NSG 4067 Week 3 Discussion-Wellness in the Elderly
A holistic approach to nursing integrates the mind, body, and spirit with the patient’s physical and mental capabilities to promote optimal wellness and treat the whole person (Miller, 2019). For my week two project, I interviewed my 87-year-old grandfather, R.L. He had a long career as a Certified Registered Nurse Anesthetist and retired twelve years ago. He has a history of myocardial infarction, atrial fibrillation, hypertension, elevated cholesterol, congestive heart failure, ventricular arrhythmias, dual implantable cardioverter-defibrillator placement, and three cardiac ablations. He was relatively healthy until ten years ago.
Although he attempts to maintain a positive outlook on life, he has bouts of depression from feeling socially isolated and a decreased energy level. He walks his dog daily, which is an excellent form of exercise, but he could benefit even more by participating in an exercise program at our local wellness center. A wellness coach at the center can educate him on the importance of exercise and develop an individualized exercise program for him. Older adults might be more willing to comply with an exercise program if they recognize the physical and mental health benefits they can attain from them. Furthermore, they may be more likely to participate in exercise programs if they are personalized to their specific functional abilities (Miller, 2019). This could assist him in increasing his energy level as well as give him an additional social outlet to reduce his depression. Another way to reduce his depression and increase his functional mobility is yoga. Yoga is an exercise that involves the mind, body, and spirit. It has been proven to reduce anxiety, depression, and pain. Also, yoga has improved sleep and overall quality of life (Hamrick et al., 2017). Our local wellness center has a yoga program. R.L. can become involved with yoga to decrease his depression and improve his mobility. Education will be provided on the benefits of yoga. A yoga instructor from the program can further educate him and develop a tailored plan to meet his needs.
R.L. has impaired gate and balance deficits, which can increase his fall risk. This is especially concerning as he wishes to remain independent for as long as possible. Older people’s most prevalent fall risk factors are impaired balance, weakness, polypharmacy drug usage, and environmental hazards (Tiefenbachová & Zeleníková, 2019). He uses a cane to walk long distances but uses no walking aids in his home. A referral by his primary care provider for home physical therapy would be beneficial. He can be assessed for his gait and balance, and physical therapy can recommend a walking aid that is appropriate for him to utilize inside and outside his home. R.L. takes a small number of cardiac medications, which are necessary for his condition. Educational material will be provided to him on potential side effects and interactions. He has environmental hazards in his home that increase his risk for falls. My grandmother loves to throw rugs, and they are everywhere in their home.
NSG 4067 Week 3 Discussion-Wellness in the Elderly
R.L. and my grandmother can be educated on removing environmental hazards such as throw rugs. An alternative solution can be presented, such as stabilizing mats under rugs in their home to prevent shifting while walking on them. An educational pamphlet will be given to R.L. on the safety hazards in his home, along with emergency phone numbers in case of a fall (Tiefenbachová & Zeleníková, 2019). Also, he needs railings in his home’s front and back entrances and visible markings on his raised thresholds. A leaflet will be provided with information on the specific modifications he needs to make and how to install them. This will include a list of local contractors installing these items (Tiefenbachová & Zeleníková, 2019).
R.L. has maintained a healthy diet all his life. However, as he and my grandmother become less able to cook all their meals, they have turned to more processed foods high in sodium. My local hospital’s dieticians can provide educational materials on reduced sodium and heart-healthy diets.
R.L. will also be shown how to regularly check food labels for sodium content. Sodium levels should be less than 1500 mg per day. With his diagnosis of congestive heart failure, this can reduce his fluid retention and increase his energy levels. As a result, he will have an increased ability to participate in his activities of daily living (Miller, 2019).
All of the interventions in R.L.’s wellness program will significantly enhance his overall quality of life. Determinants of optimal living and well-being include exercise, social interaction, and relationship development (Miller, 2019). Physical activity will increase his mobility and social interaction; therefore, it will enhance his functionality, reduce depression, and grow a positive mindset. HProper mobility assistance and a reduction of environmental hazards will increase his functional ability and decrease his risk for falls (Tiefenbachová & Zeleníková, 2019). Also, dietary modifications will increase his energy level. All these aspects work together to promote the enhancement of the mind, body, and spirit encompassed in a holistic approach (Miller, 2019). R.L. will have a greater chance of living his life to the fullest and achieve maximum independence despite his health conditions and limitations.
References
Hamrick, I., Mross, P., Nate, C., & Smith, P. D. (2017). Yoga’s effect on falls in rural, older adults. Complementary Therapies in Medicine, 35, 57-63. doi:http://dx.doi.org.su.idm.oclc.org/10.1016/j.ctim.2017.09.007
Miller, C.A. (2019). Nursing for wellness in older adults (8th ed.). [VitalSource Digital Version]. Philadelphia, PA: Wolters Kluwer.
Tiefenbachová, P., & Zeleníková, R. (2019). The effect of educational intervention by a nurse on home environmental risk factors for falls. Central European Journal of Nursing and Midwifery, 10(2), 1019-1025. doi:http://dx.doi.org.su.idm.oclc.org/10.15452/CEJNM.2019.10.0009
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Question 
NSG 4067 Week 3 Discussion-Wellness in the Elderly
Develop a wellness program with a holistic approach for the older adult you identified in your week 2
Use resources available in your community.
Discuss how this approach will provide an optimum level of well-being.