Quality of life and how nurse practitioners build a strategy into health plans

As we age, our ability to still do the things we enjoy diminishes, and with it, our quality of life begins to slip away. This is not limited to older people, however – young adults with disabilities or illnesses have a similar experience. With a diminishing quality of life comes the possibility of depression and listlessness, which can likely lead to further illness.

With the steadily decreasing availability of healthcare professionals, the focus in many healthcare environments is to shorten hospital stays and prevent the need for institutionalization or hospital readmissions. It therefore makes sense to prevent illness as much as possible and promote healing and wellness. This can be achieved by incorporating a wellness plan into the patient’s treatment plan as drawn up by the AGPC nurse.

How do we measure quality of life?

Quality of life (QOL) is a very broad, subjective concept that can be measured by both positive and negative aspects of one’s life, and as such, the definition varies depending on the outlook of the individual, their values, health status, financial status, spirituality and much more.

From a healthcare perspective, QOL is the degree to which a patient is healthy and comfortable, with the ability to continue with daily activities such as interacting with people, caring for themselves and enjoying life.

Factors that affect a patient’s wellbeing include:

  • Levels of pain, nausea, breathing difficulties and digestive tract problems.
  • Physical activity or lack thereof.
  • The degree to which the patient receives mental stimulation.
  • Social interaction with family members and peers or lack thereof.
  • The quality of medical care.

Quality of life can change in an instant, say, with a diagnosis that reduces a patient’s life expectancy or a decline in mobility. The loss of a loved one or being diagnosed with a debilitating illness such as Parkinson’s or Alzheimer’s disease is usually devastating to the patient and can plunge them into a state of depression.

Because of the numerous factors involved, assessing a patient’s QOL may be difficult; however, despite all the variables, researchers have come up with numerous ways of measuring it.

Our perception of quality of life is based on our experience and our expectations and can change over time, as discussed by Alison J Carr et al. Depending on their subjective experience, “people assess their health-related quality of life by comparing their expectations with experience.”

Therefore, raising the patient’s expectations of health is essential. For example, if a patient’s expectations of health at a particular age are low, then they tolerate low levels of health and don’t make a concerted effort to improve the status.

Strategies for improving a patient’s quality of life

The role of the adult-gerontology primary care nurse incorporates skills and competencies critical to the physical, psychosocial, mental and spiritual needs of their patients. With the online MSN AGPC program offered by Spring Arbor University, you can build on your existing nursing and leadership skills, growing a spirit of service while you acquire strategies for improving patients’ well-being.

In the process of determining the state of the patient’s well-being, according to a study by Shunguan Wu et al., a popular method that has become widely used is members rating their health on a scale of excellent to poor. It was determined that this self-diagnosis method was consistent with objective health status and, therefore, a sufficient indicator of health status in the general population.

The AGPC nurse will discuss the patient’s health status and proposed treatment plan with the patient and care givers, thus creating a ‘partnership’ in the treatment process. Having a good relationship with all parties concerned leads to more effective care with more meaningful and improved patient outcomes. If possible, invite a caring relative or friend to take part in coordinating the patient’s support.

If there are any adverse effects that the treatment may have, such as side effects of chemotherapy, the AGPC will discuss these with the patient, and decisions taken will be in line with the patient’s values, preferences and goals.

It is important to include some elements of well-being in the treatment plan, preferably in collaboration with the patient. Some lifestyle-enhancing suggestions include:

Support groups: Joining a support group is an essential part of the healing process when a patient has had a life-changing medical procedure or diagnosis. Support groups help patients come to terms with what it is they are battling with, just by realizing that they are not alone in this new experience. Support groups help emotionally and also provide advice on where to obtain medical supplies if needed, how to exercise and what foods to eat in the case of dietary issues.

Relaxation: Learning relaxation and meditation techniques can speed up the healing process while at the same time teaching the patient skills that will come in handy for years to come. Relaxing muscles relieves pain and stress – two factors that block the healing process. Classes can be arranged by the AGPC nurse or done online if a therapist is not available.

Alternate therapy: Massage or yoga, among others, build up muscle strength and are particularly relaxing. If the patient is not mobile, a masseur or someone with similar experience can be called in. Massage is great for pain relief, easing muscle tension and healing injuries.

Music therapy: The use of music therapy in healing is becoming more widespread as an evidence-based practice that helps trauma patients as well as people with mental health issues, chronic pain and other physical ailments. Music is a great stress reliever, lowering blood pressure and reducing muscle tension. It helps relieve pain and improves memory and motivation. This therapy can be done formally through a music therapist, or the nurse can organize some earbuds for the patient with music of their choice.

Creative pursuits: This can be in the form of dance or drawing and can be administered by a trained creative therapist or arranged informally by the nurse. Creative therapy helps patients channel their thoughts and emotions through artistic expression. In the case of depression or anxiety, a therapist would be able to get the patient to express themselves verbally as part of the healing process.

Exercise: An important part of recovery is starting to use muscles and joints again. Movement is also important to avoid bedsores. The longer the patient remains immobile, the more difficult it is to get going again. The AGPC nurse can help immobile patients get their bodies moving very slowly, and for those who are able, a daily gym session in the clinic will work wonders with a range of patients. Exercise improves blood circulation, boosts energy, improves sleep, acts as a mood enhancer and improves overall physical and mental health.

A common problem with elderly people is falling. As we age, people are more prone to losing their balance. Because their bone density is not what it used to be, many falls result in fractured bones. A good exercise regime helps build muscle strength and eliminate unnecessary falls.

Another common problem is obesity. The body’s metabolism slows down as we age, as do our energy levels. This leads to obesity in many elderly people and, in turn, results in chronic ailments such as type 2 diabetes, stroke, heart disease and some types of cancer. A good way to begin working on obesity is to start walking, slowly at first and then speeding up. The nurse practitioner can organize short walks with an aide, preferably outdoors for that extra benefit of fresh air and nature, or on a treadmill if one is available.

Lifestyle and education: Part of the nurse practitioner’s function is to educate patients on good lifestyle habits. This is particularly relevant to patients who are mobile and can care for themselves. For the patient, it means making a conscious effort to improve their diet and exercise regimens. Diet and exercise work wonders for our bodies and our self-esteem, but we sometimes need a little push in the right direction.

As part of the care strategy, the AGPC nurse sets aside some time to talk to patients and discuss their feelings to find out what is troubling them regarding their health and the treatment they are receiving.

It’s important to try to establish the patient’s family situation and encourage participation. Important too is a discussion around their cultural customs and spirituality, provided they are willing to share this information.

The AGPC nurse draws up a treatment plan, which can include some goals. Motivating patients to slowly take control of their lives again gives them strength and encouragement and speeds up the healing process.

Quality of life as an essential part of healthcare

From the above, the importance of taking quality of life into consideration when treating patients is obvious. From creating healthier communities to freeing up overburdened clinical facilities and staff, it’s a win-win situation.