Running head: OLDER ADULT HEALTH PROMOTION PROJECT 1

Older Adult Health Promotion Project

Katherine Vest

Bon Secours Memorial College of Nursing

Mrs. Tamera Krukiel

Nursing Research NUR 4113

April 9th, 2020

“I pledge.”
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The older adult client, MES, observed was an 84-year-old woman who currently resides

in an independent living facility in Williamsburg, Virginia. The client is recently widowed as her

husband passed away in 2017 from Alzheimer’s Disease. When her husband was diagnosed, the

couple left their home of almost 60 years to move to a facility that consisted of a memory unit

for her husband and independent living for MES. After her husband’s passing, she opted to stay

in the independent living facility. MES is a mother of eight children and a sister to four brothers.

MES was raised on catholic beliefs and holds the traditions dear to her heart. MES has a

complicated medical history consisting of melanoma and a brain tumor, but now just struggles

with migraines resulting in the use of Verapamil 300mg three times daily. MES lives a fairly

healthy, slow lifestyle but is somewhat active in her community. She identifies herself as often

forgetful and has had a few cases of falls since living alone in her apartment which were related

to impaired judgment of what she could handle in her older adult physical state. MES explained

bad health as what is seen around her facility which consisted of poor vision, hearing, gaits and a

general depressing mood. The interviewer identified MES’s vision of bad health to be the normal

signs of aging that were mistakenly correlated with poor health. MES is a visual learner and was

active in her interest to live a healthier life.

With MES’s current lifestyle, a priority nursing diagnosis is that MES is at risk for falls

related to impaired judgment (Gulanick & Myers, 2017). This fall risk was identified in the

SPICES tool utilized to determine any older adult health risks (Fulmer, 2019). This is the priority

focus for MES’s learning as it poses as the biggest safety risk for her and is the intervention that

will follow Healthy People 2020’s goal for the elderly to improve the quality of live in older

adults. MES has experienced frequent falls since living on her own in her apartment in the
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independent living facility, and it is likely that she lacks education on safety awareness and what

needs to be done in order to prevent falls in her home. MES was educated on short-term

outcomes. One short-term outcome would be for MES to identify two fall hazards currently in

her apartment by the end of the day. With this, MES would be able to manipulate these hazards,

such as loose rugs and wires in walkways, to rid the risk. To evaluate the outcome for MES, she

would be able to name two objects in which she believed could cause a fall and what was done to

manipulate the environment to decrease the risk. Another short-term goal would be to identify a

prescription drug she takes that is identified as a fall-risk drug by the end of the day. To evaluate

this, MES would be able to identify these drugs. A long-term outcome would be that MES would

not experience any fall episodes for the remainder of the month of April 2020. MES’s falls were

frequent, happening at least one time per month. With applying the short-term goals and

outcomes, the long-term outcome should be able to be established. MES will be able to report at

the end of the month that she did not experience any falls for the month of April 2020.

The teaching plan was a visual approach. MES identified that she was best educated

through this approach by completing the Survey of Preferred Learning Method. The content of

the teaching was developed mutually and focused on the goals identified to decrease the risk of

patient falls. Teaching aids consisted of showing examples of fall hazards in the place of

interview, as well as research articles provided. MES was educated about drugs that can decrease

blood pressure and cause falls, such as the Verapamil she was taking three times daily (Schub &

Karakashian, 2018). MES was instructed on environmental factors that could pose a risk in her

home for falls. Some of these factors that were correlated to MES’s environment were ill-fitting

shoes, clutter in the living space, height of the bed preventing safe transfer, inadequate lighting in

living space, and throw rugs (Schub & Karakashian, 2018). MES was able to understand the
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learning aids that were provided as her education level is high, she is literate and is a visual

learner.

MES assisted in the formation of measurable outcomes to help prevent falls in her

environment. The short-term goals of identifying potential environmental hazards and her use of

Verapamil for migraines as fall risks. These were measured based on MES’s verbal confirmation

by the end of the day. The interviewer will follow up on the client at the end of April to follow

up on the long-term goal of MES experiencing no falls for the month of April 2020. Throughout

the rest of the month, MES is supplied a list of environmental and prescription hazards that could

increase her risk of falls. With these visual tools, MES and her family can continue to refer back

to them to ensure a safe environment for MES that is free of falls.

The nursing outcomes that were provided were related tertiary prevention. MES has been

a victim to many falls within the last year. With the interventions that were provided to MES, she

will be able to live a safer life that keeps her independent as she wishes. The teachings were

deemed effective as MES was able to teach back what was instructed to her. The interviewer

would have provided shorter articles with larger words to make them easier to read for the client.

In the role of the interviewer/nurse-teacher, it felt positive to be able to provide MES with

this information to help her in her healthy living. Falls can cause serious health problems for

older adults and it is very important to take efficient precautions to promote safety in the living

environment. There was a lot to learn from this project. One takeaway was how MES thought

that the normal signs of aging were that of bad health. Another takeaway was how often older

adults who are living alone do run into issues, such as falls, and do not think much of them

because they lack the education on falls in their age group. It was a pleasure to be able to provide

this information based upon MES’s assessment.

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References

Carolan Doerflinger, D. M. (2019). Mental status assessment of older adults: The mini-cog. Try This:

Best Practices in Nursing Care to Older Adults, (3).

Fulmer, T. (2019). Fulmer SPICES: An overall assessment tool for older adults. Try This: Best Practices

in Nursing Care to Older Adults, (1).

Gulanick, M., & Myers, J. L. (2017). Nursing care plans: Diagnosis, interventions, & outcomes. St.

Louis, MO: Elsevier.

Older adults. (n.d.). Retrieved April 14, 2020, from https://www.healthypeople.gov/2020/topics-

objectives/topic/older-adults

McCabe, D. (2019). Katz index of independence in activities of daily living. Try This: Best Practice in

Nursing Care in Older Adults, (2).

Schub, T., Karakashian, A. (2018). Fall prevention plans: Implementing. CINAHL Nursing Guide.