NSG 4076 South Online Assessing & Planning Care for an Elderly Person Capstone

Description

Class:

NSG 4076 Capstone Synthesis Project

Request:

I have wrote a paper for my NSG 4076 Capstone, but the professor is not very happy with it and needs it

edited/rewritten

accordingly to ensure a high mark. I am attaching three words file

1. Original Request = this includes the original request to help you have an understand what the task is about and what the professors wants to read.

2. Original Template = this was the template provided by the professor to guide us when writing the paper

3. Final Paper = this was my paper. The professor was not happy with the content and the way the subject was approached so he marked it with a low grade. You need to adjust and rewrite some parts of the paper to ensure a high mark ( some parts needs to be fully rewritten).

Here are the

professor comments

regarding the final paper which needs to be approached:

-Both members of the aggregate are acceptable for the project.

There are many sections of the paper missing

–see template provided in feedback section. You need to add strengths and weaknesses of the community and the two members of the aggregate you assessed. The community strengths and weaknesses are based on the windshield tour you completed for the week 2 paper. The aggregate S/W are from this assessment data.

-This statement

does not provide a reason

, only information of the members of the aggregate you choose.

-The two assessments are adequate. However, you did not add all of the necessary information as noted in comment above. You also made a lot of APA errors in formatting, font used and how you added the completed assessment documents.

– Appendix go after the references not before.

