Contexts of Practice: The Older Person and Family

Discuss the biophysical processes pertinent to the case (200 words)

In this case study, it is found that Mr. Lee is a 78 years old man, his eyesight is slightly weak so he wears glasses, gait is nearly normal but still walks with a walking stick to reduce the risks of falls, and he suffers from hypertension. He also has thin and dry skin issues, his cognitive abilities are appropriate and socially interactive. However, he falls due to imbalance and gets injured. With aging the individual’s biochemical and physicochemical, biophysical properties get change such as with age the sensation of thirst decreases, so the skin becomes dry and the individual suffers from dehydration (Begg 2017). With aging the individual develops eye problems such as dry eyes or cataracts (Sandhas, Merle and Eule 2018). As the individual ages the cognitive functions also get negatively affected; with issues like memory issues, conceptual issues, or others (Limbert, Masen and Pond et al. 2019). If the elderly maintain physical health by daily physical activities or a healthy diet can prevent such issues. In this case study, Mr. Lee maintains a healthy lifestyle so he is at a healthy state with maintained and balanced biophysical factors.

References

Begg, D.P. 2017. Disturbances of thirst and fluid balance associated with aging. Physiology & Behaviorvol. 178, pp.28-34. https://doi.org/10.1016/j.physbeh.2017.03.003

Limbert, G., Masen, M.A., Pond, D., Graham, H.K., Sherratt, M.J., Jobanputra, R. and McBride, A. 2019. Biotribology of the ageing skin—Why we should care. Biotribologyvol. 17, pp.75-90. https://doi.org/10.1016/j.biotri.2019.03.001

Sandhas, E., Merle, R. and Eule, J.C. 2018. Consider the eye in preventive healthcare–Ocular findings, intraocular pressure and Schirmer tear test in ageing cats. Journal of Feline Medicine and Surgeryvol. 20, no. 12, pp.1063-1071. https://doi.org/10.1177%2F1098612X17742528

Discuss the psychosocial processes pertinent to the case (200 words)

In this case study of Mr. Lee, it is found that he is a physically active old man. He likes to go out for a walk daily and had a lovely interaction with his family members as well. He likes to go out to walk-in parks with his wife, likes playing games, walks around the block to the local park, enjoys his life, watches birds, and loves to wear his favorite sneakers for the walk. All these factors showed that even at an aging stage he had no anxiety, depression, no substance abuse, or fear. Lee loves to talk to others and drive as well. He misses sometimes the children of his daughter and is actively involved with them when they visit his house. According to Ayton, O'Donnell and Vicary et al. (2020), it is found that with aging the psychosocial processes such as interaction with family members or friends becomes weak. The old person might suffer from issues such as depression, feelings of loneliness, emotional, or social interests that decrease or suffers from stress. There are also various other psychosocial issues that might arise with aging such as fear, grief, or personality disorders (Fratiglioni, Marseglia and Dekhtyar 2020). However, in this case, study, Mr. Lee happily walks across the path and enjoys his life to the fullest and he drinks his favorite tea daily.

References

Ayton, D., O'Donnell, R., Vicary, D., Bateman, C., Moran, C., Srikanth, V.K., Lustig, J., Banaszak-Holl, J., Hunter, P., Pritchard, E. and Morris, H. 2020. Psychosocial volunteer support for older adults with cognitive impairment: Development of MyCare Ageing using a codesign approach via action research. BMJ Openvol. 10, no. 9, p.e036449. http://dx.doi.org/10.1136/bmjopen-2019-036449

Fratiglioni, L., Marseglia, A. and Dekhtyar, S. 2020. Ageing without dementia: Can stimulating psychosocial and lifestyle experiences make a difference?. The Lancet Neurologyvol. 19, no. 6, pp.533-543. https://doi.org/10.1016/S1474-4422(20)30039-9

Identify a screening tool for assessment appropriate in this case and discuss key elements of the tool (200 words)

In this case study, the patient falls due to imbalance so a fall risk assessment tool – Downton Fall Risk Index (DFRI) will be used. It is a screening tool used for the elderly. According to Mojtaba, Alinaghizadeh and Rydwik (2018), in this index, the scores are provided as per the assessments for various sections such as gait–unsafe, normal or unable; mental state – confused or oriented; sensory deficits – limb impairment, visual impairment or hearing impairment; medication issues - antidepressant, diuretics, sedatives, or none; and records for previous falls – yes or no. The individual scores 1 or 0 based upon the assessment recorded. Then the scores are added and if the range lies in between 3 or more then it means the patient is required to be provided with nursing care as he is at high risk of falls. Usually, all the scores add together to an index total of 0 to 11. Hence, if the patient is having an unsafe gait, some mental issues, or impairments then this tool can be used for screening during the assessments (Park 2018).

