Health 2- Part B-Older Adult Community Health Assignment

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Older Adult Community Health Assignment Part B

Nicole Patten and Vera Prchal

Vancouver Community College

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Health 2 Class 178

Cathy Siems

May 7, 2012

Echomap

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Actual Findings

Health Maintenance Pattern 1. The client states that she

normally only goes to the doctor

when she is not feeling well or

needs a new prescription of her

medication.

2. The client states that she takes

medication for hypertension.

3. The client maintains her safety

by remaining within close

proximity to her family for moral

support. She does not drink or

smoke.

4. The client stays healthy by

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working in her very large garden.

5. The client feels that her health

has been good over the last few

years with the medication she

takes and monitoring of her blood

pressure at London Drugs and the

doctors office. She admits that

diabetes runs in her family health

history.

Nutrition-Metabolic Pattern 1. The clients typical meal pattern

for 1 day is to eat a small

breakfast, lunch and larger dinner

every day. She eats small

amounts.

2. The client does not drink a lot of

water but rather tea, coffee and

juices. She prefers flavoured

drinks.

3. The client cooks all the meals in

the house and really enjoys eating

sweets.

4. The client does not take any

vitamins or supplements and

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believes she gets enough nutrition

from her food.

5. The client has noticed a slight

weight gain since her retirement

two years ago and now prefers

sweet foods to savory foods.

Elimination Pattern

1. The client states that she has a

bowel movement at least once per

day and that there is minimal

effort to go.

2. When the client is constipated

she eats dried prunes and dates or

fruit.

3. The client has noticed she is

less able to hold her urine for

longer periods of time and also

wakes up more frequently at night

to urinate then 10 years ago.

4. The client has experienced

leaking of urine upon coughing or

laughing.

1. The client does not have a

regular exercise regime.

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Activity-Exercise Pattern

2. The things that prevent the

client from exercising are that she

feels she is too busy with taking

care of her home and garden. She

would exercise but feel

unmotivated to do it alone.

3. The client states that exercise

would benefit her in losing her

tummy.

4. The client does all of the

household cleaning and shopping

and claims her husband does not

help enough.

5. The client does go to the park

once in a while with her

grandchildren and spends a lot of

time working in her garden

especially in the summer. She also

likes to play cards and go to the

casino with her sister and

daughter-in-law.

Sleep-Rest Pattern 1. The client states that she gets 5

to 6 hours of sleep each night.

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2. The client feels mostly rested

after a usual nights sleep.

3. The client has difficulty falling

asleep when she is worried about

family members or has had coffee

in the late afternoon.

4. The client watches a movie or

television when she wants to rest.

5. The client doesnt wake up in

the middle of the night unless it is

to urinate.

Cognitive-Perceptual Pattern 1. The client plays cards with

friends, socializes with family and

works in the garden to keep active

but states that her knees hurt

more at the end of the day.

2. The client states she is very

assertive and has no problems

making decisions.

3. The client describes her

peripheral vision to be fine but she

wears reading glasses and

frequently gets sore eyes towards

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the end of the day. The client

states that she doesnt schedule

regular eye checkups.

4. The client finds that she must

have the television volume turned

up louder in order to hear it

better.

Self-Perception-Self-Concept

Pattern

1. The client states she wishes she

had fewer wrinkles and was as

muscular as she used to be but is

overall accepting of her

appearance.

2. The clients general mood is

overall happy but she worries and

is nervous for her daughters

seizure condition.

3. The client feels she has more

aches and pains then she did

when she was young.

4. The client is happy in her life

and is satisfied with what she has

accomplished.

Role-Relationship Pattern 1. The client is very close with her

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adult children, sees them regularly

and enjoys spending time with her

grandchildren.

2. The client lives with her

husband but no longer shares a

bedroom with him.

3. The client has several garage

sales every year arranged with

neighbours but otherwise keeps to

herself.

4. The client sees her

grandchildren almost every day.

Sexuality-Reproduction Pattern 1. The client has 2 children, one

boy and one girl.

2. The client does not regularly

conduct a self-breast examination

but had a mammogram 3 years

ago.

