Advanced Health Assessment for Dementia Management

Running head: ADVANCED HEALTH ASSESSMENT
ADVANCED HEALTH ASSESSMENT
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1ADVANCED HEALTH ASSESSMENT
For the deliverance of quality nursing and achievement of positive health outcomes in the
patient, nurses must engage in the conductance of health assessment - one of the most basic and
yet essential components of nursing practice (Shen, 2015). An advanced health assessment aims
to incorporate a holistic perception towards patient needs by evaluating underlying
psychological, behavioral, social and familial and social factors which may have contributed to
the existing patient condition. Such comprehensive assessments hence, direct the execution of a
holistic management and care plan for the concerned clients (Ndiwane et al., 2017). Dementia is
a neuro-degenerative disease and comprises of age-associated deficits in cognitive functioning,
memory, thinking, logical reasoning and thinking. However, dementia associated with emotional
issues and symptoms of discomfort in patients is beyond merely physiological in nature but is
also a result of underlying behavioral and social factors – hence, necessitating the conductance of
a comprehensive, advanced health assessment framework which may dictate future execution of
quality care and management standards for the elderly residing in an aged care facility (Fry &
Wolfe, 2018). Hence, the following essay aims to discuss procedures for advanced health
assessment aimed at management of elderly patients suffering from dementia, using the ‘unmet
needs model’, and associated usage of behavior charts, incident report and corrective action
reports. The administration of such advanced health assessment tools comprising of inclusion of
unmet needs model, behavior charts, incidence reports and corrective action will contribute to
the client management plan by instructing gerontological nurses on the need to adopt
multidisciplinary, patient centered approaches for administered comprehensive screening and
treatment for dementia patients (Braun, 2019).
The purpose of an advanced health assessments lies in its ability to screen relevant
causative factors underlying the physiological, behavioral and social conditions dictating the

2ADVANCED HEALTH ASSESSMENT
behavior of a concerned patient. Hence, prior to the development of an advanced health
assessment tool, understanding and evaluating the present behavioral issues and shortcomings
affecting the patient is of utmost importance (Tepeil et al., 2017). As researched by Kar (2009),
dementia is accompanied by an amalgamation of detrimental psychological and behavioral
symptoms which not only hinder the achievement of positive health outcomes in the patient but
also disrupt the performance of associated clinical staff and aggravate care expenditures. Hence,
the advanced health assessment framework aimed at care management of elderly dementia
patients must seek to address, assess and target the psychological and behavioral symptoms to
ensure deliverance of quality care (Maidment et al., 2018). Dementia patients, due to their
experienced loss in cognitive functioning and reasoning skills, resulting in behavioral issues of
violence, aggression, restlessness, agitation, attention-seeking behavior, coupled with associated
psychological symptoms of depression and apathy (Kar, 2009). Lack of timely mitigation and
conductance of required assessments result in aggravation of such condition leading to
psychosis, social isolation and alterations in personality such as screaming, reduced perception,
decreased optimism, speech abnormalities and compromised abilities to perform activities of
daily living. In addition to the physiological implications of dementia, the associated behavioral
symptoms are often the resultant of a trigger due to surrounding environmental and social factors
– hence calling for advanced assessment frameworks (Azermai, 2015). Hence, as researched by
Kar (2009), it has been implicated that non-pharmacological interventions aimed at
encouragement of social interaction, environmental modification, minimization of sensory
deficits and behavioral interventions have been proven to beneficial in the management of the
above identified issues in dementia patients. Hence, to administer the same, an assessment of the
external causative factors underlying aggressive and violent behavior is of utmost importance

3ADVANCED HEALTH ASSESSMENT
which is why the advanced health assessment framework of dementia management must
incorporate a multidisciplinary Aged Care Assessment Framework which may comprise of an
Aged Care Assessment Team (ACAT) and comprehensive assessment tools of behavior charts,
incident reports and corrective action reports (Carthwright et al., 2015). The amalgamation of n
advanced health assessment framework consisting of an unmet needs models and behavior,
incidence and corrective action reports will aid in client management by dictating gerontological
nurses and ACAT on the need to adopt patient centered, shared decision making approaches to
address the underlying causative factors of BPSD in dementia (Rapaport et al., 2018).
As a gerontological nurse, working in a nursing home involved in the provision of
specialist residential services, for the management of dementia patients, collaborative
functioning with the ACAT is of utmost importance. Considering the multifaceted nature of
behavioral and psychological symptoms administered by dementia patient, a key responsibility
of the ACAT and gerontological nurse is to understand and assess factors which may be causing
BPSD (behavioral and psychological problems in dementia) hence necessitating inclusion of the
‘unmet needs model’ as a key assessment tool coupled with multidisciplinary ACAT assessments
of behavior charts, incidence reports and correction action reports (Black et al., 2019). As
postulated by the unmet needs model, emergence of problematic behaviors in individuals result
due to an interplay between factors such as sub-optimal environment, presence of current
physiological and psychological issues and lack of equilibrium between present personality and
lifelong habits (Muñoz et al., 2019). Hence as per the unmet needs model, dementia patients may
be engaging in acts of violence, aggression, pacing and speech abnormalities as an attempt to
communicate unmet and unaddressed biological needs such as alleviation of discomfort, social
needs such as eagerness and want of engagement in social interactions and psychological needs