Healthy Aging - Part 1

Alcohol Withdrawal Risk Assessment

According to Burkhardt, Adorjan, & Kambeitzet al. (2020), whenever a person tries to quit alcohol, he/she suffers from withdrawal symptoms like agitation, nausea, restlessness, or others. It is also found that in elderly drinking alcohol causes balance issues due to which the individual can fall and get bone fractures and other related injuries or health complications. Alcohol withdrawal risk assessment is used to manage and assess alcohol withdrawal. This assessment is based on a scaled scoring like tactile disturbances, anxiety, agitation, and others. If the patient’s scores according to the mentioned issues faced by him then the management plan can be prepared as per the patient’s requirements. In this case, the patient is an alcohol addict, if he scores on the scale on particular points then he will be given intervention and care for those to ensure that he does not get exposed to any risks in the future. If the patient has been assessed for any of the withdrawal risks then those factors will be treated during his health care. Moreover, alcohol in diabetic patients worse the health status so, this assessment will also provide insight into other relatedhealth complications that can be treated with timely nursing care services.

Cognitive Assessment

According to Krishnan, Rossetti, & Hynan et al. (2017), cognitive assessment is performed to assess brain functions like reasoning, learning, memory, and concentration. A cognitive test is performed for an aged patient who has faced/suffered injuries falls or other issues. Cognitive testing is an important part of physical examinations in those cases in whichthe fall of the patient is involved. It is also observed that nearly 60 percent of aged patients who suffer from cognitive impairment often fall (Krishnan, 2017). It is found that falling can cause effects in the brain cognitive function as falls can cause brain swelling or other injuries so cognitive assessment must be performed for the patient. In this case, as the patient is an old man who falls as he hit a child’s toy and this states that his cognitive functioning might have got impaired or with fall his brain functioning might have been affected. So, to ensure that the patient’s brain functioning is normal cognitive functioning is performed. Moreover, with age, the patient cannot pay much attention, have reduced reaction time and other poor brain function. So, to assess the patient’s cognitive ability this assessment is performed.

Falls Assessment

According to Patrick, Slobodian, & Debanne et al. (2017), many factors can create risks to fall like impaired vision, balance disorders, and others. The fall assessment tests about the likeliness of the patient to fall which can lead to many serious injuries in old patients. If the reason for falls can be assessed through the insights obtained via this assessment then the management plans can be made as per the patient’s health conditions. Fall assessment gives information about an irregular heartbeat, light-headedness, and dizziness. Therefore, in this case, as the patient is old who falls due to hitting a child’s toy, so, if the patient shows high risks in assessments then the care providers will manage strategies for the patient to prevent his further risks of falling. This will reduce the chances of fall-related injuries to the patients as well. Moreover, as the patient is an old man who has diabetes and diabetic patients often suffer from dizziness and light-headedness, which can be resolved by making care plans for the patient.

Functional Assessment

According to Liebzeit, King, & Bratzke et al. (2018), functional assessment is a process that combines listening to patients, asking questions, and observing him/her. This assessment is used to assess and evaluate the daily activities of the patient and his/her ability to do them. It is important to perform this assessment in the elderly to ensure effective rehabilitation and treatment. Usually, 20 to 39 percent of the elderly after a fall develop a fear of injuries and therefore result in their limited activity (Liebzeit et al., 2018). In this case, as the patient is elderly, it might happen that he also develops fear and limits his functional abilities. Moreover, it is also possible that he had developed such fear already that resulted in his fall. Therefore, this assessment will give clear insights intothe patient’s condition and health status. Based on his assessments, a patient-centered plan can be prepared and this is only possible if the proper functional assessment is performed to know about the patient’s ability to perform his function of bathing, mobility, vision, hearing, and others.

Nutritional Assessment

According to Correia (2018), nutritional assessment is a depth evaluation of subjective and objective data about the patient’s lifestyle, nutrition, and food intake, and medical history as well. It gives information about the clinical assessment of altered nutritional requirements, biochemical measurement of nutrients, and anthropometric measurements of the body of the patient. In the elderly, nutritional assessment is performed to know about nutrition-related health issues in the patient like diabetes due to high sugar content of food, obesity due to high fat/carbohydrate intakes or hypertension due to high salt content of food. Management in elderly cases ensures quality and holistic approach and treatment of underlying causes like depression, chronic illness, or other problems (Correia, 2018). In this case, the patient is assessed with nausea and loss of appetite with issues of constipation for a few days. This might affect his health like haemorrhoids due to constipation and weight loss due to loss of appetite. Therefore a nutritional assessment is required to be performed to explore more about the factors that are harming a patient’s health. This information will help in developing an effective plan for the patient. As in this case, the patent has hypertension, diabetes, and angina, so a proper diet is required to be maintained for him that has less salt and sugar content with a healthy diet so that the patient does not suffer from nutrition-related issues.

