Medical Diagnosis, Theory Of Ageing, Physiology Of Ageing, Primary Health Services, Strategies And Interventions For Dementia, Oral Hygiene, Pain, Nursing Care Plan Based On Clinical Reasoning Cycle - Essay.

Medical diagnosis — using the information you have been provided with describe the persons past medical history. Include the impact that this past medical history may/will have on the person. Theory of ageing— using the information you have been provided with and by doing further research determine which theory of ageing you believe is most appropriate for this person. Provide justification for your response. Physiology of ageing— using the information you have been provided with, explain the physiology of ageing and how it relates to this person's disease process Primary health services— identify which primary health services you believe would be appropriate for this person.

Justify your response. You must identify at least two (2) primary health services that are appropriate for this person. Strategies and Interventions for dementia/challenging behaviours — describe at least four (4) strategies or interventions that you may be able to utilised to assist you to care for an individual with dementia. Ensure that you have linked this back to the person in the case study (what behaviours have you identified in the case study that would need to be managed?). Include communication strategies in your answer. Oral hygiene — using the information you have been provided with, identify why this person may be at risk for not having their oral hygiene needs met. What strategies could be implemented to ensure that this person's oral hygiene needs are met? Pain — using the information you have been provided with, identify how you would determine if this person was in pain. What may cause this person pain? How would you manage this person's pain? 

Complementary therapies — using the information provide identify any complementary therapies that you think this person may benefit from. Justify your response. 

Nursing care plan, based on the clinical reasoning cycle Look, collect, process, decide, plan, act, evaluate and reflect. 
Your nursing care plan must include:

A) Two (2) actual problems/issues

B) Two (2) potential problems/issues 

The information on the patient shows that eighty nine years old Miss Alice Jones has been going through social isolation. Her past medical histories reveal that she had been diagnosed with myocardial infract which she was diagnosed about 10 years ago simultaneously with hypertension. Miss Jones was also diagnosed with osteoarthritis which occurred in the right knee. Additionally she was also experiencing depression and anxiety which had been diagnosed about a period of two years. It was also reported that recently she had been diagnosed with Alzheimer’s dementia along with the prevalence of urinary incontinence.  

The theory of ageing refers to the process of ageing as a psychological process. According to this theory, focus is given on the significance of the social activity that is ongoing. This theory also puts forward that the concept of self that is related to the roles of the individual might be not that harmful if the individual is able to maintain the roles such as the familial roles, or the recreational roles in addition to the roles of the community and the volunteer (Eliopoulos, 2013).

The physiology of ageing for this patient can be seen especially in terms of cardiovascular problems which might have occurred mainly as a result of the slowing down of the autonomic nervous response. In addition to this there is a cardiovascular function which is required in the healthy older adults. This led to the problem in the patient Miss Jones who as a result of this had developed Myocardial infract. Physiology of ageing also associated with the neurosensory problems which is associated with the loss of the neurons that is associated with the spinal cord and the brain. In this case there is also a loss of the neural dendrites which is responsible for reducing the amount of synaptic transmission. Often it can be seen that depression is one of the reasons behind impairment of the synaptic activity. This is the main cause behind the development of Alzheimar’s disease (Scott-Warren & Maguire, 2017).

The primary health care services that needs to be provided to the Miss Alice Jones involves mainly the inpatient care which involves the acute standard inpatient care along with the acute intensive inpatient care, the follow up in patient care and the long term inpatient care. The patient also requires the medical rescue service along with the emergency service. The medical rescue service refers to the health care service which is contacted using the emergency contacts (Macdonald, 2013).

Theory of Ageing

The interventions for dementia includes the pharmacological interventions which can also be referred to as the drug interventions which are available in order to manage the Alzheimer’s disease. The other interventions include the non-pharmacological interventions which include the cognitive stimulation therapy (CST), the reminiscence therapy, validation therapy and aromatherapy (Gilhooly et al., 2016).