References

Mojtaba, M., Alinaghizadeh, H., and Rydwik, E. 2018. Downton Fall Risk Index during hospitalisation is associated with fall-related injuries after discharge: A longitudinal observational study. Journal of Physiotherapyvol. 64, no. 3, pp.172-177. https://doi.org/10.1016/j.jphys.2018.05.005

Park, S.H. 2018. Tools for assessing fall risk in the elderly: A systematic review and meta-analysis. Aging Clinical and Experimental Researchvol. 30, no. 1, pp.1-16. https://doi.org/10.1007/s40520-017-0749-0

Discuss 3 priorities of care for this person (200 words)

The 3 priorities for care for his person are as follows: his high blood pressure, his low vitamin D levels for osteoporosis issues, and the skincare of the patient. In this case study, the patient is suffering from high blood pressure those results in hypertension issues. This can be managed with the help of monitoring the blood pressure levels of the patient and evaluating his results to ensure that the dosage of the antihypertensive drugs used by the patient is as per his health condition. If the hypertension condition is not treated then it can lead to dizziness, stroke, headache, or fall (Gonzalez-Marrero, Hernandez-Abad and Castaneyra-Ruiz et al. 2020). The patient should be provided with a balanced diet prepared by the nutritionist. He should be asked to continue his physical activities daily such as walk so that he stays physically fit. The patient should be asked to drink 8 glasses of water a day to maintain the hydration levels so that skin or mouth does not get dry and this skincare will prevent the risk of skin damage, which is common in old age (Laurino, Alfì and Billeci et al. 2020).

References

Gonzalez-Marrero, I., Hernandez-Abad, L.G., Castaneyra-Ruiz, L., Carmona-Calero, E.M. and Castaneyra-Perdomo, A. 2020. Changes in the choroid plexuses and brain barriers associated with high blood pressure and ageing. Neurología. https://doi.org/10.1016/j.nrleng.2020.05.007

Laurino, M., Alfì, G., Billeci, L., Bortone, I., Buzzigoli, E., Cecchi, A., Del Ry, S., Gastaldelli, A., Lai, E., Morales, M.A. and Pagni, C. 2020. Healthy aging: The INTECMAN project. Aging Clinical and Experimental Research, pp.1-5. https://doi.org/10.1007/s40520-019-01444-8

Discuss any equity, rights, and access issues relevant to the case (200 words)

In this case study, Mr. Lee lives in a town in a region that is populated with aboriginals. In such cases, there are chances that if he is an aboriginal then he might face health inequalities. The people or old individuals who live in town have difficulty traveling to the cities for their medical check-ups and this affects getting sufficient and timely access to the health care services (Kelly, Hulme and Farragher et al. 2016). Moreover, Mr. Lee has been asked not to drive by the doctor so, he will face issues in traveling to the hospital for long distances. The health care professional also does not know the language that Mr. Lee speaks but the buddy nurse knew the language so the issue was resolved. If the buddy nurse was unavailable then it might have led to health equity and geographic location will also contribute to this health equity. It is the right of the patient to get comprehensive care (Hamid 2019); so in this case study, the patient was assessed with help of conduction of tests after the nurse found that he suffered a fall and injury.

References

Hamid, M. (2019). Integrated information system for the older people with a comprehensive care delivery approach. Journal of Biomedical Science & Research,vol. 2, no. 6. http://dx.doi.org/10.34297/AJBSR.2019.02.000613

Kelly, C., Hulme, C., Farragher, T. and Clarke, G. 2016. Are differences in travel time or distance to healthcare for adults in global north countries associated with an impact on health outcomes? A systematic review. BMJ Openvol. 6, no. 11. http://dx.doi.org/10.1136/bmjopen-2016-013059

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