Discuss about the Understand and Promoting Healthy Aging.
A very important aspect of quality care delivery is proper patient assessment and processing of the situational issues faced by the patient (Lima, Newall, Jordan, Hamilton & Kinney, 2016). Clinical reasoning cycle has been used in the healthcare industry as a useful tool for optimally collecting and processing the information shared by the patient and arriving at a care decision that is most suitable for the patient (Salminen, Zary, Björklund, Toth-Pal & Leanderson, 2014). This assignment will attempt to utilize the framework provided by the clinical reasoning cycle in order to conduct a patient assessment interview of an elderly patent with the focus on promoting healthy aging and understand if there are any health issues faced by the patient.
This first of the process is the patent situational analysis; for this interview, I had to visit the house of a 72-year-old patient. In order to protect her privacy and the confidentiality of her personal information, she will be called Suzanna. Suzanna had been an elderly widower who lived alone in her house. The patient data revealed that she had suffered a major stroke in the past year and has been disabled from her waist down ever since. Hence, the interview was set up in her own house so that she can be comfortable and she would not have to suffer through her mobility restrictions to come to the interview spot (Lima, Newall, Jordan, Hamilton & Kinney, 2016). When I approached her house I noticed that her entire house was very messy with various articles cluttered all across the house. She apologized profusely forth mess that her house. I noticed that the condition of the house increased her fall risk optimally and I asked her whether she has any help with the household chores. Suzanna expressed that she has a community carer pay her a visit thrice a month but no matter how hard she has tried to keep the house clean, she cannot cope with it due to her disability and age-related restrictions. According to her wishes, we set up the interview in the living room after helping her sit comfortably on the sofa. The patient had been slightly nervous while starting the interview however when I explained to her the purpose of the interview the patient finally relaxed and was ready to proceed with the interview. The resources that I carried with me for the interview includes a voice recorder, notebook, pen and RLT model questionnaire for the interview.
In the next step of the study I attempted to collect cues and required information from the patient based on the questionnaire model that I had taken with me. The nonverbal communication traits are very important aspects while conducting patient assessment so as to help the patient feel confident, valued and comfortable to share her personal information with the healthcare staff (Morton, Fontaine, Hudak & Gallo, 2017). I approached the patient with casual conversation so that the patent can easily interact with me and can share her issues and grievances effectively. According to the Odell (2015), it has to mentioned, that while assessment often the patients feel embarrassed and uncomfortable to share the personal details of their life with a complete stranger. Hence, I attempted to discuss with her my own personal background, how I started with a profession in the health care industry and how my journey as a care provider has been. As the patent was comfortable with sharing information with me I started with the questionnaire. I began with the information regarding her environment, her communication, breathing, eating and drinking, eliminating, personal cleansing and dressing, body temperature, mobilizing capabilities, working and playing, expressing her sexuality, sleeping and lastly about dying. As per the Robert, Tilley and Petersen (2014), it is crucial for the care professionals to maintain basic decency and communicational comfort with the elderly patients. Hence during the course of the interview, I attempted to be very patient with the patient and spoke very softly so that Suzanna does not feel rushed or that she cannot keep up with the procedure. Along with that according to the guidelines of safe and effective critical aged care, it is very important for the care professionals to be optimally compassionate with the issues of old age so that the patients do not feel that they are being judged or belittled (Sørensen & Brahe, 2014). Hence, I tried to be very compassionate with the issues that she revealed and responded with empathetic words to help her feel understood and valued.
