Comprehensive Geriatric Assessment Essay Discussion

Comprehensive Geriatric Assessment Essay Discussion

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Based on data collected during CGA, the first clinical issue facing the client is soreness in the arm that started after falling on his way to the bathroom. The risk of falls is relatively high among elderly adults aged 75 years and above due to reduced stability (Sharif et al., 2018). Thus, the client’s old age makes him more prone to falls and fall-related injuries. However, the client claims he just requires more rest and he will be fine. Secondly, the client is suffering from insomnia. Based on the DSM-V diagnostic criteria, a person is diagnosed with insomnia upon failing to sleep despite having an opportunity to sleep (Reynolds et al., 2019)Comprehensive Geriatric Assessment Essay Discussion. Additionally, individuals with insomnia experience difficulty falling asleep or remaining asleep for the entire night. The client has insomnia since his daughter reports that he keeps waking up at night. Furthermore, the client is experiencing loneliness, which is caused by spending most of his time in the house alone. Nonetheless, the client objects to the thought of relocating to a nursing home claiming all his belongings are in his house. Lastly, the client is experiencing poor feeding habits and weight loss. His daughter reports finding most of the food brought to his father in the fridge as leftovers. Additionally, weight loss is depicted by his clothes being baggy and losing 2 lbs compared to his weight during the previous visit.

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Plan of Care

The client’s clinical issues can be addressed through an appropriate plan of care. First, the plan includes an intervention for addressing soreness in the arm and fall risk. The client is advised to visit a physiotherapist for further examination and treatment of the soreness to prevent further health complications. On the other hand, the risk of falls can be reduced by implementing fall prevention measures. The client’s children should hire a caregiver who will monitor their dad and support him when moving around, preventing him from falling. Additionally, an ICT-based fall management system should be implemented at the client’s home to prevent future falls. According to Khan et al. (2019), an Internet of Things-based fall management system lower fall risk in elderly adults through fall detection and prevention. The sensor will detect fall risk and the alert system will notify the caregiver when the client is at risk of falling. The caregiver will, in turn, provide him with the required support, preventing him from falling.

Secondly, sleep hygiene practices will be included in the plan of care to address the client’s insomnia. Studies show that sleep hygiene practices improve sleep quality and duration among elderly adults with insomnia (Chung et al., 2018)Comprehensive Geriatric Assessment Essay Discussion. Therefore, encouraging the client to practice sleep hygiene, including reducing stimulation, exercising daily, developing a regular sleep routine, using relaxation techniques, and restricting sleep during the day will enable him to remain asleep throughout the night.

Furthermore, the care plan should incorporate measures for addressing the client’s loneliness. The family members are advised to spend more time with the client, preventing him from being lonely. They should also hire a caregiver who will give the client company when his children are at work. Studies show that loneliness and social isolation significantly contribute to depression symptoms in elderly adults (Pai & Vella, 2022). Thus, giving the client company will reduce the likelihood of developing depressive symptoms.

Lastly, a strategy for addressing poor feeding habits and weight loss should be included in the plan of care. First, the family members are advised to hire a caregiver who will ensure that the client takes all the meals. Additionally, a meal plan indicating the client’s diet with all food components in the right portions is developed. The caregiver should adhere to the meal plan to ensure that the client takes healthy and balanced meals and snacks. In elderly adults, good feeding habits and a balanced diet prevent weight loss (Sidor & Rzymski, 2020)Comprehensive Geriatric Assessment Essay Discussion. Thus, a balanced diet will meet all the nutrition requirements of the client, making him stable and preventing weight loss.

Summary

The client’s major clinical concerns include soreness in the arm and high fall risk; insomnia, loneliness, poor feeding habits, and weight loss. The proposed care plan focuses on addressing the client’s clinical issues. First, soreness in the arm and fall risk can be addressed by referring the client to a physiotherapist for further examination and treatment and implementing an Internet of Things-based fall management system, which will detect when he is at risk of falling. Secondly, advising the client to practice sleep hygiene, including reducing stimulation, exercising daily, developing a regular sleep routine, using relaxation techniques, and restricting sleep during the day will improve his sleep quality and duration, enabling him to sleep throughout the night. Furthermore, advising the family members to spend more time with the client during their free time and hiring a caregiver to keep him company while at work will reduce his loneliness. Lastly, the client’s poor feeding habits and weight loss can be addressed by developing a meal plan and advising the caregiver to ensure that the client takes all the meals as indicated to meet his nutritional needs.

References

Chung, K. F., Lee, C. T., Yeung, W. F., Chan, M. S., Chung, E. W. Y., & Lin, W. L. (2018). Sleep hygiene education as a treatment of insomnia: a systematic review and meta-analysis. Family Practice, 35(4), 365-375.

Khan, S., Qamar, R., Zaheen, R., Al‐Ali, A. R., Al Nabulsi, A., & Al‐Nashash, H. (2019). Internet of Things based multi‐sensor patient fall detection system. Healthcare Technology Letters, 6(5), 132-137.

Pai, N., & Vella, S. L. (2022). The physical and mental health consequences of social isolation and loneliness in the context of COVID-19. Current Opinion in Psychiatry, 35(5), 305-310.

