Drexel University Normal Changes of Aging and Chronic Conditions Questions APA format, 6 pages excluding reference and title page, See rubric for further d

Drexel University Normal Changes of Aging and Chronic Conditions Questions APA format, 6 pages excluding reference and title page, See rubric for further details.

Textbook needed :

Evidence-Based Geriatric Nursing Protocols for Best Practice (5th ed.)

Boltz, M., Capezuti, E., Fulmer, T., Zwicker, D.

978-0-8261-7166-5

The case studies presented in this course are based on real patients. These individuals have agreed to share their stories to aid in the education of nursing students. Please respect their privacy and maintain confidentiality by adhering to HIPPA regulations. Please shred any printed case studies at the end of the course.

In this assignment the student will use writing to communicate with an interdisciplinary team such as during a case presentation during patient rounds.The purpose of this assignment is to identify the normal physical changes that occur in older adults and the impact of chronic disease on the aging person. The student will demonstrate understanding of the nursing process by interpreting the geriatric assessment tools and utilizing the evidence based protocols to develop an individualized plan of care.

Read the case study on Anne Morrell.
Utilize your textbook and review the following chapters as they may pertain to this case study: Chapter 4, 5, 6, 14, 15, 17, 20, 21, and 22
Analyze the case and create a plan of care including the following information.The paper should not exceed 6 pages, excluding reference pages.

a. As we age the body undergoes some normal changes that may impact functioning, such as the lens of the eye becomes less flexible so near vision decreases.Many older adults need to use reading glasses.Based on the information presented in the case study, choose 2 normal age related changes that this patient is experiencing and discuss how they would impact the quality of life.Be sure to support your thoughts with examples from the case and with evidence from the text book or literature.

b. Identify 2 current chronic medical problems for this patient and discuss how these conditions impact her quality of life of the patient. Be sure to support your thoughts with examples from the case and with evidence from the text book or literature.

c. Compare and contrast the normal changes of aging and chronic conditions of this case study patient to the older adult you interviewed(see SUMMATION OF OLDER AUDULT INTERVIEW) . How are their situations similar or different? Does their chronological age correlate with their physical limitations?

d. Choose a theory of aging that would be applicable to this case study. Provide your rationale for choosing the theory utilizing specific information from the case.

