Health & Illness in the Older Person

Read about the case study of Mrs. Helena Jones and the care plan developed for her comorbidities. Learn about nursing interventions for rheumatoid arthritis, type 2 diabetes mellitus, and falls.

Running head: HEALTH & ILLNESS IN THE OLDER PERSON
HEALTH & ILLNESS IN THE OLDER PERSON
Name of the student
Name of the university
Author note

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Par 1: The Case Study
Introduction
Aging is the biological process that every living being faces due to accumulation of
their cellular and biological molecular damages (Gibellini et al., 2019). These damages
creates complications in the physical and mental capacity of the individuals undergoing aging
processes and increases their risk of health complications with morbidity and mortality
(Sharpe, 2016). As aging is primarily associated with dependency inability, while providing
care for such patients, it is important to implement proper nursing strategy so that the needs
of the patients could be addressed (Garvey, Hurley & Kushner, 2016). Similar clinical
experience encountered in the clinical placement would be mentioned in this paper so that the
application of theoretical aspects in the practical scenario could be understood. With the
description of the case study of Mrs. Helena Jones (58) and her associated health
complications, the care plan developed for her con-morbidities would be mentioned.
Case study
I would mentioned about one of the case scenarios that I experienced while my
clinical placement in the care facility and in the process I would mention about the clinical
condition of Mrs. Helena Jones, a 58 year old female, who was admitted to the healthcare
facility with increased blood glucose level and increased pain in her right knee. The patient
had a 13 year long history of arthritis and her daughter mentioned about her weaknesses in
legs due to which she was unable to walk on her own. She also mentions of her dizziness and
sensitization in hands, due to which she was unable to hold objects in her hands. At the time
of admission, urine incontinence was observed in the patient. In a recent health checkup in
her locality, the patient was diagnosed with type 2 diabetes mellitus and due to which her
blood glucose level increased. Upon assessing the knee pain of the patient in the PQRST

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assessment scale, the pain level was found to be 8/10. Hence, from the entire health
complication, two of the aspects that were identified as the primary comorbidity for the
patient was her severe arthritis associated pain and her increased blood glucose level.
In this context, the effect of stereotyping on the healthcare aspects of the patients
should be discussed as aging is highly associated with stereotyping in Australian culture.
Stereotyping aging population affect the ability of the individuals to attain health as people
stereotype their abilities, their physical and mental strength (Martinez et al., 2016). In case of
Mrs. Helena Jones, her mental abilities nd health was also stereo typed due to her pain and
her inability to move and her complication of incontinence. She also suffered from stress and
depression due to her inabilities of performing activities of daily life on her own. Besides
this, nursing professionals stereotypes her condition with other cases of rheumatoid arthritis
and despite her will of acquiring walking, moving on her own, she was asked to take rest on
her bed. Hence, this affected her chances of recovery and affected her mental health. Due to
this, the complication of patient’s condition increased (Robinson et al., 2019).
Part 2: Plan of Care
Introduction
While providing care to the patients, there are multiple aspects that the nursing
professionals need to remember and implement. One of the most important aspects that
should be included in this care process is the application of patient centered care so that all
the needs and requirements of the patient to achieve well- being could be provided to the
patients. As per Garvey, Hurley and Kushner (2016) patient centered care helps the nursing
professionals to involve the patient in the care process so that with application of effective
interventions, the patients and their health literacy could be enhanced. There are multiple
aspects which could be used while implementing patient centered care, such as

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implementation of plan of care so that people could understand the effectiveness of it and
could help the patient with consistent care. Hence, it helps to develop holistic approach of
care. In this case of Mrs. Helena Jones, I would be discussing about the care plan I developed
for her arthritis and diabetic conditions. In this aspect, the discussion would be based upon
three primary objectives of the nursing intervention so that her critical condition related to
rheumatoid arthritis and diabetes could be treated and managed effectively. Further, with
proper implementation of effective care for Mrs. Helena, the critical nursing interventions,
their risks and their scope of improvement would be discussed so that the scope of improved
quality of life could be understood.
Priority 1
The first care priority selected for Mrs. Helena Jones is her rheumatoid arthritis
related condition, due to which she is suffering from severe pain. As per Newlove‐Delgado et
al. (2017), the primary concern of rheumatoid arthritis is associated with the synovial
membranes of joints that leads to deformities in the patient’s joints and increases the level of
pain. This pain could turn up in critical condition, as nursing professionals generally
stereotype this pain with the aging related pain due to which complications arises. Further as
per Frecklington et al. (2018), if the pain of rheumatoid arthritis are not treated or managed
properly, then it could lead to critical health complications with swollen joints, hampered
functioning in major organs as well as deformities in the bones. In this aspect, it is important
to implement nursing interventions, both pharmacological and non pharmacological
interventions so that the pain and inabilities related to critical conditions could be treated
(Davis et al., 2015). Within pharmacological treatment, the patient would be provided with
anti-inflammatory drugs including the NSAIDS, morphine or other steroids, as well as
physical exercise related non- pharmacological aspects such as physical therapy, counselling
as well as diet (Frecklington et al., 2018). There are multiple aspects that work as evidence

