The Assessment Of Insomnia Assignment Discussion

The Assessment Of Insomnia Assignment Discussion

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During the week six home visit, the nurse aimed to assess the client’s progress by assessing the client, his daughter, and the client alone. This discussion presents major health issues identified during the assessment and evidence-based interventions for addressing g them.

Assessment

The first health issue identified during the assessment is insomnia. Individuals are diagnosed with insomnia upon reporting difficulty falling or remaining asleep for many hours despite having adequate opportunity to sleep (Krystal et al., 2019). The client qualifies to be diagnosed with insomnia since her daughter reports that her dad wakes up so often at night. The second health issue is age-associated memory impairment. In people with this condition, memory loss and forgetfulness worsen with aging (Resnick et al., 2019)The Assessment Of Insomnia Assignment Discussion. Elderly adults diagnosed with age-associated memory impairment take a relatively long time to form new memories, although their cognition ability is not impaired. The client reports being forgetful and having difficulty remembering things, qualifying for this diagnosis. Lastly, the client is experiencing excessive weight loss and poor feeding habits. Excessive weight loss is depicted by losing 4 lbs since the previous home visit. On the other hand, poor feeding habits are depicted by the daughter’s claim that her dad is not feeding well.

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Plan of Care

First, the plan of care includes interventions for improving the client’s sleep quality and duration. Studies indicate the efficacy of sleep hygiene practices and behavioral changes in improving the quality of life in elderly adults diagnosed with insomnia (Salvemini et al., 2019)The Assessment Of Insomnia Assignment Discussion. Thus, the client is advised to practice sleep hygiene and behavioral changes. He is advised to engage in moderate aerobics during evening hours, including walking, which would make him tired. Additionally, the client should avoid activities that enhance his alertness, such as taking caffeine at night, watching TV or listening to music while in bed, and sleeping with lights on. Implementing the proposed sleep hygiene practices and behavioral changes would improve the quality and duration of the client’s sleep.

Secondly, the plan of care includes interventions for managing age-associated memory impairment. The client’s memory can be improved since his cognition is not impaired. Elderly adults with age-associated memory impairment require more time to remember things (Resnick et al., 2019). Therefore, since his cognitive and memory functions are intact, the client would remember things and answer the question correctly if given adequate time to think and answer questions. Additionally, the client’s daughter is advised to set the alarm for her dad, which will remind him about significant activities, including visiting the washroom and eliminating preventable accidents.

Lastly, the plan of care aims at addressing the client’s excessive weight loss and poor feeding habits. In the elderly adult, poor feeding habits significantly contribute to weight and muscle loss (Fostinelli et al., 2020). Therefore, the client’s weight loss is caused by malnutrition. As a result, this plan proposes strategies for improving the client’s feeding habits to meet his nutrition needs and prevent further weight loss. According to Ricardo et al. (2022)The Assessment Of Insomnia Assignment Discussion, nutritious food improves weight in the aging population. Thus, the family members are advised to give the client a balanced diet with limited calories. His diet should contain different fruits and vegetables, proteins such as fish or poultry, whole grains such as whole-wheat bread, oatmeal, and brown rice.

Summary

Based on data collected during the assessment, the client’s significant health concerns include insomnia, age-associated memory impairment,        excessive weight loss, and poor feeding habits. In this client, insomnia is characterized by waking up regularly at night. This condition was managed by proposing sleep hygiene practices and behavioral changes such as engaging in moderate aerobic exercises and avoiding watching during bedtime. Furthermore, the client’s age-associated memory impairment is characterized by being forgetful and having difficulty remembering things. This health issue is addressed by advising family members to give the client ample time to remember things. They were also encouraged to set the alarm to remind the client about important activities such as visiting the washroom. Lastly, the client’s excessive weight loss and poor feeding habits are demonstrated by losing 4 lbs within one month and her daughter’s claim that the client is not feeding well, respectively. This issue was addressed by advising the family members to give the client a balanced diet of proteins, whole grains, and vitamins. Improving the client’s nutritional status would prevent weight loss. The Assessment Of Insomnia Assignment Discussion

References

Fostinelli, S., De Amicis, R., Leone, A., Giustizieri, V., Binetti, G., Bertoli, S., … & Cappa, S. F. (2020). Eating behavior in aging and dementia: the need for a comprehensive assessment. Frontiers in Nutrition, 7, 604488.

