Course: NURS 2700 Health Promotion and the Role of the Professional Nurse

Course: NURS 2700 Health Promotion and the Role of the Professional Nurse

Title of Assignment: Health History/Wellness Assessment-Geriatric In-Home Functional Assessment

Competency Addressed:
• 7O: Discuss common social justice issues as they relate to vulnerable individuals, families, and communities.
Course Outcomes/Upon completion of this assignment, the student will:
• #1: Apply theories and concepts of social and cultural factors to provide prevention-based nursing care.
• #6: Conduct a health history and wellness assessment to identify risks and/or determinants of health.
• #7: Describe behavioral change techniques to promote health and manage illness.
• #9: Provide safe, holistic client-centered nursing care in promoting health across the lifespan.

PREPARATION MAKE SURE YOU HAVE 1 THROUGH 5 COVERED

1. Select an individual to interview:
• An elder male or female age 68 years or older, that is not related to the student
• Lives in his or her own home or apartment
• Single or married
• Suggestions: you may select a friend of one of your relatives, a neighbor, or a person related to one of your friends
• Select a time to interview – allow yourself at least two hours
2. Download, print and familiarize yourself with required assessments tools:
• Review assessment tools prior to going to your interview.
• Review demonstration videos at the following website:
https://consultgeri.org/tools/try-this-series

• You may choose to utilize additional resources for preparation, including but not limited to:
American Geriatrics Society website
http://www.americangeriatrics.org/about_us/who_we_are/
Healthy Aging website
http://www.healthinaging.org/

During your interview, you will use each tool to guide standardized assessments of various components of your chosen individual’s functional status. You may want to take notes on these assessment tools as you engage with your chosen elder in his/her home setting.

• Fulmer SPICES (Common Syndromes of the Elderly)
• Katz Index of Independence in ADLs (activities of daily living)
• Falls Risk
• Get Up and Go Test
• Geriatric Depression Scale
• Mini Mental Status Assessment

3. Develop a list of open-ended questions prior to the interview date (these questions should be designed to initiate conversation rather than elicit a yes or no response).

Topics/open-ended questions to consider:
• What is your cultural background and/or related preferences?
• How long have you lived in your home (or in this apartment, or in this complex etc.)?
• How long have you been married (or, how long have you lived alone)?
• Notice whether pets are a part of this elder’s life and ask questions about his/her experiences with animals.
• Work history: Were they employed outside the home? What kind of jobs or work did the elder engage in? Or, if the elder is currently employed, what is his or her job? What did/does he or she enjoy about the work? What challenges did/do they encounter in their work?
• Ask about volunteer activities: Where have they or do they volunteer? What were/are their responsibilities? What did/do they enjoy about volunteering?
• What things do you like to do for fun? Ask about social outings such as playing cards, going to church, meeting for breakfast with friends, going for walks, etc.

THE ASSIGNMENT

Use the guide below to assist you in completing the written assignment:

Data Collection Guide

Date of Interview: _____________________
Demographic Data:

Age: ______________
Gender: ___________
Lives alone? ________
Lives with:
Spouse? ________
Other? ________
Living Situation:
Own Home _________
Apartment _________
Assisted Living ______
Other _____________

General Medical History (questions to consider):
• Do you have a primary care provider (physician, nurse practitioner, physician assistant) whom you see on a regular basis?
• Do you have health care directive, or have you talked with a medical provider about advance directives?
• How often do you see your medical provider (physician, nurse practitioner, physician assistant)? When was your last medical appointment?
• Ask regarding medical history, recent surgeries, and medications including prescription and over-the-counter drugs. (You do not need to list specific names of medications rather ask if they take medications for the conditions that they report to you: For example: if they report having high blood pressure then ask if they take medication to control blood pressure.
• Ask about pain. When they experience pain, what helps to relieve the pain?
• Ask if the individual has a health care directive or knows about preparing a health care directive.
• Ask about alcohol use and smoking history.
• Ask about any problems with hearing, vision or dentition.
• Ask regarding cognitive problems you or the individual might be concerned about. Consider problems such as dementia, confusion, depression, anxiety, etc.
• Ask about any situations, incidents or medical diagnoses that occurred throughout your lifespan and have impacted you throughout your life or have surfaced in your later years.
• Have they ever received, or do they now receive home care services or community services such as: Meals on Wheels, Hartland Bus, Silver Sneakers, First Alert for seniors, etc.?
• Ask about safety home. Do they feel safe physically? Emotionally? Other?
• Are there any obstacles that may prevent your ability to receive quality healthcare?
• Social Justice: Social Justice in terms of the distribution of wealth, opportunities, and privileges within a society (Oxford Language, nd.). Look up the definition of social justice prior to completing the assignment. Include a source citation.

