Comment [TM1]: No running head -2pts

Aging Module II Kimberley Horton Texas Womans University

Table of Contentsp. 2 Nutrition Assignment..pp. 3-4 Sexuality Assignment....pp. 5-6 Transitions and Role Changes Assignment....pp. 7-8 Consultant Questions....p. 9-11

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Nutrition Assignment So, how many dependent patients can one nurse aide feed during one meal time? 2. Now, after completing the assignment, how many dependent patients can one nurse aide feed during one meal time? 1. Start time: 16:00 End time: 16:30

Wow. This assignment really opened my eyes on how lucky I am to be independent from help. My boyfriend played the role of the nurse and I was the dependent patient. We went to a park for a so called, picnic. I wanted to be in an open environment so I would get the full effect of how it feels to not only be fed in public but how humiliating it can be if not properly taken care of in a professional manner. Poor physical or mental health, social isolation, alcoholism, limited functional ability, poverty, and polypharmacy are the major risk factors for malnutrition in older adults (Jarvis, 2008). So, when a person is completely dependent on a nurse, it is so important that they are cared for properly to prevent malnutrition or other physical ailments. My boyfriend tried his best not to get food all over me and was very patient. This is not a typical situation, sadly. Ive seen my share of medical staff who have been easily frustrated while feeding patients. I think I was more frustrated with him than he was with me. He wanted to talk about his day, etc. while I was sitting there starving. His dad called so he stopped feeding me to talk to him for a few minutes. I almost gave up on the whole feeding situation but it made me think of how patients must feel when their nurse gets distracted and makes them wait on him/her for something that isnt as important. It took thirty minutes for me to be fed a sandwich, chips, and a banana. Normally, it would take me 10-15 minutes to eat but it was a lot longer due to someone else performing the task. I felt extremely helpless when I had mayo on my face and could not wipe it off. It drives me crazy to have something on my face and I had to sit there knowing it was there and not being able to do anything. I wanted to cry or even scream. I never realized how much stress is on the patient P. 3
Comment [TM2]: How sweet.

and the caregiver for such a simple task. I will definitely take this into consideration the next time I have the opportunity to feed a patient. I feel that this assignment is a great way for a nurse to learn how frustrating this situation can be and learn how to be more patient and sympathetic toward the patient during feedings. When clients need assistance with eating, its important to protect the clients safety, independence, and dignity (Potter & Perry, 2009). I feel to give your complete, undivided attention you can only feed one patient at a time, safely. I would have like for you to tell me more about safety, how

can you help try to prevent a patient who has difficulty swallowing or chewing from aspirating?-2 pts Potter, P., Perry, A. (2009). Fundamentals of Nursing (7th ed.). p.1110. Canada: Elsevier, Inc. Jarvis, C. (2008). Physical Examination & Health Assessment (5th ed.). p. 195. Canada: Elsevier, Inc.

P. 4 Sexuality Assignment Mrs. Collins, age 72, is about to be dismissed to home after being in the hospital for a broken R hip. She is walking with a walker and is feeling good. She confides in you that she is worried about sex when she gets home. She and her husband of 46 years still enjoy sexual intercourse. She wants to know if she can have sex and what she should do or not do. She tells you that she is just too uncomfortable to talk to her physician about this matter. What will you tell her? Review the brochure (sex after hip surgery.htm) information also provided. This is obviously not the only information you need to discuss with your client. What other information is important for your client to know? What else are you going to discuss? Include your response with Module II. I would advise Mrs. Collins that it is a very common concern among not only people of her age but of all patients that have recently had hip breaks, to be concerned with having sexual intercourse. She needs to know that it is okay for her and her husband to be able to have intercourse. She is the only one that can determine what is comfortable and what is not. If she feels uncomfortable in a certain position then she needs to reposition to where she feels comfortable. Many people express a concern about a dislocation or damage to the prosthesis while having intercourse after a hip replacement. After 10-12 weeks the pseudocapsule has reformed around the hip joint, and the muscles typically have been rehabilitated so that the risk of a dislocation or damage to the prosthesis is negligible. The positions that need to be avoided until she is healed are: hip flexion, hip adduction, and internal rotation. These positions may cause pain and discomfort. Good communication is critical for the couple to maintain a healthy sex life. She needs to remember that once you break your hip you are at a higher risk for breaking it again. The home needs to be comfortable and have a safe environment. The hallways need to be light and cleared of clutter. The rugs need to be slip resistant or tacked in place to keep her from falling. Anything that can cause Mrs. Collins to fall needs to be taken care of, to prevent future falls. Also, I would express the importance for her to talk with her doctor about her concerns about sexual intercourse. Sensitive attention to the maintenance of sexual function and identity is significant in
Comment [TM3]: Good especially about any new pain following intercourse.

