Gary Goodson Case Study Sample

Subject Name : Nursing

Healthy Ageing

Interview Assessment

Gary Goodson is 75-year-old men living with his granddaughter Maria in a small house. He is proactive, enthusiastic, and energetic personality. He is retired from government job and after, he is not working. He usually spends his time with his rand daughter, his neighbours and close friends. His son and daughter in law not live with him due to their office work, but often come thrice a month to see him.

On regular basis, he plays billiards, during his lunchtime and was a tournament winner. He was also state winner in billiards, and football. He is active person but from past 10 years, he left all these activities, as his wife died 10 years back. This sometime create a disturbance in his characters as he is not habitual of sitting ideal and free for long time without any activities. However, his granddaughter makes him busy in moving outdoors, playing indoors game with friends, and walking.

He is suffering from diabetes from past six years, and now his condition is worsening day by day. Because of geriatric age, he is developing sign of fear, anxiety, and memory loss. He diagnosed with diabetes type two six year back, when was admitted to hospital because of foot wound, which was not heeling up for past two days. Then doctor checked his blood glucose level and found that he is suffering from diabetes type two. From that day he is taking his medicine regularly and goes for regular health checkups with his granddaughter. He loves to go out with his granddaughter for medical checkups, as on return home, they both enjoy the street food. He loves street food and with doctor’s permission takes street food once month. He is fond of eating sugary food, but from past two years has made restriction on sugar intake because of diabetes. He has never smoked, but takes one standard glass of beer only when his son comes to meet him. Otherwise, he never drinks with his friends, neighbour or any other family member. Because he believe that smoking and drinking is injurious to health. He has tasted cigarettes once at school times, but after that he never smoked. Another reason for him to not smoke is that his wife does not like it an she always ask me to never smoke. He loves her wife abundantly and never disobeys her wish.

When his wife passes away, he went into depression, with the feeling of guilt and loneliness. At that time, He also develops the characteristics of societal disconnections, lesser productive roles, cognitive regression, and limited talking. As the time passes, he started moving out of grief and live the life again as they both used to do. He started moving out, meeting with friends, and started gossiping. Now, he is living a happy nd a good life with his granddaughter and friends. He has prepared a timetable with the help of his granddaughter to keep him busy through different activities. He busy himself in gardening, playing, walking, and doing some household chores. When his granddaughter arrive from offices, both use to go for evening walk in the central park.

The prevalence of type II diabetes is indicated to increase gradually through the prolongation of population, aging, and life expectancy (Yakaryilmz & Ozturk, 2017). Geriatric person are more prone of diabetes as the micro vascular, and micro vascular complications arises. He has developed cognitive impairment, depression, urinary incontinence, and memory loss. MR. Goodson has never fall surprisingly, but however, he develop the feeling of unconsciousness, due to this fear as it may result into falling sometime, a full time medical care provider is kept, who take care of his health. Older adults have higher chances of developing myocardial infarction, disease renal condition, stroke, or permanent kidney damage (Munshi, 2019). Thus, the self-care and prevention of various complications can be challenging. The health care professional needs an insight for glycemic targets and other unique treatment options to geriatric population (Bigelow, & Freeland, 2019).

He suffer form diabetes type II from past six years, as the time passes, he has develop th symptoms of blur vision with short term memory loss and acidic problems.

Criteria 2 Summary of The Older Person’s View of Ageing and Your Insights

He says that old age does each one of us experience a golden age, which should. His perception for old age is that the age makes the strong bond with their grandchildren, with their friends, and family members, as he has. Although, he is suffering from diabetes type II and sometime develop worsen condition, then also he is happy and active. The article (Dionigi, 2015 state that positive stereotype can improve the performance, daily task activities, and their psychological distress. He takes his insulin injection with proper medication prescribed by the doctor. He also takes proper healthy food after every two hours as per her nutritionist prescriptions. He does his walk regularly to maintain his glucose level and his health condition.

The perspective of Mr. Goodson is that the old age is the time where each one of us can utilise to perform his habit, which however was not, adopted during our younger time. The article published by Ng, Tey, & Asadullah (2017) state that the effect of socio-demographic, economic, health, daily instrumental activities, community interaction, and family members link will determine the degree of geriatric people life satisfaction. He also believe that in older age, we can explore and teach our younger generation with the innovative ideas through the mixture of experience we have and our learning. He believes that with the mixture of our old tradition and new learning’s, we can provide a novel approach for the society. I think this is the different and a good perspective of such an old person, who is at the age of 75, is ready to face challenge.

