Running head: HEALTH PROMOTION PROJECT 1

Older Adult Health Promotion Project

Samantha Aitchison

Bon Secours Memorial College of Nursing

NUR 4113: Gerontological Concepts and Issues

Tamera Krukiel, NP

April 19, 2020

I pledge
HEALTH PROMOTION PROJECT 2

Older Adult Health Promotion Project

Assessment

I met with Mrs. J on the dates of March 7 and 14. She is a 67-year-old Black female

living in Chesterfield County, Virginia. She was very welcoming to me and was very pleasant to

me as her guest. I enjoyed speaking with her. She has been married for 35 years and lives with

her husband in a two-story home. They have one child together who does not live with them.

Mrs. J is currently an office manager and told me that she worked her way up from a dental

assistant position from her last practice. She told me I could address her by her first name, but I

did notice that she became uneasy if I got too close to her. So, I made sure at our meetings, that I

sat at least a foot away. English is her first language and she had no issues with reading. She is

near sighted which is easily corrected with glasses. She has no visual or speech impairments and

was pleasant in conversation. She has a vehicle and has no problems driving but I did offer to

come to her home for our interviews.

Her personal knowledge of her health is fair. She only goes to the doctor when she must, uses

home remedies and multi-vitamins, and goes for walk sometimes. She has a strong faith and is

very involved in her church. She is taking 25 mg every day of HCTZ for hypertension. Her

BMI is 28.3 and her favorite foods are soda and pizza. She has an uneventful medical/surgical

history but due to her age, BMI, and eating habits I want to make health a priority in her teaching

plan. We both discussed this, and the patient wants to learn about dental care and a healthier

lifestyle which includes diet and exercise. These topics relate to Healthy People 2020 with the

goal: “Improve health-related quality of life and well-being of individuals” (Healthy People

2020).
HEALTH PROMOTION PROJECT 3

Nursing Diagnosis

The nursing diagnosis appropriate for Mrs. J is Ineffective health management related to

family patter of healthcare as evidenced by failure to take action to reduce risk factors (Gulanick

& Myers, 2017). This diagnosis was chosen and important for this patient due to some deficits

in her nutritional habits and she needs assistance in reinforcing her exercise routine. Due to her

diagnosis of hypertension, it is essential that she makes these changes to improve her health to

where she may be able to discontinue her medication. The short-term outcome for Mrs. J will be

that she will verbalize an intention to follow a prescribed regimen by our final meeting. The

long-term outcome is for Mrs. J to demonstrate ongoing adherence to her treatment plan when I

place a follow up call in two weeks. This goal can be easily monitored by her family and/or

friends for accountability purposes after my two week check in .

Teaching Plan

In the creation of the teaching plan, the client was very enthusiastic which was very

promising. Her husband was not present at our meetings but she said that she would share the

teaching plan with him so he could help keep her focused. The Survey of Preferred Learning

Method(s) showed that Mrs. J is a visual learner so, I took this into consideration. I began with

her diet. We went into the kitchen and looked through the refrigerator and we discussed which

food she should discontinue, cut back on, or eat more of. She has an affinity for her sodas and

that is something we discussed her cutting back on. The hope is eventually, she can completely

remove them from her diet. According to Soo, “recently, the World Health Organization

recommended that added sugar should account for less than 10% of total daily energy intake”

(2018). Decreasing her soda intake would cut back on unnecessary calories. I had an interesting

idea and I used the computer and took her to Pinterest. We looked through healthy recipes and
HEALTH PROMOTION PROJECT 4

she told me which ones she would realistically enjoy eating. She can save those recipes so that

she can refer to them for shopping lists and the instructions. “Dietary education as a common and

well-developed method contributed to somehow improve older people’s healthy eating when

evaluated in terms of food intake, nutrition status, and eating habits” (Zhou et al., 2018). As a

visual learner, I also used the computer to take her to YouTube and we saved ten workout videos

that she could easily do at home either after work or on the weekends. We went outside together

for a short walk and she showed me the path she takes when she does go for her walks. Initially,

I could not think of the best way to incorporate the dental education but, I just decided that I

would sit with her while she made an appointment for a checkup with her dentist. I told her that

if she had a neighbor or friend that could accompany her, that would help to keep her motivated.

She had experience in the dental field, she has just gotten too busy and let her dental health

suffer. Mrs. J admitted she just needed someone to coax her to get back on track.

The short-term outcome of her verbalizing her prescribed regimen was met by the end of

our first meeting. This was a promising development. In this instance, because this outcome

was a verbal commitment, I was able to witness this goal personally. The plan to help the client

follow-up on long-term goals was that Mrs. J would have at least one accountability partner. She

named two before we ended our time together. She was to tell these two people her health goals

and they would check in with her at least once a week in order to see if she has been adhering to

the plan. The two people she designated were her husband and a friend from church.

Evaluation

The nursing outcomes identified for this patient were related to primary interventions.

We were focusing on prevention of poor health and a poor quality of life. It seemed to me that

the client was receptive to my teaching. She was engaged and asking plenty of questions which
HEALTH PROMOTION PROJECT 5

to me was an example of her interest and involvement. She verbalized how “easy and simple”

the recipes we located would be to prepare. She did say, “I hope they’re yummy!” She admitted

that she liked the fact that she could “just go to this YouTube and find all of these free videos to

watch!” She was excited about that and since it’s visual, she admitted that it would keep her

attention much better. The only thought I had as to how I could have done things differently is to

have her spouse involved. That way I would be certain, he would receive the information as I

intended it and he would understand the details of the plan. I wanted to leave a physical tool that

would her Mrs. J be compliant so, I located a special chart on the internet. It is called an

Adherence Chart which would allow her to keep track of her goals each day. I told her to hang it

on her refrigerator so that it would be visible regularly and it would motivate her to make better

meal choices and exercise.

Summary

This was such an insightful experience. There is so much to learn in our regular

interactions with different people. Mrs. J opened my mind to a different point of view regarding

health, life, and education. Those differences are not wrong, they are just different. As a nursing

student, it is important that I encounter these discussions now because I will encounter them on a

regular basis within the patient population. I was a bit intimidated in being a teacher to someone

older than me, but she was very welcoming and open to what I had to share with her. There is

something to be said for being an educator as nurse. As I have these assignments, I see the

importance of this role to the benefit of the community. It is the core of what we do. We teach

patients about preventative measures, their treatments, and any disease process they could be

currently experiencing.
HEALTH PROMOTION PROJECT 6

References

Gulanick, M., & Myers, J. L. (2017). Nursing care plans: diagnoses, interventions, & outcomes.
St. Louis, MO: Mosby, an imprint of Elsevier Inc.
Older Adults. (n.d.). Retrieved from https://www.healthypeople.gov/2020/topics-
objectives/topic/older-adults
Soo Lim. (2018). Eating a Balanced Diet: A Healthy Life through a Balanced Diet in the Age of
Longevity. Journal of Obesity & Metabolic Syndrome, 27(1), 39–45.
https://doi.org/10.7570/jomes.2018.27.1.39
Transfitblog. (2014, March 5). adherence chart - " Blog. Retrieved from
https://www.transfitathens.com/transfitblog/tag/adherence chart
Zhou, X., Perez-Cueto, F. J. A., Santos, Q. D., Monteleone, E., Giboreau, A., Appleton, K. M.,
… Hartwell, H. (2018, January 26). A Systematic Review of Behavioural Interventions
Promoting Healthy Eating among Older People. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5852704/