NURSING 18 – Well Elder Assessment

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Question :

Fundamentals Of Nursing (Kingsborough Community College)

NURSING 1800 – Well Elder Assessment

Analyze a case study of an elderly adult patient who resides alone in the community. Upon review of the case study, complete the Home Safety Assessment Tool that is based upon the information provided in the case study. Prepare a teaching plan for this patient based on the information in the case study, and on the documentation on the Home Safety Assessment Tool. This assignment is to be completed and submitted to your clinical instructor by the deadline due date.

Learner objectives

1. Identify the safety needs of a well elder who lives alone in the community.

2. Develop a Teaching Plan to meet the identified needs of the well elder.

3. Discuss safety measures for the well elder that should be implemented to maintain optimal wellness.

4. Identify the SLO that was achieved after completing this activity.

Course SLOs

1. Recognize the steps necessary to deliver safe patient-centered care at a fundamental


2. Select priority nursing interventions specific to the care of the older adult.

3. Identify actions that support evidence-based practice when providing care.

4. Define critical thinking/clinical reasoning strategies when delivering care.

5. Describe standards of teamwork and collaboration in the provision of care.

6. Explain leadership and management strategies utilized in the delivery of care.

7. Use the principles of informatics and technology in nursing care.

8. Describe ethical and legal beliefs as it applies to the practice of a registered nurse.

Case Study

Mr. J is an 88 year old Hispanic Male patient who lives alone on the second floor of a 4 story home. Mr. J admits to a history of multiple falls. He walks with an unsteady gait, and although a walker has been prescribed for use with ambulation, Mr. J states: “I really only use it when my daughter stops by.” Mr. J does not have a PERS unit. He wears a hearing aid in the leftear which “needs a new battery”, and eyeglasses that are for distance and reading. A nurse has

been assigned to evaluate the safety of Mr. J’s home environment; the following is the report of the evaluation. There are 5 steps to enter Mr. J’s building, but there are no handrails on either side of the steps. The entrance hallway has only 1 light that is dimly lit. The apartment opens to a small entranceway, with the kitchen area to the left. The kitchen appears to be cluttered: there are groceries all over the kitchen counters, along with plates and cups. The sink is full of dirty dishes and utensils; there is a soiled scatter rug on the floor by the kitchen sink. There is a refrigerator, stove, and a microwave in the kitchen, and all the wires appear to be grounded: none are frayed. There are no smoke detectors or carbon monoxide units in the kitchen area; there is overhead tract lighting but no wall or floor night lights. There is a telephone on the kitchen table: the table and chairs appear to be sturdy. There is a candle on the table that is lit - Mr J states: “it’s nice to keep a candle on the table to take the smell of food out of the kitchen.”

The bathroom is located to the right of the kitchen: there is a conventional commode, but there are no grab bars next to the toilet. The sink is free-standing with a medicine cabinet directly above which holds several medications that have expired. The lighting is limited to one small lighting fixture that is directly above the medicine cabinet: there are no night lights in the bathroom. There is a scatter rug in front of the sink; the tub does not have a safety mat and there

are no grab bars in the shower. The bedroom is at the end of a hallway that is next to the bathroom: there is no lighting in the hallway, and there is a scatter rug on the floor. There is a conventional bed with a clean covering on it, a dresser that holds Mr. J’s clothes, and a table with a lamp on it right next to the bed: there is no phone in the bedroom. A chair is located in the corner of the bedroom with a blanket thrown over the seat: one of the legs appears shaky and unsteady. There is a scatter rug directly in front of the bed. The living room is at the end of the hallway, just past the bedroom. There is a couch with a blanket thrown over the side; next to the couch is a table with only one lamp that has no light bulb. Mr J. states: “I keep forgetting to put a bulb in there – when the television is on it gives off enough light.” Directly in front of the couch is a television set; on top of the TV is a radio and a clock all plugged into one outlet: the wire on the extension cord is frayed. There are 2 chairs underneath a window in the living room that are cluttered with newspapers. The floor in this room is bare. There is a small fan in the corner of the room: the cord is not plugged into the wall outlet, but is draped across the floor in front of the fan. There are no wall or floor night lights in the living room.

The nurse is to complete the following home safety assessment tool for Mr. J, and is to develop a teaching plan for a well elder who resides alone in the community.                      

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Answer :

Teaching Plan

Learning Need -Patient will be benefitted replacing rugs by safety mats to avoid risk of fall

-Danger of actively burning candle

-Appropriate benefits of having adequate lighting

-Electrical safety tips

Changing the batteries of hearing aid are vitally important for communication and self-safety

-Importance of PERS unit in emergency situations

-Inadequate and unsafe ambulation conditions

Domains of Learning -Cognitive perspective: apprehending about dangers of inadequate lighting, burning candle, frayed wires, expired medications, use of walker

-Psychomotor perspective: apprehend to safely ambulate around the house with a walker, instructing and applying the usage of PERS unit, changing batteries of hearing aid

-Affective learning perspective: engage the patient in an active conversation regarding the safety issues around the apartment.

Available Resources -Daughter

-Physical therapist

Content of Teaching


-Appropriate and safe usage of assistive device, such as walker

-Scatter rugs on the floor must be replaced by a non-slippery mat to avoid risk of fall

-Teaching the client to dispose expired medications on time

-Educating the client of potential dangers of having constant lit candle on the table

-Installing grab bars in the toilet and the bathtub

-Installing and monitoring smoke detectors and carbon-monoxide detectors in the apartment

-Educating the client how to replace batteries of the hearing aid

-Frayed wires need to be fixed, and wires should be arranged in the way so that they don’t block walker passage around the apartment

-Instructing how to make the kitchen cleaner and dispose unnecessary objects and item for safer and wider ambulation

-Replacement of sturdy and broken furniture

Teaching Strategies -Showing videos on safety, and benefits of safety floor mats and grab bars in the bathroom to avoid risk of fall, observe at the same time patient’s properly using the assistive device

-Showing educational videos on how to properly ambulate with the walker and benefits of adequate lighting

-Showing instructional videos or instructional techniques on how to turn on and off the lights around the apartment

-House visiting PT (physical therapy) based on client’s needs

-Have a representative to come to demonstrate PERS unit