Running head: SENIOR HEALTH PROJECT 1

Senior Health Promotion Project

Nicole Melton

Bon Secours Memorial College of Nursing

NUR4113

I Pledge- Nicole Melton

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The client is an 80-year-old female. The only communication problems she has, is

vision. She wears bifocal glasses. Her preferred leaning style is to be provided with written

material that she can understand. The clients current health conditions include: Diabetes type II,

hypertension, and rheumatoid arthritis. She does not seem to have much difficulty with her

rheumatoid arthritis at this current time. Upon doing the tests that were required of us to perform

on our client, results found that the client had abnormal scores relating to: Hearing screen,

Sleepiness Scale, SPICES indicated problems with sleep and confusion, and the Sleep Quality

Index. These disorders relate to Healthy People 2020. Healthy People 2020 aim to reduce the

problems that occur with hearing difficulties. Healthy People 2020 aim to improve adequate

sleep that people receive. Healthy People 2020 aim to reduce the rates of dementia. Healthy

People 2020 aim to improve the quality of life for people who have DM. Healthy People 2020,

have a lot to do with the improvement of many of the issues that this client has.

Sleep pattern disturbance, related to presleep thoughts, as evidence by verbal complaints

of not feeling well-rested, this is the nursing diagnosis I chose for this client. The reason I chose

this diagnosis is because sleep is very important for this client, and recently her sleep has been

declining. This is an important condition to address because sleep improves our overall health.

The short term outcomes we chose included: 1) The client will verbalize a plan to implement

bedtime routines and 2) The client will identify personal habits that disrupts sleep patterns, and

will verbalize strategies to improve quality of sleep. The long term outcomes we chose included:

1) The client will awaken refreshed and will not be fatigued during the day, and 2) The client

will wake up less frequently throughout the night as measured by verbalization of less frequent

awakening, compared to before. The teaching plan was developed mutually between the client

and I. The client was very cooperative in recognizing the aspects of the teaching plan and
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following through with them. I told the clients ways to improve her sleep (dont drink caffeine

before bed, empty bladder before bed, dont watch TV right before bed, and dont take long naps

during the day to ensure better sleep that night). The client was able to repeat these back to me,

in order to improve her sleep.

Research has proven that sleep has a huge impact on mental and physical well-being

(Malinowska et al., 2016). Inadequate sleep can result in mental disorders, fatigue, and even

mobility disorders. Improving sleep has been proven to result in a better quality of life,

especially in people who have chronic health disorders. Sleep disorders are relatively common

in older adults, and propose a major health problem for this population. Females are more likely

to have sleep problems than men, most likely contributing to emotional/psychological disorders.

In the article conducted by Strand et al., 2015, it has been proven that glucose levels can become

increased because of disturbed sleep. In this clients case, she has DM and her blood sugars have

been running slightly high. Her sleep may contribute to her higher glucose levels.

The content of teaching was utilized by giving the client information pertaining to health

problems that she has, and any questions she has. The main focus of concern for her is her sleep

problems. She sleeps during the day because she does not feel rested when she wakes up. She

feels more depressed than usual, which may be related to her sleep problems. She feels she has

memory deficits and the tool utilized shows that she possibly does have problems with mental

health. I told the client that she should be followed up for her confusion instances and her sleep

disturbances. Teaching was done in our second session together, in which we identified what her

main concerns were for her health. I evaluated what interventions would be needed to improve

the conditions that she is having problems with. For her depression, I told her to get out of the

house more because she enjoys that, and she states that she feels better when she is away from
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home. She wishes to move back towards her children instead of being so far away, she stated

this is a main reason why she feels depressed. For her DM, I taught her interventions to help

keep her glucose under control. I taught her ways to keep her blood sugar levels within a normal

range. Making sure she ate a good diet, and exercised was vital to the teaching plan. For her

memory complaints, I told her to write things down and keep them on the refrigerator to keep her

on track. She now has a calendar that she writes doctor appointments down on.

The short term outcomes were achieved. The outcomes were achieved by the client

stating ways to improve her bedtime routine. The client also identified reasons why she cannot

sleep as effectively as she would like. Some of the reasons why she could not sleep as well, is

because of emotional issues that run through her mind at night. The clients long term goals will

be followed up on within the next few weeks. The long term goals are very self directed and can

be evaluated easily.

The nursing outcomes were related to primary, secondary, or tertiary prevention

strategies. The outcomes all address primary prevention because they seek to prevent disease.

Lack of sleep can result in disorders ultimately. Therefore, the outcomes prevent the onset of

disease and other illnesses. The outcomes relate to secondary prevention because, quality of

sleep can be examined and if sleep problems are noted, interventions can be made. These

outcomes relate to tertiary prevention strategies also, because if you already have a disorder then

sleep can improve the disease/disorder. In this case, the client has DM and sleep can make

coping with the disorder better, because less complications will come about.
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References

Aging and Sleep. (n.d.). Retrieved April 17, 2017, from https://sleepfoundation.org/sleep- s

aaaaaaaatopics/aging-and-sleep

Malinowska, K. B., Okura, M., Ogita, M., Yamamoto, M., Nakai, T., Numata, T., . . . Arai, H.

aaaaaaaa(2015). Effect of self-reported quality of sleep on mobility in older adults. Geriatrics &

sssssssssGerontology International,16(2), 266-271. doi:10.1111/ggi.12468

(n.d.). Retrieved April 17, 2017, from https://www.healthypeople.gov/

Strand, L. B., Corenethan, M., Biggs, M. L., Djousse, L., Kaplan, R. C., Siscovick, D. S.,

aaaaaaaaRobbins, J. A., Redline, S., Patel, S. R., Janszky, I., Mukamal, K. (2015). Sleep

aaaaaaaadisturbances and glucose metabolism in older adults: the cardiovascular health study.

aaaaaaaaDiabetes Care, 38, 2050-2058. doi: DOI: 10.2337/dc15-0137