e. Identify 2 chronic problems (nursing diagnoses) that are impacting this patient’s quality of life.Examples of problems would be urinary incontinence, increased risk for falls, adverse drug events, etc.Develop a plan of care for Anne listing at least 3 interventions for each chronic problem identified. Elaborate on how the interventions will help this patient meet her goals.Be sure your plan of care is individualized to this patient. Support your thoughts with evidence from the textbook or the literature.The plan of care should be written in narrative form.Bullet points, lists or outline format is not acceptable.(10 point deduction) Summation of older adult interview
For this assignment, I decided to interview my father in law. He is a 76-year-old male, retired and
recently widowed after 54 years of marriage. The death of my mother in law just 3 short months ago has
had a tremendous impact on our family and the dynamics there of.
For privacy purposes we will call him R.H. R.H is currently a retired Journeyman Assembler for RollsRoyce who for all intents and purposes has been in great health most of his life, having only trouble with
normal parts of aging. For instance, R.H only needs glasses for reading and will squint or hold object
further away to better see an object. Vision changes are a normal part of aging, as the lenses become
stiffer and more unwilling to bend, seeing objects closer becomes daunting. R.H wears bilateral hearing
aids and when not turned on, has trouble hearing high pitched sounds as well as hearing in busy places.
RH is a retired Navy veteran and states some of his hearing loss he attributes to working on the docks
and machinery underneath the large vessels he was stationed on as well as the machinery he worked
around at Rolls-Royce most of his life. R.H states other medical conditions he has is Osteoarthritis, a
wearing down of the cartilage between bones, to the right knee which he recently had replaced as well
as benign prostatic hyperplasia (BPH) a common condition as men get older, before having
Transurethral Resection of the Prostate( TURP). Since the procedure he has been symptom free of urine
stream troubles. R.H denies any other medical conditions or taking medications for anything else
currently.
I asked R.H to reflect on the aging process as a whole and what getting older means. R.H states that
getting older means getting close to end of life and all though this brings many physical and psychosocial
changes that happen to all of us, only some of us are lucky enough to experience it. Some cons of
getting older, especially since the age of 25 are his stamina. R.H reports fatigue and his inability to not
only keep up with daily tasks without fatigue or aching but the wrinkling of his skin as well. Aside from
the physical cons of getting older, R.H states that losing the people he loves is one of the hardest things
about getting older. The pros to R.H of getting older is that he has become much wiser which can only
come by the experience of living.
Some normal neurological changes of aging are slowing of memory, thought and thinking as well as
reduced reflexes. R.H admits to slowing of thought, and sometimes he states it will take him longer to
remember something and admits to some forgetfulness. R.H still is independent in driving but admits his
reaction time has probably slowed as he has aged. I then administer the Mental Status Assessment of
Older Adults (The Mini-Cog) to R.H. This tool is used to quickly detect cognitive impairments in language
and memory among other things. During this test I instructed him to try to remember the following
three words: child, penny, dog. I repeated these words three times. I then had R.H draw the face of a
clock on a blank sheet of paper with numbers to the clock as well, I then asked R.H to draw the hands to
read 11:10 which he did with success. I then asked him to state the three words I had given him which
he did with success on his first try and his screening was negative.
Since the passing of my mother in law I wanted to focus more on the psychosocial aspects of his life. I
asked him about any changes in his emotional health. R.H goes on to say that throughout his life he has
rarely had depression, anxiety or loneliness and has always stayed positive, that is to say before his wife
passed away he had a constant companion but since she has passed on he feels more lonely. R.H.
expresses a deep belief in GOD and denies fearing death but fears only if he too, will make it to Heaven.
He goes on to say that he feels that having a relationship with God is the secret to happiness. He also
discusses social changes that come with aging, such as the loss of friends not only to death but after
retirement. R.H has not engaged much in social activities since his wife became ill 2 years prior to her
death, most of his days consisted of taking her to chemotherapy or other doctors’ appointments. This is
a time when R.H expresses that these moments and hardships had brought them closer and he had no
problem dropping most social ties due to a hectic schedule. After his wife’s death, he finds himself
getting out more by attending local football games, his grandsons sporting activities and even meeting
up with former coworkers for breakfast. He finds more value in relationships and seeks them out more
than he did before. He is ecstatic that his relationships with his 5 children has also become stronger
since her death. We discussed local facilities that offer seniors activities and he was not interested in
those at this time but was aware of their existence. During this time, I administered the long form of the
Geriatric Depression Scale, a tool used to assess for depressive symptoms. A short form of this tool is
also available for those with cognitive impairments. R.H scored a 4 out of a possible 30 which according
to the scale is normal. A score of 20-30 signifies severe depression while a score of 10-19 signifies mild
depression.
R.H states is had advice for younger people he would tell them to avoid all vices in life, this includes
