life versus quantity of life. The nurse practitioner plays a major role in facilitating care that honors the frail elderly patient’s desires for advance directives. The purpose of this assignment is assist the nurse practitioner in helping and support a frail elderly patient with advance directives and giving bad news so the patient can determine their autonomous wishes in a timely manner so they will be honored and upheld.
- Share with your peers a situation when you have had to address advance directives and share bad news with a frail elderly patient you have cared for in this clinical.
- Share the clinical situation including medical diagnoses, treatments tried or if the patient declined treatment, and the reason that you are addressing advance directives at this time.
- How did you deal with this experience both professionally and personally?
- Describe what resources and support you had or were lacking in this situation. What resources and support could you have used more of to be better prepared for this clinical experience?