The Geriatric Assessment Discussion Paper

The Geriatric Assessment Discussion Paper

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The assessment that is most pertinent to the problem the patient has is dementia. This is a general group of conditions characterized by the impaired ability the elderly has to think, remember, and make decision and this interferes with their everyday activities. In this case, the patient fell since he got confused while going to the bathroom. Confusion is one of the signs and symptoms of dementia and the patient may be having it (Mehdizadeh et al., 2020)The Geriatric Assessment Discussion Paper. The patient also fears being isolated. His daughter buys him things and she think that the fall has affected him in distinct ways but he denies it since he does not want to be a burden to her and fears that he may be eventually left alone.

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1. Plan of Care
   1. Develop a brief plan of care related to the CGA assessment conducted.

The plan of care includes several things.  The first is for the patient to have a nurse at home to help him in his daily activities.  From the assessment, it shows that the patient has a problem with his memory and he fears being isolated. The home nurses have to be available 24/7 for long-term care to assist in avoiding more falls within the home setup (Taylor-Piliae et al., 2017). The home nurses are also knowledgeable about the elderly care plan that they should follow and they provide personal support and personalized care services to the patient (World Health Organization, 2007). They will help the patient in this case understand the healthcare conditions and needs that he may have, the medications and treatments to treat the outcomes of the fall and recommend to him the best self-care practices (Peek et al., 2020)The Geriatric Assessment Discussion Paper. The nurses will help the patient overcome any obstacles that prevent them from making healthy decisions.

The patient can also undergo counseling. This can help him understand that the act of his daughter buying him things is a sign of love and it does not show that he has been a   bother to him.  The father should learn how to manage his emotions and become outspoken and confident.

1. Information Gathered
   1. Gather supporting data from at least 3 references to support your plan.

The nurse’s role will be critical for certain reasons.  The nurse will help the patient to become more conscious about his health and he will understand the importance of being truthful about his health. The nurse will provide him with company and he will feel valued and loved.  Patient   will help Mr. Grant to have a positive outlook of life and he will understand the importance of valuing the help he is given by his family and other members. The education also helps him follow the checklist on the prevention of falls. For instance, he can be taught the importance of wearing shoes in and out of the house (Centers for Disease Control and Prevention, 2015).  The daughter should also be taught on how to prevent falls by improving on lighting and placing the necessary measures.

He will also understand how self-help practices can be applied in improving his condition. Mrs. Grant has a memory problem that caused fall as he was going to the bathroom. Falls are common among the elderly since they are caused by a decrease in motor skills and other conditions (Zhang et al., 2019). As people grow older, their mental health and physical health declines and this could create huge problems for them (Modarresi et al., 2019)The Geriatric Assessment Discussion Paper. The patient has to undergo training on ways of preventing more falls and conducting exercises that will improve the quality of life and memory.

1. Summary Paragraph

In conclusion, Mr. Grant is a patient who is having a hard time adjusting to old age. The patient has had a fall while going to the bathroom and he states that he was confused during this time. The patient seems to have bene hurt but he denies it even after her daughter explains to the nurse that he is unwell. He tries to hide his pain since he does not want to feel as if he is stressing her. When the daughter gives a suggestion for the father to be taken care of by a nurse at home. He refuses thinking he is being taken to an old age home and claims that all the family items are in their home.  He was afraid of being taken far away from his home and that explains the role of the nurse. The nurse could help the patent understand ways of taking care of himself. The self-help practices he is taught will assist him understand how to live with others and the importance of taking care of himself to prevent falls.

References

Centers for Disease Control and Prevention. (2015). Check for Safety: A home fall prevention checklist for older adults

Mehdizadeh, S., Dolatabadi, E., Ng, K. D., Mansfield, A., Flint, A., Taati, B., & Iaboni, A. (2020). Vision-based assessment of gait features associated with falls in people with dementia. The Journals of Gerontology: Series A, 75(6), 1148-1153.

Modarresi, S., Divine, A., Grahn, J. A., Overend, T. J., & Hunter, S. W. (2019). Gait parameters and characteristics associated with increased risk of falls in people with dementia: a systematic review. International psychogeriatrics, 31(9), 1287-1303.

Peek, K., Bryant, J., Carey, M., Dodd, N., Freund, M., Lawson, S., & Meyer, C. (2020). Reducing falls among people living with dementia: a systematic review. Dementia, 19(5), 1621-1640.

Taylor-Piliae RE, Peterson R, Mohler MJ. Clinical and Community Strategies to Prevent Falls and Fall-Related Injuries Among Community-Dwelling Older Adults. Nurs Clin North Am. 2017 Sep;52(3):489-497. doi: 10.1016/j.cnur.2017.04.004. PMID: 28779828.

World Health Organization. (2007). WHO global report on falls prevention in older age.

Zhang, W., Low, L. F., Schwenk, M., Mills, N., Gwynn, J. D., & Clemson, L. (2019). Review of gait, cognition, and fall risks with implications for fall prevention in older adults with dementia. Dementia and geriatric cognitive disorders, 48(1-2), 17-29. The Geriatric Assessment Discussion Paper

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. The Geriatric Assessment Discussion Paper

Review the information gathered from Homan’s Physicals

Weight: 142 lbs. (BMI: ), Previous Visit: Weight: 144 lbs. (BMI 21.9)

Follow-up

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

Visit with Homer

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.
      

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Name: CGA Rubric Weeks 2 – 6