4. Complete this assignment by compiling the following information from the interview of your selected elder:
A. A written summary of information obtained from the Data Collection Guide listed above (One-Paragraph, do not rewrite each question with the client’s response following.)
B. Identify an area of this client’s current living situation that may actually or potentially jeopardize or impede their right to social justice related to meeting their healthcare needs.
• Explain your answer.
C. A written discussion of each standardized assessment tool used in your assessment; address the value of each tool (discussion of what evidence-based research finds regarding those standardized assessment tools), the reason or reasons each tool may be used, and a summary of your general findings from each tool. (One-two paragraphs per assessment tool.)

D. Summarize your assessment findings including a discussion of
• Potential or actual safety issues in the home of the elder you visited.
o Home Safety Checklist
• Your elder subject’s functional strengths, limitations, and potential risks.
• Actual or potential geriatric syndromes your elder subject may be experiencing or is at risk for experiencing. (These three bullets may be summarized in one-two paragraphs.)
E. Develop three prevention-based nursing interventions with rationales appropriate to the individual’s situation.
Interventions must focus on the following:
• Behavioral change techniques to promote health (See promotion/health determinants lecture.)
• Illness management. (See promotion/health determinants lecture.)
• Safety

5. Submit your completed assignment:
• Health History Wellness Assignment. This assignment should be double-spaced and have a cover page and 8-10pages
• Scan and submit the assessment tools used during your visit,
• You may communicate your findings in a narrative form.
• Use APA format to cite all references and resources used and; include a reference page. Site the assessment tools

Health History Wellness Assignment Checklist

Please utilize this checklist before submitting your paper. This will help to assure that you have met all requirements of this assignment.

Completed Assessments Scanned for upload to DropBox
☐Fulmer SPICES (Common Syndromes of the Elderly)
☐Katz Index of Independence in ADLs (activities of daily living)
☐Falls Efficacy Scale-International (FES-I)
☐Get Up and Go Test
☐Geriatric Depression Scale
☐Mini Mental Status Assessment

Make sure that your paper includes summaries of all of the following information:

☐Pertinent information from open-ended questions/Data Collection Guide
Pertinent information from general medical history
☐Situations, incidents or medical diagnoses that occurred throughout your lifespan and have
impacted you throughout your life or have surfaced in your later years.
☐How the client’s current living situation may actually or potentially jeopardize or impede
upon their right to social justice related to meeting their healthcare needs.
☐Your assessment findings and the value of the Fulmer SPICES
☐Your assessment findings and the value of the Katz Index of Independence in ADL’s
assessment.
☐Your assessment findings and the value of the Falls Efficacy Scale-International (FES-I)
☐Your assessment findings and the value of the Get Up and Go Test
☐Your assessment findings and the value of the Geriatric Depression Scale
☐Your assessment findings and the value of the Mini Mental Status Assessment
☐Actual or potential risk to social justice issues related to healthcare needs with clear rationale.
☐The individual’s potential or actual safety issues found using the Home Safety Checklist
☐The individual’s functional strengths, limitations, and/or potential risks and actual or
potential geriatric syndromes
☐Three nursing interventions with rationales:
• Behavioral change techniques to promote health
• Illness management.
• Safety
SUBMISSION

☐Please submit your typed assignment into the D2L Brightspace DropBox labeled
Health History Wellness Assignment.
☐Scan and submit the assessment tools used during your visit, into the D2L Brightspace
Dropbox labeled Health History Wellness Assignment.

Rubric: Health History/Wellness Assessment Geriatric In-Home Functional Assessment
Content Exemplary Proficient Developing Unacceptable Comments Points
6 – 5.47 5.46 – 5.1 5 – 4.68 4.67 – 0
Completion of Required Assessments

Completes all assessments with accuracy. (5.46 pts) Completes 5 of 6 assessments with some difficulty.

(5.1 pts) Completes 4 of 6 assessments with some difficulty. (5 pts) Completes 3 of 6 assessments with some difficulty.

