Ageing and Related Complications: A Case Study of Mrs. Patel

This case study explores the effects of ageing on Mrs. Patel, a 72-year-old female patient with dementia, incontinence, and osteoporosis. The article discusses the theory of wear and tear, the impact of ageing on different body systems, and a nursing care plan for Mrs. Patel.

Running head: AGEING AND RELATED COMPLICATIOS.
Ageing and Related Complications
Name of Student
Institutional Affiliation

AGEING AND RELATED COMPLICATIOS.
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Mrs. Patel is a 72-year-old female patient who is currently been taken care of
at the aged-care centre. She has been at the facility for the past one month receiving
holistic care from the medical practitioners. Issues being addressed majorly are
nutrition, comfort and preserving quality of life. During my clinical placement, I have
been assisting the team in the collaborative care of Mrs. Patel. She was diagnosed
with dementia, incontinence of both stool and urine and osteoporosis.
Mrs Patel has been presenting with memory loss. She has short term memory
and cannot remember where she left her belongings or even the meal she took in
the morning. Mrs. Patel forgets even to eat her food and must be reminded over and
over again (Kales, Gitlin & Lyketsos, 2015). She keeps repeating statements the t is
due to the memory loss. She has difficulty in expressing herself since she takes time
finding appropriate words for a scenario. She has reduced ability to concentrate on
tasks given and gets easily distracted and rarely completes tasks. Mrs. Patel has a
difficulty in identifying people, even the family members and keeps on asking them
over and over again. These are clear symptoms of dementia. Mrs Patel has a
constant complaint of back pains. From the assessment, she has lost weight and has
a hunched gait. From the history, Mrs Patel has been admitted severally due to bone
fractures that result from minor falls (Sotelo & Acevedo-Vasquez, 2016). These
symptoms point out to osteoporosis. Due to urine incontinence, she experiences a
strong and uncontrolled urge to void (Jones, 2015). She voids on herself by a mere
cough or sneeze. She cannot control stool elimination.
The conditions have impacted greatly on Mrs. Patel and the environment.
They have affected the quality of life, caused a social, emotional impact and affected
physical state of Mrs Patel and the surrounding people in general. She has
incontinence of both urine and stool. This conditions have affected her quality of life
and her self-esteem is very low. She has to walk in diapers to avoid soaking herself.
Due to the incontinence, she has to stay in the facility and this has added a financial
cost to the family. This has led to strain on resources to enable cater for the medical
attention she needs. The emotional state of Mrs. Patel has been affected and she
feels withdrawn and neglected. She keeps forgetting things and gets frustrated
looking for them and she feels more of a burden. The family and the care
practitioners need to monitor her closely in terms of nutrition. Physically, she has
osteoporosis and this has impaired her ability to move around. She is prone to falls

AGEING AND RELATED COMPLICATIOS.
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and gets fractures easily. Due to this, she needs assistance in moving around by the
care practitioners and family members.
The appropriate theory of aging that explains Mrs. Patel’s condition is the
theory of wear and tear. This theory explains that ageing is due wearing out of cells
and tissues with time. It explains that body parts are like machine parts and the more
they are in use, they wear out with time. It explains that the wearing out is
contributed due to the environmental factors e.g. toxic substances, radiations and
the ultraviolet rays or intrinsic body metabolic processes (De & Ghosh, 2017).
Metabolic processes using oxygen leads to eliciting of free radicals that are not
friendly to the cells and tissues and cause damage. Damaged cells tend to
regenerate and remodel to replace the damaged ones, with time, the DNA strands
dividing become very short and cannot remodel anymore this leads to increased rate
of damage than remodelling. This is the cause of osteoporosis where the rate of
bone resorption is more than remodelling. Some tissues tend to get weakened and
function is lost according to the theory. In due time the tissues get overwhelmed due
to years of functioning they strain and weaken such like machine parts. To control
elimination of urine or stool, one ought to have strong sphincters. The bladder and
anal sphincters contract and relax voluntarily normally and one voids on urge and
can hold, in cases where they are weakened, one loses the ability to control them
and urine and stool leaks out. This is presented by Mrs Patel in the case where the
anal sphincters and bladder sphincters are weakened and resulting into
incontinence. Cells of the central nervous system do not regenerate hence the
damage is progressive. Mrs. Patel has dementia and the symptoms are deteriorating
since nerve cells are gradually getting damaged and remodelling does not take
place.
Ageing is the process of becoming older. It involves decaying process where
the cells, tissues and organs are gradually damaged due to release of intrinsic and
extrinsic toxins or by just wearing out (Zimmerman, Anderson, Mattu, Grossman &
Rosen, 2016). In the central nervous system, ageing leads to short term memory
loss and loss of ability to learn new materials and tasks. This is due to the damage of
nerve cells responsible for memory, reasoning and creative thinking. It leads to loose
of communication abilities and one may lack words to describe a situation or the right
vocabulary. This is due to the loose of function to the sensory speech area of the

