Caring Community Nurses With Family Readiness to Receive Advanced Therapy Information in the Elderly

The increase in the number of elderly indicates an increase in life expectancy. The increasing elderly population reflects an increase in health services. The application of caring by nurses in the community has not been explained. Caring is the basis for nurses to be able to analyse nursing actions that are carried out properly and appropriately for clients who are a reference in follow-up care. The literature search in this study was carried out by identifying all types of national and international articles regarding Caring for Community Nurses and the readiness of families to receive further therapy information. The electronic database used is PubMed, Springer, and Google Scholar with a search strategy using the PICO (patient, intervention, comparison and outcome) method. Participants revealed that caring is an attitude of empathy, caring for the patient's needs, providing nursing care not only when the patient comes to the public health centre, but also when the nurse does home care. Participants expressed caring behaviours such as empathy, being friendly to patients who came to the treatment centre, caring about patient needs, making patient home visits, paying attention to the health that needs by patients. Caring for community nurses as an effort to improve the performance of community nurses in providing nursing services to the elderly so as to create integrated and comprehensive care for the elderly. The increasing relationship between patients and nurses that are established in a professional manner, helped participants get to know the many patients who came for treatment at the Public health centre.


INTRODUCTION
The growth of Indonesia's elderly population experienced the largest growth in Asia, which was 414%, Thailand 337%, India 242% and China 220% (WHO, 2015). The number of elderly people in Indonesia according to BPS in 2010 was 14,587,381 (6.19% of the total population of 237,641,326). WHO predicts that in 2020 it is estimated that the number of elderly in Indonesia will be around 80,000,000 people (WHO, 2017). This figure is a fairly large number if efforts are not made to improve the welfare and health of the elderly from now on, because the elderly have several health problems starting from the decline of body cells, so that the function and endurance of the body decreases and the risk factors for disease increase. Health problems that are often experienced by the elderly are malnutrition, balance disorders, sudden confusion, etc. In addition, several diseases that often occur in the elderly include hypertension, hearing and vision disorders, dementia, osteoporosis, etc. (Shrivastava, S. R. B., Shrivastava, P. S., Ramasamy, J., 2013).
On the other hand, an increase in the number of elderly indicates an increase in life expectancy. The increasing elderly population reflects an increase in health services. A number of policies have been carried out by the government to overcome the problems faced by the elderly. Nurses have the opportunity to provide health services and health promotion for the elderly as an integral part of holistic nursing. This holistic assessment will help nurses identify realistic nursing interventions to improve the functioning of the elderly's health quality. One way that can be done is by establishing an Elderly Caring Nursing Centre as an integrated service centre for nursing services (Miceli et al., 2014).
The application of caring by nurses in the community has not been explained. Caring is the basis for nurses to be able to analyse nursing actions that are carried out properly and appropriately for clients who are a reference in follow-up care, in other words, caring is an ideal moral of the nursing profession which refers to the willingness to provide sincere care with sincerity in taking care of health clients. Kusnanto, 2019) Good quality nursing services can be realized by implementing professional nursing care by applying the caring principle which is the essence of the nursing profession. Nurse professionalism is shown by special knowledge and skills that include intellectual, technical, and interpersonal skills whose implementation must reflect caring behaviour, which makes nurses a respectable profession (Tyas, Dwiantoro, & Ardani, 2016). Caring not only practices the art of care, giving love to relieve the suffering of patients and their families, improving health and dignity but also expanding nurses' self-actualization which is carried out by applying effective and therapeutic communication, providing positive responses and always providing support in interventions that are in accordance with standards (Kusnanto, 2019).
Nursing care includes independent intervention, collaboration, education and monitoring. In the context of the community, nurses have an important role, namely care giver, client advocate, counsellor, educator, collaborator, coordinator, change agent, consultant. Nursing care in the community nursing service setting can be provided in 2 services, namely: services inside the building and services outside the building (home visits). Services in the building by community nurses include assessment, nursing diagnosis, provision of nursing interventions and evaluation. Management of chronic disease in community nursing services in the building is very closely related to the role of the educator who dominates and the role of the caregiver. In carrying out their duties, caring is perceived differently by each individual nurse.
The purpose of this literature review is to explore the problems of the elderly, the form of caring community nurses for elderly families and identify forms of family readiness to receive information on advanced therapy in the elderly based on research.