(4.84 pts) Completes 2 of 6 assessments with some difficulty.

(4.68 pts) Completes 1 of 6 assessments with some difficulty.
Two or more assessments are not accurately completed and/or not completed at all.
5 – 4.6 4.59 – 4.25 4.24 – 3.9 3.89 – 0
Interpretation of
Assessment Data
Is able to thoroughly synthesize information gathered from all assessments.
Is able to synthesize assessment data with few gaps in information. Minimal synthesis of assessment data. Multiple gaps in information. Is unable to synthesize assessment data and/or missing this portion of assignment.
6 – 5.47 5.46 – 5.1 5 – 4.68 4.67 – 0
Summary of General Medical Data, Including health status across the lifespan
Clearly identifies general medical data and situations, incidents that occurred throughout your lifespan and lifelong effects. Identifies general medical data and situations, incidents that occurred throughout your lifespan but does not identify lifelong effects. Missing one component of medical data or situations, incidents that occurred throughout the lifespan.

Does not address general medical data and/or does not relate medical data to lifespan.
Content Exemplary Proficient Developing Unacceptable Comments Points
3 – 2.76 2.75 – 2.55 2.54 – 2.34 2.33 – 0
Social justice issues
Clearly describes actual or potential risk to social justice issues related to healthcare needs and provide a clear rationale. Includes description of actual or potential risk to social justice related to healthcare needs and/or does not provide clear rationale.

Does not clearly describe actual or potential risk to social justice related to healthcare needs and/or does not provide clear explanation. Minimal description of actual or potential risk to social justice related to healthcare needs and/or does not provide clear explanation as to how. Or omits either component.
7O: Discuss common social justice issues as they relate to vulnerable individuals, families, and communities.
*This competency must be met to pass the course.
5 – 4.6 4.59 – 4.25 4.24 – 3.9 3.89 – 0
Home Safety Checklist
Clearly evaluates home safety home safety and discusses the client’s functional strengths limitations and potential risks, and actual or potential geriatric syndromes. Evaluates home safety home safety but minimally discuss the client’s functional strengths limitations and potential risks, and
actual or potential geriatric syndromes.
Evaluates home safety but omits one or more of the following:
Functional strengths limitations and potential risks, and
actual or potential geriatric syndromes. Does not evaluate home safety and/or omits one or more of the following:
functional strengths limitations and potential risks, and actual or potential geriatric syndromes.

2 – – 0
Evidence-Based Support of Findings
Supports assessment findings utilizing evidenced-based resources (includes citations).

N/A
N/A Does not support ALL assessment findings utilizing evidenced-based resources.
Content Exemplary Proficient Developing Unacceptable Comments Points
6 – 5.47 5.46 – 5.1 5 – 4.68 4.67 – 0
Synthesis-Interventions
(Interventions based on client assessment data.)
Formulates 3 clearly articulated and effective interventions + rationales that include:
-A behavioral
change
technique
-Illness
management
-Safety
Formulates 3 interventions + rationales that include:
-A behavioral
change
technique
-Illness
management
-Safety Interventions + rationales do not correlate with assessment findings.
Omits one or more interventions and/or rationales and interventions do not correlate with client data.
3 – 2.76 2.75 – 2.55 2.54 – 2.34 2.33 – 0
Organization of Content Organization of content is clear, logical, and organized. Complete introduction, development, and conclusion of ideas.
No more than 10 total pages in length (Including cover page & reference list).
Content is clear and organized. Minimal areas lack development or transition between ideas. Minimal organization. Lack of transition between ideas. Content only able to follow with effort. Ideas do not flow. Organization of content is disorganized.
4 – 3.68 3.67 – 3.4 3.39- 3.12 3.11 – 0
APA/Mechanics Presentation has rare mechanical, grammatical, and APA errors.
(2 or less errors) Presentation has occasional mechanical, grammatical, and APA errors. Additional editing would have been helpful.
(3-4 errors)
Presentation needs improvement and attention to improve mechanical, grammatical, and/or APA format.
(5-6 errors) Presentation has significant mechanical, grammatical, and/or APA errors; risk for illegibility or plagiarism.
(> 6 errors)
Met Not Met Met/Not Met
Health Survey/Interview
Completes all components of assignment and meets required competencies. Does not complete all components of assignment and/or meet required competencies at Proficient level.

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