3. The client is no longer sexually

active with her husband. They live

together only for financial,

domestic, and convenience

purposes.

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4. The client is still legally

married.

5. The client stated that

menopause began at age fifty-

one.

Coping-Stress Tolerance Pattern

1. The client found her daughter

unconscious on the floor from a

grand mal seizure and had to call

an ambulance, this was a stressful

event.

2. A recent stress for the client

has been her husbands verbal

abuse towards their daughter and

the fact that her daughter and

husband no longer speak to one

another.

3. The client tries to manage her

stress by working in the garden

and feels this is effective.

4. The clients biggest change is

having her young granddaughter

around the house and adjusting to

a lower salary due to retirement.

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Value-Belief Pattern

1. The client considers how

decisions will affect her family

before making a decision.

2. The three things the client

values most are her family, her

home/garden and her finances.

3. The client is a non-practicing

Catholic who attends church for

Easter and Christmas.

4. The client comes from an

Eastern European background

where you deal with your stress

on your own rather than seeking

support from others.

Compare and Contrast Findings

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day to maintain proper hydration for an older adult. According to Potter

& Perry, a low fluid intake can cause constipation and slow peristalsis

(2009, p. 1125). Proper hydration can also decrease the risk of colon

cancer, breast cancer and decrease the risk of bladder cancer (Potter &

Perry, 2009). A health strength for this client is that she is still able to

cook for herself and her family and prepares all foods from a health food

store. A health weakness is she may not be getting the proper vitamins

and nutrients daily in her own food and should consider taking

supplements. Calcium and vitamin D help prevent osteoporosis (Potter &

Perry, p. 780, 2009). The client should also minimize sodium intake due

to her hypertension and sugar intake due to her family history of

diabetes.

Elimination Pattern (Vera)

The actual findings for this pattern show that the client still has full

control of her bowel movements and still feels she is going regularly.

The client feels she has less control of her bladder and finds she has

occasional leaking and urinates more frequently. Reduced bladder

control is an expected finding in an older adult (Potter and Perry, p. 385,

2009). There is also a higher potential for constipation due to lack of

fluids and fiber in the diet. The client does not drink enough liquid in an

average day according to her 24-hour diet recall and therefore is more

prone to constipation as she gets older. Although the client is having

regular bowel movements, her increasing appetite for savory foods (high

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sodium) and sweets mixed with a lack of fiber and fluids could

eventually lead to other health problems such as constipation,

secondary hypertension, diabetes, atherosclerosis and heart disease

(Potter & Perry, 2009). A health strength for this client is that she is able

to recognize that prunes and dates can assist with bowel movements. A

health weakness would be her increasing need to void and reduced

bladder function, which may interfere with sleep and social events.

Activity-Exercise Pattern (Vera)

The actual findings for this pattern are that the client is still mobile and

works in her garden 4 times a week for 2-3 hours. The expected findings

are that the older adult is still enjoying activity as she can tolerate it

within her natural capacity. Working in the garden contributes to the

clients health in that she is outdoors and physically moving each day.

Gardening is relaxing and rewarding for the client, which is a health

strength. A health weakness could be the client not finding time to do

other physical activities such as walking or other low impact exercises

such as riding an exercise bike or exercising in a swimming pool, which

help protect the musculoskeletal system and joints (Potter, p. 393,

2009). A health strength is that the client still remains active in activities

that she enjoys and tries to keep up with her grandchildren.

Sleep-Rest Pattern (Vera)

The actual findings for this pattern show that the client sleeps the

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average amount of hours as other older adults (5-6 hours). There is not

much difference between expected findings and actual findings. The

client has also admitted to needing less sleep at night but realizes that

she needs to rest more throughout the day. The client will take small

rests throughout the day by either watching television or taking a short

nap on the couch. This is normal for an older adult but can contribute to

a feeling of frustration since a deep sleep can sometimes not be

achieved due to sleeping in the middle of the day. The client already has

trouble falling asleep when worried about her family and could become

more susceptible to colds and illness if not properly rested. Lack of sleep

could contribute as a weakness because sleeping is essential to your

physical health and emotional well-being. According to the help guide

for insomnia in older adults, for seniors sleeping, a good nights sleep is

especially important because it helps improves concentration and

memory formation, allows your body to repair any cell damage that

occurred during the day and refreshes your immune system, which in

turn helps prevent disease

(http://www.helpguide.org/life/sleep_aging.htm). A strength for the client

is when she feels tired she knows it is time to rest. She takes a break

and rests and therefore may be at less risk for a fall.