Running head: ASSESSING AND PLANNING
Assessing and Planning Care for an Elderly Person
Erin Golder
South University Online
NSG4067 – Gerontological Nursing CP01
Week 2 Project
November 11, 2020
ASSESSMENT AND PLANNING
Assessing and Planning Care for an Elderly Person
Compare and contrast the age-related changes of the older person you interviewed
and assessed with those identified in this week’s reading assignment.
A person is considered older or elderly when the cumulative effects of age-related
changes take place (Miller, 2018, p.4). These age-related changes may include change in
gait and balance. When using the Tinetti Balance and Gait Evaluation, I found Mrs. E.B.
has a total score to be 15 out of 28 putting her at high risk for falls. When speaking with her
I learned these changes are new. She recently has had some back and hip pain due to a
pinched nerve accounting for the changes in gait, balance, and mobility. She needs minimal
assistance first thing in the morning getting her day started due to stiffness. Once she is up
and moving her mobility gets better.
After performing the Katz Index of Activities of Daily Living assessment, it
revealed she is still independent when it comes to performing self-care and feeding. She is
capable of bathing, grooming, and dressing herself without assistance. She does not cook all
her meals, but she can cook small meals and eats with her family when possible. She can be
left alone and can perform tasks independently.
The Barthel Index Test confirms her capability of performing simple tasks. Her
bedroom is on the top floor of the house and uses the rails when going up and down the
stairs. She tries to come down once she is ready for the day and stays downstairs until ready
to go to bed. While speaking with her, she mentioned drinking water and trying to eat
healthy to increase her strength and health. She watches her consumption and eats small
healthy meals she fixes on her own.
Issues Identified During Data Analysis
1. The addition of supplements to her daily routine may aid in strengthening her hips,
and lower back. Bone density decreases with age; thus, the reason physicians
recommend a bone density screening for women over 65 and men over 70.
ASSESSMENT AND PLANNING
2. Securing the house and making arrangement for Mrs. E.B. to ambulate safely and
freely. Mrs. E.B. is in the process of moving with her other daughter where all the
bedrooms are on the first floor. This will decrease the need for her to travel up and
down stairs and there is no carpet, decreasing her risk for falls. This will also help
after her back surgery coming up soon.
Health Promotion Interventions
Interventions are developed for health problems in older adults to reduce modifiable
risk factors while promoting positive outcomes (Miller, 2018).
1. Supplements and Diet
An increase in calcium and vitamin D intake should be considered aiding in both
bone and ligament health. Decreasing the risk for osteoporosis, low back pain,
fractures, muscle weakness and atrophy (Miller, 2018, p. 368). Learning more about
what food provides an increase in intake could help not only her but also her
children who are aging as well. If the family incorporates these items in their diet it
may be easier for everyone.
2. Physical Activity
An increase in exercise and physical activity can help reduce pain and improve
function for low back pain, osteoarthritis of the knee and hip, and improve wellbeing, and symptoms. Therapies that combine exercise and mind–body approaches
are more effective than a single modality (Miller, 2018, p. 596). As a family the
encourage getting out and walking together or riding bicycles together. They live in
a safe neighborhood where walking trails can be easily accessed.
These findings confirm that the relationship between questionnaires and scales to
assess activity of daily living and the functional tests can have more practical applications
such as normative cutoffs, and establishing parameters to prescribe exercise, prevent
mortality or identify the frailty syndrome (de Oliveira Brito, 2014).
ASSESSMENT AND PLANNING
Identifying the needs of an elderly individual and developing interventions and a
plan help with promoting the optimal quality of life for an individual. An elderly person
was chosen and interviewed to identify their needs and values. Assessment tools and
questionnaire were used to aid in this assessment, these can be found in the Appendix of
this document. A questionnaire was completed to identify the needs and values of the
individual. A functional assessment aided in recognizing the current functional level of the
participant. Health problems were also identified, and interventions discussed. These are all
tools used to help promote independence and meet the needs of an elderly person. They
deserve respect, independence (as much as possible), privacy, and the right to optimal
health and to live their life to the fullest.
