NCMA 314 WEEK 4 activity in the manner or within the range

considered normal for a human being.

Nursing Care of Older Adult in Wellness
▸ Handicap: A disadvantage for a given
Assessment:
individual, resulting from impairment or
Assess for potential health hazard to identify disability that limits or prevents the fulfillment
risk factors for illness and injury. of a role that is normal (depending on age,
sex, and social and cultural factors) for that
Risk Factors: individual.

▸ Habits Activities of Daily Living (ADLs)

▸ Lifestyle patterns ▸ The original ADL tool was developed by

Katz and colleagues.
▸ Personal and family medical history
▸ Katz Index distinguished between
▸ Environmental conditions
independence and dependence in activities
Functional Status Assessment and created an ordered relationship among
ADLs.
Functional status is considered a significant
component of an older adult’s quality of life. ▸ It addressed the need for assistance in
bathing, eating, dressing, transfer, toileting,
▸ Functional status assessment is a and continence. 8 Instrumental
measurement of the older adult’s ability to
perform basic self-care tasks, or ADLs, and ▸ Instrumental activities of daily living include
tasks that require more complex activities for a range of activities that are considered to be
independent living, referred to as IADLs. more complex compared with ADLs and
address the older adult’s ability to interact
▸ Determination of the degree of functional with his or her environment and community.
independence in these areas can identify a
client’s abilities and limitations, leading to Tasks Typically Assessed with IADL
appropriate interventions. Assessment Tools

▸ The client’s situation determines the ▸ Using the telephone

location and time when any of the scales or
▸ Taking medications
tools should be administered, as well as the
number of times the client may need to be ▸ Shopping
tested to enjoy to ensure accurate results.
▸ Handling finances
▸ Many tools are available, but the nurse
should use only those which are valid, ▸ Preparing meals
reliable, and relevant to the practice setting.
▸ Laundry Light or heavy housekeeping
WHO (1980) ICIDH Classification
▸ Light or heavy yardwork
▸ Impairment: Any loss or abnormality of a
▸ Home maintenance
psychological, physiological, or anatomical
structure or function. ▸ Using transportation
▸ Disability: Any restriction or lack (resulting ▸ Leisure/recreation
from an impairment) of ability to perform an
Katz Index physical, and affective realms; and
expressions of sense of worth and
The Katz Index is a useful tool to describe the emotional state.
client’s functional level.

Cognitive Assessment 2. Roles/Relationships Pattern

Changes in cognitive function with age vary ▸ This pattern encompasses the
among older adults and are difficult to achievement of expected developmental
separate from others. tasks.

▸ Generally speaking, older adults manifest a

▸ Basic needs for communication and
gradual and modest decline in shortterm
interactions with other people, as well as
memory and experience a reduction in the
meaningful communications and
speed at which new information is processed
satisfaction in relationship with others are
MiniMental State Examination examined.

Physical Assessment 3. Health Perception/Health Management

Pattern
▸ Conducting a physical assessment of an
older adult is based on technical competence
in physical assessment, and knowledge of ▸ This pattern encompasses the
the normal changes. perceived level of health and current
management of any health problems.
▸ Circulatory Function
4. Nutritional/Metabolic Pattern
▸ Respiratory Function

▸ Gastrointestinal Function ▸ This pattern encompasses evaluation of

dietary and other nutrition-related
▸ Genitourinary Function indicators

▸ Sexual Function 5. Coping/Stress-Tolerance Pattern

▸ Neurological Function
▸ This pattern encompasses the client’s
▸ Musculoskeletal Function reserve and capacity to resist challenges
to self-integrity, and his or her ability to
▸ Sensory Function manage difficult situations.
▸ Integumentary Function
6. Cognitive/Perceptual Pattern
▸ Endocrine and Metabolic Function
▸ This pattern encompasses self-
PAR -Q AND YOU management of pain, presence of
Gordon’s 11 Basic Functional Health communication difficulties and deficits in
Patterns of Older Adult sensory function.

1. Self-Perception/Self-Concept Pattern 7. Value/Belief Pattern

▸ This pattern encompasses a sense of ▸ This pattern encompasses elements of

personal identity; body language, spiritual well-being that older adults
attitudes, and view of self in cognitive, perceive as important for a satisfactory
 daily living experience and the Implementation
philosophic system that helps him or her
function within society. ● Adopting a proactive stance toward an
action plan for health promotion of the
8. Activity/Exercise Pattern older individual

▸ This pattern encompasses information ● Activities, locations, and means of

related to health promotion that disseminating health promotion
encourages the older adult to achieve the
recommended 30 minutes daily of ● Annual health promotion screening
physical activity on most days of the
week. ● Program that provide vaccinations for
older adult
9. Rest and Sleep Pattern
● Screening for cancer , diabetes, and
▸ This pattern encompasses the sleep other condition
and rest patterns over a 24-hour period
and their effect on function. ● Monthly health talks provided in senior
centers
10. Sexuality/Reproductive Pattern
● Housing sites
▸ This pattern encompasses the older
adult’s behavioral expressions of ● Continuing retirement communities
sexuality.
● Advocate and educate about health
11. Elimination Pattern promotion

▸ This pattern encompasses bowel and ● Safe medication use

bladder excretory functions.
Evaluation
Planning
● Determining effectiveness of care plan
● Exploring older adults’ personal ideas
and beliefs concerning health needs ● Check established goals

● Reading current literature regarding ● Establish appropriate and realistic

latest update for specific health promotion revised goals and realistic steps to
achieve them
● Current health policy information that
will safeguard client rights

● Understanding and use of behavior

change theories