Duan huijuan- Aging

THOMAS UNIVERSITY Huijuan DuanINTRODUCTIONThis interview was conducted in a nursing home with an older adult named LJ, a 93 years old woman that including a health history, medication history, social history, and environmental assessment. After finished the interview, I provided some interventions and recommendations to mitigate health problems, social involvement, and improve safety for the older adult.• Health HistoryLJ is a 93 years old woman with a good mental state, she told me that she has been living here for 2 years with her roommate. In the past years she suffered from a lot of diseases such as gallstone, gastritis, and renal edema, what lucky is that thes e kinds of disease all have been cured. About her mother, she was very glad to tell that she was a 104-year-old longevity woman with no health problems and her father had a bronchitis. When it comes to recent problems of her body, she a nswered that an hypertension became an obsession, and her eyes tend to dry and astringent easily means had a cataract. Apart from these, she is always feeling tightness of her chest. According to her health problems, doctor in the nursing home giving her Amlodiping Besylate Tablets to control her blood pressure, Pirenoxine Eye Drops to keep her eyes in a good state and some compound Salvia tablets to mitigate the tightness of chest and these medications will be supplied on time. There is a table of medicines of LJ, include the name of the medicine, the dosage regimen, the length of time taking medicines, and the reasons.• Medication HistoryName Methods Time Dose Length AmlodipingBesylateTabletsPo, qod ac, One piece 2 yearsPirenoxine Eye Drops External useqdqm, qn 2 drops 6 monthsSalvia tablets Po, qd hs 3 pieces 13 months REASONS:Amlodiping Besylate Tablets: with the function of lowering the blood pressure, should take it before meals to ensure the efficacy.Pirenoxine Eye Drops: Prevent the binding of quinoid compounds and water-soluble proteins of the lens, preventing denaturation of lens proteins, thereby protect the eyes from serious problems of a cataract.Compound Salvia tablets: relieve the tightness and pain of the chest, keep the older woman sleep well.• Social HistoryLJ is living in a room towards the sun with her roommate on the fourth floor, she said she was a teacher before retired. She was living in her home before living in here, and now she is always happy together with her friends, so she doesn’t need to change the living arrangement. Here the adults, doctors, nurses, care givers and workers areAN INTERVIEW AND ASSESSMENT OF AN OLDER ADULTfriendly and kind, she told that there will be no abuse here. About her family, she said that there is a big family of 14 members, they visit her on festival days and call her often to understand what she need and her situation in the nursing home. LJ also told me that her sons and daughters pay for the spends here, they’d like to participate the assessment of her body on schedule and take part in the activities hold by the nursing home. There is no living will in the nursing home, because people always accomplish it in their home with family members. About her a normal day entail, include schedule meals, an hour walking, 30 minute for nap, playing Mahjong with her friends, taking with doctors or nurses and the most important are take medicines on time and have a good sleep. No DPOA, but a security department with 30 members will ensure the safety of the older adults.• Safety assessmentWith the guide of LJ, I have a assessment of environment of living. Wide stairs with bright lighting, adequate railings to keep security of the older adults. Elevators are provided to the disabled older adult in every building, emergency alert systems are installed in every elevator. About her own room, windows are toward the sun to absorb enough light and sunlight, there is a air conditioning to keep a comfortable temperature both in summer and winter. A emergency phone is install on the wall with a guidebook of how to escape when a emergency happen. In the bathroom, equippedwith a toilet and handrail, a mat on the floor, two heating lamp, to prevent the older adult from falling and keep warm when taking shower.She said eating in restaurants is convenient, caregivers and nurses will take food to them to avoid falling if it is raining outside. Medications stored in the nursing apartment, she get the pills every morning when the nurses check her blood pressure. And there are many fire hydrant and fire extinguish on every floor preparing for emergencies.• Interventions and recommendationsMitigate health problems - Nurses in the nursing home should urge older adults to be more physically active, urge those who smoke to quite, educate regarding a heart healthy diet, keep a health weight. Family members should support the older adult to loss weight, come to visit the elder adult in the nursing home avoid the loneliness of them. Tabloski, P. A.(2014)Lifestyle changes, such as quitting cigarettes, losing weight, and increasing exercise, can dramatically reduce blood pressure. One study found that engaging in aerobic exercise sixty to ninety minutes weekly may be sufficient for producing maximum benefits. Another study found that taking ten-minute brisk walks four times per day significantly improves blood pressure. EBSCO CAM Review, B. (2012).Principal proposed natural treatments: Antioxidants, beta-carotene, lutein, lycopene, v itamin C, vitamin E.Other proposed natural treatments: Bilberry, carnosine, ginkgo, li poic acid, oligomeric proanthocyanidins, selenium, taurine, turmeric, vitamin B2 (riboflavin),vitamin B3 (niacin), whey protein, zinc. EBSCO CAM Review, B. (2012).Educate the older adult what a cataract is , cataract symptoms, and treatment operation, and complications of cataract include infection, wound dehiscence, severe pain. Care givers and family members should provide adequate care and support to prevent falling and confusions. Tabloski, P. A.