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Health Assessment

Elizabeth Brackett Day

Unit 6

I did a health assessment for a 68 year old women named Sylvia. Sylvia is seeking help eating healthier and adding more activity into her life. She is afraid that her age and some of her past health issues are going to stand in the way of her reaching her health goal she has set for herself. That health goal is to simply lose 5-10lbs and add more activity to her daily life.

PAR-Q/Health Status:

When I assessed Sylvias PAR-Q, she answered yes to a few of the questions. She complained about having chest pain in the past month even when not doing physical activity, but also when doing physical activity. We will discuss this further later on. Also, she is taking blood pressure medication. I think (after further evaluation which we will discuss later) Sylvia is cleared to partake in a health and fitness plan.

General Medical History:

Sylvias medical history is pretty common for someone of her age. She has had knee surgery in the past 5 years and a little over a year ago she had a valve replaced in her heart. She feels that she is able to get around well and doesnt rely on anyone else to help her in her day to day life.

Medication:

Sylvia is on a few different types of medications. She did not have her medication on her at the time of our meeting, so she did not know the exact dosage amount. She takes Lipitor for high cholesterol, Zaroxolyn for high blood pressure, and an anticoagulant medication that she couldnt remember the name of. Its a blood thinning medication meant for people who have a

mechanical valve in their heart. All three are daily medications. She also takes a One-a-Day multi vitamin for seniors.

Risk Factors and Precautions

Sylvia is cleared to participate in normal daily activity and low impact exercises. With her knee replacement and heart valve replacement, and also her age, I wouldnt suggest anything to strenuous. Her high blood pressure is controlled with the medication listed above and she takes a blood thinning medication as well to help prevent blood clots.

Even at age 67, she is still able to move and bend with quite a bit of ease. Her mention of chest pain while doing (and not doing on occasion) physical activity is a minor concern. I feel that the pain is directly related to the heart valve replacement she had done about a year ago. Id still recommend airing on the side of caution, but no history of stroke or heart attacks tells me she is still in very good health for an elderly woman.

Health and Lifestyle Behaviors

Sylvia is pretty social and enjoys getting out with her friends. She plays bingo once a week, enjoys gardening and canning her vegetables from her garden. Sylvia also attends church every Wednesday and Sunday and participates in a womens group at her church that often does bake sales. She has 3 grand children and 1 great grand child who also help keep her busy. She babysits her great grandchild for a few hours every month on her own, and is still able to keep up with the busy toddler (as she proudly told me.)

Nutrition:

Sylvia believes her diet and nutrition status to be pretty healthy. She has a lot of fresh vegetables in her daily diet as her garden produces quite an abundance in the spring and summer. She cans and freezes the extras so she can always have home grown, organic, vegetables all year long. She doesnt eat red meat except on very rare occasions and eats white fish or chicken at lunch and dinner. She told me she eats plenty of fruits, oatmeal, and peanut butter. She does love to bake and has quite a sweet tooth. She doesnt use any sort of fake (as she called it) sugar or butter. She just doesnt trust the imitation food like that and still drinks whole milk most the time. She told me her granddaughter had spoke to her about trying almond milk, so Sylvia wanted to know a little more about incorporating that in her diet.

Assessment Results

Sylvia did a few of the functional testing recommended for older adults. She was able to do 16 chair stands, 10 arm curls, and she also wanted to do a 1-mile walk on a treadmill. She did this at her daughters house (even though I suggested she try something a little different) but she timed herself and completed the 1-mile walk in 24 minutes, which is actually not too bad. The chair stands show good lower body strength and the arm curls showed that she needs a little improvement with upper body strength.

Body Composition:

Sylvias height is 64 inches and her weight is 149lbs. This gives her a body mass index (BMI) of 26.4. On a normal scale, this is considered overweight. However, some doctors believe

that for the elderly, having a BMI between 25-27 is healthy and can help prevent osteoporosis. While this hasnt been determined yet to be factual, its not been proven to be false either. I do not see Sylvia as overweight, and she doesnt feel that she is either. She does, however, wish to lose 5-10lbs.

Readiness for Change:

In the Readiness for Change model, Sylvia is in stage 4. She is ready to make the changes she needs to lead a healthy lifestyle that she can follow and stay focused on. Since she is somewhat active already and eats fairly healthy, I dont think the following recommendations for her will be difficult for Sylvia to follow.

Motivational Strategies/Techniques/Recommendations:

For Sylvia, I have a few ideas. She expressed to me she wants to lose 5-10lbs and increase her daily activity. I think that what would be best for Sylvia would be to start going on more walks. She enjoyed her 1-mile walk she tried on her daughters treadmill, so I think if she tried to take a walk after lunch or dinner (or both) at least three times a week, this would be a great start. I dont think her diet needs too much improvement, but she does enjoy taste testing her baking, so I would suggest limiting sweets to something just as a once in a while treat. I want her to bring in a few more fruits into her diet, as well. Overall, I think Sylvia is doing great at taking care of her mental health as well as her physical health. I want her to stay on track and Id like to see her join a local YMCA or even a gym. A lot of these places have special classes just for seniors. I think she might enjoy a step class or even a yoga or Pilates class. She has good lower body strength but she needs to improve her upper body strength. Yoga is a good place to

start this. Its low impact and helps tone muscles. Using light weights (5lbs, 8lbs) a few times a week just doing basic reps of 10-12 reps/3 sets will help increase her upper body strength.

Conclusion:

Sylvia was great to work with and I think she is going to be just fine following her new plan and staying active. As long as she keeps up with her physical activities and watches her sugar, shes going to be live a healthy life for the rest of her days-which will hopefully be many more!

References:

Franks, B. and Hawley, E. (2007). The Fitness Professionals Handbook. 5th Edition. Published by Human Kinetics.

http://www.livestrong.com/article/336966-body-mass-index-older-people/

http://www.samhsa.gov/co-occurring/topics/training/change.aspx