Social relationship, positive thinking, good quality of health, impendent volunteering, adequate sleep, positive thing are some of the characteristic being defined by World Health Organisation (WHO) as the success for good elderly life (Tavares, Jesus, Machado, Braga, Tocantins, & Merighi, 2017). Similarly, Mr. Goodson led his life positively, with a way forward to cherish his time and attain his life goals. He is proactive, happy and spiritual personality. He involve himself with various activities, which proves him that he hi young though and also involve in social integration with voluntary work contribution. He is physically active, eat suitable and healthy food according to his prescriptions and tried to maintain his cognitive health.

Criteria 3 Summary of initial healthy ageing screening (first interview and second interview)
Sections: Socio-demographic factors and personnel well being	Findings: Mr. Goodson is a 75 year old active, enthusiastic, and energetic personality. He is retired from government job and lives with his granddaughter. His son and daughter in law live in another house due to their work and office. But, often, they came and meet him thrice a month. His wife died ten years back because of cancer. After that he become depressed, anxious, and socially determinant personality. It take time for him to move out from this unfortunate time. He is suffering from diabetes type II which was diagnosed six years back. He take his mediation regularly with the support of a medical care provider. He makes himself busy with various other activities like gardening, walking, indoor games, and social activities. He also join a society old age group, where he provide his ideas which could be used for the further development of society He has no bad habits of smoking or drinking. But sometime drink only when his son come to meet him.
Medical and Health care support	Mr Goodson goes to hospital with his granddaughter for regular health checkups. In hospital, pulse rate, sugar glucose level, blood pressure, and respiratory rate monitored. Along with this, he also visits to his nutritionist who updates his diet chart and makes a note on his weight and other digestive problems. In his society, an old age medical centre is developed. The center monitors the health of geriatric population of age more than 65 year. The centre also deals with the emergency calls and need of the person. The community nurse also tracks the physical exercise of that person who is suffering from diabetes.
Social Support and Activity	His granddaughter lives with him, and she always help me with my activities. When she goes to office, the community nurse refers a health care provider to help him in his activities. Although, he uses limited nurse’s help. He did not require meal services. He is always willing to work by his own. In addition, if he require help, his granddaughter is always there for help him He is a proactive and energetic person from his school onwards. he involved himself in gardening, playing indoor games, gossiping, and walking. He also do household chores.
Functional assessment	Lawton Score = 6 Kartz Score = 6
Health issues and problems	He has never developed feeling of trouble like anxious, unhappy, or any other. Sometime due to his disease condition, he develops fatigue, and unconsciousness a two week back. He regularly do exercise and make him physically fit. He goes outside with his granddaughter for one hour in evening. On every morning he do half an hour exercise including simple aerobics, meditation, and yoga He does not encounter any skin problem. But he usually take care of sars and wound as they are difficult to heal because of diabetes. He does not have any sleeping difficulties. Neither he takes sleeping pills to sleep nor he uses any sleeping tool like sleep apnea etc. He have bladder or bowel inconsistent. He has to go urinate many times during day and night. In morning he also have constipation problem. To treat the constipation problem, he has increase roughage food item in his diet.
Home safety assessment	Mr Goodson sometime feels fatigueless and unconsciousness, thus require a health care provide who is with him in absence of his granddaughter. The health care provider is informed about each and every minute health requirement of Mr. Goodson. His grand daughter has provided the care provider with the daily routines of mr. Goodson. She also provided him the medications and diet chart. So, that he can take care of Mr Goodson better.
Personnel nutrition assessment	He follow a good diet chart. Early in the morning, after exercise, he takes a full glass of juice along with nuts. After this, he usually do some household chores such as maintaining his almiraah, maintain his room by own, laying his bed sheet and keeping thing in their places. At 10:00 clock, he usually take a healthy rich bowl of healthy breaksfast, it usually involve cereals, musli, or oats or other fibrous food. As he think that these food help him to deal with constipation. At 12:00, he take a fresh fruits that are prescribed by doctors. After that he usually go for indoor games with his friends. In afternoon he take a good sized meal along with some amount of sleep. In evening, he usually goes outside for a walk with his granddaughter for one hour. Walking is one of the important activities for him to balance his sugar level. O their way back to home, he take a cup of tea with some healthy snack. At night he usually take light food with the glass of milk. He eat outside food once a month, only when they have to meet their doctor. In addition, on their return back home, he and his granddaughter eat street food with doctor’s permission, which is available near that hospital. He does not have problem with eating or swallowing food. He usually take fibrous food due to his constipation health problem He has lose his weight by two kg. This may be due to fatigueness and unconsciousnees which he feel last two week before He never smoke and drink occasionally when his son arrive to meet him up. With him he drink two standard beer.
Cognition	He has a good cognitive thinking and ability as he always provide new ways to society for society development and further maintenance in compliance with environment safety. However, from past two week he is developing short-term memory loss characteristics and unconsciousness.
Mood/Behaviour	He involves himself in various activities and always keeps himself happy and busy. But, when he remember his wife, he feels sad and depressed.
Appearance	He is physically active with a good physique and personality. He is long with short hair with good grooming.