ASSESSMENT AND PLANNING
References
de Oliveira Brito, L. V., Maranhao Neto, G. A., Moraes, H., Emerick, R. F. e S., & Deslandes, A. C.
(2014). Relationship between level of independence in activities of daily living and
estimated
cardiovascular capacity in elderly women. Archives of Gerontology and
Geriatrics, 59(2), 367–371. https://doi-org.su.idm.oclc.org/10.1016/j.archger.2014.05.010
Katz Index of Independence in Activities of Daily Living. Alzheimer’s Association. (2020).
Retrieved from: https://alz.org/media/documents/katz-independence-activities-dailyliving.pdf?_ga=2.118770954.2063856011.1605408018-73855779.1605408018.
Miller, C. A. (2018). Nursing for Wellness in Older Adults. [South University]. Retrieved
from https://digitalbookshelf.southuniversity.edu/#/books/9781975100735/
Patient Questionnaire NSG 4067 [Interview of Chosen Older Adult]. (2020, November).
NSG 4067 Gerontological Nursing.
Tinetti Gait and Balance Tool. (n.d.). Retrieved from
https://www.uclahealth.org/geriatrics/workfiles/education/clinicalskills/handouts/Tinetti-Gait-and-Balance.pdf
ASSESSMENT AND PLANNING
NSG4067 Gerontological Nursing
Page 1 of 5
© 2015 South University
Appendix A
Patient Questionnaire
INTERVIEW OF CHOSEN ELDER ADULT
Name: Mrs. EB /Erin Golder Age: 90
Brief Introduction (Background information):
Ernestine Bell is the fifth child of seven children born May 19, 1930 in Evanston,
IL. Married in 1947, mother of 8 children, 6 boys, 2 girls. Grandmother of 15
and Great grandmother of 12 great grandchildren. Great-great grandmother of
2. Several nieces, nephews, and a few cousins still living.
1. Philosophy on living a long life
“Obey your parents so that your days will be long.”
2. Thoughts about when a person is considered “too old”
“I don’t think a person is “too old” unless they feel old.” “Sometimes you may not
be old but feel old. I think you go according to how you feel.”
3. Opinion on the status and treatment of older adults
“I’ve been treated well. As far as I am concerned, it depends on the way the old
person acts and their attitude. Sometimes they can have bad attitudes and so
then you will have to have a lot of patience to deal with
them.”
4. Beliefs about health and illness
“Some of the elderly don’t have ailments.” I believe the health and illness effects
everyone differently. If you have a problem of a serious nature you need to see
your physician immediately. Try eating the right foods for your body and drink
plenty of water daily.
5. Health promotion activities he or she participates in
Walking when possible. Drinks plenty of water to stay hydrated.
6. Something special that helped the person live so long
” The Lord’s mercy for sure. I also quit smoking after 50 years of doing that and
my health improved.”
7. Life span of other family members
ASSESSMENT AND PLANNING
“My parents lived into their early 80’s. I am the longest living of my generation
and family to date at 90 years young.” Every one of my siblings have passed
and only two lived to be 80+. All others passed at 70 years or
younger.”
8. Special dietary traditions in patient’s culture attributed with aiding long life
“I have always drunk plenty of water and I know that’s a good thing.”
“Eating plenty of fruits and vegetables in your diet is helpful as well.”
9. Any remedies/medications that have been handed down in family/group.
If yes, describe.
“All my parents did is put blessed olive oil on everything that ailed you.” Did not go to a
doctor for anything growing up.”
10. Patient’s description of current and past health status
” Current health status for my age I would say is pretty good.” Past health status,
I had severe pain and was told I need a hip replacement and I declined that
suggestion. I chose to have treatment at a Pain Center and the pain has been
reduced significantly. I also have lumber stenosis and will be having a procedure
to correct that and that should do it for me.” Before the hip pain a few years ago,
I did pretty well apart from Glaucoma which is being successfully managed by a
couple of specialists.”
11. The values that guided life so far
First and foremost, I believe in God for everything! I believe in treating others the way I
would like to be treated.
Additional Questions
1.What do you do to help keep your mind active and healthy?
“Watch Jeopardy and Wheel of Fortune, Play Dominoes, cards, and read the
newspaper.”
2.What advice do you have for younger adults that you wish you would have
done different?
” I wish I would have never started smoking. I also wish I would have started
going to the doctor earlier and on a regular
basis.”
ASSESSMENT AND PLANNING
Appendix B
ADL TOOL ASSESSMENT
Erin Golder KATZBASICACTIVITIESOFDAILYLIVING(ADL)SCALE
Today’s Date
Patient Name
E. B.
ACTIVITIES
POINTS (0 or
1)
BATHING
P
OIIN
PO
NTTSS::
1
DRESSING
P
OIIN
PO
NTTSS:: _1
TOILETING
P
OIIN
PO
NTTSS:: _1
TRANSFERRING
P
OIIN
PO
NTTSS::
0
CONTINENCE
P
OIIN
PO
NTTSS:: _1