B. METHOD 1. Research question
Caring for Community Nurses with family readiness to receive information on advanced therapy for the elderly. Article inclusion criteria are: 1). Participants were elderly cases with disease in post-hospital services, 2). The intervention used is community nurse caring 3). The results showed that there was an effect of caring for community nurses with family readiness to receive further therapy information in the elderly. c. Exclusion Criteria Exclusion criteria are articles that are not relevant to the research question.

C. RESULT AND DISCUSSION 1. The advantages of Implementing Community Nurse Caring
Participants revealed that caring is an attitude of empathy, caring for the patient's needs, providing nursing care not only when the patient comes to the public health centre but also when the nurse does home care. Participants expressed caring behaviours such as empathy, being friendly to patients who came to the treatment centre, caring about patient needs, making patient home visits, paying attention to the health needs of patients. This is in line with (Kusnanto, 2019) who explained that caring is defined as a behaviour or action taken to sincerely provide a sense of security both physically and emotionally to others. Caring is an open service provider relationship, and nurses care about clients (Potter & Perry, 2010).
Caring behaviour performed by participants when nurses provide services is friendly, gentle, polite to patients, care, patient and calm in dealing with patients, using therapeutic communication when with patients and patients' families, good verbal and non-verbal communication to patients. Every action is always agile, fast, Figure 3 Search Algorithm precise and skilled, has a sense of empathy, cares about the needs of the patient, especially the problems or complaints that are felt during the visit and motivates the patient to be enthusiastic about undergoing treatment. Caring must be realized through a caring attitude, being ready to meet the needs of the client, being friendly, being calm and having empathy for the client and family. This includes the role of a nurse to always be responsible and display a professional attitude through talks and other work in health education, counselling, and listening to clients (Dedi, Setyowati, & Afiyanti, 2008).
The dimension of caring carried out by participants when caring for patients is Maintaining Belief which has been carried out by participants, namely when meeting patients, greeting patients, using good verbal and non-verbal communication, being friendly, good eye contact, focusing on complaints felt by patients, listening to every complaint felt by the patient. Thomas, Finch, Schoenhofer, & Green (2009), said caring has implications for nursing practice so that nurses who are caring will speak in a friendly and polite manner, have attention, are full of interest in helping clients, and build relationships in every action they take.

The advantages of Elderly Getting Caring Nurses in Advanced Therapy
Caring for community nurses as an effort to improve the performance of community nurses in providing nursing services to the elderly so as to create integrated and comprehensive care for the elderly. Increasing professional nurse patient relationships, participants said that they were helped by getting to know the many patients who came for treatment at the public health centre. Not infrequently nurses are assisted by patients who are met on the street when looking for addresses of other patients, when a professional relationship is established in the healing process and the nursing care process during home visits is also getting better. Patients get a fast healing process, get good treatment for health problems. Health changes for the better, make patient satisfaction and nurse satisfaction. (Wolf, Miller, & Devine, 2010) which states that the performance of nurses including caring behaviour can make a major contribution to the quality of the patient's experience during treatment. Patient satisfaction is the outcome of health services. Patient satisfaction is one of the goals of improving health services (Wright, Causey, Dienemann, Guiton, Coleman, & Nussbaum, 2013).

D. CONCLUSION
The problem of lack of caring for nurses in advanced therapy for the elderly can be overcome by applying caring for community nurses with a caring dimension approach that is carried out by participants when caring for patients, namely Maintaining Belief which has been carried out by participants, namely when meeting patients say greetings, using good verbal and non-verbal communication, being friendly, good eye contact, focus on the complaints felt by the patient, listen to every complaint felt by the patient. (Thomas, Finch, Schoenhofer, & Green, 2009) said caring has implications for nursing practice so that nurses who are caring will speak in a friendly and polite manner, have attention, are full of interest in helping clients, and build relationships in every action they take.