Running Head: HEALTH PROMOTION PROJECT 1

Senior Health Promotion Project

Serena Blalock

Bon Secours Memorial College of Nursing

Tamera Krukiel, RN, MSN, ANP-BC, PMHNP-BC

Gerontological Concepts and Issues NUR 4113

November 9, 2017

I pledge the honor code.

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The purpose of this paper is to review the health promotion project that was conducted on

a client that was over the age of sixty-five. My client was a seventy-four-year-old female whom

was in relatively good health. She struggled with hypertension that happened to run in her family

on both her mother and father’s side. The patient was anxious because of the changes that are

occurring in her life as they are going through the process of moving from their family home.

The patient also states that she needed to get back to her weight watchers program, so that it

would help maintain her cholesterol problem for which she is currently taking medications. The

goal of this project was to identify any learning needs or teaching that needed to be done for the

client. Overall this paper will discuss the promotion of health in my senior patient.

The client was asked an array of questions so that I could determine what areas needed to

be worked on so that teaching could occur. In some respects, I found this part the most

interesting because I had the opportunity to get to know the client better as a person. All of the

assessment tools determined that overall my client is healthy for the age of seventy-four. In

relation to Healthy People 2020, we want to aim to improve the health of this client so that her

quality of live may also benefit. I decided to try to find ways to reduce her anxiety so that her

busy life wouldn’t have so much effect on making her anxious. If the client is able to reduce her

anxiety then it will help with her blood pressure problems as well. Engaging in prayer not only in

the morning but also any time that she just need to calm herself would be a good idea. Along

with prayer, I wanted the client to be open to trying meditation. I also wanted to implement a

healthier diet for my patient. Due to her cholesterol problems and high blood pressure, it would

be to her benefit to eat less fatty foods. Getting back on track with her weight watchers and

eating healthier will help manage her cholesterol and overall make her feel better so that she has

more energy to do the things that she loves, like playing with the grandchildren.
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The diagnosis that I chose for my client was “Anxiety related to the stress of moving as

evidenced by expressed concerns about changes in life events” (Gulanick & Myers, 2014, p. 16).

I believe that this is the most important issue for the client because while she has medications for

all three of her main problems, I feel that this could be effecting her the worst at this time. I

planned some coping mechanisms for her short-term goals. I suggested prayer, meditation,

reading scripture or a book, or deep breathing when the patient was feeling anxious. I told the

patient to write down what she found to work best for her when the anxiety tried to take control.

Her time frame for this goal was a week. Then I would be able to see if she had utilized any of

the suggested coping mechanisms. Her long-term goal was for the client to remove herself from

any stressful situation so that it would have less effect on making her so anxious. When removed

from the situation take time to reflect and journal on what brought on the anxiety. The time

frame for this long-term goal will be assessed when I go to see her again on Christmas day of

this year. This will give her enough time to try out her coping mechanism and see if she is

capable of removing herself from stressful situations.

This plan of reducing anxiety for the patient was mutually discussed because she said that

sometimes she doesn’t have time for other things that she would enjoy doing because there is just

so much going on in her life. She agreed that trying to implement more quiet moments in her

day, when she begins to feel overwhelmed, would benefit her well-being. I used the assessment

to determine the additional tool that needed to be used in addition to the four tools that had to be

done on every client. I completed the preferred learning method survey with the client and came

to find out that the preferred method of learning for the client was kinesthetic. For the mini-

mental exam (1975), the patient scored a 28/30 which was a normal score. The only part that she

found difficult was the memory recall of the three words that I had asked her to repeat earlier.
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The geriatric depression scale (2012), proved that my client is not depressed because her score

was a zero. When performing the Katz ADL scale (2012), the client was determined to be a very

independent individual. The SPICES (2012) scale was also used and it showed no evidence of

sleep disorders, problem eating, incontinence, confusion, evidence of falls or skin breakdown.

The only other scale that I found to be relevant would be the Epworth Sleepiness Scale (2012)

because the client doesn’t have as much energy as she would like and wishes that she got more

sleep at night. Her score for the Epworth Sleepiness Scale was an 8 which was an average score.

Based on the assessment tools that were available to utilize, I still believe that the client’s

anxiety is what needs to be addressed. I taught the client to take a moment to herself and practice

prayer if she felt necessary. Usually the client has a devotion and prayer in the morning but I

informed her that prayer when needed would also benefit her anxiety. I tried to get her to open

up to the idea of meditation. She was hesitant at first but when I informed her that it was just her

taking time to calm herself and make sense of her situations then she was more willing to try it.

