Aging Adult Case Study 

This case study involves a 68-year old woman who is having some health issues. This case study will do an in-depth analysis of her health, social, and financial ability, and after that determine the measures that she should take to improve her quality of life. From the background information given, this woman lives alone and she is independent with all activities of daily living (Batsis, Sahakyan, Rodriguez-Escudero, Bartels, Somers, & Lopez-Jimenez, 2016). Her mobility is perfect in that she has no restrictions because she can quickly move from one place to another, from one room to another, and even go up the stairs. She is competent and oriented x4 meaning that she knows her name, her location, time, and that she knows why they are in the hospital. She has a fixed income that she can live a modest life. Her weight is 210 lb, and she is of 5’ 6” in height. 

What is the Client’s BMI

The BMI of the patient is 34. The BMI for this patient indicates she is carrying extra weight, meaning she is overweight. This is dangerous because she is aged, which makes her susceptible to other lifestyle diseases such as hypertension, diabetes, heart conditions, and arthritis. For this reason, it will be very prudent for the patient to start doing physical exercises that would help her to start losing some of the excess weight she is carrying (Morle et al., 2018). It is also essential for her to start eating a healthy diet that does not lead her to add extra weight. The fact that the patient is oriented X4 will make it easier for her to understand why her lifestyle has to change, and this will make it very easy for the client to participate in the weight loss exercises actively.

The screening tools to be used to assess nutritionally and exercise knowledge

1. The Malnutrition Universal Screening Tool

The Malnutrition Universal Screening Tool is one of the most effective tools in measuring the nutrition levels of an individual and for this reason, I would choose to have it as one of the tools that I would use in this case scenario. This tool involves five steps with the first step being to measure the weight and height of the patient to get their BMI score. The second step consists of noting the percentage of the unplanned weight gain or loss, and this will then be followed by establishing the acute disease score and effect (Morle et al.,  2018). The fourth step would involve adding all the scores from the previous three steps to obtain the overall risk of malnutrition. The fifth and final step would be to utilize local or universal management methods to develop a care plan for the patient.

2. The Malnutrition Screening Tool (MST) 

The Malnutrition Screening Tool (MST) is another essential tool that can be used to measure the nutritional levels of people. The tool is used in acute healthcare institutions to determine the nutritional value of the aged and after that help in developing functional dietary and physical exercises that can be used by an old individual to gain useful and better health. If an individual is not overweight, this tool still helps in determining the best lifestyle habits that can be used by the patient to maintain their good health and nutrition. This tool could be useful in determining the nutritional level of the patient and determine the next course of action to help them live a better lifestyle that would enhance their quality of life.

Identify two client outcomes that are reasonable, measurable, and realistic

We identified that the 68-year-old woman is overweight and she will need to have a weight management plan to help her lose some of the extra weight. For this to be attainable, it is essential for the weight management plan to have outcomes that are reasonable, measurable, and realistic.

The first outcome should be to lose several pounds to ensure that her weight comes down to what is considered healthy. The number of pounds the woman should lose should be realistic, reasonable, and measurable to ensure that the trainer, nutritionist, and she all know the targeted weight loss that should be attained. Considering the woman is 68 years old, the reasonable amount of weight that she should work towards shedding should be about 20 pounds. This is a realistic amount of weight that can be lost easily through light exercises like daily walks of about 30 minutes and proper nutrition. After the daily walks, the woman should be advised to do some swimming for about 15 minutes. All these exercises will help her in cutting down her excess weight and have a correct BMI.

Another outcome the woman should work towards attaining is lowering her BMI to about 24. That is the ideal BMI for a 68-year-old woman of her height, which is 5’ 6”. By targeting a BMI of about 24, this can be described as an outcome that is measurable in that she will have to cut ten units in her current BMI, which stands at 34. This outcome is also reasonable in that her plans involve physical exercise and eating healthy, and for this reason, she is bound to cut weight and be able to live a better life. Weight loss and having the correct BMI are the best possible outcomes that can be measured and are realistic.

