DW3- Gerontological Nursing
Week 3 Discussion
TASK
Post your initial response to the topic below.
Wellness in the Elderly
· Develop a wellness program with a holistic approach for the older adult you identified in your Week 2 project (ATTACHED).
· Use resources available in your community.
· Discuss how this approach will provide an optimum level of well-being.
As in all assignments, cite your sources in your work and provide references for the citations in APA format. Support your work, using your course lectures and textbook readings. Helpful APA guides and resources are available in the
University Online Library
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. The American Psychological Association website also provides detailed guidance on formatting, citations, and references at
APA Style.
ASSESING AND PLANNING CARE 1
ASSESING AND PLANNING CARE 2
Assessing and Planning Care
Viviana Torres
NSG4067 Gerontological Nursing
South University
January 25, 2021
Introduction
The interviewee in this case is a 66-year-old male by the name Mr. James. The patient has been an artist since he was a child and is well known for his poetry and the singing skills.. James is well travelled and is very energetic person valued around the community. James is a family man with two daughters and one son. At the same time, he lost his wife 19 years ago after she had dealt with breast cancer and hypertension for a long period. James and his family have been in deep sadness since the death of his wife.. He was left to take care of his kids and this is where his focus is all the time. The passing on of his wife is what motivated James to live a healthy life , also teaching this lifestyle to his children. James has found a purpose in his life through his kids all these years and only creates his own fun when he is participating in his poetry and other activities such as karaoke. James believes in routine and this is what has helped him to remain independent over his life at this age. James believes that life does not stop and he is dedicated to getting more experiences as he grows older. The risk of diseases according to him is reduced when one has a pattern in life and they are able to have a life with meaning and with excellent sleeping patterns.
Preliminary Issues
The issues which have been identified include constipation, sleeplessness, risk of falling, and backaches. The secure shows that the patient is at moderate risk of falling because of his age. The age factor has a huge influence and this is why there is risk of falling severely and suddenly. The same has to do with sleeplessness and insomnia for the elderly which is common. There is also likely to be issues in toileting and stiffness and backache. The patient is also likely experiencing issues in walking and standing. The age of the patient also means that he is likely to face issues of bowel movement such as constipation (Watson and Mears, 2019). There are also certain issues such as stress and depression which can come up because of loneliness as the children are already older. The patient has no one to take care of him every day and this can lead to such challenges. The risk of diseases can be minimum if the patient was to take proper care of his diet. The patient also needs assistance when he is moving around because of his age.
Alterations
There are several alterations that can be made in the health of the patient to improve his life. The core issues that have been identified include intestinal problems, difficulty in speaking, as well as the loss of taste buds. One of the interventions that can be taken is making sure that the patient is observing a proper diet. At the same time, the patient has to have constant exercise and communication to deal with the difficulty that he may face when speaking (Watson and Mears, 2019). At the same time, the loss of taste buds can be taken care of using diet and through visiting a physician.
Cultural Awareness
The patient is a Native American and needs to be handled as such. It is important to look at issues such as family care and cooperation. The Native Americans at the same time place great value on spiritual beliefs and family and this is something that one needs to be aware of. The state of health according to them is in balance with nature and this must be considered. Illness also has to do with physiological state and the balance that is there between the individual and the forces in nature. There are also cases where one might want to visit a local medicine man for consultations. There are several challenges which come in as the nation diversified (Horioka et al., 2018). It is important to also look at the various challenges and opportunities that there are when handling people from various cultures. The individual and organizations need to address all of the linguistic, social, and cultural needs of each patient. It is important to provide care looking at the ethnic and racial disparities.
References
Watson, E. A., & Mears, J. (2019). Women, work and care of the elderly. Routledge.
Horioka, C. Y., Gahramanov, E., Hayat, A., & Tang, X. (2018). Why do children take care of their elderly parents? Are the Japanese any different? International Economic Review, 59(1), 113-136.
