1

Age-Related Changes and Health Issues in an Elderly Patient: A Case Study

Emmanuel Prospero Tejido

Post Graduate Nursing Diploma, Selc College

NGER: Care of older adults – Gerontology

Nicky Karimpineth John

March 31, 2024

 2

Case Study Analysis

Overview

Mr. Johnson, a 78-year-old retired schoolteacher, resides in a two-story house in a suburban

neighborhood. He has been managing multiple chronic conditions, including osteoarthritis and

peripheral neuropathy, which have significantly impacted his mobility and ability to perform

activities of daily living.

His mobility is limited, uses assistive devices (cane, walker). This case is a typical example of

the challenges faced by the elderly population, particularly those with chronic conditions that

affect mobility. His determination to maintain independence, despite his physical limitations, is

commendable. However, it also highlights the importance of a comprehensive and coordinated

care plan to ensure his safety and improve his quality of life.

Problem Statement

Mr. Johnson is experiencing a progressive decline in mobility due to his chronic conditions.

This has impacted his ability to perform daily activities and engage in social activities, leading to

feelings of frustration and isolation. These includes:

Mobility Challenges: Mr. Johnson's osteoarthritis and peripheral neuropathy have

significantly impacted his mobility, making it difficult for him to navigate stairs and move

around his home independently.

 3

Social Isolation: Due to his mobility limitations, Mr. Johnson struggles with feelings of

frustration and isolation as he is unable to engage in social activities and visit friends and family

outside the home.

Desire for Independence: Despite his physical limitations, Mr. Johnson is determined to

maintain his independence and continue living in his own home.

Interventions

The healthcare team's comprehensive care plan for Mr. Johnson includes:

Physical Therapy: This aims to improve his strength and flexibility, thereby enhancing his

mobility.

Home Modifications: Changes to his home environment are made to enhance accessibility

and safety.

Home Health Aides: These professionals assist with activities requiring mobility assistance.

Outcomes

With the appropriate interventions in place, Mr. Johnson experiences gradual improvement in

his mobility and confidence. He is able to maintain his independence and continue living

comfortably in his own home while managing his mobility challenges effectively.

Age-Related Changes in Mr. Johnson's Case

Mr. Johnson's case presents several age-related changes that have significant impacts on his

health and well-being. These changes include:

 4

Osteoarthritis: This is a degenerative joint disease that often occurs with age. It causes pain

and stiffness in the joints, which can limit mobility and make daily activities difficult.

Peripheral Neuropathy: This condition, often associated with aging, affects the peripheral

nerves, causing weakness, numbness, and pain, usually in the hands and feet. It can significantly

impact mobility and balance.

Decreased Mobility: Age-related muscle weakness and joint pain can lead to decreased

mobility, making it challenging for older adults to navigate stairs and move around

independently.

Social Isolation: Limited mobility can lead to social isolation, as it becomes more difficult to

engage in social activities and visit friends and family outside the home.

Impact on Health and Well-being

The age-related changes experienced by Mr. Johnson have several impacts on his health and

well-being:

Physical Health: The physical pain and discomfort caused by osteoarthritis and peripheral

neuropathy can significantly impact Mr. Johnson's physical health.

Mental Health: The frustration and isolation resulting from limited mobility can lead to

feelings of loneliness and depression, impacting Mr. Johnson's mental health.

Quality of Life: The combined effects of physical pain, decreased mobility, and social

isolation can significantly reduce Mr. Johnson's quality of life.

 5

Nursing Assessments

Nursing assessments are crucial in identifying the needs of a patient and formulating a care

plan. For Mr. Johnson, the following assessments would be appropriate:

Physical Assessment: This includes assessing Mr. Johnson's mobility, strength, flexibility, and

pain levels. It also involves evaluating his use of assistive devices like the cane and walker.

Home Safety Assessment: This involves evaluating Mr. Johnson's home environment for

potential hazards and identifying modifications that could improve his safety and mobility.

Psychosocial Assessment: This involves assessing Mr. Johnson's emotional well-being,

including feelings of frustration and isolation, and his social support network.

Functional Assessment: This involves assessing Mr. Johnson's ability to perform activities of

daily living independently.

Nursing Interventions for Mr. Johnson

Based on the assessments, the following interventions could be implemented:

Physical Therapy: This could help improve Mr. Johnson's strength, flexibility, and overall

mobility. It could also help manage his pain.

Home Modifications: This could include installing grab bars in the bathroom, using a stairlift,

and rearranging furniture to create clear pathways.

Psychosocial Support: This could involve providing emotional support, encouraging social

interaction, and referring Mr. Johnson to support groups or counseling services.

 6

Home Health Aide Assistance: This could involve aiding with activities of daily living that

Mr. Johnson struggles with due to his mobility issues.

Education: This could involve teaching Mr. Johnson about his conditions, how to use his

assistive devices properly, and strategies to manage his symptoms.

