Ageing Case Study

This case study focuses on the physical health condition of a 68-year-old patient and suggests care intervention strategies for positive outcomes. It includes screening tools for nutrition and exercise assessment, expected care outcomes, nursing interventions, and referrals.

Running head: AGEING CASE STUDY
AGEING CASE STUDY
Name of the Student:
Name of the University:
Author Note:

1AGEING CASE STUDY
Introduction:
The case study deals with a 68 year old patient who lives independently and his ADL
skills are intact. The patient has been reported to experience no problems in relation to his
mobility, orientation or competence. In addition to this, the provided case information
suggests that the patient has a family but prefers to stay independently and is proud of her
self-reliance. The case study would focus on the existing physical health condition of the
patient and suggest care intervention strategies that could assist with positive care outcome.
Client’s BMI:
The provided case information suggests that the patient weighs 210 lb which can be
considered equivalent to 95.25 Kg. Also, the patient’s height has been mentioned as 5’ 6’. On
the basis of the information provided in terms of the height and weight parameters the BMI or
the Body Mass Index of the patient can be estimated. As stated by Nuttall (2015), the Body
Mass Index can be defined as a measure of body fat that is dependent on the height and
weight parameters of adults. The weight of the patient has been mentioned as 95.25 kg and
the height has been mentioned as 5 ft 6 inches. The height can be converted to CGS unit as
167.64 cm. Therefore the BMI can be calculated based on the standard formula of
weight/height. Therefore, the appropriate BMI can be calculated as (95.25Kg/167.64ccm)
which is equivalent to 33.9. As per the World Health Organization a BMI equivalent to 33.9
is considered as obese (Chernoff, 2013). As per the World Health Organization, there are four
different categories for BMI. The categories comprise of Underweight equivalent to <18.5.
The normal weight range is considered in between the range of18.5 to 24.9 whereas
overweight is considered between 25 to 29.9. A Body Mass Index equivalent to 30 or more is
considered as obese (Chernoff, 2013).

2AGEING CASE STUDY
Screening tools for nutrition and exercise assessment:
According to the U.S Preventive Services Task Force it has been recommended that
clinicians and care professionals must conduct a mandatory obesity screening for identifying
old age patients who are at a high risk of suffering from obesity (Clegg, 2013). As per the
guidelines a Body Mass Index that is greater than 30kg/m2 or higher must be treated as an
obese body weight. It should be mentioned in this context that the patient is at a high risk of
suffering from complex complications such as hypertension and Diabetes due to unmanaged
weight. The clinician could make use of a number of screening tools such as calculation of
BMI value and measuring wait circumference in order to screen for obesity and accordingly
make use of appropriate interventions so as to assist the client with a healthy life style.
In order to assist the patient with weight management, the primary intervention
strategies would comprise of fostering an active lifestyle with the inclusion of a healthy diet
and physical exercise routine. In order to assist the patient with physical exercise a functional
assessment of the patient would be conducted. The functional assessment would majorly
comprise of conducting balance tests that would include testing the efficiency of the sensory,
vestibular and visual systems (Sardinha et al., 2016). Also, the patient’s reaction time needs
to be assessed in order to detect the level of awareness (Bouchonville et al., 2014). The
evidence base suggests that conducting the time up and go test and sit to and go test can help
in assessing the level of physical activeness of the patient (Kitzman et al., 2016). The first test
includes the use of an armchair that is placed 10 feet away from the chair. The objective of
the test is to make the client get up and walk quickly to the line and them get back to the chair
and sit down (Batsis et al., 2017). Time taken less than 10 seconds suggests that the patient is
free from the risk of falling. On the other hand time taken more than 20 seconds suggests that
the patient has a high risk of falling. The second test includes the patient having to sit with
their back relaxed against the back of the chair and then get up and repeat up to 5 times

3AGEING CASE STUDY
(Batsis et al., 2017). Patients between 60 to 69 years of age are expected to complete the
assessment within 11.4 seconds. On the other hand, patients between 70 to 79 years of age
are expected to complete the assessment within 12.6 seconds. On the other hand, patients
between 80 to 89 years of age are expected to complete the assessment within 14.8 seconds.
In addition to this, the client would also be questioned about the physical activities
undertaken on daily basis so as to assess the client’s knowledge about exercise and physical
activity.
Expected care outcomes:
The two care outcome for the patient would comprise of integrating a healthy dietary
routine and ensuring weight loss. The two care outcomes are reasonable and realistic as the
client’s body weight suggests that she is obese which might lead to a number of physical
health complications such as hypertension, Type II Diabetes as well as Depression. Shifting
to healthy eating habit and leading an active lifestyle in terms of performing physical
activities can help in improving care outcome. The proposed care outcomes can be measured
by means of regular weight measurement and monitoring the total calorie intake through web
based application.
Three Nursing Interventions and associated rationales:
The three nursing interventions that would be undertaken for an appropriate weight
management care plan for the patient would comprise of reviewing the individual cause for
obesity, emphasize the importance of avoiding an unhealthy diet and determine activity levels
of the patient and assist with an appropriate physical exercise program. The rationale for the
first intervention can be explained as identification of the life influences that trigger obesity
among the old age patients (Brown & Kuk, 2015). In addition to this, reviewing the
individual cause of obesity would also help in estimating the total calorie intake which would