Appendix
Patient Questionnaire
INTERVIEW OF CHOSEN ELDER ADULT
Name: __________James______________________ Age: ______66__________
Brief Introduction (Background information):
A 66-year-old man with three kids, two daughters and a son. The wife passed on after a struggle with breast cancer and hypertension. He dedicated the remaining part of life taking care of the children.
1. Philosophy on living a long life
Dedication to a healthy life involving family, the spiritual world, and a healthy mind.
2. Thoughts about when a person is considered “too old”
There is nothing like too old since people pass on at any ages. There is nothing like too old.
3. Opinion on the status and treatment of older adults
Need to be treated better as they are a core part of the systems which they built. Should be given better healthcare as they near end of their life.
4. Beliefs about health and illness
Health and illness is a personal responsibility. Health is also tied to the spiritual world.
5. Health promotion activities he or she participates in
Eating well, daily walks.
6. Something special that helped the person live so long
Love for his three children.
7. Life span of other family members
Wife died earlier on from disease.
8. Special dietary traditions in patient’s culture attributed with aiding long life
Eating healthy foods from nature.
9. Any remedies/medications that have been handed down in family/group. If yes, describe.
No, but might seek traditional medicine.
10. Patient’s description of current and past health status
Overall healthy and considers some of these as temporary setbacks such as constipation.
11. The values that guided life so far
Family life. And love for the community.
Additional Questions
1. Factors towards a long life
The patient believes it is the dedication towards taking care of his three children.
2. What is health and fitness?
The second question is on what one believes illness and health is. The patient has a positive attitude and believes that health improves on their quality of life. The patient believes that he can do anything so as to remain healthy in all aspects. Health and illness are part of life but he is working towards having a healthy body. The healthy body according to James connects one to a higher purpose. The belief on fitness is an important part of the life of the patient.
3. What is age to you?
There are some important aspects to talk to the patient about and the first one is their views on age. Age is also about perception. It is important to understand how the patient is feeling about the course that their life is taking. Age is the wealth that is there in life for all of them. It is important to make sure that life is considered in all ways such as prolonging of their life. It is important to look at ways which the patient is being affected as per their lives. There are issues to deal with aging that must be considered such as race, gender, and the social class. James believes that he is still young and does not think that age should be stopping of his life.
Summary
The patient is optimistic about life and believes in good health and taking care of family. Patient has an overall positivity towards life and living longer in good health and takes step to make sure it happens.
Contrast of client’s responses with findings in current literature
· The responses are in line with views towards living healthy so as to live longer.
· Literature supports living longer has to do with one’s perception also as they are proactive in maintaining their health.
· The patient believes mental wellness requires support of family as one grows older because of issues such as loneliness.
Tinetti Balance and Gait Evaluation
Balance Section
Gait Section
The subject is seated in hard armless chair
The individual is moving with variable paces (usual to fast)
Balance in Sitting
1
Indication of gait
1
Rises from the Chair
2
Step length and height
1
Attempts to rise
2
Foot clearance
1
Immediate standing Balance
2
Step symmetry
1
Standing balance
2
Step continuity
1
Nudged
1
Path
2
Eye Closed
1
Trunk
2
Turning 360 degrees
0
Walking Time
1
Sitting down
2
Balance Scores = 13/16 & Gait Score = 10/12
Total Score = Balance Score + Gait Score = 23/28
Tinetti Tool Score = Moderate, since the value is 23 so the risks of fall are moderate. (ME, 1986)
Katz Index of Activities of Daily Living
Activities
Independence
1 point
Dependence
0 point
NO supervision, direction or personal assistance.
WITH supervision, direction, personal assistance or total care.
Bathing
1
0
Dressing
1
0
Toileting
1
0
Transferring
1
0
Consistence
1
0
Feeding
1
0
Total Score
(Wallace, 2007)
High
06
Low
0
The Barthel Index
Activity
Score
Feeding
10
Grooming
5
Stairs
10
Bladder
5
Toilet Use
10
Transfers from Bed to Chair & Back
10
Bowels
5
Dressing
10
Mobility
5
Bathing
5