A plan of care for the patient

A plan of care for the patient

Introduction

This paper will be a case study about an older woman above the age of 65 years. I will conduct a therapeutic assessment interview using assessments such as the Geriatric Depression Scale, Fulmer Spices Assessment, Patient stress questionnaire, and the mini-mental status exam. I will focus on the patient’s demographics, significant times, hardship and losses, personal strengths, coping skills, theoretical perspective, assessment, as well as the necessary interventions. The assessment will also include a plan of care for the patient.

Demographics

In this paper, the therapeutic assessment will be carried out on Mrs. K. She was born in October 1940. She was the firstborn in their family of three. Mrs. K. was born in Dallas, Texas, where she was raised in her childhood. She studied nursing at the University of Dallas and later worked for several hospitals in Dallas, Texas, until she retired at the age of 55. Mrs. K. was married and had four kids. Her major work was as a nurse was to identify symptoms of the patients, administering of medication by taking measures in their scope of practice, offer other guidelines for alleviation of symptoms, and being in collaboration with other medical practitioners to make the best out of the patients’ families understanding, comfort and adaptation. Mrs. K. was a very hardworking woman who loved her career because she loves helping people to resume back to their normal health conditions. She used to enjoy spending more time with the sick in the medical wards giving the patients motivation and hope that all will be well. She was a source of happiness to many who came across her in the hospital because she was a very charismatic person with professionalism, and most patients loved her work.

Significant times

Mrs. K. was an icon in the hospitals that she served in Dallas, Texas, because everyone who came across her always wanted to be attended by her all the time a complication comes up. Not only was she recognized for her charisma but also, she was helping the needy patients by paying their hospital bills and made follow-ups until the patient was in a stable condition. Mrs. K. also loved educating her patients on various self-management techniques that would help the patient manage themselves when in a critical condition. She enjoyed every bit of these moments to the fullest, and she states that those were the best moments of her life.

Hardships and losses

Adults who are older have gone through various losses, and they have also faced a lot of hardship than most of the younger people. Mrs. K. grew from a humble background, and her family went through a lot of struggles to meet their basic requirements. Mrs. K. was the firstborn, meaning she went through a lot of hardships before becoming a professional nurse. She used to work extra hours after school so that her family could get enough meals and money for basic needs, which was hard and tiresome for her, but she had no other choice. Mrs. K. depended on the money she got from the side jobs to pay for her school fees and her sibling’s fees, but it could not be enough. After high school, Mrs. K. got sponsorship to study nursing at the University of Dallas, Texas. She was married by his colleague, who was a surgeon in the health care facility they were working with, and they had four children. Mrs. K.’s husband passed on in 1970, which affected her very much, and it was difficult for her to move on since the husband meant everything to her, and she had no idea of how to raise the big family by herself even though she had a job. After a few months, her father passed on, and this really broke her heart to the point of giving up.

At this point, she felt the pain of her loved ones, but that was not the end; her mother and her two sons were traveling to upcountry on August 19, 2008, when they had an accident that killed all of them instantly. Mrs. K. knew that was the end of her world, and she felt so disappointed with the cruelty of death. She always wished that she could have died on behalf of her children since she was aging. All her kids and her mother had never had any health condition, and the sons were grown men at the time since one was an assistant professor at a University in Norway, and the one was a doctor. Mrs. K. stated that losing money is refundable, but losing your family is like being snatched your heart because that love is irreplaceable.

Personal Strengths

When Mrs. K. was queried about her personal strengths, she smiled after a long moment of sadness and sorrow that was written all over the face. She breathed deeply in and out and said that prayers kept her living. In addition, she said that every time she felt troubled or lifeless, she used to pray, and all her troubles went away, and that’s how she has been surviving the challenges. She felt to be a very holy woman and very peaceful. This did not stop Mrs. K. from helping others or giving hope to the hopeless, although she was frustrated about her own life. She kept being selfless, and also, she supported the remaining children in their endeavors and kept on keeping the spirit of praying. During her free time, she still used to go and share with the admitted patients in a nearby hospital from her home, and this made her happier.

She brought her mother-in-law to live with her so that she could care for her. She did not want her mother-in-law to go into a nursing home. She chose to provide care at her own house. Her compassion is also seen through the times she would go back to Kansas to care for her own ailing mother. She never went long without going back home to make sure her mother was doing well. Her compassion also shined through when caring for her dying daughter. She flew across the country with no questions and did what she could to care for the family. She knew she was needed more there than anywhere else. She also drives her friend to the doctor every week for an appointment. She feels that she needs to care for others while she is still able. She is very selfless when caring for her family and friends. Mrs. K. has kept a good reputation in society since she was born, and that is the reason why she was very disappointed with losing part of her family.

