As expected, my encounter with an elderly adult, for client teaching purposes, was not without many opportunities to implement strategies that would help to promote her individual wellness. Although I had a pre-established relationship with my client prior to this interview, information that I had received from her helped me to recognize subtle areas of her life that could be focused on in order to bring about a greater quality of living. Her cooperation with this entire process reflected her willingness to explore, and implement, certain strategies that we had both been unaware of prior.
With nursing being a client-centered profession, the value of any data received from the client can provide an adequate foundation by which to implement care. This same interaction with my client helped me to identify several aspects of her life that should be focused on, in order to establish, and implement, teaching strategies directed towards promoting wellness.
Even though, by the age of 77, her life has become casually routine, the necessity for these subtle interventions became clearly evident, as I had listened intentively, and further reviewed my interview with her. Although her love of life, through humor, resonates through her demeanor, her physical condition still remains a reality that accompanies her age. As our interview reflects, oftentimes, she finds herself living in a body that is incapable of achieving the youthful goals that her mind would like to. For this reason, a noticeable degree of risk is inherent, and, should be addressed with concern.
At this stage of her life, with consideration given to her past health history, a continual risk for falls around her home is clearly evident. While she is 'set in her ways', there are still minor adjustments that can be implemented, that would, at the very least, draw an increased awareness towards her condition and the need to maintain a safe environment.
After a recent hip replacement surgery, followed by a few months of subsequent successful rehabilitation, a risk for falls will potentially always remain. For this reason, I provided for her an online printed out resource from the CDC/ National Center for Injury Prevention and Control. Included within this resource are many facts related to falls, as well as, things that seniors can do to help minimize this risk.
Even though I live with her, and care for her, prior to doing this exercise, I had very seldomly thought about things I could do to further help diminish her risk for falls. With the kitchen being her prime candidate for spending a majority of her time, an evident risk was the extremely poor lighting that she had become accustomed to working with over the years. This lighting, coupled with potential clutter, no-doubt posed a risk that could be remedied very easily. For this reason, I recruited a friend of mine to help me install a new overhead lighting system.
The combination of providing information to her, as well as implementing a tangible lighting system, were both welcomed with open arms-especially since she didn't have to pay for them. Both strategies helped to generate further awareness of her condition and what 'could happen' if she doesn't remain continually mindful of her behaviors. As a 'free-spirit', she oftentimes attempts to do things that she probably shouldn't do, such as, climbing to the top step of an upright ladder. She is aware of her limitations, but, with her youthful outlook on life, she attempts to push through them, and, in turn, sometimes jeopardizes her condition.
Because of my living with her, I am in a position where I can continuously monitor her during her engagement in daily activities. Prior to providing for her information, as well as, installing a new lighting system in her kitchen, she would have roughly one fall a week. Evaluation is ongoing, as I make it a priority to check on her frequently. Since the implementation of these strategies, she has not fallen.
In this particular situation, health teaching became very natural because of my inherent closeness with my Grandmother. Knowing what I know about her, my goal from the start was to not seem like I was essentially trying to 'change' her life, but rather encouraging her independence by empowering her to make changes for herself. I wanted to create a situation that was least invasive to her life and routine, as possible. Even still, I believe that my strengths lie in the fact that I genuinely care about her condition and, I don't want to see anything happen that could potentially worsen it. These subtle changes represented ways that could just help her to garner further awareness of her vulnerable condition, all while posing minimal threat to the daily routine that she has become accustomed to. Minimal effort was needed on her part, beyond reading the information that I had given to her, to accomplish a goal that, over time, could very well manifest into less hardship placed on herself, as well as, her family. Although I may not have realized it prior, injecting a little creativity into any situation could lead to a very positive response and outcomes for the client. The role of the nurse in implementing health teaching strategies can really lead to a lasting change/ improvement in a client's condition.
With consideration given to her risk for falls, as well as, her frequent inability to remember where she had placed items of value, I implemented a third strategy in an attempt to address those issues simultaneously. The use of a rolling cart has become something that she has felt increasingly comfortable using on a daily basis. Not only did I encourage her to utilize this cart as a safe haven for items that she does not want to loose (car keys, stamps for her letters, etc.), but, it has also provided a stabilizing force for her as she maneuvers around her house. By grasping the sides of it, she has found it easier to move beyond the kitchen and her living room. With her level of determination, it hasn't been uncommon to see her power tools on this cart. It has come to serve many purposes and was easily implemented into her daily routine.
Because of her oftentimes careless approach to her medication regime, having her medications available on her movable cart makes it easier for her to remember these very important things that she should do, that she would typically forget.
Even though I do care about her, my weakness from the start in this health teaching was that I automatically assumed that there probably wouldn't be anything I could do further to elicit an improvement for the better in her life. As I began interviewing her, this became a fun project and a collaborative effort between both of us to implement some strategies that we both knew she needed, but we had seldomly thought about. I admit, having lived with her for years aided greatly in both our being comfortable, and, I believe, gave an incredible advantage in proceeding. Pre-established trust made this an effortless activity, although, I have thought extensively about how I would respond to different situations regarding the elderly. Because no two people are alike, I do know that the participation that I received from my Grandmother may not be the same as what I receive from others. With my military background, I'm no stranger to flexibility, as well as, adapting to certain situations, given the cues that are given.
This activity taught me numerous things in regards to taking in all available data and attempting to address a given problem with consideration given to a client's entire condition. Certain variables may influence an intervention, and, only collecting as much data as possible, will I be able to adequately address those needs.
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