Healthy Aging - Part 2

Plan and Implementation

The chosen factor is hypertension which is caused by high blood pressure. According to Pinheiro, de Oliveira Ferreira, & Guerraet al. (2020), hypertension can cause various complications like blurred vision, weakness of the limbs, shortness of the breath, swollen ankles, and headache. This can lead to a high risk of falls in the elderly and these factors also affects the postural balance and body balance that leads to falls in the elderly. In diabetes, the patient suffers from major damage to the blood vessels which lead to atherosclerosis. This causes high blood pressure which leads to hypertension if untreated severe hypertension can affect the body in various ways like heart attack, kidney issues, dementia, and many others. In this case, diabetes and high blood pressure of the patients contribute to his bad condition for hypertension and related risks of fallsfor which nursing action will be taken. According to Liebzeit, King, &Bratzkeet al. (2018), the nursing actions to be taken are –the measurement of clinical data like levels of blood urea nitrogen, electrolytes, blood cell count, and others. These factors are required to be assessed to know about the contributing factors.

There should be regular evaluation and monitoring of blood pressure to ensure that no complications are arising and if any of the symptoms are observed then actions are taken with effective care plans. The patient should be provided with a peaceful and calm environment to ensure improved relaxation of the patient. The response to the medication should be recorded to ensure that there are no side effects to the drug therapy and the patient’s progress is tracked. The patient should be administered with a beta, alpha, and centrally acting adrenergic antagonists liketerazosin, methyldopa, labetalol, metoprolol, and others (Liebzeit, King, &Bratzkeet al. 2018).

These ensure that cardiac output, angina, and other related issues are maintained and controlled so that there are no issues with postural balance and body balance, and the risks are reduced. Moreover, the patient should be referred to physician for a regular visit to monitor his vital signs like blood pressure, blood sugar levels, temperature, and others(Khorsandi,Fekrizadeh, &Roozbahani, 2017). He should be referred to a pharmacist for his medications and physiotherapists – to have sessions for light exercises so that body is fit and maintained in a healthy state to reduce the chances of risks of hypertension and falls. According to Khorsandi et al. (2017), the nutritionist ensures that the diet is maintained if the patient needs a diet as per a diabetic patient and hypertensive patient with maintained levels of carbohydrates, salt, and fat. The nutritionist maintains the diet of the patient so that he lives a healthy lifestyle, as in this case, the patient is an alcohol addict so there is a need for a nutritionist to ensure no nutrition-related issues occur that can lead to hypertension and other fall-related risks.

Healthy Aging - Part 3

A Biopsychosocial Approach

According to Griffith(2016), a biopsychosocial approach considers social factors like peers, family circumstances, or school; psychological factors like coping skills or social skills; and biological factors like physical health or disability, with the interactions among these factors in understanding the health caredelivery, illness, and health. In this case, the physical health of the patient is not good as he has diabetes, hypertension, angina, constipation sometimes, and others. He also showed the following signs: nausea, developing cataract, bowel sounds normal, loss of appetite, decreased vision, and pain in the right hip. These factors indicate that he is not physically fit and as he is an individual with 9 years of schooling so, this factor affects his psychosocial health by leading to issues related to poor economic status like depression or stress. This because education controls the choices in lives and ensures a life with better security. In this case, he is an aboriginal who usually does not get access to education due to which he is less educated and involved in habits of drinking to ease his stress.

However, he often goes to churches for funerals and has extended family; this indicated that he is a social individual. He also showed normal cognitive functions, no vomiting, and no pain in urine passing. These factors affected the psychosocial health of the patient, but coping mechanisms can be used to promote his health. According to Wiss(2019), the patient’s family and the patient should be taught about family involvement in patient care, so that the patient feels less stress or depression and in more involved in his family happily. Community or group activities should be organized for the patient so that he actively takes part in those and gets more social with the results of improved cognitive functions. This will also help in maintaining his physical fitness and reduces levels of stress and depression and keep him away from using alcohol to reduce his stress. With the sessions with a nutritionist, the patient will get a healthy diet plan to follow and his physical health is maintained (Wiss, 2019). The patient should be educated about his health status and disease so that he can cope up and understand the care plans.