(2014)Social engagement - encourage the older adult out of their personal home to participate in activities that hold by the nursing home and their family members should support them go out to exercise. Make friends with the neighbors, nurses, doctors and other workers, play together and enjoy the time living in the nursing home.Improve safety - in the nursing home, it is necessary to ensure the safety of the equipment include stairs, bathing and toileting, medications, advance directives, nutrition and cooking, falls, smoke detectors, emergency numbers, temperature of home, water, safety of neighborhood, and financial. Tabloski, P. A.(2014). About falls, The two cornerstones of successful fall prevention programs are using a standardized fall risk assessment tool properly and implementing interventions that target the individual’s specific risk factors identified by the assessment. Identifying and d recommending dosage changes or drug substitutions can significantly decrease a resident’s fall risk. Sometimes simply changing the administration time for certain medications can help reduce the risk of fall. For example, diuretics should be givenearly enough in the day to avoid nocturia. Hill, E., & Fauerbach, L. A. (2014). Psychological safety of patients is also important in nursing home, doctors, nurses, care givers and family members should pay close attention to the older adults. Anxiety and depression symptoms are common among nursing home residents without cognitive impairment and much more common than the diagnoses of anxiety and depression in their medical records. More residents used antidepressant and anxiolytic drugs than were diagnosed but fewer than the number detected with symptoms. Attachment was associated with fewer anxiety symptoms, and reassurance of worth and social integration were associated with less depression. For the residents without cognitive impairment, it seems to be important to give support to improving attachment, reassuring worth and social integration and closely observing them for symptoms of anxiety and depression.Drageset, J., Eide, G. E., & Ranhoff, A. H. (2013).CONCLUSIONIn this interview and assessment of LJ in nursing home include health history, medication history, social history and environmental assessment that associated with the older adult, the key content is interventions and recommendations according to the situation in nursing home of the older adult. Health care perspective, the care givers, and the family member should better participate in the progress of the prevention. All the interventions and recommendations are devoted to make the older adults live in nursing home comfortable and happy.Thomas universityHuijuan DuanReferences1. Drageset, J., Eide, G. E., & Ranhoff, A. H. (2013). Anxiety and depression among nursing home residents without cognitive impairment. Scandinavian Journal Of Caring Sciences, 27(4), 872-881.2. EBSCO CAM Review, B. (2012). Natural treatments for cataracts. Salem Press Encyclopedia Of Health.3. EBSCO CAM Review, B. (2012). Natural treatments for hypertension. Salem Press Encyclopedia Of Health.4. Hill, E., & Fauerbach, L. A. (2014). Falls and Fall Prevention in Older Adults. Journal Of Legal Nurse Consulting, 25(2), 24-29.5. Tabloski, P. A.(2014). Gerontological nursing. (3rd ed.). Upper Saddle River, New Jersey: Pearson Education.Rubric for Final Paper Name: Wang Qing1.Health History 5pts_____4.0______Utilizing best practices to assess the older adult highlight the items that were found an d address these in narrative form as to the significance and identified deviation of theolder adult. This area should include a generalized description of the chosen older adu lt. Do not use the individual’s name, only initials.2.Medication History 2pts_____2.0______Include the older adult’s medications. Include prescription medications, over-the-coun ter medications, and any other alternative medications. These should be written as a li st as part of the health history (why does the individual take the medication? It should relate to the health history in some fashion). Include the name of the medication, the d osage regimen, length of time taking the medication, and the reason the medication is being taken. Analyze polypharmacy.3.Social History 4pts______3.5_____Describe the older adults living arrangements. Are the living arrangements anticipated to change? Comment upon the elder abuse assessment. What access to family does th e individual have, what resources do they access, what activities do they participate in , what does a normal day entail? Is there a living will, a DPOA?4.Safety Assessment 4pts_____4.0______Complete a safety assessment (Home Safety Inventory) of the older adult’s primary pl ace of residence. This should include an analysis of the environment as discussed in C hapter 3 of the text. Include a narrative of this assessment as part of the paper.5.Interventions and Recommendations 10pts _10.0__________Based on the above items (#1-4) what interventions should be implemented or continu ed for this older adult? What recommendations are there to mitigate health, social inv olvement/engagement, and improve safety? Include interventions and resources that are available in the older adult’s area. Include the interventions from both the healthcar e perspective, the lay caregiver, and the family perspective. These should relate to the learning outcomes for the course.6.APA Requirements 5pts________4.5___This includes references (minimum of 4 professional references which can include we bsites, research articles, or scholarly readings), appropriate in-text citations, grammar, spelling, flow, organization, and a total of 5-6 pages in length (excluding title page, ab stract if used, and reference list).Total possible = 30 points_____28.0______Assessment1- Use APA format to organize Running head and a title on pages2- Grammar punctuation and sentences error3-Good effort, answer all questions, also some reduction of clarity.。