AGEING AND RELATED COMPLICATIOS.
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brain. Ageing leads to lose of function to the frontal lobe leading to slow task
handling and lose of intellectual ability (Fjell, Sneve, Storsve, Grydeland, Yendiki &
Walhovd, 2015). There is reduced blood flow to the central nervous system,
diminished number of nerve cells and hardening of vertebrae. In the genitourinary
system, the bladder sphincters are weakened, the capacity of the bladder is reduced
and the nerve cells loose sensation. This leads to stress incontinence (Hutchinson-
Colas & Segal, 2015). There is reduced functions of renal tubules and the rate of
glucose reabsorption is reduced. There is reduced number of glomeruli hence
reduced kidney function. In the gastrointestinal system, there is decreased rate of
motility and food tends to spent more time in the tract (Saber & Bayumi, 2016).
Water is reabsorbed and the food gets dehydrated hence one suffers from
constipation. The internal and external anal sphincters loose the tone and become
weakened. One is not able to control the contraction and relaxation of sphincter
muscles hence leading to stool incontinence. Concerning the musculoskeletal
system, there is decrease in muscle bulk, this is due to damage and loss of cells
(Briggs, Cross, Hoy, Sànchez-Riera, Blyth, Woolf & March, 2016). Ageing
contributes to disease of the joints, degeneration of cartilages, bone pains limiting
daily activities and increases the rate of bone resorption compared to remodelling.

AGEING AND RELATED COMPLICATIOS.
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Nursing Care Plan
Nursing
diagnosis
Goals Interventions Rationale Evaluation
Disturbed
thought
process
related to
impaired
memory due
to dementia
as evidenced
by patient
unable to
reason, has
memory loss,
disoriented
and is easily
distracted.
Patient
should be
able to
demonstrate
improved
thought
processing.
Patient will
demonstrate
orientation to
time place
and person.
Examine the
patient often
on the thought
process.
Assess levels
of memory
loss,
communication
patterns and
orientation.
Orient patient
to the
surrounding.
Label drawers
and use
reminders for
the patient
Assessing the
memory change,
communication
patterns and
orientation
enables identify
whether patient is
improving or
worsening
(Maillet &
Schacter, 2016).
Labelling assists
the patients
memory to avoid
looking for things
After the
interventions,
the patient
was able to
demonstrate
orientation in
time place
and person
and improved
thought
process.
Self-care
deficit related
to dementia
as evidenced
by patient
unable to
brush teeth,
don clothing
and patient
being unable
to obtain or
pick clothing.
Patient will be
able to
demonstrate
ability to
appropriately
dress well
with minimal
or no
assistance
after one
week.
Allow patient
to perform
tasks on her
own.
Provide oral
care including
cleaning of
dentures after
meals.
Educating
family on the
adaptive
measures of
helping the
patient cope.
This will boost
confidence and
self-esteem.
Oral care
promotes dental
hygiene and
prevents tooth
decay (Wallace,
Mohammadi,
Wallace & Taylor,
2016).
Helps in
collaborative care
of the patient.
After the
interventions,
the patient
was able to
groom
appropriately
without
assistance.
Impaired
physical
mobility
related to the
disease
process
leading to
pain, bone
loss and
inability to
bear weights
Patient will be
able to
mobilise with
minimal
assistance
and be free of
complications
due to motion
by the end of
facility stay.
Encourage
range of
motion
exercises.
Assist patient
to walk around
and provide
Enables
regaining of
function and
prevents
contractures and
death of muscle
due to disuse.
Helps patient
gain
independence
and self-esteem.
Patient
demonstrated
ability to
move with
minimal
complications.