He should be provided with a healthy and supportive environment by encouraging him for reading, mediation, watching television, doing exercises, stretching and meeting and talking to friends or new people (Rubin, 2018). As he is involved in listening to music, this habit will help in coping up with improving his health as well. Moreover, the associated health professionals and family members should be asked to properly acknowledge the points of the patients and also ensure that patient is getting spiritual or religious support as well like prays to cope with pain or other issues (Holden, Kulanthaivel, &Purkayastha et al., 2017). It is found that common coping mechanisms in elderly health include denial, passivity, social contact, active solitude, and increased active distancing. Better coping mechanisms can help the patient to get encouraged to start living a healthy life and leave all his bad habits like alcohol or smoking. 

References for Healthy Aging

Burkhardt, G., Adorjan, K., Kambeitz, J., Kambeitz-Ilankovic, L., Falkai, P., Eyer, F., & Dwyer, D. B. (2020).A machine learning approach to risk assessment for alcohol withdrawal syndrome. European Neuropsychopharmacology.DOI: 10.1016/j.euroneuro.2020.03.016

Correia, M. I. T. D. (2018). Nutrition screening vs nutrition assessment: What’s the difference?. Nutrition in Clinical Practice33(1), 62-72. DOI:10.1177/0884533617719669

Griffith, D. M. (2016).Biopsychosocial approaches to men's health disparities research and policy. Behavioral Medicine42(3), 211-215. DOI: 10.1080/08964289.2016.1194158

Holden, R. J., Kulanthaivel, A., Purkayastha, S., Goggins, K. M., &Kripalani, S. (2017). Know thy eHealth user: Development of biopsychosocial personas from a study of older adults with heart failure. International Journal of Medical Informatics108, 158-167. DOI: 10.1016/j.ijmedinf.2017.10.006

Khorsandi, M., Fekrizadeh, Z., &Roozbahani, N. (2017).Investigation of the effect of education based on the health belief model on the adoption of hypertension-controlling behaviors in the elderly. Clinical Interventions in Aging12, 233.DOI: 10.2147/CIA.S117142

Krishnan, K., Rossetti, H., Hynan, L. S., Carter, K., Falkowski, J., Lacritz, L., & Weiner, M. (2017). Changes in Montreal cognitive assessment scores over time. Assessment24(6), 772-777. DOI:10.1177%2F1073191116654217

Liebzeit, D., King, B., Bratzke, L., &Boltz, M. (2018).Improving functional assessment in older adults transitioning from hospital to home. Professional Case Management23(6), 318. DOI: 10.1097%2FNCM.0000000000000293

Orsano, V. S. M., de Moraes, W. M. A. M., de Sousa, N. M. F., de Moura, F. C., Tibana, R. A., de Oliveira Silva, A., &Prestes, J. (2018). Comparison of the acute effects of traditional versus high velocity resistance training on metabolic, cardiovascular, and psychophysiological responses in elderly hypertensive women. Clinical Interventions in Aging13, 1331.DOI: 10.2147/CIA.S164108

Patrick, R. J., Slobodian, D., Debanne, S., Huang, Y., & Wellman, C. (2017). The predictive value of fall assessment tools for patients admitted to hospice care. BMJ Supportive & Palliative Care7(3), 341-346. DOI:10.1136/bmjspcare-2015-001070

Pinheiro, P. C. M., de Oliveira Ferreira, G., Guerra, F. V. G., Frota, T., Cavalcante, N. G. G., & Moreira, R. P. (2020).Nursing intervention assessment tool fall prevention in elderly people with systemic arterial hypertension. Journal of Nursing Education and Practice10(7).DOI: 10.5430/jnep.v10n7p60

Rubin, L. P. (2016). Maternal and pediatric health and disease: Integrating biopsychosocial models and epigenetics. Pediatric Research79(1), 127-135. DOI:10.1038/pr.2015.203 

Wiss, D. A. (2019). A biopsychosocial overview of the opioid crisis: Considering nutrition and gastrointestinal health. Frontiers in Public Health7, 193.DOI:10.3389/fpubh.2019.00193 

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