Criteria 4: Healthy Ageing

Yes, Mr Goodson is growing old with healthy aging. According to World Health Organisation, Healthy ageing i defined as a process of developing and maintaining the functional ability which help in enabling the well-being of older age (World Health Organisation). It state that healthy aging is about creating new environment, new opportunities and new values that would enable people to do what they want. Similarly, Mr Goodson has also living a proper and healthy life. This can be witnessed fro the fact that he actively involve himself in different task like gardening, maintaining his room, exercise, counselling the society committee, and developing a good social relationship with his neighbour and friends. These activities make him active and as well, as make him busy as in older age many people complaint that they does not fit in the society as they have nothing to do (Kourkouta, Ch, & Monios, 2015). But, Mr . Goodson has prove that age does not bar the individuals hobbies, activities, and learning. A state of complete physical, social, mental, and emotional well-beings among individual are responsible for the development of healthy ageing. Basic needs satisfaction and coping with the changing environment are the fundamental, which are useful in context of healthy ageing. They determine the importance of happiness, harmonious relation, and security among old age people (Michel & Sadana, 2017). Mr Goodsons has balanced his life with work and healthy eating. He follows a good diet rich in fibre, fruits, and leafy vegetables. He is physically fit and involve in exercises and other activities.

Criteria 5 List All Areas of Concern/issues that You Have Identified for Your Older Person

Mr Goodson is proactive and enthusiastic person. He is lovable, and practical personality who knows that old age is a part of life and has a deep determination in living life positively. He has developed diabetes type II disease, due to which he is faces some problems like bowel inconsistency, depression, and fatigue and unconsciousness.

Although he has planned his health with proper, diet and exercise. He also involves himself in other activities to make him busy and active. He regularly take his medicines and go for regular health check up with his granddaughter. He is enjoying his life at fullest and also providing younger generation with new ideas in context of sustainable development and management.

Criteria 6

Criteria 7

Criteria 8

Problems/issues Depression due to his wife

Measurable goal

To provide him psychotherapy which involve behavioural therapy, cognitive therapy, and self management therapy

Intervention

Adopting various depression assessment test such as behaviour, cognitive, and personality. The assessment test will allow him to talk about the issues, drawback, and other faults he is suffering from. The test will address the relevant positive outcome that help him to move out from depressive mood

Rationale

With the depression assessment test, Mr. Goodson has develop a positive attitude. The test address the self-theories, and help in shaping one’s intelligence, way of thinking, and perspective towards life (Chambliss, et al, 2018). It also suggest that the depression assessment test provides a positive outline towards individual health. The assessment provide Mr Goodson a broad thinker in term of life and wellbeing

Intervention

Nurse counselling will help Mr. Goodson to relate the realistic things. It will resume the active role of Mr. Goodson to initiate communication, assess its coping abilities, and skills. The counselling should address the psychological needs to him and his well being

Rationale

Depression relates to the inhibition or slowdown of psycho physiological function which is responsible for prevailing the feeling of guilt and decreased wellbeing level (Goncalves, pereira, Ribeiro, &Santos, 2016). Through active counselling, Mr. Goodson develop positive and effective behaviour. It help him to come up with the sense of healthy livelihood.

Problems/issues

Fatigue and unconsciousness

Measurable goal

To aim is to reduce the fatigueness and rate of unconsciousness through active involvement in activities.

Intervention

As a nurse, assess the patient’s instrumental activities of daily living, demands of daily living, and nutritional ingestion. Observe his sleep patterns, heart rate, blood pressure rate, and his physical exercise.