Krystal, A. D., Prather, A. A., & Ashbrook, L. H. (2019). The assessment and management of insomnia: an update. World Psychiatry, 18(3), 337-352.

Resnick, S. M., Matsumoto, A. M., Stephens-Shields, A. J., Ellenberg, S. S., Gill, T. M., Shumaker, S. A., … & Snyder, P. J. (2019). Testosterone treatment and cognitive function in older men with low testosterone and age-associated memory impairment. Jama, 317(7), 717-727.

Ricardo, A. M., Damaris, H. G., Daniel, L. G., & Marta, L. M. (2022). Nutritional Status, Dietary Habits, and Physical Activity in Older Adults from Manta, Manabí. Foods, 11(23), 3901.

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Salvemini, A., D’Onofrio, G., Ciccone, F., Greco, A., Tullio, A., Addante, F., … & Greco, A. (2019). Insomnia and information and communication technologies (ICT) in older adults: a systematic review. Medical sciences, 7(6), 70.

Nurse: Hi, there. Well, you both look tired today. Tell me how things have been in the last month?

Daughter: Yeah, this last month has been tough for us all. Dad is up during the night a lot again. He can’t make it to the bathroom, and I can’t help him get there fast enough either, so then he has an accident. I’m doing laundry all night long. I’ve had to use some of my sick time because I’m too tired to go to work. I get some sleep when the caregiver comes during the day, but then it all starts over again at night.

Nurse: I’d like to do a full exam of your father today. For his privacy, I’d like you to leave the room for today’s exam. Mr. Grant, as part of your exam, I have to ask these questions. Do you feel safe at home? Is your family taking care of you? Are your family members hurting you in any way?

Father: No, no. The kids have been good to me. I know I get a little forgetful– having trouble remembering things. Julie worries I’m not eating enough. My boys call me and come by whenever they have time. They’ve got their lives and families. I’m just a tired old man. I want to stay in Julie’s house as long as I can.

Nurse: Thank you, Mr. Grant. Let’s get your daughter back so we can go over your information. Julie, you and your brothers might want to think about a living will for your father. Talk it over with your brothers, and determine your options for your father’s care. Mr. Grant, we’ll see you later for your next follow-up appointments.

Review the information gathered from Homer’s physical.

Weight 135 lbs. (BMI) Previous Visit: Weight 139 lbs. (BMI) The Assessment Of Insomnia Assignment Discussion

Follow-up

I’d like to see you again in 2 weeks for a follow up.

Week 6 Assignment 2: Comprehensive Geriatric Assessment, Visit 6

Visit with Homer

One month has passed since Homer’s fifth visit. Watch his latest visit:

CGA Sixth 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. The Assessment Of Insomnia Assignment Discussion

Name: CGA Rubric Weeks 2 – 6

• Grid View
• List View

Name: CGA Rubric Weeks 2 – 6

• Learning Objectives

By the end of this week, you will be able to:

• • Discuss ethical implications related to discharge against medical advice.
  • Discuss ethical implications related to elder abuse/financial exploitation.
  • Recognize the importance of interdisciplinary team members in ethical situations.

Week 6: Learning Materials

Readings

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Required

Read the following articles and/or web resources:

• • Center for Disease Control and Prevention (CDC). (2020, May 12). Preventing elder abuse. Violence Prevention.
  • Hartford Institute for Geriatric Nursing. (2020). Elder mistreatment assessment. ConsultGeri.
  • MedicareAdvantage.com. (2020). A complete guide to elder financial abuse.
  • Mion, L. C., & Momeyer, M. (2019). Elder abuse (PDF). Geriatric Nursing, 40, 640–644.
  • National Institute on Aging (NIH). (2020, July 29). Elder abuse. The Assessment Of Insomnia Assignment Discussion