P. 5 promoting wellness (Eliopoulos, 2010). He may have other concerns about different positions or the dos and do nots. To help increase her bone density Mrs. Collins needs to take vitamins and supplements, including bisphosphonates for osteoporosis, calcium, vitamin D, or starting estrogen to help strengthen her bones. Eliopoulos, C. (2010). Gerontological Nursing (7th ed.). p. 141. Philadelphia: Wolters Kluwer Health|Lippincott Williams & Wilkens.
Mont, M., Tankersley, W., Hungerford, D. Young, M., OYang, B., Steins, S. (2007). In: Rehabilitation Secrets. About Joints, pp. 330-337.

P. 6 Transitions and Role Changes Assignment

To begin with, watch the movie, Iris (with Judy Dench and Kate Winslow), then post your answers, to the questions below, on discussion board. Iris is a very interesting movie that encompasses many of the issues that can face the geriatric population. For this assignment, I would like for you to focus on analyzing the role changes of the aging individual and the impact on the aging family. I want you to define the adaptation needs anticipated in aging related to transitions and roles changes. Include the loss of spouse role, role reversal and work/retirement. Discuss the relationships related to belonging, family relationships and group & community affiliations. As a gerontological nurse, today, in this society, what are some of things you could have done to change the outcomes in anticipation of their adaptation needs? In the movie Iris, Iris Murdoch, the main character struggles with the ailments of Alzheimers. In the beginning, there are subtle changes such as short term memory loss and seems to day dream quite a bit. She frequently and spontaneously looses track of thought and forgets what she is doing or talking about. She forgets that she is a writer, which she has been all of her life. As time continues, she begins to forget peoples names, where she is, and things that were common to her. She even starts to forget how to pronounce simple words. Her husband John, suffers right along with her during the different stages of Alzheimers. Consistency in care is important; thus, the patient benefits from interaction with only a limited number of people (Eliopoulos, 2010). You can tell that her husband John loves her dearly. He does the best that he can to take care of Iris. He treats her with respect and love even when its hard for him to show and do. After time has passed, he becomes more easily aggravated with the situation but still does what he has to do to take care of Iris. Iris begins to sundown and it makes it even harder for him to take care of her. Both Iris and John are losing their minds. This is a very sad movie but depicts the reality of Alzheimers and the trouble that the families must endure. As the movie progresses, John really shows how caring and how much in love he is toward Iris. He is such a valuable tool to Iris. He becomes her babysitter more than her husband. I cant imagine how hard Alzheimers must be for families, for someone that you love to no longer recognize you. Her

P. 7 brain scans show less and less brain matter each time. She no longer remembers her friend Janet or Morris. John begins to resent Iris due to the stress that comes with taking care of her. He pulls through and keeps his word to keep on loving her. Alzheimers affects not only the ones that love the person but the person as well. In the end he had to make the hardest choice of his life and put Iris in a home for his and her safety. As a gerontological nurse, I would express to the family that Alzheimers is quite common and that there are homes and support groups available for families. One in every three families in the United States is affected by the disease (Monahan et al., 2007). I would make sure the family has the best experience possible when in my care. I would empathize with them on how Alzheimers can be a struggle. I would try to help them make their life as easy as possible and let them know of all of their options available to them. They would need to know how to safeguard their homes for the person in their care. The families need support to get through this time and need to know they are not alone. Reference: Eliopoulos, C. (2010). Gerontological Nursing (7th ed.). p. 413. Philadelphia: Wolters Kluwer Health|Lippincott Williams & Wilkens. Monahan, F., Sands, J., Neighbors, M., Marek, J. (2007). Phipps Medical-Surgical Nursing (8th ed.). p. 23. Missouri: Mosby| Elsevier.
Comment [TM4]: Good analysis of the movie.