FEEDING
POINTS
P
1
11/1/20
INDEPENDENCE:
(1 POINT)
DEPENDANCE:
(O POINTS)
NO supervision, direction or personal
assistance
WITH supervision, direction,
personal assistance or total care
(1 POINT) Bathes self completely or
needs help in bathing only a single
part of the body such as the back,
genital area or disabled extremity.
(0 POINTS) Needs help with
bathing more than one part of the
body, getting in or out of the tub
orshower. Requires total bathing.
(1 POINT) Gets clothes from closets
and puts on clothes and outer
garments complete with fasteners.
May have help tying shoes.
(0 POINTS) Needs help with
dressing self or needs to be
completely dressed.
(1POINT) Goes to toilet, gets on and
off, arranges clothes, cleans genital
area without help.
(0 POINTS) Needs help transferring to
the toilet, cleaning self or uses
bedpan or commode.
(1 POINT) Moves in and out of bedor
chair unassisted. Mechanical
transferring aides are acceptable.
(0 POINTS) Needs help in moving
from bed to chair or requires a
complete transfer.
(1 POINT) Exercises complete selfcontrol over urination and
defecation.
(0 POINTS) Is partially or totally
incontinent of bowel or bladder.
(1POINT)Needs partial or total help
with feeding or requires parenteral
feeding.
(0 POINTS) Needs partial or total
help with feeding or requires
parenteral feeding.
ASSESSMENT AND PLANNING
TOTAL POINTS= 5/6
6=HIGH(patientindependent)
0 = LOW (patient very dependent)
ASSESSMENT AND PLANNING
Appendix C
Gait and Balance Assessment Tool
Erin Golder/ EB
Tinetti Gait and Balance Assessment Tool
BALANCE Instructions to Examiner
• Provide overview of what the assessment will consist of and tell them you’ll “talk them through it”
• Begin with patient seated in hard, armless, stably positioned chair
• For rising and sitting, ask patient to attempt it without using their arms/hands
• Examiner stands near patient (few feet in front and slightly to the side; “spot” for safety at all
•
times
Nudge test -> patient stands with feet as close together as possible; examiner presses on sternum
with palm of hand (3 trials)
Domain
Evaluation Characteristics
Description of Deficit
Leans or slides in chair Steady, safe
=0
=1
Unable to without help
Able, uses arms to help
Able without use of arms
=0
=1
=2
Unable to without help
Able, requires > 1 attempt Able to
rise, 1 attempt
=0
=1
=2
Immediate standing
balance (first 5 sec)
Unsteady (staggers, trunk sway)
Steady but uses walker or other support
Steady without walker or other support
=0
=1
=2
Standing balance
Unsteady
Steady but wide stance (>4 inches) or uses support
Narrow stance without support
=0
Sitting Balance
Rises from chair
Attempts to rise
Nudge
Nudge, eyes closed
=1
=2
0
1
1
1
2
Begins to fall
Staggers, but catches self
Steady
=0
=1
=2
1
Unsteady Steady
=0
=1
1
ASSESSMENT AND PLANNING
Discontinuous steps Continuous
Turning 360 degrees
(“make a complete
Unsteady (grabs, staggers) Steady
circle”)
Sitting down
=0
=1
0
=0
=1
0
Unsafe (misjudged distance, falls into chair) = 0
Uses arms or not a smooth motion
Safe, smooth motion
=1
=2
1
8 /16
Balance score
Based on Tinetti ME. Am J Med.1986 (3):429-34.
P a g e | 1 of 2
Tinetti Gait and Balance Assessment Tool
GAIT Instructions to Examiner
• Examiner moves along with patient; “spot” for safety at all times
• Patient walks across room (using walking aid if customary for them) for approximately 25 feet each
•
way.
Provide overview of what assessment will consist of and tell patient you’ll “talk them through it”
On way “out” ask patient to walk at usual pace; on way “back” ask patient to walk at rapid, but
safe, pace.
Instruct patient about the starting cue (go), and that they should stop if they feel unsafe
•
Definitions of terms used in gait assessment tool
• “Aid” is rated positive if patient is using his/her walking aid or if patient grabs at rails or furniture
• “Stance foot” is the foot that remains on the ground during gait cycle
Domain
Indication of gait
(Immediately after “‘go”)
Step length and height
Evaluation Characteristics
Any hesitancy or multiple attempts No
hesitancy
Right foot swing
Does not pass L stance foot
Steps past L foot
Does not clear floor
Clears floor
Left foot swing
Does not pass R stance foot
Steps past R foot
Does not clear floor
Clears floor
Description of Deficit
=0
=1
=0
=1
=0
=1
=0
=1
=0
=1
0
1
1
1
1
support
Narrow stance without support
ASSESSMENT AND PLANNING Begins to fall
Nudge
Step symmetry
Nudge, eyes closed
Staggers, but catches self
Steady
Right and left step length not equal Right and
Unsteady
left step length equal
Steady
Stopping or discontinuity between steps = 0
Discontinuous steps
Turning 360 degreesSteps continuous
Step continuity
Continuous
=0
=1
=1
=1
=2
2
=0
=1
=2
1
=0
=1
01
=0
=1
1
0
(“make a complete Marked deviation
=0
Unsteady (grabs, staggers)
=0
Mild/moderate deviation or uses aid
=1
Path circle”)
10
Steady
=
1
Straight without aid
=2