Healthy vs. non-healthy coping skills

When Mrs. K. was asked about the coping skills she has gone through in her life, she started with healthy coping skills. She stated that her biggest coping skill is praying to God to help her overcome all her challenges and always believing that there is no other supreme being than God. In addition, she states that helping the needy people is a blessing from God, and she cannot go against it because she gives, the more receives. Mrs. K stated that an individual can lack at a given point of life but will never lack forever. She also loves sharing her knowledge, and she looks happy to have been of assistance to many throughout her life, and it makes her feel complete. Sharing is caring as she concluded. The non-healthy coping skills Mrs. K. has always been avoiding is stress and drug abuse. She states that the abuse of drugs makes the problem constant because when an individual is on the abuse of drugs, the individual cannot solve the problem since the body is not at its normal function, thus escalating the problems. Mrs. K. advised individuals in the same situation to avoid the abuse of drugs since it wastes time, money, and energy for many who are thinking they are solving the problems out, but they are making it worse.

Three pieces of advice to my younger self

Mrs. K. bluffed, when she was queried about the three main pieces of advice, and she could offer to her younger self. She started by stating that she would be making decisions by herself since her late husband used to make most of the major decisions for her and her family. Mrs. K. state that people who are self-oriented are able to overcome challenges easier since they can manage themselves. The other advice was to put a stronger faith in God because she thought that she diminished her faith when her husband and father died, and she thinks that was the reason she started giving up in life. She said that she felt like she questioned God too much about her faith. Finally, she stated that she would have created more time to spend with her loved ones because she feels that she never had enough of her family.

Assessments

When Mrs. K. was evaluated on a geriatric scale, she scored a zero. In addition, she said that she had been depressed when the major of her family passed, but she moved on after a few weeks, and she has not been depressed since then. According to Greenburg (2012), when evaluating Mrs. K., she did not display any sign of being in depression at any given time. When carrying out the SPICES evaluation, although she is older, Mrs. K. has good stability; thus, she has very minimal falls. Mrs. K. was a nurse, and this means that she is very aware of the falls that come with aging, and that is why she was very keen on her surrounding environment (Fulmer, 2001). She also underwent a stress test, which she did not attain a score since she had a feeling that it was in G0d’s favor that she was alive. When it came to the mini-mental exam, she had a score of 28 because she answered all the questions accordingly. Mrs. K. stated that she had had normal sleep, and she enjoyed her day to day life that she enjoyed with her grandchildren and her two elder kids. She was also used to carrying lunch for patients in nearby hospitals and spent most of the afternoon educating the elderly.

Erickson’s ego integrity vs. despair

There are various stages of life as per Erickson’s ego integrity versus despair perspective. Clark (2015) asserts that the final stage of Erickson’s approach is a psychosocial stage of life, which is a reflection period, mostly for individuals over 65 years. Individuals at this stage tend to lock back on their lives as well as evaluate the feeling of life they led. Individuals in the despair phase are always not happy, their hearts are full of regrets and they feel guilty of wasting their lives. Erickson’s ego integrity stage is about the individuals who are happy, and they have a feeling that they led a satisfying and happy life as well as they have fewer regrets. Mrs. K. is in the stage of ego integrity since she has been feeling satisfied with her life and she has a few regrets of losing her parents and two children. She feels that it was God’s plan to make her stronger, and she does not regret anything. Mrs. K. always feels happy, and if she does not look happy, she is looking for something to make her happy. She is a woman with extra charisma and happiness in her soul.

Nursing Care Plan

Key nursing diagnosis for Mrs. K regards patients’ falls. In the past period, she had two falls, which could be attributed to her old age. Patients fall is a common diagnosis for older adults, and it the duty of nurses to ensure that they come up with interventions to reduce cases of patients fall. Some of the nursing interventions that could apply to Mrs. K’s case is assessing the environment to make sure it is safe, put up enough lighting to avoid falls, and other precautionary measures such as signs, thus ensuring that she avoid such cases of falls and associated injuries.

Conclusion

Based on the case study of Mrs. K, the patient has had a healthy, happy life, and along with one, although due to her old age, she has become subjected to patient falls, which affects her health. Nevertheless, the patient is fully motivated and believes that she can overcome her issues with the help of family and friends. Nursing interventions are helpful in such situations, although the assistance and support of family and friends can be very helpful to a patient, especially elderly patients, and help in their recovery process. The nursing plan is effective since it helps the patient to deal with the illness and come up with the interventions that will aid the patient in recovering. In this case, the patient case about falls, which could be solved by ensuring that the nurses ensure that they assess the safety of a patient’s environment and ensure that it is ultimately safe.