gerontology

Wellness in the Elderly

1.Develop a wellness program with a holistic approach for the older adult you identified, in your week 2 project.
2. Use resources available in your community.
3. Discuss how this approach will provide an optimum level of well-being.

Please provide references APA style and Attached is week two’s project.

attachment
GerontologicalWK2ProjectPM.edited.docx
Running Head: GERONTOLOGICAL WEEK 2 PROJECT 1

GERONTOLOGICAL WEEK 2 PROJECT 2

Gerontological Week 2 Project

Patricia Marrero

South University

June 13, 2020

A summary of the response provided by the older adult

With regard to the asked questions, the older adult, Lawrence Kelly, gave out the feedback proposing that he was entirely in the know of the various health risks that he was exposed and had taken steps aimed at reducing these risks. Kelly was actively engaged in farming activities, which required a lot of physical engagement. Lawrence has enjoyed a very stable, healthy life and had only been involved with minimal hospitalization. However, he indicated that his ability to carry out farming activities has been diminishing over time, making him not able to engage in vigorous and physically demanding tasks. The reduced capability can be attributed to reducing muscle activity, and body strength prevalent as aging continues. The patient as well indicated that his bones and joints had become generally weak, a condition attributable to the disruption of hormonal balance in the body and the old age. The patient reported that these healthy changes started to present in his fifties, and they have been increasing gradually ever since. Also, he argued that he could not stand on a single foot the way he was doing at his younger days. The Tinetti mobility assessment considered it necessary to incorporate the use of walking assistants as one of the bases for assessing elderly persons. In regard to the conducted test on the 76year old patient, there was no need for the patient to be given mobility assistive devices reflecting the good patient’s health condition resulting mainly from the physical activities involved in his farming job. The patient also indicated that he followed a strict diet regimen, always ensuring that the serving is balanced and contains all the essential nutrients (Sanders, Scott, & Ebeling, 2016).

The similarities and differences between age-related changes of the older person and that in the literature

The study respondent, the older adult, gave out the response, which suggested that he had, over time, observed various health changes. An example is that his energy had been reducing, and his ability to carry out demanding physical tasks had also reduced. His bones had also weakened and experienced pains in the knee joint when sitting or standing from a chair. This weakness is attributable to the increased number of falls Lawrence reported. Kelly stresses out that he had had a first hospitalization after a fall in the course of attending to his animals that injured his knee. In their study of how to prevent falls in older adults, Khanuja, Joki, Bachmann, & Cuccurullo, 2018, acknowledged that falls were quite frequent among the elderly population, which imposed the medical burden upon the economy of about half a billion-dollar annually. They also note that the number of fall cases and the extent of the injury increased with age, with elderly persons experiencing frequent and more harmful injuries. The Response given by Lawrence highly correlated with this Khanuja, Joki, Bachmann, & Cuccurullo, 2018 study findings. The study went ahead to provide possible intervention strategies that would be useful in fall prevention, including the elderly patient’s assessments and provision of mobility assistive devices like walking sticks. It as well observed that the majority of these falls were linked to chronic illnesses and related medications, making the patient lose balance. This is precisely what was observed with Lawrence as his falls were associated with weak bones and joint conditions. This Lawrence mode of walking can be evaluated through the use of Tinetti Balance and Gait Evaluation, which highlights out areas that require further examination.

Lawrence Kelly weakened bones, diminishing energy levels, and the joint diseases as well as compromises his ability to carry out the activities of daily living (ADLs) such as bathing, cooking, and walking without sitting and standing. The declining ability to carry out ADLs as the age progresses have adverse effects on his quality of life as it makes him less and less capable of performing essential tasks. The Katz index of activities of the daily living tool is useful in the assessment of elderly persons’ functional status to inform about their ability to perform the ADLs independently. Clinical personnel has widely applied the Katz index in older persons. The index gives rank to individuals’ ability to perform six key ADLs, which include bathing, toileting, dressing, feeding, continence, and transferring. The patient’s assessment involves giving a yes or no to their effectiveness and independence of carrying out these tasks. The highest score of six implies that the older person can independently and effectively perform all the outlined tasks. A score of four shows that the impairment is moderate while that or two r less shows the inability of the patient to perform these tasks (Shelkey & Wallace, 2019).

Older person assessment identified Preliminary issues

In assessing Lawrence, a total of four issues important to his health and wellbeing were identified. The Barthwell index indicated that though the patient has some degree of independence to handle any diseases associated with he had a right knee problem, which was painful and attributed it from having fallen in the course of his farming activities. He also had reduced eyesight but had no significant effect on the performance of his daily tasks. Based n the Katzs index, the issue can affect the execution of his important ADLs like sitting, toileting, walking if no assistance is provided. The second problem identified was that Lawrence was in danger of developing spinal cord problems that could result in complete paralysis, which would as well affect the patient’s ADLs. An assessment of the safety of his home showed that Lawrence’s home was not secure as his house had loose ceiling boards at the edge of falling, which couped with his walking problems could pose great danger. Also, Lawrence lived alone, which is not suitable for both his mental, psychological, and physical wellbeing. His old age and condition need someone to be around him for comfort and assistance where possible (Bell et al., 2015).