The oral hygiene for patients with Alzheimer’s disease involve the health professionals instructing the patients to use different types of toothbrushes. The patients should also be instructed to floss regularly and be aware of any kind of significant mouth pain (Zenthöfer et al., 2014).

In patients suffering for dementia, there are chances of experiencing neuro-pathological changes which has an effect on the medical pain system. Pain can be assessed through the utilization of the pain assessment in advanced dementia scale (PAINAD). The scale involves the aspects like the breathing, the negative vocalization, the facial expression, the body language, and finally consolability. Considering the conditions the scale can be measured which involves the different symptoms (Hadjistavropoulos et al., 2014).

Her past medical histories reveal that she had been diagnosed with myocardial infract which she was diagnosed about 10 years ago simultaneously with hypertension. Miss Jones was also diagnosed with osteoarthritis which occurred in the right knee. Additionally she was also experiencing depression and anxiety which had been diagnosed about a period of two years. It was also reported that recently she had been diagnosed with Alzheimer’s dementia along with the prevalence of urinary incontinence.  

The patient had been experiencing cardiovascular problems which might have occurred mainly as a result of the slowing down of the autonomic nervous response. In addition to this there is a cardiovascular function which is required in the healthy older adults. This led to the problem in the patient Miss Jones who as a result of this had developed Myocardial infract.

Problems were also associated with the neurosensory disturbances which were associated with the loss of the neurons that is in turn related to the spinal cord and the brain. In this case there is also a loss of the neural dendrites which is responsible for reducing the amount of synaptic transmission. Often it can be seen that depression is one of the reasons behind impairment of the synaptic activity. This is the main cause behind the development of Alzheimer’s disease

The smart goals related to care for dementia includes that the client will be able to maintain the physical care with lesser assistance within a period of two weeks of intervention. The long term goal might involve the participation of the patient in several activities through the nurse and patient social interaction (Vandervoort et al., 2014).

The problems that the patient is facing currently involves the increasing pain in her knee along with the problems of fall.

The patient is able to participate in the activities by avoiding the risk of fall and knee pain. Additionally the patient is able to groom oneself by using minimal assistance (van der Steen et al., 2014).

While working with this patient I have understood that I should be more careful with the patient since she is suffering from chances of fall. I also need to identify the possible impacts of my professional practise.

References:

Eliopoulos, C. (2013). Gerontological nursing. Lippincott Williams & Wilkins.

Gilhooly, K. J., Gilhooly, M. L. M., Sullivan, M. P., McIntyre, A., Wilson, L., Harding, E., ... & Crutch, S. (2016). A meta-review of stress, coping and interventions in dementia and dementia caregiving. BMC geriatrics, 16(1), 106.

Hadjistavropoulos, T., Herr, K., Prkachin, K. M., Craig, K. D., Gibson, S. J., Lukas, A., & Smith, J. H. (2014). Pain assessment in elderly adults with dementia. The Lancet Neurology, 13(12), 1216-1227.

Macdonald, J. J. (2013). Primary health care: medicine in its place. Routledge.

Scott-Warren, V., & Maguire, S. (2017). Physiology of ageing. Anaesthesia & Intensive Care Medicine, 18(1), 52-54.

van der Steen, J. T., van Soest-Poortvliet, M. C., Hallie-Heierman, M., Onwuteaka-Philipsen, B. D., Deliens, L., de Boer, M. E., ... & de Vet, H. C. (2014). Factors associated with initiation of advance care planning in dementia: a systematic review. Journal of Alzheimer's Disease, 40(3), 743-757.

Vandervoort, A., Houttekier, D., Van den Block, L., van der Steen, J. T., Vander Stichele, R., & Deliens, L. (2014). Advance care planning and physician orders in nursing home residents with dementia: a nationwide retrospective study among professional caregivers and relatives. Journal of pain and symptom management, 47(2), 245-256.

Zenthöfer, A., Schröder, J., Cabrera, T., Rammelsberg, P., & Hassel, A. J. (2014). Comparison of oral health among older people with and without dementia. Community dental health, 31(1), 27-31.