Home Safety and Elderly Assignment
· What did you learn about the role of the community public health nurse in completing a home safety assessment?
· How did the public health nurse use a strengths based approach to make assessments of the client, his family and the home environment?
· Reflect on how you feel about working with a client whose home is in disarray. What might be the same or different than working with a client who lives in a home that is neat and clean?
How would you apply this virtual experience to clients in other home visiting situations?
What did you learn about the complexity of working with a client who is having a difficult time maintaining a safe home environment? How would you involve the client, the family, or outside agencies in the assessment and plan?
Using principle of motivational interviewing, what are some options for discussing with the client an disseminating a plan for making the home a safe environment?
As a public health nurse working with an elderly client, you may encounter some resistance to change. What are some options you could use to decrease the resistance?
Mrs. Anna Jordan is a 76 year-old woman who lives independently in her own home. She has come in to your primary care clinic for a wellness visit.
Mrs. Anna completes the Stay Independent brochure in the waiting room. She circles “Yes” to the questions, “I have fallen in the last 6 months” and “I take medicine to help me sleep or improve my mood.” Her risk score is 3.
Gait, Strength & Balance Assessment (Completed and documented by medical assistant)
Timed Up and Go: 12 seconds. Gait: decreased arm swing but otherwise normal.
30-Second Chair Able to rise from the chair without using Stand Test: her arms to push herself up. Score of 14 stands.
4-Stage Able to hold a full tandem stance for 10 seconds Balance Test: unsupported without postural
When asked, Mrs. Anna Jordan reports she fell the previous week but wasn’t hurt and so didn’t seek medical attention. She says she was out walking with a friend, they were talking and she wasn’t looking where she was going, and she tripped over a crack in the sidewalk. This was her first fall.
Anna reports that she usually walks about 2 miles each day around her neighborhood. She feels steady when walking at all times, even when out of doors. She tries to avoid potholes and usually watches out for cracks in the sidewalk so she won’t trip. She’s not afraid of falling. Walking is her only form of exercise.
Medical Problem list
· Seizure disorder
· Schizoaffective disorder
· Chronic kidney disease stage 3
1. Depakote 250 mg twice daily
2. Zyprexa 12.5 mg daily
3. Ativan 0.5 mg twice daily
4. Levothyroxine 750 mcg daily
5. Colace 250 mg daily
6. Tylenol 500 mg 4 times daily as needed for pain
Review of Systems
Positive for poor eyesight, urinary incontinence, and nocturia >2 times a night.