My patient is a seventy five year old African American man with Geriatric condition. Geriatric is a condition that affects elderly people. The medication administered to such individuals is called Geriatric medicine. It is also called family medicine or internal medicine. This medicine helps to promote the prevention of disabilities and diseases in older adults (Kagan, 2010). The physician who administers geriatric medicine to the patient is called a geriatric physician or a geriatrician. In other words, Geriatrics is the ‘care of elderly or aged individuals’.
As said above, my patient is a seventy-five old African American male. His name is Caleb Rama. He used to drink heavily in his youth. In addition, he also used to attend the gym. This means that he used to exercise. This helped him. He has remained strong over the years. However, recently, because of his age, he has started experiencing bouts of sicknesses. For instance, only last week he suffered a stroke. This made his family worried. As a result, my care for this man has had to be an increase.
Rama is a very spiritual person. He believes in Jesus Christ and believes that God can heal him of his sicknesses. While he was young, Rama had a good number of sexual encounters. As a result, he got a number of sexually transmitted diseases such gonorrhea and Syphilis. These diseases made his bladder weak. Thus, he does not have control over his bladder now. One tool that has continued to enable me administer Geriatric medicine to Rama is SPICES. This tool is used to examine these older patients than others. Mental Status Assessment of older adults is measured by a tool called the Mini –Cog (Eliopoulos, 2014). This is a very useful tool to Geriatricians since it assesses the mental health of individuals.
There is another very useful tool in Geriatrics. This is the Geriatric Depression Scale. I have continually used this on my patient. This is because Rama has a tendency to get depressed whenever a family member or a friend or even a volunteer does not visit him. In his younger days, Rama was the man. He used to have countless friends and admirers. Therefore, he is used to having company around.
Rama is a patient that enjoys a lot of sleep. Though this is expected of a person his age, I admit that he is one of the few that likes resting and sleeping. Many individuals his age just do it because they behave no choice. His eating habits on the other hand, contradict the needs of his body. Since he used to like take-out food and he took lots of it, he still prefers it up to now. His comfort comes from family and friends. His body is used to pain so he rarely feels any. This happens more so when medication has to be given via a syringe. My patient also finds safety in numbers just like any human being. One thing about him is that he hates being alone. I am sure if left alone, he can go bananas.
As mentioned above, my patient enjoys his sleep. One of the Hartford Institute Geriatric Nursing Tool that has helped asses his sleeping quality and patterns is the Pittsburg Sleep Quality Index (Kagan, 2010). This gives the quality of his sleep. A related tool is the Epworth Sleepiness Scale which shows how sleepy an individual is. Rama’s nutrition habits have been affected since he prefers non-healthy foods with fats and calories. However, I always make sure he takes healthy food. I examine his nutritional needs by using the Mini Nutritional Assessment which involves administering the tool and watching. After this, inferences are made.
The circulatory system of many elderly individuals is usually weak. Rama is no different. Because of his former lifestyle, his system has been weakened at a great deal. Therefore, constant assessment is needed. Digestion is usually slow in elderly individuals. It is no different in Rama. The tool used for examination is referred to as D24: Digestion Difficulties; Assessment and Interventions. This can also be assessed using the first tool; SPICES.
Elderly individuals have a weak immune system. Rama’s immune system, though weak, is stronger than most people’s his age. Though I have said that Rama’s lifestyle when he was young was a bit extreme, and given the fact that he used to drink a lot of alcohol and eat take out foods most of the time, he used to exercise a lot. Looking at his history, he also used to eat healthy foods whenever possible. The combined effect of exercise and healthy eating gave him some immunity. Using Issue 21 which measures the immunization for older adults, I have assessed that Rama’s immune system is quite strong.
Fulmer Spices: Assessment Tool for the Older Patient
For my patient, I considered using the Fulmer Spices model as it is easy to use and descriptive to the patient’s needs considering our patient is not suffering from any terminal illness. As it is known, normal aging comes about with irreversible and inevitable changes. This changes in the body of the elderly increases the risks of the patient developing health-related problems. The problems experienced by the old generation may include: skin breakdown, evidence of falls, confusion, incontinence, and problems associated with feeding or eating, and sleeping disorders (Kagan, 2010). Nurses should be familiar with these commonly occurring disorders in order to prevent iatrogenesis and to promote the optimal functioning of the older adult patient. In the case of any flagging condition, the assessment will allow the nurse to adopt therapeutic and preventive interventions on time.