Rationale

Aging is an age that develops stress, which further responsible for aggravating diabetes. The diabetes further elevate the advanced glycation in body parts. This is responsible for fatiguenes and unconsciousness (Iyer, Iyer, Venkatraman, 2019)

Intervention

Teach him about energy conservation methods and advise him to collaborate with other occupational therapists if needed.

Rationale

Identifying energy conservation method will help Mr Goodson to save his energy nd divide into convineient segment. It alo offer him diversional soothing activities. These methods help in reducing use of nervous energy and lessen anxiety. The management of unconscious patient in term of standardised multidisciplinary approach and algorithm is difficult. Hence, an alarm-triggered management routine need to desighned that would help in patient upbringing (Cooksley, Rose, Holland, 2018). With these techniques, Mr. Goodson has developed a strong relationship with energy conservation and found that with this approach he never feel distressed.

Problems/issues

Bowel inconsistent

Measurable goal

Provide learning about healthy and fibrous diet. Motivate him about the physical activities that will support him in bowel consistency.

Intervention

Physical exercise will help M. Goodson for bowel consistency. The problem usually occurs in patients suffering from diabetes type II

Rationale

Non pharmacological have more significance in treting problems associated with bowel (Eder, Niezgodka, Kazmierczak, Eder, 2019). Physical exercise will help him in proper digestion and proper body function. This will further reduces the chances of bowel inconsistency.

Described intervention no2:

Healthy, Fibrous diet with fruits and vegetables will help in easy defecation

Rationale: Bowel inconcistency can be improved by adopting various means of activities like exercises, diet, and medicines (Mounsey, Raleigh, Wilson, 2015). With these interventions, Mr Goodson will developed positive health benefits.

References for Healthy Aging

Bigelow, A. & Freeland, B. (2017). Type II Diabetes care in the elderly. The Journal for Nurse Practitioners, 13, 181-186.

Chambliss et al (2018). Links between depression and fixed versus growth mindsets. Clinical Research in Psychology, 1, 1-10.

Cooksley, T., Rose, S. & Holland, M. (2018). A systematic approach to the unconscious patient. Clinical Medicine, 18, 88-92.

Dionigi, R. (2015). Sterotypes of aging: their effects on the health of older adults. Journal of Geriatrics, 2015, 1-10

Eder, P., N. Kazmierczak, Niezgodka, A., Eder, K. S. (2019). Dietary support in elderly patients with inflammatory bowel disease. Nutrients, 11, 1-16.

Gancalves, P., Pereira, N., Ribeiro, A., & Santos, C. (2016). Nursing interventions in patients with chronic pain and depression: A systematic review. The European Proceedings of Social and Behavioural Sciences, 1-26.

Iyer, S., Iyer, R, Venkatraman, B. (2019). Avoiding type 2 diabtes express highway from infancy to old age – focus on newer risk factors. Journal of Association of Physician of India, 67, 68-72

Kourkouta, L., Ch, I., Monios, A. (2015). Psychosocial issues in elderly. Program Health Science, 15, 232-237.

Munshi, M. (2019). Treatment of type II diabetes mellitus in older patient. Retrieved from: https://www.uptodate.com/contents/treatment-of-type-2-diabetes-mellitus-in-the-older-patient

Mounsey, A., Raleigh, M., & Wilson, A. (2015). Management of constipation in older adults. American Family Physician, 92, 500-504.

Michel, J. P., & Sadana, R. (2017). “Healthy aging” concepts and measures. Journal of the American Medical Directors Association, 14, 460-464.

Ng, S. T., Asadullah, M. N., & Tey, N. P. (2017). What matters for life satisfaction among the oldest-old? Evidence from China.Received from http://ftp.iza.org/dp10624.pdf

Tavares, R. E., Jesus, M. C., Machado, D. R., Brga, V. A., Tacontins, F. R., Merigh, M. A. (2017). Brazilian Journal of Geriatrics and Gerontology, 20, 878-889

World Health Organisation. (n.d.). What is healthy ageing. Retrieved from https://www.who.int/ageing/healthy-ageing/en/#:~:text=Healthy%20Ageing%20and%20functional%20ability,they%20have%20reason%20to%20value.

Yakaryilmaz, F. D. & Ozturk, Z. A. (2017). Treatment of type II diabetes mellitus in the elderly. World Journal of Diabetes, 15, 278-285.

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