smoking, drinking alcohol and staying out late. These vices wreak havoc on your body and your ability to
stay independent as you get older. I enjoyed talking with R.H and have learned that aging can be
enjoyable depending on how you treat not only your body but your mind as well. The only alternative to
not aging is death so try to enjoy the ride.
Case Study 1: Anne Rubric
Student:
Date submitted:
Originality score:
POINTS EARNED COMMENTS
10
Normal physiologic changes of aging
Identifies 2 Normal physiologic changes
of aging
Discusses how these changes effect QOL
of the patient
Supports opinion with information from
the textbook or literature
Chronic disease/conditions
10
Identifies 2 chronic conditions
Discusses how these conditions effect
QOL of patient
Supports opinion with information from
the textbook or literature
Compare and contrast case study
20
patient and older adult interview
Demonstrates thoughtful and critical
analysis of similarities and differences
Theory of Aging
10
Applies a theory of aging to case study
patient
Provides rationale for choice utilizing
specific example from case study
Plan of Care
30
Identifies 2 nursing diagnoses with 3
interventions for each problem (6 total)
Plan of care is individualized to Anne
Supports opinion with information from
the textbook or literature
APA formatting
10
Citation/References
Grammar/Spelling
10
Total possible points:
Grade:
100
Assignments submitted after the due date will result in a loss of 5 points per day unless prior
arrangements have been made with the professor. Assignments submitted more than 1 week after
the due date will not be accepted.
Patient Name: Anne Morrell
Age: 74
Race: Caucasian
Religion: none
Education: Associates Degree
Marital Status: Widowed
Occupation: retired administrative assistant
Children: 4; all living
Living arrangements: lives alone in 1 bedroom apartment; senior citizen housing, 3 rd floor, elevator
building
Hobbies/Leisure: watches television/movies; reading
Past Medical History:
Hypertension 1986, Hyperlipidemia 1986, Osteoarthritis, Osteoporosis of right hip, Renal Insufficiency
2009
Diabetes Mellitus Type II 2005, Left LE neuropathy and Charcot foot 2008, Osteomyelitis 2009
Osteosarcoma left thigh 1996 treated with surgery, chemotherapy and radiation therapy
Breast Cancer 2003, treated with radiation therapy
Past Surgical History:
Tonsillectomy 1962, Removal of osteosarcoma left thigh 1996, Lumpectomy left breast 2003
Allergies: Sulfa?Hives
Medications:
Drug
Metformin
Actos
Triamterene/HCTZ
Zocor (Simvastatin)
Atenolol
Cozaar
Aspirin
Dose
500 mg
15 mg
37.5 mg
20 mg
100 mg
100 mg
81 mg
Frequency
Twice daily
Daily
Daily
Daily, hs
Daily
Daily
Daily
Assessments:
Height 5’1” Weight 191 lbs. Has tried to lose weight but finds it difficult because she cannot exercise.
Should be on a low carb low fat diet but does not adhere to restricted diet. Prefers breads and pastries,
eats few fruits and vegetables. Prefers pork and fish, eats little chicken or beef. Eats less than one
serving of dairy. Drinks little water, mostly coffee and caffeine free diet soda
Has annual eye exam. Wears glasses for reading.
Barthel Index (ADL) score: 95 Needs assistance with steps, ambulates with a cane since she fell last year.
Left foot with slight foot drop, slaps ground when walking.
Instrumental Activities of Daily Living: 5/8 Has a housekeeper to do cleaning and laundry. Daughters do
shopping, provide transportation and balance checkbook. Leaves her apartment to go to medical
appointments and during holidays/special occasions. Experiences back pain when standing or walking
for longer than 10-15 minutes.
Fulmer SPICES: Problems with sleep and Falls
Mini Nutritional Assessment: screening score-13
Assessment: 23.5
Depression scale short form: 5
Short Portable Mental Status Questionnaire: 1 error
Mini-Cog: 3 no dementia
Epworth Sleepiness Scale: 9 High chance of dozing while reading or watching TV, moderate chance of
dozing in the afternoon or after lunch
Pittsburgh Sleep Quality Index: 14 she is in bed 7.5-9.5 hours but sleeps 4-5 hours/night. Wakes up in
the middle of the night, has nocturia, rates sleep quality as fairly bad
Complains of arthritis pain in her back and right shoulder. Pain at rest and interrupts sleep. Develops
dyspnea when ambulating more than one block or when going upstairs.
Physicians: Primary Care, Podiatry, Nephrology
Interview on the effects of aging
Secret to healthy aging: have a good, positive attitude, find good doctors, pay attention to what they
say and have faith in them, see them regularly
Most difficult aspect of aging: boredom and a lack of purpose. Volunteering gives me a fake sense of
purpose; it is not the same as working or raising a family. Recommend living with young people or
mixed community rather than a retirement community. Young people keep you young.
What would you do differently now that you know what being an older adult is like: I couldn’t really
do anything any different. I was limited in my jobs with how much money I could save. Good planning
for retirement depends on health, how much money you have and how much family you have around
you that can help you. I am lucky I live near family and have good living conditions.
Of your medical conditions which has caused you the most problems: Charcot foot because it has
limited my independence and my mobility. It has had a tremendous impact. It works on my emotional
state as much as the physical. It is frustrating because there is no reversal and no cure. At least with the
cancer I would have the surgery, chemo or radiation and the cancer was gone. This will affect my life
forever.
What do you expect for the future regarding your health and how can the health care providers help
you: There is no cure for what I have so I don’t expect a change in my health. Everything depends on
the other. I can’t be mobile or exercise which makes me gain weight that makes my blood sugars go up
and puts more pressure on my foot which makes the Charcot foot worse and makes me even less
mobile and around it goes.

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