Identify three nursing interventions for each client outcome and give rationales

For the result set to be attained, several nursing interventions must be implemented to ensure that the necessary action must be put to provide the required outcomes are achieved. The first outcome, as discussed above, is for the patient to lose 20 pounds of weight. For a 68-year-old woman, this is not an easy task, and it will require the medical team to come up with nursing interventions that will help the patient attain the weight loss. The first nursing intervention that should be administered to the patient is nutrition or diet therapy. The diet for the patient should not include fast food or foods high in fats and starch since they lead to excess weight gain in an individual. The diet the patient should take should include foods such as white meat, many vegetables, whole bread, and fruits. These foods will be rich in all the vitamins the body requires without having to increase the amount of cholesterol as well as weight to the body.  

The third nursing intervention that can lead to the attainment of this outcome is for the patient to be supervised as they do their physical exercises such as walking and swimming. This would ensure that the patient is encouraged to work hard to ensure that the excess weight is lost. The secondary outcome was for the patient to work towards attaining the correct BMI, which is about 30 and below. The clinical interventions in achieving this outcome are similar to the response that was undertaken to ensure the patient lost some weight. The main reason for this is that losing weight and attaining a lower BMI are identical in that they involve eating the right foods and participating in physical exercises that can help in burning calories. The patient should also avoid partaking in dangerous activities such as excessive consumption of alcohol, as well as smoking of cigarettes.

Identify what weakness in the client’s life and supports may be impacting the client’s activity and diet?

Many factors play an essential role in determining if an individual will be successful in their quest to live a healthy lifestyle. In this case scenario, for example, this patient lives alone and she prides herself in the fact that she is independent and able to do all her ADLs by herself. Even though this is commendable of her, this lifestyle has a significant weakness. The fact that she lives alone, she does not have any support system that can help her live a better life where she can eat healthily and participate in healthy activities. At her age, family and friends should surround the patient and work with her in her diet therapy, as well as encourage her to do physical exercises. The fact that she should be walking for thirty minutes every day and swimming regularly can be very tiring and for this reason, she should be living with someone to encourage her to undertake these exercises.  Research has shown that people who live alone are prone to engage in poor and dangerous eating habits (Manini et al. 2015). The reason for this is that many people tend to feel that preparing healthy food for one person is costly and time-consuming and as such, one tends to consume fast foods, which can be detrimental to the health of the individual. This is one of the significant weaknesses of the kind of life being led by the patient, and it would be essential for her to change her lifestyle for her to be able to attain the weight loss outcomes that were set.

What referrals would you make and why?

Having come up with suitable clinical measures that can help the patient lose weight and lead a better life, I would make referrals to other needy old people so that they can be helped to improve their lives. The fact that nutrition therapy can be offered to patients is outstanding because the diet consumed is one of the most critical factors that help determine if one becomes obese or overweight (Manini, et al. 2015). Physical exercises are essential in healthy lifestyles, and this is another crucial reason why I would refer an obese individual to a nutritionist to help them improve their lives 

References

Batsis JA, Sahakyan KR, Rodriguez-Escudero JP, Bartels SJ, Somers VK, Lopez-Jimenez F. (2016). Normal weight obesity and mortality in United States subjects >/=60 years of age (from the Third National Health and Nutrition Examination Survey) Am J Cardiol. 112(10):1592–8.

Manini TM, Everhart JE, Patel KV, Schoeller DA, Colbert LH, Visser M, et al. (2015). Daily activity energy expenditure and mortality among older adults. JAMA. 296(2):171–9

Morley JE, Argiles JM, Evans WJ, Bhasin S, Cella D, Deutz NE, et al. (2018). Nutritional recommendations for the management of sarcopenia. J Am Med Dir Assoc.11(6):391–6.