4AGEING CASE STUDY
help in customising an appropriate intervention strategy for the patient. The rationale for
imparting health literacy can be explained as making the patient aware about the unhealthy
diet habits that could lead to serious metabolic imbalances such as fatigue, headache,
instability and weaknesses which could further lead to serious disorders (Gill et al., 2015). At
the same time, it would also help in educating the patient about impact of unhealthy eating on
the effectiveness of the recommended weight loss program. The rationale for the third
recommended intervention can be explained as harbouring weight loss by ensuring a
reduction of appetite and increasing energy within the patient so as to ensure that the patient
adhered to the proposed exercise plan (Gill et al., 2015). Research studies suggest that an
exercise plan based on the customary need of the patient can help in enhancing physical as
well as cardiac fitness and at the same time ensure toning of muscles and integrate wellness
(Ahmadi et al., 2015).
Life stressors and weaknesses that affect patient’s activity level:
On closely assessing the case study, it can be said that the current life stressors for the
client could possibly include social isolation on account of staying alone without a family. In
addition to this, leading a sedentary lifestyle due to lack of physical activity, social interaction
and unhealthy diet routine can be said to have affected the physical activity level of the
patient.
Referrals and Rationale:
In order to assist the patient with the recovery process, the patient would be referred
to a nutritionist and a physical therapist. In addition to this the patient would also be referred
to a psychologist. The rationale for the referral to a nutritionist can be explained as offering
assistance to the patient with the help of an appropriate diet plan which would help in the
effective management of the body weight of the patient (Brown & Kuk, 2015). The rationale

5AGEING CASE STUDY
for the referral to a physiotherapist can be explained as assisting the patient with a customised
physical exercise plan which could assist the patient in managing excess body weight
(Kitzman et al., 2016). On the other hand, the rationale for the referral to a psychologist can
be explained as providing assistance with motivational interviewing which could help the
patient in adhering stringently to the devised nutrition plan as well as the physical exercise
routine (Batsis et al., 2017). Therefore, the combination of the referrals would help the patient
with a positive recovery process and at the same time would yield positive outcome for the
patient.
Conclusion:
Therefore, to conclude, it can be mentioned that the case study critically highlights the
scenario of a patient who experiences no restrictions for mobility, is competent and is
oriented. In addition to this the patient can effectively manage her activities of daily living
and is independent. However, the patient’s weight an calculated BMI is problematic as it
indicates obesity. On account of the unmanaged body weight, the patient is at a high risk of
developing chronic illnesses such as Diabetes, Hypertension as well as other cardiovascular
disorders. Therefore the expected care outcome for the patient would comprise of managing
the body weight which would be done my creating an appropriate nutrition plan and an
effective exercise routine so as to ensure physical wellness and recovery for the patient.

6AGEING CASE STUDY
References:
Ahmadi, S. F., Streja, E., Zahmatkesh, G., Streja, D., Kashyap, M., Moradi, H., ... &
Kalantar-Zadeh, K. (2015). Reverse epidemiology of traditional cardiovascular risk
factors in the geriatric population. Journal of the American Medical Directors
Association, 16(11), 933-939.
Batsis, J. A., Gill, L. E., Masutani, R. K., Adachi‐Mejia, A. M., Blunt, H. B., Bagley, P. J., ...
& Bartels, S. J. (2017). Weight loss interventions in older adults with obesity: a
systematic review of randomized controlled trials since 2005. Journal of the American
Geriatrics Society, 65(2), 257-268.
Bouchonville, M., Armamento-Villareal, R., Shah, K., Napoli, N., Sinacore, D. R., Qualls,
C., & Villareal, D. T. (2014). Weight loss, exercise or both and cardiometabolic risk
factors in obese older adults: results of a randomized controlled trial. International
journal of obesity, 38(3), 423.
Brown, R. E., & Kuk, J. L. (2015). Consequences of obesity and weight loss: a devil's
advocate position. obesity reviews, 16(1), 77-87.
Chernoff, R. (2013). Geriatric nutrition. Jones & Bartlett publishers.P.88
Clegg, A., Young, J., Iliffe, S., Rikkert, M. O., & Rockwood, K. (2013). Frailty in elderly
people. The lancet, 381(9868), 752-762.
Gill, L. E., Bartels, S. J., & Batsis, J. A. (2015). Weight management in older adults. Current
obesity reports, 4(3), 379-388.
Kitzman, D. W., Brubaker, P., Morgan, T., Haykowsky, M., Hundley, G., Kraus, W. E., ... &
Nicklas, B. J. (2016). Effect of caloric restriction or aerobic exercise training on peak

7AGEING CASE STUDY
oxygen consumption and quality of life in obese older patients with heart failure with
preserved ejection fraction: a randomized clinical trial. Jama, 315(1), 36-46.
Nuttall, F. Q. (2015). Body mass index: obesity, BMI, and health: a critical review. Nutrition
today, 50(3), 117.
Sardinha, L. B., Santos, D. A., Silva, A. M., Grøntved, A., Andersen, L. B., & Ekelund, U.
(2016). A comparison between BMI, waist circumference, and waist-to-height ratio
for identifying cardio-metabolic risk in children and adolescents. PLoS One, 11(2),
e0149351.