Analysing the information that was received in the interview, it can be mentioned that the patient had a clear idea regarding concepts of healthy aging. Regarding the safe environment the patient was asked whether she is able to prevent accidents have from happening or if she was under any risk from infections, if she was aware of safe taking or receiving any medication, whether she was under any stress and anxiety, idea of safe living and availability of resources. She expressed that she liked to keep the windows and doors in her house open so that air and light can pass through, but due to he disabilities she could not complete these tasks on her own. She expressed she thinks due t the clutter she was at high risk of falling and she had anxiety about it. Regarding ADLs, Suzanna was asked whether she could actively perform the personal hygiene such as bathing, washing and dental care. She understood that the concepts of cleanliness and hygiene are very important for healthy living, however, she was completely dependent on the visit of her carer for these things. Hence, she had a clear idea about healthy living but in the absence of her carer she was at high risk of fall due to the cluttered house and could not perform activities of daily living either. Along with that, with the absence of her carer she cannot perform activities of daily living properly hence, she is at high risk for infections In case of communication factors the patient was asked from the questionnaire whether she is able to communicate effectively, her native language understanding and that she is experiencing a acute pain or speaking disability. Her communication skills were fine and she could express her wishes and issues effectively (Bacsu et al., 2012). Regarding her dietary patterns, She was asked whether she understands what is a healthy diet, her current diet, Whether she is capable of preparing a nutritious diet for herself, and her cultural understanding of healthy eating and drinking. For eating and drinking, she receives meals from a local delivery restaurant and is unsure of the effect of not eating home cooked food for a prolonged time. She is mobility restricted and she does not work either, although every other week the carer takes her out for strolling which is highly appreciated by her. Next her normal occupational activities were asked followed by whether she has any cultural or traditional views regarding her gender. Lastly, she was asked about her normal sleeping and waking routine followed by her idea and concepts regarding death and dying. Her sleep patterns were fine with 8-9 hours of sleep throughout the night and she had a fearful and uncertain take to death.
Reflecting on the entire procedure, it has to be mentioned that except for death, the patient had a very positive understanding of aging. Despite her disability and mobility restriction, she was coping fine with the issues. Although a few needs that have been expressed by the patient includes her high risk of fall due to the cluttered house, lack of ability to perform activities of daily living, lack of healthy eating and proper healthy mobilization from time to time. Hence Suzanna will require full-time assistance from a personal care provider to assist with each and every activity of healthy aging and living. Along with that, she will require visits from a physiotherapist to help her cope with her disability and a dietician for a healthy diet plan to follow.
Conclusion:
On a concluding note, this assignment gave me a wonderful opportunity to explore and understand the concepts of healthy aging, how the elderly population perceives it and the pertinent issues associated with aging in the society. With respect to the recommendations outlined in the reflection, it can be hoped and she will be able to live in a healthy and content manner for the rest of her life.
References:
Bacsu, J. R., Jeffery, B., Johnson, S., Martz, D., Novik, N., & Abonyi, S. (2012). Healthy aging in place: Supporting rural seniors’ health needs. Online Journal of Rural Nursing and Health Care, 12(2), 77-87. Retrieved from https://rnojournal.binghamton.edu/index.php/RNO/article/view/52
Kerr, J., Rosenberg, D., & Frank, L. (2012). The role of the built environment in healthy aging: community design, physical activity, and health among older adults. Journal of Planning Literature, 27(1), 43-60. Doi: 10.1177/0885412211415283
Lima, S., Newall, F., Jordan, H. L., Hamilton, B., & Kinney, S. (2016). Development of competence in the first year of graduate nursing practice: a longitudinal study. Journal of advanced nursing, vol 72(4), pp 878-888. https://doi.org/10.1111/jan.12874
Morton, P. G., Fontaine, D., Hudak, C. M., & Gallo, B. M. (2017). Critical care nursing: a holistic approach (p. 1056). Lippincott Williams & Wilkins. Retrieved from : https://www.just.edu.jo/ar/CoursesAndLabs/Advanced%20Adult%20Health%20Nursing%20(Theory)_NUR%20415/NUR%20415.doc
Odell, M. (2015). Detection and management of the deteriorating ward patient: an evaluation of nursing practice. Journal of clinical nursing, vol 24(1-2), pp 173-182. https://doi.org/10.1111/jocn.12655
Robert, R. R., Tilley, D. S., & Petersen, S. (2014). A power in clinical nursing practice: concept analysis on nursing intuition. Medsurg Nursing, 23(5), 343-350. retrieved from: https://go.galegroup.com/ps/anonymous?id=GALE%7CA389798016&sid=googleScholar&v=2.1&it=r&linkaccess=fulltext&issn=10920811&p=AONE&sw=w&authCount=1&isAnonymousEntry=true
Salminen, H., Zary, N., Björklund, K., Toth-Pal, E., & Leanderson, C. (2014). Virtual patients in primary care: developing a reusable model that fosters reflective practice and clinical reasoning. Journal of medical Internet research, 16(1). Doi: 10.2196/jmir.2616
Sørensen, E. E., & Brahe, L. (2014). Interruptions in clinical nursing practice. Journal of clinical nursing, vol 23(9-10), pp 1274-1282. https://doi.org/10.1111/jocn.12329
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