Unsafe (misjudged distance, falls into chair) = 0
Trunk Sitting down
Marked
oror
uses
=0 = 1
Usessway
arms
notaida smooth motion
1
NoSafe,
sway smooth
but flexedmotion
knees or back or
=2
spread arms wide
No sway, flexion, widened arms or aid
Walking stance
Heels apart
Heels almost touching while walking
Based on Tinetti ME. Am J Med.1986 (3):429-34.
Based on Tinetti ME. Am J Med.1986 (3):429-34.
=1
2
Balance =score
=0
=1
1
8 /16
0
Gait score
7 /12
Balance score (prior page)
8 /16
Total Score
15/28
P a g e | 2 of 2
P a g e | 1 of
Running head: AGGREGATE ASSESSMENT
Title of Paper
John Q. Student
South University Online
1
AGGREGATE ASSESSMENT
2
Full Title of Essay
Start here and include introduction to paper by identifying the purpose and content of the
paper.
Environment and Family Assessment
Include a general description of aggregate members used for assessment of family, home,
environment, and health risk factors. Identify how family, home, environment, and health risk
assessment was conducted using textbooks and journal articles as supporting data for approach
and findings.
Report assessment findings. Summarize assessment findings in a clear, organized, and
concise paragraphs. Refer to Appendix D in course textbook where you will find Friedman
Family Assessment Model for family assessment that includes family structure, home,
environment, and risk factors. Other possible applicable assessment tools are found in text
appendix E.1 to E.4.
Strengths and Weaknesses Assessment
Start here and include general introduction to purpose of identifying strengths ad
weaknesses of aggregate and general content of the section. (Suggest you include 2 journal
articles from your research as sources about purpose and process for assessing strengths and
weaknesses of aggregate).
Aggregate and Community Strengths
Start here
Aggregate and Community Weaknesses
Start here
Health and Safety Risks for Aggregate
AGGREGATE ASSESSMENT
3
Start here and explain purpose and process for risk assessments. Identify risks identified
using both week 2 community assessment and week 4 family, environment, home and risk
assessment data.
Risk for
Start here to provide supporting data for risk.
Risk for
Start here to provide supporting data for risk.
Risk for (add or subtract “risk for” headings as needed)
Start here to provide supporting data for risk.
Conclusions
Start here and include general overview of what you see as strengths and weaknesses of
community and the health and safety risks of the aggregate.
AGGREGATE ASSESSMENT
4
References
(make sure you include at least 2 journal articles as sources for information in the text)
Author, A. A. (Date of publication). Title of article in sentence case, only first letter capitalized.
Magazine/Journal Title Capitalized, volume #(issue #), page range.
Author, C. C., & Author, D. D. (Year). Name of course textbook, sentence case, only first letter
capitalized [VitalSource Digital Version]. City, State: Publisher.
South University Online. (2014). Course ID: Title of course in sentence case: Week x:
Specific lecture page in sentence casing. Retrieved from myeclassonline.com
Internet website (if no author use Organization name). (Date if available, n.d. if no date). Title of
article in sentence case. Retrieved from Newsletter/Website Title Capitalized. Retrieved from
URL
This is the original Request
In a Microsoft Word document of 4-5 pages formatted in APA style, complete the following
assessments (as they pertain to your aggregate) by interviewing 2-3 members of your aggregate:
•
•
•
•
Environment (Comprehensive Occupational and Environmental Health History)
Home (from lecture in class)
Family (Friedman Family Assessment)
Risk assessment (from lecture in class describe risks for your aggregate based on local
statistics and services available)
Describe the results of the assessments, including examples and support from journal articles,
following the guidelines below:
Risk Assessment
•
•
•
•
How Environment was Assessed
How the Home was Assessed
How the Family was Assessed
Risk Assessment
Strengths and Weaknesses
•
•
•
•
•
Strengths of Community
Weaknesses of Community
Strengths of Aggregate
Weaknesses of Aggregate
Health Risks of Aggregate Identified
On a separate references page, cite all sources using APA format. Helpful APA guides and
resources are available in the South University Online Library. Below are guides that are located in
the library and can be accessed and downloaded via the South University Online Citation
Resources: APA Style page. The American Psychological Association website also provides detailed
guidance on formatting, citations, and references at APA Style.
• APA Citation Helper
• APA Citations Quick Sheet
• APA-Style Formatting Guidelines for a Written Essay
• Basic Essay Template
Please note that the title and reference pages should not be included in the total page count of your
paper.

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