Health alterations and possible problems

Among the alterations identified included the sensory deficiency, which limited his hearing capability, pharmacokinetics changes as well as the adverse outcomes coming from the provided medication (Forman et al., 2019). The problems may have emerged from the reduced ability of body organs like the liver, ear, and kidney due to age. The alterations can be minimized by tailoring the medications to suit the needs of the patient and avoid adverse side effects coming with those medications as well as using a hearing aid to enhance Lawrence’s hearing capability and effective information grabbing. It is also crucial for Kelly to take a balanced diet that is easily digestible to avoid constipation and related gut problems (Bell, Patel, Sonani, Badheka, & Forman, 2016).

References

Bell, S. P., Orr, N. M., Dodson, J. A., Rich, M. W., Wenger, N. K., Blum, K., … Forman, D. E. (2015). What to expect from the evolving field of geriatric cardiology. Journal of the American College of Cardiology, 66(11), 1286-1299. doi:10.1016/j.jacc.2015.07.048

Bell, S. P., Patel, N., Sonani, R., Badheka, A., & Forman, D. E. (2016). Care of older adults. Journal of Geriatric Cardiology, 13(1), 1–7. Retrieved from https://doi.org/10.11909/j.issn.1671-5411.2016.01.019

Forman, D. E., Rich, M. W., Alexander, K. P., Zieman, S., Maurer, M. S., Najjar, S. S., … Wenger, N. K. (2019). Cardiac care for older adults. Journal of the American College of Cardiology, 57(18), 1801-1810. doi:10.1016/j.jacc.2011.02.014

Khanuja, K., Joki, J., Bachmann, G., & Cuccurullo, S. (2018). Gait and balance in the aging population: Fall prevention using innovation and technology. Maturitas, 110, 51-56. doi:10.1016/j.maturitas.2018.01.021

Sanders, K. M., Scott, D., & Ebeling, P. R. (2016). Vitamin D deficiency and its role in muscle-bone interactions in the elderly. Current Osteoporosis Reports, 21(1). doi:10.1007/s11914-014-0193-4

Shelkey, M., & Wallace, M. (2019). Katz index of independence in activities of daily living. Journal of Gerontological Nursing, 56(3). doi:10.3928/0098-9134-19990301-05

Appendix
Questionnaire

INTERVIEW OF CHOSEN ELDER ADULT

Name: _____Lawrence Kelly_______________________ Age: 76 years old

Background data

Lawrence is a devoted farmer engaged in the rearing of animals and farming of crops, including cotton. He has enjoyed a long healthy life and had only been involved with minimal hospitalization. Ever since he fell, he has always complained of back and joints pains.

1. Philosophy on living a long life

Lawrence’s philosophy of leading a long and healthy life is to avoid packed foods, including fruits in the diet and keeping the body engaged with physical exercises.

2. Thoughts about when a person is considered “too old.”

According to Lawrence, a person is considered old if he is not able to carry out his ADLs without assistance. He alluded to not able to bathe and move as per his wish.

3. Opinion on the status and treatment of older adults

He was concerned about society’s negligence and disregard of elderly persons. Kelly insisted they require adequate care, access to a balanced diet, and fitness activities.

4. Beliefs about health and illness

Kelly seemed very concerned about health and illness and saw them as a congromeromerate of so many things, including physical, emotional, social, economic, and geographical factors. He is thankful and appreciative of his healthy life but sounded pessimistic of his recent knee joint aches.

5. Health promotion activities he or she participates in

Kelley requires keeping up with his farming activities that aid his body workouts as well as a strict balanced, and healthy diet regimen. He also requires much participation in social affairs and establishes an agemate friendship, which will be very helpful.

6. Something unique that helped the person live so long

Kelly’s devotion to farming activities from his youth has contributed significantly to the current health he enjoys.

7. The life span of other family members

He was very interested in explaining how his family members from his a century-old father have enjoyed a long healthy life. At an average, they lived for about 90 years.

8. Special dietary traditions in patient’s culture attributed to aiding long life

Lawrence and many of the family members and at large his neighborhood were mostly vegetarians with some seafood episodes, which he sees a major cause of longevity.

9. Any remedies/medications that have been handed down in a family/group. If yes, describe.

None

10. Patient’s description of current and past health status

Lawrence has enjoyed a healthy life from his childhood, with no major condition reported. Apart from the recent fall that saw his knee joint sometimes in pain, he cannot complain of any other condition that can require special focus. The only thing he cannot do is only standing on a single foot as he used to.

11. The values that guided life so far

Hard work and humility

Additional Questions

1. Patients hobby

Kelly described his love for swimming, especially in summer. He also likes taking considerable time in with his parent and granddaughters.

2. Does the patient drive

Lawrence does not have a driver and prefers driving himself, which he called very engaging.