Fulmer Spices tool is the most effective and efficient tool for obtaining the relevant information required to detect and prevent health alteration of the patient in time. ‘SPICES’ is an acronym that describe the common syndromes that the elderly are most likely to acquire. S for sleep disorders; P for problems associated with feeding or eating; I for Incontinence; C for Confusion; E for Evidence of falls and S for Skin Breakdown.
Fulmer Spices: Overall Assessment Tool
After the use of the Fulmer Spices tool to assess the patient, there need to be a diagnosis and action plan in case of any complication (Eliopoulos, 2014). With this plan, the nurse will always be in a position to treat the patient and attend to him or her whenever the nurse observes that there is a complication. The tools below will help in the treatment of the patient as they provide the nurse care plan needed by the nurse for quality health care delivery to the patient.
Need: Risk Reduction
Nursing Diagnoses in case of the various mal-functions to the body of the elderly include Disturbed Sensory Perception (auditory, visual, tactile and olfactory) related to the Age of the Patient. Risk of any injuries on the sensory organs. Risks associated with the impairment the skin and reduced immobility and decreased sensations; Convalesces and Impaired home maintenance.
The Goals to be achieved are: Ensuring the patient possesses intact skin, free from injury, possess the appropriate devices such as hearing aids if using any to compensate for the failing sensory deficits.
Nursing Actions needed to be formed and checked against criteria formed. These include: Compensate for the poor vision, compensate for the decreased ability to smell, compensate for hearing loss, prevent falls, marinating of proper body alignment and maintaining of a good skin condition.
The diagnosis involved in these criteria includes notably disturbed patterns of sleep.
The goals of the nursing will be to ensure that the patient obtains sufficient sleep at all times to be free from fatigue and have proper sleeping patterns.
Actions by the nurse to proper diagnose the condition will be: Control of the environment stimuli.
The nursing diagnosis of these criteria is acute pain related to the fracture.
The goal of the nurse will be to make sure the patient is free from pains and any strains related with movement.
The action to be taken in these criteria includes monitoring any signs of pain and assist in physical exercising of the patient.
Nursing Diagnoses include Risk infection and Ineffective Health maintenance.
The goal in this criterion is to make sure the patient is free from infection.
The actions to be taken by a nurse to make sure that the goals are met include nutritious food intake, stress management techniques, immune-enhancing exercises and immunizations (Eliopoulos, 2014).
The diagnosis involved in this criterion includes risk of infection as a result of malnutrition and constipation.
The nurse should ensure the patient is free from any infections and regular bowel maintenance is assured.
The action to be taken to achieve these will include: Promoting of regular elimination of bowels and bladder; developing good hygiene practices and prevention of social isolation.
The diagnosis involved in this criterion involves any signs of impaired mobility due to fractures and activity intolerance associated to fracture and malnutrition.
The goals of the nurse will be to ensure that a patient achieves good physical exercise and to make sure the patient can to move from one place to another easily.
The actions to be taken in order to ensure this goal is met include adjusting of hospital routine to the individual’s pace.
With all these assessment taken, the results should be compared against the goals of each of the criterion. This will enable the nurse to be in a better position to know whether or not the goals have been met or not. My patient, Rama, will receive quality health care if these guidelines are met. The assessment tool will help the nurse to establish a point of focus easily. The use of nursing assessment tools makes it easier for the nurses in that they know which areas to check and which areas to focus on when they have a personal relation with their patients. Private nursing is most effective as the nurse will be in a position to know of the needs of the patient hence addressing them effectively and efficiently (Eliopoulos, 2014).
Eliopoulos, C. (2014). Gerontolocial Nursing. 8th Ed. Philadelphia: J.B. Lippincott
Kagan, S.H. (2010). Geriatric syndromes in practice: Delirium is not the only thing. Geriatric Nursing,