Ethical Considerations in Caring for Older Adults

When caring for older adults like Mr. Johnson, several ethical considerations come into play:

Respect for Autonomy: This principle emphasizes the patient's right to make decisions about

their own care. In Mr. Johnson's case, his desire to maintain independence and live in his own

home should be respected and incorporated into his care plan.

Beneficence and Non-Maleficence: These principles require healthcare providers to act in the

best interest of the patient and avoid causing harm. The healthcare team should ensure that the

interventions they propose are beneficial and do not pose unnecessary risks to Mr. Johnson.

Justice: This principle requires fair distribution of healthcare resources. Mr. Johnson should

have access to the necessary resources to manage his conditions effectively.

Confidentiality: Healthcare providers must respect Mr. Johnson's privacy and keep his

medical information confidential.

Cultural Sensitivity in Caring for Older Adults

Cultural sensitivity is also crucial in providing care to older adults like Mr. Johnson. The

following are to be considered:

 7

Understanding Cultural Background: Healthcare providers should understand Mr. Johnson's

cultural background and how it might influence his health beliefs and behaviors.

Communication: Providers should communicate effectively with Mr. Johnson, considering

any language barriers or cultural nuances.

Respect for Cultural Practices: Providers should respect any cultural practices or beliefs that

Mr. Johnson may have, as long as they do not interfere with his health.

Comprehensive Care Plan for Mr. Johnson

This comprehensive care plan aims to address Mr. Johnson's individual needs and preferences,

with the ultimate goal of improving his quality of life and maintaining his independence.

1. Physical Therapy

Physical therapy is crucial for Mr. Johnson to improve his strength, flexibility, and overall

mobility. A physical therapist can provide exercises tailored to his specific needs and conditions.

Goal: Improve strength, flexibility, and mobility

Action Plan: Regular sessions with a physical therapist (2-3 times per week)

2. Home Modifications

Modifying Mr. Johnson's home can enhance his safety and accessibility. This could include

installing grab bars, ramps, stairlifts, and ensuring clear pathways.

Goal: Enhance safety and accessibility in the home

 8

Action Plan: Consult with an occupational therapist or a home modification expert to assess

the home and recommend necessary modifications.

3. Home Health Aides

Home health aides can assist Mr. Johnson with activities that require mobility assistance, such

as bathing, dressing, and meal preparation.

Goal: Assist with activities of daily living

Action Plan: Hire a home health aide for daily assistance.

4. Social Engagement

To address feelings of isolation, it's important to incorporate social activities into Mr.

Johnson's care plan. This could include regular visits from friends and family, or participation in

community activities that are accessible to him.

Goal: Improve social engagement and mental well-being

Action Plan: Coordinate regular visits from friends and family, explore local community

activities.

5. Regular Medical Check-ups

Regular medical check-ups are essential to monitor Mr. Johnson's health status and adjust the

care plan as necessary.

Goal: Monitor health status and adjust care plan as necessary

Action Plan: Schedule regular appointments with healthcare providers

 9

References:

"Aging and Physical Mobility: A Review of the Literature" - This paper discusses the impact of

aging on physical mobility.

"The Role of Physical Therapy in the Management of Osteoarthritis" - This article provides

insights into how physical therapy can help manage osteoarthritis.

"Home Modifications for Aging in Place: Best Practices" - This source provides information on

how to modify homes for elderly individuals to live independently.

"The Role of Home Health Aides in Providing Care to Elderly Individuals" - This article

discusses the importance of home health aides in elderly care.

“Aging and Musculoskeletal Disorders" - National Institute on Aging

"Osteoarthritis" - Mayo Clinic

"Peripheral Neuropathy" - Mayo Clinic

"The Impact of Social Isolation on Mental Health in Older Adults" - American Journal of

Geriatric Psychiatry

"The Impact of Chronic Disease on Physical Function: The Importance of Self-Management" -

Journal of Aging and Health.

“Nursing Assessment: Gathering Data Assessment Techniques" by Potter et al. in the book

"Fundamentals of Nursing."

"Nursing Interventions & Clinical Skills" by Elkin, Perry & Potter

 10

"Home Health Assessment Criteria: 75 Checklists for Skilled Nursing Documentation" by

Barbara Acello

"Geriatric Nursing Review Syllabus: A Core Curriculum in Advanced Practice Geriatric

Nursing" by the American Geriatrics Society.

"Ethical Considerations in Geriatric Medicine" - a book by Amy S. Kelley and Robert M. Arnold

"Cultural Sensitivity in Healthcare: A Personal and Professional Guidebook" - a book by Robert

Like

"Ethics in Aging: A Case-Based Approach" - a book by Marshall B. Kapp

"Cultural Competence in Health Care: Is it important for people with chronic conditions?" - a

research article by Lisa C. Gary.