Cognitive-Perceptual Pattern (Nicole)

The actual findings for this pattern show that the client uses an assistive

device (reading glasses) and doesnt have any problems with her

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peripheral vision, however she does not have annual eye checkups. The

client also notices that her hearing isnt as good as it used to be and she

often finds herself turning the volume up on the TV to hear it. The client

maintains a healthy social life by gathering regularly with friends and

family. A health strength for the client is that she maintains her social

relationships and continues to be assertive and make decisions for

herself. A health weakness for this client is that she doesnt have regular

eye exams which could affect her overall eye health and lead to further

vision impairment, vision loss, and could eventually affect her ADLs.

Self-Perception-Self Concept (Nicole)

The actual findings for this pattern show that the client meets the

expected outcomes for this pattern. The client perceives herself as

overall healthy and feels involved in her own life. She makes use of

supports and is satisfied with what she has accomplished in her life so

far. She generally enjoys her life. The clients outlook on life is a health

strength, she a positively minded thinker and although she wishes for

less wrinkles and more muscle strength she has an overall positive

attitude which will continue to help her remain healthy.

Role-Relationship Pattern (Nicole)

The actual findings for this pattern show that the client meets the

expected outcomes. She has close relationships with her family and

friends; she enjoys spending time with them and arranging activities

with them in her neighbourhood. The client at times feels isolated due to

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support groups) given her ethnic background. Her preference for dealing

with stresses on her own could eventually affect her health and well-

being and lead to depression. Support groups and networks are so

important for the older population in maintaining mental and physical

health.

24 - Hour Dietary Recall(Food and Fluids)

Breakfast1 glass orange juice = 112 cal2 slices of rye toast = 136 cal

2 tbsp butter = 204 cal2 tbsp of raspberry jam = 100 cal

2 cups of coffee (with 2 tsp sugar and cream) = 121 cal

Lunch1 bowl of vegetable soup = 115 cal

4 crackers = 104 cal4 cookies = 400 cal

2 cups of apple juice = 234 cal

Dinner

1 cup of green peas = 134 cal1 baked potato (with butter and chives) = 390 cal

1 pork chop (with BBQ sauce) = 228 cal1 glass of lemonade soda = 112 cal

1 dinner roll (with 1 tsp butter) = 154 cal

Snack2 cups of tea (with milk and sugar) = 69 cal

2 slice of lemon cake = 478 cal

Canada Food Guide Expectations

Servings expected as per CanadaFood Guide

Servings found for older adult

7 servings Fruit/Vegetables 7 servings (5 servings from juice)6 servings Grain Products 2 servings

3 servings Milk & Alternatives 0 servings

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2 servings Meat & Alternatives 1 servings

Calorie intake required: 1850/day Actual calorie intake: 3091/dayFluid intake required: 1.6 2.5

L/day

Actual fluid intake: 1.75 L/day

Local Resources

1. Kitsilano Community Centre

Kitsilano Community Centre is just across the street from the clients

home. They have many senior programs and activities to choose from

such as dance, yoga, health and wellness programs, education and

development and a fitness room. Even though the client gets exercise in

her garden, riding a stationary bike or joining a senior aerobics weight-

training class could help improve her cardio and muscle strengthening.

This could further prevent older adult complications such as heart

disease, osteoporosis and peripheral vascular disease. Socializing and

learning new skills can also help build relationships with other older

adults in her community and promote independence and a sense of well-

being.

2. Kitsilano Neighbourhood House (KNH)

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Documents

Health 2- Part B-Older Adult Community Health Assignment