The older adults’ population is fast growing in United States and their health status has become a major concern to the healthcare providers and the country at large. Although some enjoy good health some of them suffer from significant disability and multiple illnesses. They suffer major cognitive functional and affective problems. Particularly those in poor neighborhoods are at a high risk of inappropriate institutionalization.
Research indicates that about 45% of the older adults have a certain form of chronic illness accompanied with other forms of physical illness (Kazer & Murphy, 2015). As a result, it is very important to perform an assessment of their condition as an assisting nurse to gain a holistic view of their medical needs. The study carries out a psychosocial and functional assessment of a 79 years old family friend. Born from Maryland he is married with 4 children and 6 grandchildren.
Summary of the assessment
To summarize the psychosocial assessment, the respondent attributes his ability to live so long to healthy living which includes eating healthy, exercising, and maintaining good mental health. He notes that he has been suffering from diabetes for the past five years which has led to the change in his lifestyle but has received great help from family members in managing the disease.
He believes that there needs to be improvement in treatment and maintaining the status of adults in the country citing lack of adequate health care of older adults facilities especially in the poor neighborhoods thus placing older people in higher risk. In his comments on health status of older adults, the respondent points out that the country should take seriously the health of these people due to higher risks for illnesses. He adds that family and the surrounding environment play an important role in one’s health such as through support and availability of health facilities.
Analysis shows that there is high correlation between responses and the findings in literature. The literature supports the respondents secret to long life which is attributed to maintaining good physical and mental health (Burbank, 2006). The current literature also supports the respondent argument that family plays a key role in managing various illnesses at old age. Moreover, his observation on the impact of poor health facilities in poor neighborhoods is echoed by various researchers (Burbank, 2006).
Functional assessment
The participant scores 17 on the Barthel Index of Activities of daily Living. This indicate that the elderly is fairly able to undertake his daily activities with minimal difficulties. It shows that he has fecal incontinence and experiences occasional stool leaking at most once in a weak. In terms of bladder functionality, the person also experiences occasional accidents of urine leak. As indicated in the test, he can perform other daily activities such as bathing, dressing, grooming, toilet use, and feeding independently. However, he experiences difficulties climbing up a staircase and needs assistance.
Comparison and contrast of the age-related changes
The age-related changes reported by the participant correlates with those proposed in the literature. According to literature, as one ages they start experiencing issues of controlling urination. This is because the amount of urine that can be held in the bladder decreases which in turn results in frequent urination (Miller, 2019). Moreover, the muscle responsible for controlling urine passage becomes weak and unable to prevent leakage. This is similar to the issues of bladder functionality reported by the participant characterized with occasional accidents of urine leak.
During the interview, the participant reported having several old-age related diseases like diabetes. This is similar to the literature which indicates that immune system of the body at old age becomes weak and slow which decreases their ability to destroy foreign substances hence the creeping in of diseases like cancer and diabetes (Miller, 2019).
The participant also noted that he was experiencing vision problems which is similar to an argument in literature. According to literature, there are several changes in one’s vision as they age such as stiffening of the lens, slow reaction of the pupil, the lens becoming yellow, and production of less fluid (Burbank, 2006). This factors contribute to limited vision as some cannot see object less than 2 feet closer. Some also experience changes in color perception as they may not be able to identify certain colors. As they grow older some may find it difficult to see in dim light due to decreased transparency of the lens.
Preliminary issues
One of the preliminary issues from the participant’s assessment is the weakening of bones which can be attributed to the bones becoming less dense due to low calcium. Another preliminary issue is the stiffness of joints which limits the ability of the participant to climb up a staircase. This can be attributed to decreased elasticity and wear and tear of the cartilage lining the joints. Third, the loss of near vision could be attributed to stiffening of the eye lens. Fourth, the issue of urinary incontinence due to looseness of the urinary sphincter.
Intervention to the weakening of the bones
Weakening of bones can be managed through eating balanced diet rich in Vitamin D and calcium. Vitamin D will help in absorbing the calcium into bones. Second, it is important to minimize daily activities and movements that may increase the risk of bone fractures (Burbank, 2006). Third, the condition can be treated using bisphosphonates such as non-hormonal medications to improve bone density.
Intervention to stiffening of the joints
One of the intervention for stiffening of the joints is to undergo joint treatment especially if the stiffness results in swelling of injury of the joint (Kazer & Murphy, 2015). This involves putting the injured joint to rest by avoiding its usage during treatment. Second, it is recommended that one performs regular joint exercise and indulging in light activities like gardening. Third, one can receive an-inflammatory medication or surgery for excessive joint problems or damages of the cartilage or ligaments.
Intervention for loss of near vision
Loss of near vision can be rectified by use of optical aids like special magnifiers. Second, loss of near vision can be as a result of a disease like diabetes and thus can be treated by managing the underlying disease (Burbank, 2006). Third, the intervention of a physical therapist can be used to help one in balance or walking problems resulting from vision issues.
Intervention for urinary incontinence
Urinary incontinence can be managed through frequent pelvic floor muscle exercise to strengthen the urination muscles (Burbank, 2006). It can also be controlled through bladder training that involves delaying urination whenever there is an urge. Third, it can be controlled through diet and fluid management by reducing consumption of acidic foods and alcohol.
Cultural considerations in the interventions
The interventions for weakening bones can be promoted by a change in cultural eating behaviors or lifestyle to include calcium-rich foods in the diet. The intervention related to assistive movement for vision loss may be subject to discomfort for the patient as one may feel helpless having to be assisted to move from one point to another. Similarly, an adult may feel ashamed having urinary issues which may in turn affect their response to interventions for managing the problem.
References
- Burbank, P. M. (2006). Vulnerable Older Adults: Health Care Needs and Interventions. New York, NY: Springer Pub.
- In Kazer, M. W., & In Murphy, K. (2015). Nursing case studies on improving health-related quality of life in older adults.
- Miller, C. A. (2019). Nursing for wellness in older adults.
