Philadelphia Nursing Home is a long-term care facility with a large community of nursing care providers and patients. It is located in Philadelphia, the largest city in Pennsylvania, with a population of 1,517,550 people (Data USA, 2020). Its geopolitical and financial features include 18 representatives in the U.S. House, a median household income of $46,116, and 714,000 people in the workforce (Data USA, 2020). Educational statistics show that 30% of the population have a Bachelor’s degree or higher, while 50% have a high-school diploma. Phenomenological and ethnic features are characterized by diversity, as there are 40.1% of African American, 34% of Non-Hispanic White, 7.34% of Asian, and 5,33% of Hispanic residents (Data USA, 2020).
The barriers and challenges are insufficient funding, workforce shortages, and communicative barriers with mentally disabled patients (Forsgren et al., 2016). Social determinants of health reflect that 33.7 % of elderly (65+) people have unsatisfactory financial situation, 18.2% experience loneliness, and 29.4% report relationship problems (Pooler & Srinivasan, 2018). The types of the community’s social interactions are verbal communication with staff, indoor/outdoor activities, and social networking with families. The common goals and interests are effective case management, achievement of policy goals, and improvement of health.
The community’s functional health patterns are characterized by actual diagnoses of diabetes, dementia, mental/cognitive problems, poor vision, and the risk of fall injuries and hip fractures. Nutritional-metabolic patterns includes the lack of appetite and malnutrition, which should be addressed by measuring body mass index and introducing supplements. Elimination pattern is associated with patients’ poor hygiene and should be resolved by involving more nurses supporting hand washing and bathing.
Activity-exercise pattern includes patients’ limited abilities to independently eat, groom, bathe, and dress, so they depend on partial or full nursing assistance. Sleep-rest patterns are irregular, as some patients have prolonged periods of daytime rest, while others experience insomnia. Cognitive-perceptual patterns, including dementia and vision/hearing impairment, should be regularly assessed and treated with appropriate medication (Kendall & Wiltjer, 2019).
Self-perception is characterized by low self-esteem, depression, and anxiety in elderly patients concerned about their declining independence, physical and mental abilities. Role/relationship pattern reflects inadequate family communication, loneliness, and grief, which can be alleviated by appropriate rehabilitation programs. Coping-stress-tolerance pattern exposes high levels of stress due to declined self-efficacy, while the sexuality-reproductive pattern is not applicable. Value-belief patterns includes the role of religious practices and uncertainty about the future.
Philadelphia Nursing Home is a not-for-profit entity, so its funding comes from government programs (Medicaid/Medicare subsidies), local authorities, and public donations. The facility has partnerships with local hospitals, the Medical Reserve Corp, and the Philadelphia Department of Public Health (Philadelphia Nursing Home, 2020). The interview with the facility’s principal officer responsible for its operational and employee management indicated the challenges with workforce shortages and insufficient funding.
Responding to the question about the need for changes, the officer explained that he collaborates with partners and donors to receive the essential resources. Additionally, the officer was asked to name the main health issues he observed in the community, which he described as dementia, diabetes, and bone fractures. He also mentioned the plans for the purchase of low beds and crash mats to reduce the risk of fall injuries common for the residents.
The main issue is that the expenses of the long-term care facility exceed its profits, which causes workforce shortages, inadequate hygiene, and depression in the patients. The problem undermines health promotion opportunities, but it might be resolved by attracting volunteer support and advocating for increased government funding. Moreover, communicative difficulties with mentally disabled patients should be addressed by inviting a mental health specialist to perform workshops for nurses. Overall, the facility responds to the basic needs of the community. However, its management should introduce improvements to the general health of its patients via employing additional nurses to care for the residents and purchasing necessary resources and safety equipment.
References
COVID 19 Information. (2020). Philadelphia Nursing Home. Web.
Data USA. (2020). Philadelphia, PA. Web.
Forsgren, E., Skott, C., Hartelius, L., & Saldert, C. (2016). Communicative barriers and resources in nursing homes from the enrolled nurses’ perspective: A qualitative interview study. International Journal of Nursing Studies, 54, 112-121. Web.
Kendall, N., & Wiltjer, H. (2019). Assessment of older people 3: assessing the functional domain. Nursing Times, 115(7), 52-55.
Pooler, J., & Srinivasan, M. (2018). Social determinants of health and the aging populations. IMPAQ International.