Geriatric Nursing Paper
Geriatric Nursing Paper
The student was able to spend four hours during two different occasions with Thelma (alias) at her home. Thelma was a 72 year old female. She had many medical diagnoses’s, some of which include: osteoarthritis, diabetes, hyponatremia, and hearing loss. The student was lucky enough to perform an assessment of Thelma’s functional, environmental and psychosocial status during an interview type of process. The tools that were used to perform theses assessments and a brief description and an analysis of the findings will follow. Functional Assessment
Upon interviewing Thelma many tools were used to assess her functional status. The first tool that was used was the Katz Index of Independence in Activities of Daily Living (Wallace & Shelkey, 2008). This tool helped to detect subtle changes in health and prevent a functional decline. It did this by measuring the elder’s capacity to care for him or herself. Thelma score was independent in all areas except continence. She had night time incontinence for which she wears briefs while she sleeps. Due to this fact her score was a 5 on a score of 0-6, meaning that she was still at full independent functioning. This Katz ADL can be used as a baseline measurement because Thelma was well but can be reassessed periodically.
The next tool that was used was the Lawton Instrumental Activities of Daily Living Scale (Graf, 2008). The Lawton IADL scale assesses a person’s ability to perform tasks such as doing laundry, handing money, shopping, using a telephone and using transportation. The scoring ranges from 0 (low functioning) to 8 (high functioning) for women. Thelma score on this assessment was an 8. She said she did not like to drive at night anymore but this did not change the score.
The next assessment that was completed was a vision assessment. Thelma was asked a series of questions about her vision and her eyes and changes that she may or may not have noticed over the years (Miller, 2008, p. 346). According to the questions that were asked the big thing that came up was over the past 5 years Thelma said she had noticed that she is not able to see as well at night and in poorly lighted areas. The student then asked when the last time she had her eyes examined and she said it had been years and she could not remember. The student noted this as a possible teaching tool due to her diagnosis of diabetes and functional vision decline with ageing.
The final functional assessment that the student completed with Thelma was the Brief Hearing Loss Screener (Demers, 2007). This assessment tool is used to identify individuals who needs further hearing evaluation. The scores can range from 0-8, with a score of three or more meaning that the individual needs further hearing evaluation. Thelma score was a 7 but this was expected because she has a prior diagnosis of a hearing impairment and already wears hearing aids. The student asked some other questions unique to her situation regarding how often she has her hearing aids checked and cleaned and she stated that this is something that she gets done frequently. Assessment of Home Environment
The student did a complete assessment of Thelma’s home environment. This assessment was done in order to ensure her safety, and optimal functioning in her home. The assessment tool that was used went over the aspects of illumination, hazards, furniture, stairways, bathroom, bedroom, kitchen, assistive devices, temperature, and overall safety (Miller, 2009, p. 107). Things that were noted were that she does use a nightlight in her bathroom, there was a rug at her back door that seemed to be a tripping hazard because it hooks on the door, she does have stairs at the back door to the basement but she says she never goes down there. In the bedroom the one thing that was noted was that there was no phone. The kitchen appeared clean and she had adequate food storage and food...
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