Reynolds, A. C., Appleton, S. L., Gill, T. K., Adams, R. J., & Sa, W. (2019). Chronic insomnia disorder in Australia. Sleep Health Foundation, 4(2), 1-7.

Sharif, S. I., Al-Harbi, A. B., Al-Shihabi, A. M., Al-Daour, D. S., & Sharif, R. S. (2018). Falls in the elderly: assessment of prevalence and risk factors. Pharmacy Practice (Granada), 16(3), 1-7.

Sidor, A., & Rzymski, P. (2020). Dietary choices and habits during COVID-19 lockdown: experience from Poland. Nutrients, 12(6), 1657 Comprehensive Geriatric Assessment Essay Discussion.

CGA Fourth Visit

Nurse: Well, Mr. Grant, your daughter tells me that you fell on the way to the bathroom. How are you feeling? Any soreness?

MR.GRANT: I’m fine. It was just a little slip. I fell on my arm. It’s a bit sore. But I’m all right. I just have to be more careful is all. I got a little confused on the way to the bathroom.

Daughter: I don’t know about that, dad. You still seem pretty stiff. It took us a while to get out of the car and into the office today. You’ve been using your left arm a lot more, too.

MR.GRANT: Oh, I’ll be just fine in another day or two. I just need more rest.

Nurse: What else has been going on since our last visit together?

Daughter: Well, I bought him a new pair of pants, but he doesn’t want to wear them. He likes his old clothes, which are so baggy. I got him a new belt, but he says he likes his old belt better. I still can’t get him to put in his dentures.

MR.GRANT: I don’t know what all the fuss is about. I like my old clothes just fine. Your mother bought me this belt. I told you, my dentures don’t fit.

Daughter: I’m worried about him being home alone, especially since the fall. I don’t think being home in that house is the safest place for him. I stayed over at the house with him after the fall, and he’s still waking up several times during the night.

Whenever, I bring food over, it’s still mostly left over in the fridge when I come back. It’s hard to work and check up on him and take care of his house and my house, too. I don’t really know what else I can do. My brothers think we should start looking for nursing homes or check with the local veteran’s home to see if they have any availability.

MR.GRANT: No, no. I’m fine at my house. I’m not going anywhere. I don’t want to leave my house. All our belongings are in that house.

Nurse: I understand, Mr Grant. But no one is saying you have to leave your house. Let’s take a look at your chart. Well, Mr. Grant, no wonder your clothes are getting baggy. You’ve lost quite a bit more weight since your last visit. Let’s check your vital signs.

Review the information gathered from Homan’s Physicals

Weight: 142 lbs. (BMI: ), Previous Visit: Weight: 144 lbs. (BMI 21.9)Comprehensive Geriatric Assessment Essay Discussion

Follow-up

I’d like to see you again in one month for a follow up.

Visit with Homer Grant

Two months have passed since Homer’s third visit. Watch his latest visit:

CGA Fourth Visit

This Week’s Assignment

Identify what your assessment and plan of care would be for Homer at this visit. Indicate what parts of the CGA you would complete next for Homer. What questions would you ask Homer and his daughter, and what additional tasks would you perform? Provide a rationale for all decisions.

Use the Comprehensive Geriatric Assessment (CGA) Outline to prepare your assignment based on this week’s visit with Homer. Use each of the headings listed in the outline in your document. Your assignment should be written using APA 7^th edition, and include references. To view the rubric for this assignment, please go to My Grades in your course menu. Locate the assignment in the list and select View Rubric.

Comprehensive Geriatric Assessment (CGA) Outline

1. Assessment
   1. Choose which assessment from the CGA is most pertinent to the problem that the patient presents with.
2. Plan of Care
   1. Develop a brief plan of care related to the CGA assessment conducted.
   2. Prescribing medication or ordering labs is not expected; however, suggestions on what your thoughts would be can be part of the plan of care.
3. Information Gathered
   1. Gather supporting data from at least 3 references to support your plan.
4. Summary Paragraph
   1. Summarize the CGA and plan.

Read the following articles and web resources: Comprehensive Geriatric Assessment Essay Discussion

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• • Centers for Disease Control and Prevention. (2015). Check for Safety: A home fall prevention checklist for older adults (PDF).
  • ConsultGeri. (2020). Fall prevention.
  • ConsultGeri. (2020). Palliative care.
  • Diaz-Gutierrez, M., & Martinez-Cengotitabengoa, M. (2018). Overdosing of benzodiazepines/Z-drugs and falls in older adults: Costs for the health system. Experimental Gerontology, 110, 42–45.
  • Horgass, A. (2017). Pain assessment in older adults. Nursing Clinics of North America, 52(3), 375–385.
  • Taylor-Piliae, R., Peterson, & R., Mohle, M.J. (2017). Clinical and community strategies to prevent falls and fall-related injuries among community-dwelling older adults. Nursing Clinics of North America, 52(3), 489–497.
  • World Health Organization. (2007). WHO global report on falls prevention in older age (PDF)Comprehensive Geriatric Assessment Essay Discussion.

Name: CGA Rubric Weeks 2 – 6

Comprehensive Geriatric Assessment Essay Discussion