Care for an Elderly Person

Care for an Elderly Person

Care for an Elderly Person

The elderly are a group of vulnerable populations in most societies. They have complex health needs that may predispose their dependence on others. Therefore, this research paper summarizes an assessment performed on an elderly client. It explores different assessment tools’ outcomes and identifies issues, alterations, and interventions needed to promote the client’s health.

Comparison

The assessment of the elderly client using the Tinetti Balance and Gait Evaluation showed that he was highly at risk of falling when undertaking his routines. The balance assessment demonstrated that the client rises from the chair using arms to help him. He also requires assistance as he attempts to rise from a chair. The client’s immediate standing balance is steady but uses a walker. He uses a walker to maintain standing balance with some evidence of staggering. He, however, works steadily with eyes closed and when turning through 360 degrees. He uses his arms to maintain a smooth motion when sitting down. The assessment of gait also revealed that the patient-initiated gait without hesitancy. His step length and height were asymmetrical. For example, the right swing foot failed to pass the left stance foot with step. The right and left step lengths were also asymmetrical. The trunk had marked sway, as evidenced by his use of a walking aid. The above balance issues were attributed to the reduced elasticity of the tendons and ligaments of the bones.

The Katz Index of Activities of Daily Living assessment showed that the client performs all the activities of daily living independently. The client reported bathing independently and only needing help bathing the lower extremities. He also dresses independently and may need help in tying his shoes. He also reported being able to toilet, transfer himself in bed unassisted, and does not experience incontinence problems. He also feeds without any assistance. Based on the above, the client can perform all his daily living activities without any help from his family members.

The Barthel Index confirmed the client’s independence in undertaking his activities of daily living. The assessment demonstrated that the client is independent in feeding, bathing, dressing, bowels, bladder, toilet use, and transfers. He, however, uses a walking stick for mobility and assistance in climbing stairs. The client reported during the interview that he engages in regular walks to strengthen his bones and muscles. However, he was diagnosed with dementia one month ago and had to minimize walking out of their compound because of fear of getting lost. He reported that he takes a healthy, balanced diet to minimize health problems like cancer, diabetes, and fractures. He also has a diabetic foot, which is dressed weekly in a nearby public facility. The assessment showed the increased need for family involvement in the management of diabetes and promotion of his safety in familiar and unfamiliar environments to promote safety.

Home safety assessment showed the home to be moderately safe. The home had a fire extinguisher at the point of entrance with working smoke and carbon monoxide detectors at every house level. Flammable objects were distantly located from the stove area. The family reported that chimney sweeps are performed yearly. The home has an accessible phone for the emergency dial, with emergency numbers posted near the phone. The home also has a first aid kit and assistive devices for the elderly such as a walking stick. The electrical appliances are safely covered with plate covers with cords not being cracked or frayed. The floor and hallways are adequately lit, with carpeting secured and indoor stairways having side rails. The kitchen has adequate space and lighting. The parking area is safe, as evidenced by sufficient lighting and having a reasonable level.

Identified Issues

Several issues were identified during the assessment. One of them is the inadequate support from the family members on diabetes management. The elderly client has diabetes with a diabetic wound. He visits a nearby public facility for the dressing of the wound regularly. He is also expected to monitor his blood glucose levels daily. However, the client reported that he receives minimal support from the family members in monitoring his blood glucose levels. He also attends the weekly hospital visits alone. The client also does not have a spouse to accompany him to the hospital or walk him around the community as part of his physical activity daily.

The second issue identified from the assessment is the client’s risk of injury. The client was recently diagnosed with dementia. He reported getting lost in his familiar environments. The family also reported that he often forgets their identity. The memory loss predisposes the client to risk harm due to falls and getting lost in his environment. The family should therefore ensure the prioritization of his safety needs.

The third issue identified from the assessment is the lack of awareness among the family members on diabetes and dementia. The client has diabetes and has dementia. The family members have limited knowledge on the effective management of diabetes and dementia. They also do not understand their increased predisposition to diabetes and dementia. They should therefore be educated about the risks and ways of minimizing them.

The last issue that was identified from the assessment is the need for dietary supplementation of calcium to prevent fractures in the client. The Tinetti Balance and Gait Evaluation demonstrated the client to be at a high risk of fractures. Therefore, the client and the family should be educated about the importance of increased intake of foods rich in calcium. They should also be educated on the strategies to minimize the risk of falls in the home environment.

Alterations and Interventions

Utilization of Screening Services

One of the required alterations for the client and the family is increased utilization of screening services. The client and the family should be encouraged to utilize screening services for health problems such as diabetes, hypertension, different types of cancers, and eye problems. The elderly client has diabetes. As a result, the family members should be encouraged to undergo annual diabetic screening due to their genetic predisposition. The client should also be educated on the importance of screening for prostate and colon cancer, renal and eye problems due to the increased risk of diabetic neuropathy and retinopathy. The client should also undergo regular checkups for blood pressure since he is highly predisposed to hypertension as a comorbidity of diabetes (Ishak et al., 2017). Community health nurses should also educate the community members about the importance of screening services. Health education will raise awareness among the community members, hence, increasing the uptake of screening services and early identification and management of potential cases.

