A comprehensive assessment provides a foundation for individualized care and planning for the older adult. The findings can aid both in identifying risks as well as preventing problems which could jeopardize the wellness state of the person. Older adults experience a variety of unique physical, mental, and social changes and problems that often co-exist and are interrelated. A comprehensive assessment requires the nurse to understand these changes and to be able to identify problems which are unique to the personal presentation of aging. This paper is to be a representation of problem identification, analysis, interpretation, and intervention as specific to the older adult assessment. It should provide explanation, clarification, and illustration of the older person through integration of theory, use of assessment tools, and observational skills. Support your findings and conclusions using evidenced-based research, primarily from professional nursing journals and textbooks. OUTCOMES: 1. Describe factors that contribute to an adaptive, healthy lifestyle of this older adult. 2. Identify factors that promote or inhibit the older adults independence. 3. Discuss the characteristics of successful aging for an older adult in relationship to the older adults predicted aging process. 4. Identify appropriate theories of aging for this older adult and discuss the relevance to this persons aging process. 5. Discuss the pharmacologic and nutritional considerations specific to the needs of this older adult as identified by your assessment. 6. Describe the nursing care initiatives given to the older adult you assessed based on your findings. PROCESS: 1. Compare physical changes in the client with age-related expected changes A. Gather historical health information B. Observe for physical changes and/or problems C. Identify the persons physical level of FUNCTIONALITY by: (1) Identifying his/her normal daily routine (2) Performing a functional assessment using an appropriate functional assessment tool 2 (3) Discussing the results of the functional assessment (4) Discussing the adaptations made based on your assessment D. Identify any geriatric syndromes present in this client. E. Note any information that could put the client at risk. Discuss the nursing interventions, adaptations, and recommendations you made based on your findings. 2. Complete a nutritional overview of this client. A. Identify any nutritional inadequacies observed or described by the client (. elimination problems, weight loss, osteoporosis, etc.) B. Discuss use of food supplements, eating habits, etc. C. Note any information that could put the client at risk D. Identify recommended nursing interventions and goals you made specific to the client. 3. Discuss the pharmacologic status of the client. A. Complete a drug data survey and identify at risk situations and polypharmacy problems. B. Identify educational needs based upon pharmacodynamics, pharmacotherapeutics, and client compliance C. Specify recommended nursing interventions and goals related to the findings and the clients needs. 4. Analyze the clients health insurance plan to determine coverage and premiums for services. A. Review the health insurance plan for this person. If the individual has Medicare and a supplemental plan, concentrate on the supplemental plan. You can address how this plan supplements Medicare coverage. B. Research the plan for types of coverage provided and its cost. C. Determine if prescription coverage is provided by the plan and include the following: (1) How much does it cost? (2) What types of medications are covered? (3) Does it meet the guidelines for Medicare Part D? D. Identify the pros and cons of the plan. E. Discuss the thoughts of the client about the plan. F. Discuss if you would or would not recommend this plan. 5. Identify an appropriate theory of aging for this client. A. Select at least one biological and one psychosocial theory of aging which best describes the aging process for this client. Other theories may be included if they apply to this individual. B. Discuss why you feel these theories are appropriate for this client. 3 6. Discuss the interrelationship of social function and aging as it relates to this client. A. Describe the clients environment by including the following: (1) living arrangements (2) proximity or access to essential services (3) level of safety B. Describe the clients social situation by including: (1) the impact of economics upon their present situation (housing, transportation, physical and safety needs, and health status) (2) the capacity for self-maintenance (3) the type, frequency, and quality of social participation C. Note any specific problems or tendencies which would place the client at risk, including any geriatric syndromes. D. Identify recommended nursing interventions and goals you made specific to the client. Be sure to include any community settings which might benefit the individual or caregiver/family member such as a specific service offered by the Area Agency on Aging or the setting you visited as part of the community assessment requirement. 7. Assess the family system. A. Establish what constitutes family for this client. Identify the family type using the Family Apgar Score or another instrument of your choice. B. Determine the primary and secondary roles for each family member. C. Define the dynamics of the family system by: (1) identifying communication patterns and emotional climate (2) explaining the impact of decision making for the client (3) articulating the relationship of the family with the community D. List any at risk situations or problems which need to be addressed E. Identify recommended nursing interventions and goals you made specific to the client. 8. Perform an assessment of cognitive function. A. Use a cognitive assessment tool to identify any deficits significant for the client B. Compare your clients general cognitive behavior with normal changes or behavior for the older adult C. Discuss any adaptations needed based on your findings D. Identify recommended nursing interventions and goals you made specific to the client. 9. Format A. Write the paper using APA format (6th ed.), including title page, body of paper, and references. B. References shall reflect the materials discussed and shall include textbooks, professional journals, and internet sources for concepts and theoretical data. 4 C. References are to be from at least five (5) different sources, three (3) of which must be professional journal publications. D. Place assessment tools in an appendix. 10. Style A. The paper shall reflect a professional level of writing, presentation of materials and assessments, and referencing. B. Flow of the paper should be clear and follow the areas listed above. C. Use of headers is encouraged for each section. D. Type paper using 12 point font, Times New Roman. 11. Total pages for this paper shall be at least six (6) excluding title page, references and appendices. Five (5) points will be deducted for each page in deficit of the required number. 12. Five (5) points will be deducted for each day the paper is late. 13. Failure to submit a paper will result in a grade of zero (0) for this project, resulting in a grade of F. This constitutes failure of the course. Please Note: It is the students responsibility to contact the older client living in the community to assist in doing this project. The student shall explain the project to the client and have them sign the release form. This form should be submitted with the paper, or mailed to the professor. The student shall review and prepare all data collection materials independently to complete this project.