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for the support of the implementation of these interventions for the benefit of such patients
that are struggling with pain and inability so that patents could be provided with effective
care. As per Newlove‐Delgado et al. (2017), it is important for the healthcare professionals to
implement integrative approach of intervention for the pharmacological and non-
pharmacological application of interventions for effective and rapid improvement of the
patient’s wellbeing. Hence, in this condition, it is important for the healthcare professionals to
implement such interventions so that the pain and inconvenience of the patient could be
relieved and she could lead her life with effective ability of conducting activities of daily life.
After implementing the intervention, the evaluation would be the main aspect that would help
the patient to overcome the critical conditions (Davis et al., 2015). After implementation of
interventions, her pain score would be assessed weekly so that the level of pain and her
critical conditions could be assessed. Through the application of PQRST scale, her rating of
pain score would be analysed and hence visualisation of pain score and improvement in her
minimal mobility would help the patient to overcome her critical health conditions. However,
while implementing, understanding the effectiveness and determining the benefit of this
condition, the patient should be assessed for her health complication and improvement
without any stereotype (Robinson et al., 2019). There were multiple aspects in which the
patient and her health complications were stereotypes and considered her pain to be aging.
Hence, it could affect the application and implementation of the interventions and hence, this
should be taken care of while providing care to the patient (Martinez et al., 2016).
Priority 2
As per Vahedi et al. (2015), Type 2 diabetes mellitus and rheumatoid arthritis are
conditions that are critically associated with each of other. There are data as per which,
patients that are affected with rheumatoid arthritis, are most likely to be affected with
diabetes and the rate of this occurrence is 50%. Inflammation is the health condition that

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helps the patient’s body to reduce the level of infection arising (Agca et al., 2017). However,
with increased inflammation, the patient’s insulin producing hormone starts working
adversely. Hence, the increased insulin resistance in the patient condition also increases the
risk of type 2 diabetic mellitus (Hotamisligil, 2017). Further, in this critical condition, the
patient and her inability to make enough insulin could increase the risk of damages to other
organs and hence, this is the condition, that should be identified and effective interventions
should be implemented for this health condition (Vahedi et al., 2015). Mrs. Helena also was
diagnosed with increased blood glucose level and resulting type 2 diabetes mellitus due to
which her health complications increased. Hence, the patient should be provided with
effective interventions so that the increased critical diabetes health conditions could be
identified. Upon admitting in the healthcare facility, her diabetes condition increased
drastically and in this aspect her increased blood sugar level should be decreased (Vahedi et
al., 2015). She would be provided with medications especially her insulin dosage so that her
bodily glucose levels could be decreased. Finally, the patient should be provided with diet
and nutrition so that her health complications could be decreased and she could develop
effective abilities and her blood glucose level could be creased. This would be evaluated
using her blood glucose level and this would be assessed every week so that the effectiveness
of the diet and medications could be effectively assessed (Agca et al., 2017). The patient’s
condition would be assessed in the progress notes so that her blood sugar level, her urinary
incontinence and her insulin levels could be effectively assessed (Hotamisligil, 2017).
Priority 3
The third and final priority for the patient centered care developed and implemented
for the Mrs. Helena would be her critical conditions related to her stress, anxiety, her
continence and her increased risk of falls (Xue et al., 2017). As per Denkinger et al. (2015),
fall and anxiety are the aspects that are closely associated with the complications of the

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patients affected with her rheumatoid arthritis. As per Sharpe (2016), patients that are
affected with rheumatoid arthritis, are suffer from the critical risk of falls and pain, anxiety
and stress. As RA affects the bone, bone strength and bone structure of the patients, risk of
fall increases. Therefore, it is the primary aim of the nursing professionals associated with the
patient to implement strategies so that their risk of falls and increased pain could be
decreased. Mrs. Helena also suffered from RA and her pain score indicated critical conditions
due to which it could be inferred that her risk of fall was higher (Xue et al., 2017). Hence, in
such condition, the patient should be provided with interventions related to pain and falls and
should improve her body balance so that they could understand the effectiveness of it. She
would be provided with diet that decreases the critical signs of RA, and she would be
provided with high protein diet so that her bone strength could be increased (Prioreschi et al.,
2016). Further, she would be provided with physical exercises so that her body balance and
her ability to maintain bone strength could be identified (Sharpe, 2016). This would
effectively increase the patient’s ability to maintain activities of daily life, her ability to
maintain stable lifestyle could be enhanced. With this, her condition related to incontinency
would be managed by implementing effective treatment and adult diapers so that she does not
feel embarrassed while receiving care from the healthcare professionals (Beeckman et al.,
2016). While discussing these incidences and interventions, the risk of stereotyping and
inability of the nursing interventions should be discussed so that her health complications
could be addressed with effective and improved health interventions (Corrigan, 2018).
Therefore, these stereotypes should be eliminated and evaluation process should be
effectively identified. The evaluation would be the patient’s ability to maintain stable lifestyle
and her ability to perform activities of daily life (Robinson et al., 2019). Hence, in
conclusion, it could be said that all these nursing priorities should be addressed immediately
so that the rate of improvement could be improved.

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