Family Involvement in Client Care

The second alteration identified from the analysis is the need for family involvement in caring for the elderly client. The effective management of diabetes and dementia requires the active participation of the family members. Family members should assist the client in undertaking daily glycemic monitoring and attending the weekly dressing for the diabetic wound. Family involvement will minimize the risk of hypoglycemia, hyperglycemia, and worsening of the diabetic foot. Therefore, family members should be educated about their critical role in promoting the effective management of diabetes. The client is also at risk of injury due to dementia. The family should be involved in promoting the client’s safety. They should be educated about the importance of ensuring that the client lives in a well-lit and familiar environment. The community nurse should also link the client and his family to the available social support systems in the community for diabetes and dementia (Caner & Cilasun, 2019). Social support networks will assist the client and family learn about effective ways of coping with their health needs.

Nutritional Modification

The assessment demonstrated the client is at an increased risk of falls. Falls contribute to adverse outcomes in elderly patients, such as fractures and loss of mobility. Therefore, the client and family should be educated about the importance of nutritional modification to strengthen the client’s bones. The family should be educated about the importance of increasing the intake of foods rich in calcium, such as milk. The client and the family should also be educated about the risks of high intake of diets that limit the dietary absorption of calcium. The client should also be educated on the importance of engaging in moderate physical activity to strengthen the bones and minimize calcium loss (Bischoff-Ferrari et al., 2018). The client was also educated about the signs and symptoms of bones’ low calcium levels, such as bone pain and easy fractures.

Conclusion

The elderly comprise the vulnerable populations in our societies. They are predisposed to health problems such as diabetes, dementia, and hypertension. The assessment of their health needs guides appropriate interventions to promote their health. Therefore, this exercise has increased my understanding of how the health needs of the elderly populations can be met.

Care for an Elderly Person References

Bischoff-Ferrari, H. A., Bhasin, S., & Manson, J. E. (2018). Preventing Fractures and Falls: A Limited Role for Calcium and Vitamin D Supplements? JAMA, 319(15), 1552–1553. https://doi.org/10.1001/jama.2018.4023

Caner, A., & Cilasun, S. M. (2019). Health Care Services and the Elderly: Utilization and Satisfaction in the Aftermath of the Turkish Health Transformation Program. Gerontology and Geriatric Medicine, 5, 2333721418822868. https://doi.org/10.1177/2333721418822868

Ishak, N. H., Mohd Yusoff, S. S., Rahman, R. A., & Kadir, A. A. (2017). Diabetes self-care and its associated factors among elderly diabetes in primary care. Journal of Taibah University Medical Sciences, 12(6), 504–511. https://doi.org/10.1016/j.jtumed.2017.03.008

Week 2 Project Assessing and Planning Care for an Elderly Person In order to gain an insight into the world of elder adults, it is important to understand how they view themselves and the values they hold. Additionally it is important to assess and determine his/her needs and establish appropriate interventions for this individual. By the due date assigned, choose an older adult to interview. This cannot be a patient in your clinical setting. You can use a friend, family member, or co-worker. The older adult should be 65 years or older. Use the format provided to record the responses. A list of questions is available for you to start with. Include 2–3 questions of your own to get a complete picture of the older adult. Summarize your findings and also contrast the responses with findings in your readings and other current literature. Download a patient questionnaire. This form should be used as an example. After gaining permission, conduct a physical and mental functional assessment of the older adult you have chosen. Review your readings for the process of functional assessment. Make use of the tools discussed this week to complete a comprehensive assessment of your patient. Search the Internet for resources on these tools. Tinetti Balance and Gait Evaluation Katz Index of Activities of Daily Living Assessment of Home Safety The Barthel Index Make sure the older adult is clearly identified on the tools.

Care for an Elderly Person

Do not include their name, but do include professional or other designation, and age. Your name should also be identified on the tool. (This should be a part of your Appendix.) Compare and contrast the age-related changes of the older person you interviewed and assessed with those identified in this week’s reading assignment. During this data analysis process provide at least 4–6 preliminary issues that you have identified. Identify three alterations in health that you would propose and describe them. Identify a minimum of three comprehensive interventions for each problem. Make sure that you integrate personal cultural awareness and cultural competency. Paper should be 5–6 pages, not including the questionnaire or tools used. These should be attached as an Appendix. Remember to use headings to identify the different sections in your paper. On a separate references page, cite all sources using APA format. Use this APA Citation Helper as a convenient reference for properly citing resources. This

handout will provide you the details of formatting your essay using APA style. You may create your essay in this APA-formatted template.

Care for an Elderly Person

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

• Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
• Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
• One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
• I encourage you to incorporate the readings from the week (as applicable) into your responses.

Weekly Participation

• Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
• In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
• Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
• Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

APA Format and Writing Quality

• Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
• Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
• I highly recommend using the APA Publication Manual, 6th edition.

Use of Direct Quotes

• I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
• As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
• It is best to paraphrase content and cite your source.

 

LopesWrite Policy

• For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
• Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
• Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
• Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.

Late Policy

• The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
• Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
• If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
• I do not accept assignments that are two or more weeks late unless we have worked out an extension.
• As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

Communication

• Communication is so very important. There are multiple ways to communicate with me: 
  • Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
  • Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.