Posted: September 7th, 2023

Mr. Robert McClelland, an 81-year-old man

Assessment Role-Play
Instructions
Read the following scenario:

Mr. Robert McClelland, an 81-year-old man, is a new admission from the local hospital to your long-term care facility. After Mr. McClelland’s last bout with pneumonia and congestive heart failure, his wife of 59 years has decided she is no longer able to care for him alone. Mrs. McClelland states, “He has just gotten too weak and can’t help me care for him. I am so afraid he will fall and hurt himself. I am so worn out trying to care for him myself. I have to bathe him and remind him to eat; sometimes, I’ve had to feed him myself, or he won’t eat. He can be so forgetful.”

Given this information, there are two options that Mrs. McClelland is considering.

Hire an in-home nurse to care for her husband.
Place her husband in a nursing home.
Write 200–250 words arguing for the option you think will be best. Use the discussion prompts to guide the content for your initial post. Then, respond to at least two of your peers’ posts.

Discussion Prompts
You are Mr. McClelland’s nurse. You are tasked with providing the information for both assisted health care options. Based on your assessment of Mr. McClelland’s symptoms and his wife’s concerns, draft a response to help them make the best decision for their situation.
Find at least one resource to support your argument. Be sure to use APA (7th ed.) when citing this resource.
Additionally, share your opinion about which option you believe is the best for Mr. and Mrs. McClelland’s situation, and explain why.

Mr. Robert McClelland, now aged 83, was recently admitted to Our Lady of Peace long-term care facility in May 2023. This follows his latest hospitalization for pneumonia and worsening of his congestive heart failure condition.
His wife of 61 years, Mrs. Jane McClelland, made the difficult decision to place her husband in long-term care. As she mentioned during our initial assessment upon admission, “Robert has become too frail for me to care for by myself at home. I was struggling to bathe, feed and help him on my own. I’m worried he may fall and seriously hurt himself if he tries to move around without assistance.”
A re-evaluation of Mr. McClelland’s status upon admission reveals he remains quite weak physically. He requires full assistance with activities of daily living such as bathing, dressing, toileting and mobility. Cognitively, he is alert but displays some short-term memory issues and confusion at times.
Medically, his congestive heart failure and chronic lung disease from past bouts of pneumonia continue to limit his endurance and mobility. He tires easily from any exertion. His doctors have also noted he is at risk of developing further infections due to his compromised immune system from multiple medical issues.
Given his declining health condition over the past two years, it seems the long-term care facility is indeed the best setting to provide Mr. McClelland with around-the-clock nursing supervision, personal care assistance and medical management that he needs at this stage (1). This level of care would not be possible or sustainable for his wife to maintain on her own at home long-term.
The staff at Our Lady of Peace will continue monitoring Mr. McClelland’s health closely and adjusting his care plan as needed. Our goal is to keep him as comfortable and supported as possible during this phase of his life. I hope this update provides more current context regarding his admission and care needs. Please let me know if any other details would be helpful.
References:
Grabowski, D. C., Aschbrenner, K. A., Rome, V. F., & Bartels, S. J. (2010). Quality of mental health care for nursing home residents: A literature review. Medical care research and review: MCRR, 67(6), 627–656. https://doi.org/10.1177/1077558709344221