According to Hoge et al., 2013, mindful meditation has been shown to decrease the amount of

anxiety symptoms and also improve stress within people whom suffer from general anxiety. I

believe that this article also helped in her decision to try out meditation. The article by Beck &

Clark, 1997, that I gave her discussed how writing down the situations that gave her anxiety

would be a form of reflective journaling. The process of writing down the situations that brought

anxiety to her would allow the both of us to understand why she became anxious. From the

reflective journaling, we can work through ways to manage her anxiety based on the situation.

No teaching aids were necessary because the only aid that the client had were her glasses which

she wears at all times during the day.

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Through my evaluations that occurred on my last visit in November, I came to the

conclusion that the patient had benefitted from properly using her coping mechanisms. She wrote

down throughout the week the different coping mechanisms that she utilized. She found that a

quick meditation was what worked for her best. If she decided to go into prayer then she thought

that it took too much time because she got caught up in taking with God. I measured her short-

term goal outcome through her notes that she took on how often and which coping mechanism

that she utilized. The goal was met because the client was effectively able to calm herself

through meditation. As for the long-term goal, it will be more difficult to obtain. In order to be

able to completely take oneself out of a situation, the person must show great will power to walk

away. This goal I plan to revisit at Christmas when I go to visit. The client would rather not let

others know how anxious she gets in a situation because that gives her more anxiety. I believe

with patience the client will be able to remove herself from stressful situations so that she may

then come back with a clear head in her own time.

The nursing outcomes can be seen as tertiary prevention because she is trying to make the

best of dealing with her anxiety. This was a very successful teaching project because the client

was able to explore new ways of coping with her anxiety. The client stated, “I would have never

thought that taking a deep breath and a moment to myself could be so calming in stressful

situations.” This is proof that the client did reap the benefits of the teaching that was done here.

Because there were not many problems related to my patient, I believe that nothing could be

done differently. The goal was successfully achieved.

In conclusion, I found this project to be rewarding. I was able to help one of my loved

ones’ deal with her anxiety in a way that she hadn’t really contemplated before. She found

reflective journaling and meditation to be a helpful way to deal with her anxiety. As a nurse-
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teacher, she was very proud of the advice that I was able to give her. I felt a sense of

accomplishment, because I was able to teach my client a new coping mechanism that she will be

able to use in her years to come. I learned a lot about my client that I had never know before and

I believe that I was able to create a stronger bond between the client and nurse relationship.
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Reference

Beck, A. T., & Clark, D. A. (1997). An information processing model of anxiety: Automatic and

strategic processes. Behaviour Research and Therapy, 35(1), 49-58. doi:10.1016/s0005-

7967(96)00069-1

Folstein, M., Folstein, S., & McHugh, P. (1975). Mini-mental state exam.

Fulmer, T., & Wallace, M. (2012). Fulmer SPICES: an overall assessment tool for older adults.

Retrieved from https://consultgeri.org/try-this/general-assessment/issue-1.pdf

Greenberg, S. A. (2012). The geriatric depression scale. Retrieved from

https://consultgeri.org/try-this/general-assessment/issue-4.pdf

Gulanick, M., & Myers, J. L. (2014). Nursing care plans: Diagnoses, interventions, and

outcomes (8th ed., p. 16). Philadelphia, PA: Elsevier/Mosby.

Hoge, E. A., Bui, E., Marques, L., Metcalf, C. A., Morris, L. K., Robinaugh, D. J., …

Simon, N. M. (2013). Randomized controlled trial of mindfulness meditation for

generalized anxiety disorder. The Journal of Clinical Psychiatry, 74(08), 786-792.

doi:10.4088/jcp.12m08083

Older adults | healthy people 2020. (n.d.). Retrieved from

https://www.healthypeople.gov/2020/topics-objectives/topic/older-adults

Shelkey, M., & Wallace, M. (2012). Katz index of independence in activities of daily living.

Retrieved from https://consultgeri.org/try-this/general-assessment/issue-2.pdf

Smyth, C. (2012). The epworth sleepiness scale. Retrieved from https://consultgeri.org/try-

this/general-assessment/issue-6.2.pdf