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Consultant Questions Nutrition: Ask your consultant to tell you about grocery stores during her/his childhood? What did they buy and how much did it cost? Ask your consultant what he or she thinks about taking vitamins. How about any other nutritional supplement? What kind of milk does he or she drink? Walter remembered little about the grocery stores when he was younger. He did remember that the stores had the essentials but were very limited in groceries, nothing like todays options. There were very few vegetables at the grocery store. The only vegetables that were available were the ones that were in season. If you wanted vegetables you had to grow them in your own garden. Food was a lot cheaper back then but less selection. From what he remembers the grocery prices were as follows: bread was 0.20 cents a loaf, sausage or beef was 0.25 cents a lb., bacon was 0.29 cents a lb., fajitas (trash meat at the time) was 0.19 cents a lb., potatoes were 0.10 cents a lb., onions were 0.05-0.10 cents a lb., beer was $19 a keg, case of beer was $5 and gasoline at the grocery store was 0.15 cents a gallon. Walter never took vitamins growing up. Nobody really knew about them. There wasnt research like there is now. The only vitamin he would ever take would be vitamin C and only if he were sick. He cant remember hearing about any other vitamin. They werent important like they are now. He drinks vitamin D milk, full fat. Walter only remembers there being one type of milk. It came straight from the dairy cows and delivered to the front door by the milk man. The milk man would come 2-3 times a week depending on how much milk you wanted. It was usually delivered in a gallon.
Comment [TM5]: I havent heard about the milk man in a while.

Sexuality: Ask your consultant what dating was like when he or she was a teenager. Where did they go? What kinds of activities did they attend? How old were they when they started dating? Dating was very different back then. Walter stated that if you took someone out during the

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week you had to be in by 9-10pm and during the weekend would be between 11pm-12am, at the very latest. The summer dating schedule was the same. We would go to the drive-in and see picture shows or go parking, haha. At the drive-in we would get a coke, hamburger, and/or a milk shake. They would go to the drive-in on the weekend, drive down main streetMain Street, go parking, go roller skating. The roller skating rink would only come in town for 2-3 weeks during the summer. The people would come set up the wooden floors and it would be covered by a big tent. Also, if there were dances he would attend. Walter didnt start dating until the 8th grade. Every date had to be chaperoned until you got your own car. His first car was a 1950 ford coupe during his freshman year of high school. He seemed to reflect on this time with fond memories and smiles.

Wellness and Health Promotion: Ask your consultant what kinds of things he or she does to stay healthy? Do your consultants remember anyone talking about getting exercise when they were young? Walter says he drinks beer to stay in shape, now. He says he does, budweiserBudweiser presses. He said this is how him and his friends stay in shape nowadays. Walter said, I cant do much exercise now due to neuropathy of my feet. He likes to go hunting, fishing, play golf, and plant his garden when he feels well enough. He doesnt remember anyone really emphasizing how important exercise was back then. He remembers one health program that the president presented and you would get a certificate if you were able to meet the goal. You had to do a PT program where you did as many sit-ups and push-ups as possible. He did 275+ sit-ups and doesnt remember how many push-ups. He said he couldnt walk for the next week from being so sore. Most of the guys played some type of sport back then. That is how he stayed in shape. He played football, basketball, track, baseball, and played golf. All of the stores would shut down on Friday nights for the football games; it was the highlight of everyones life. He said, as you get older, you realize how important your health is and try to do as much as you are
Comment [TM6]: Hows that working out for him? Is this something to be concerned about?

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physically capable of doing.

Social Isolation: What kinds of social interaction opportunities does your consultant have? How does your consultant keep up with friends? Does your consultant have any long-term friends that they still contact? We have high school reunions every 5 years now. He said they do them more often now due to people starting to die. Walter plays on a pool league and golfs with friends when they have the time or a chance. Within the last 10 years Walter and his friends have been using email to keep in touch. He keeps in touch with 8-10 people from his high school class. He talks to 2 people at least once a week by phone. His class only had 60 people in it, so everyone was pretty close to each other. He said he felt and still feels like he has 5 brothers even though he only has one.
Comment [TM7]: That is a good idea.

Once again, I have enjoyed reading about your consultant. I can tell that you are enjoying getting to know your consultant more. On your final module, I would like to see more comments from you on how this information impact your career as a nurse? -2 pts. Overall nice job. Grade 56 points

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