Running Head: SENIOR PROMOTION HEALTH PROJECT 1

Senior Promotion Health Project

Bon Secours Memorial College of Nursing

Gerontology NUR4113

Bethany Porter

4/15/2017
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Senior Promotion Health Project

For this assignment, I interviewed a 65 year-old male in relatively good health who

still works and has minimal deficits. Hes married with three adult children, is somewhat

active, has no allergies, no active medical conditions, minimal surgical history, and

considers himself to be in good health. He is 6 feet tall and weighs 234lbs, with a BMI of

31.7, which is considered obese. In addition to the provided assessment tools, I included

the Pittsburgh Sleep Quality Index. He has a history of difficulty sleeping (currently

treated with Ambien) and uses a C-PAP machine for sleep apnea.

When assessing the client, he seemed very aware of his weight and expressed a

desire to develop a healthier lifestyle. He stated that the biggest hurdle to losing weight is

simply breaking a lifetime of poor eating habits. Based on this information, the nursing

diagnosis for this client is readiness for weight management, related to an unhealthy

BMI, as evidenced by the clients eagerness to make healthy habits (Gulanick & Meyers,

2017).

I selected this diagnosis because it was the most pressing of his assessment data,

and because someone in his age group could develop other complications secondary to

obesity (diabetes mellitus, hypertension, etc). Some short-term outcomes could be an

improved diet and a more active lifestyle, so we talked about what this might look like

for him. Watching his portion sizes, his sugar intake, and the time he eats (ie no more

bed-time snacks) are all small changes that can make a big difference in his weight over

time. We also picked an appropriate exercise goal for him; he used to be an avid biker,

and expressed an interest in making it part of his daily routine again.

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The long-term goal for this client was weight loss enough to put him in a healthy

range for his age and height. The client thought the goal of losing 34lbs was attainable,

and hopes to reach his goal by the end of the year. By working together to find

interventions that were reasonable for his lifestyle and age, the client felt motivated and

even excited to make some changes. I provided him with a segment from the CDC

website that listed causes and consequences of adult obesity. This information helped

make him more aware of the possible harm he could do to his body in the long run.

As mentioned above, the client and I spent some time discussing realistic ways he

could reach his goal. By being more aware of what and how much he puts into his body,

he can start to make some positive changes in lifestyle. For instance, someone in his age

range should be eating more fiber, protein, vitamins and minerals (Touhy & Jett, 2016).

We also discussed exercise; he made the goal to be in the habit of biking 3 days a week

by the time summer started in June.

Ive become more aware how rapidly moving through patient education can be

confusing and frustrating for older adults, so I would want be mindful of my pace

(Engelke, Schub & Pravikoff, 2016). My client, fortunately, is pretty sharp and using

special teaching tools or techniques wasnt needed. Because the client seemed open to

talking about being overweight, we reviewed the different ways in which obesity can

negatively affect the body. Abdominal obesity (carrying large amounts of weight in the

abdominal area) puts the client at a much greater risk for cardiovascular disease, coronary

artery disease, hypertension, diabetes type II, and general physical limitations (Marcel &

Pravikoff, 2016). He was very receptive to my providing statistical data and general

information about his condition and possible outcomes.

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When followed up with on a later date, the client reported that he had had some

success with his new eating plan. He was still working on cutting out sweets, but is

motivated and will continue to work at it. He also informed me that his wife started a new

low-carbohydrate diet, and that it had been helping him too. We discussed methods to

help him stay on track with his eating habits, and he described an app he was going to

download that could keep track of caloric intake and track your steps. Hes also going to

work with his wife to have accountability with his goal of better eating. Hopefully these

interventions will assist him in reaching his long-term goal of weight loss. In working

with him to make better habits and positive lifestyle changes, it promotes the main goal

of Healthy People 2020 for older adults by promoting better health, function, and quality

of life.

While working with this client, we were able to establish primary outcomes

(education about preventing further complications from obesity), secondary outcomes

(screening tools) and tertiary outcomes (setting realistic and attainable goals with

interventions to help him be successful). Because of my clients age (just turned 65 in

January) and high level of independence, he was very receptive to the whole process and

enjoyed the teaching. Because he has minimal deficits, many of the screening tools didnt

necessarily apply to him. In the future, I may have done a bit more research ahead of time

to find screening tools that were more applicable to him. I didnt realize until meeting

with him that some of the assessment tools (ie Katz ADL) were more appropriate for a

patient with more deficits.

Regardless, it was a good experience and I enjoyed the opportunity to provide

patient teaching and care to someone in the geriatric population. The client stated how
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much he got out of the experience. He and I both learned a lot and hopefully the changes

will be beneficial for him in the long run.

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References

Engelke, Z., Schub, T., & Pravikoff, D. (2016). Patient Education: Teaching the Older

Adult. CINAHL Nursing Guide, 1-8.

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

outcomes. St. Louis, MO: Mosby, an imprint of Elsevier Inc.

Marcel, C., & Pravikoff, D. (2016). Obesity in Adults. CINAHL - Nursing Guide.

Touhy, T. A., & Jett, K. F. (2016). Ebersole & Hess' toward healthy aging: human needs

& nursing response. St. Louis, MO: Elsevier.