AGEING AND RELATED COMPLICATIOS.
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as evidenced
by history of
fractures with
mere falls.
walkers where
necessary.
Turn patient
often and
assess cough
reflexes.
Turning patient
prevents
developing of bed
sores preventing
skin
integrity(Pickham,
Ballew, Ebong,
Shinn, Lough &
Mayer, 2016)
Imbalanced
nutrition less
than body
requirement
related to low
levels of
calcium and
vitamin D as
evidenced by
loss of weight
and history of
fractures
Patient
should be
able to
demonstrate
normal levels
of calcium
and vitamin D
in the body by
the end of 72
hours.
Advice and
administer
1500mg of
calcium daily.
Advice patient
on the benefits
of sunlight and
assist her to
bask.
Limit intake of
coffee or any
foods with
caffeine.
Intake of calcium
replenishes the
body with calcium
for normal bone
remodelling.
Sunlight is the
main source of
vitamin D which
helps in bone
remodelling.
Caffeine inhibits
the absorption of
calcium in the
gastrointestinal
tract (Areco,
Rivoira,
Rodriguez,
Marchionatti,
Carpentieri &
Talamoni, 2015).
After the
interventions,
the patient
was able to
demonstrate
normal levels
of calcium
and vitamin
D.
Bowel
incontinence
related to
inability to
voluntarily
control anal
sphinters due
to nerve
damage as
evidenced by
patient unable
to dictate
passage of
stool.
Patient will be
able to
verbalise
ability to
control stool
passage by
the end of 5
days.
Assist patient
come up with
an elimination
plan.
Assess the
frequency of
passing stool.
Educate
patient on
coping
mechanisms
including use
of diapers.
Educate
patient on
foods to eat to
keep stool
regular and of
good
consistency.
This stimulates
patient’s
confidence and
cooperation.
It helps monitor
the progress
whether patient is
gaining control.
(Scerri, Innes &
Scerri, 2015).
Following 5
days of
nursing
interventions,
patient was
able to control
elimination of
stool.
Risk for falls Patient will Provide Assisting patient After the

AGEING AND RELATED COMPLICATIOS.
7
related to
weakening of
bones
secondary to
osteoporosis.
demonstrate
ability to
maintain
balance and
support body
weight.
support and
assistance
during motion.
Provide
walkers or a
wheelchair to
the patient.
Educate
patient and
family on the
importance of
preventing
falls.
to walk prevents
falls since some
of the body
weight is held by
the care giver.
To enable easy
movement
through the
facility.
Falls even the
mere ones can
lead to extensive
fractures.
interventions
the patient
was able to
maintain body
balance.
Risk for
dehydration
related to the
increased
urinary loss
secondary to
incontinence.
Patient will
demonstrate
adequate
hydration
status
throughout
the period of
stay in the
facility.
Assess the
mucous
membranes.
Encourage
intake of fluid.
Monitor vital
signs.
Mucous
membranes are
indicators of
dehydration.
They should be
moist at all times.
Fluid intake
rehydrates the
body cells.
A rising pulse and
a falling blood
pressure points to
low fluid volumes
in the body.
After the
intervention,
the patient
demonstrated
adequate
hydration
status.

AGEING AND RELATED COMPLICATIOS.
8
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