Nursing Care For Old People Case Study 2022

Running head: Nursing care for older people
Nursing care for older people
Name of the student:
Name of the university:
Authors note:

1NURSING CARE FOR OLD PEOPLE
Introduction:
Care for elder people is vast and includes service that can enhance their living
condition. Aged people face many physical disabilities and needs advanced care. With the
help of person centric assessment tool, I would like to throw light on the need of holistic
approach for their care. In a recent demonstration, I interviewed an old man who lives alone
and faces age related issues (Dias et al. 2019). In conversation with him, I understood the
psychology of such persons better. When I told him about the interview he gave his consent
and willingly sit with me for the interview. My conversation was based on basic questions
like how he was coping with the loneliness and how optimistic about his age. This outline is
important to understand the need of care for them. The psychological needs of old people are
often neglected, through this outline I would like to throw light on their physiological and
psychological needs. Mr John is an 82-year-old widower who lives alone in an apartment as
his son is living away. He suffers from asthma and uses nebuliser. The report would be based
on the conversation I had with him and its correlation with the care for aged population
(Donovan et al. 2017).
Critical reflection
From the conversation with him I found Mr John as very humble and optimistic
person. He actively took part in the interview and answered all my queries. Mr John spoke
clearly and loudly with minor interruptions. He was an asthmatic person and generally stayed
indoors. I asked him about his personal interests and he replied gardening. He had a keen
interest for outdoor games but his age does not allow him. Mr John misses his friends and
working days, which sometimes make him, feel withdrawal. He does not like to live alone but
he has no companion of his age. Mr John has successfully adapted to the age related stressors
which is a good sign as many develop suicidal feelings in this age. He is an hopeful person

2NURSING CARE FOR OLD PEOPLE
who wants to live and see his grandsons grow. However he has admitted to feeling anxiety
and depression at times due to isolation. Insomnia is also prevalent among him, sleep hygiene
practise is not well practised. In this age, there is a need of someone who would take care and
make necessary interventions for their health. However, Mr John was living alone and he
sons visit him annually. Mr John is suffering from hypertension, takes medication but
sometimes he forget to take his medicines, and this elevates his condition. In the age, memory
loss is a common thing as memory cells get diminished with ageing. Therefore, there is a
need of care for aged person like him who lives alone (Dunietz et al. 2018). Mental health
and social factors has an effect on normal physiology also. I would like to encourage Mr John
to take part in social gatherings in community, which may help him get rid of the isolation.
Mental health is an important factor that has a bad effect on his physiological health also. The
man also told me that there are a number of things that were important to him in the past but
have no relevance now as his priorities have changed. These changes are due to the fact that
at the younger age having a car, buying a house and earning a lot of money was much more
important to him. However as the days passed by the priorities changes and now staying
healthy and fit and staying with the family is much more important to him.
Current literature review
This study done by (Gatchel et al. 2019) throws light on some literature findings that
throw light on the issue of aged care. In critical analysis of issues faced by aged person there
were evidences of anxiety and depression. Maximum people of this age are suffering from
depression according to a study. The study focuses on the need of companionship in this aged
people. They feel suicidal in continued isolation and suffer from anxiety bouts. In a health

3NURSING CARE FOR OLD PEOPLE
care setting a study was conducted to find out the organizational factors enhance the
symptoms of depression.
(Foster and Wells 2019) found it out that the aged person living alone and living in
poverty are more prone to depression. In such case, social factors are challenging for aged
groups. The hierarchical regression supported the hypothesis of the study. A study conducted
by the Sleep research institute showed how sleep patterns are important indicator of
depression. Pain is common in aged person and in the study, it was constructed the long term
effects on insomnia symptoms that focus on depression and anxiety effects in aged
population. The study was conducted by interviewing the old people. As a result, it was found
that anxiety symptoms mediated between insomnia symptoms and anxiety. However,
depression symptoms did not show any mediation with sleeping patterns.
Through this findings we can say that with age there is tendency to develop
depression and suicidal. The anxiety symptoms and depression are prevalent in this age and
many factors like social factors and sleep pattern intensify the condition. Ageing person of
both sexes needs to be engaged in activities that are more social. The aged persons are more
prone to physical disabilities and needs more nursing care. According to the findings it can be
considered that aged population is vulnerable to both mental and physical abuse. Therefore
there is a need of providing them with care to take care of both physical and mental
disabilities they may face. Depression can lead to impaired functioning among older adults in
daily activities (Leyhe et al. 2015). Aged people with depressive symptoms are more prone to
poor functioning of chronic conditions they may face. Sustainable policies must be
implement to provide the aged population with palliative care. Mr John is also suffering from
loneliness and isolation that is slowly affecting his health.

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Current literature review by (Kok and Reynolds 2017) states that old people are more
vulnerable to mental health problems. There is a need of health promotion and
implementation of strong intervention to take care of aged population. Its important
intervention must include detecting and managing the challenging behaviour or symptoms.
Effective community based mental health care is crucial for older people. Sleep patterns is
important indicator of health and often gets disturbed due to mental illness. Dementia and
depression are two common issues that prevails in old age. This literature review articles
helped to establish the fact that the aged population is vulnerable to such kind of mental
ailment and therefore proper policies must be implemented to control the situation. Mental
illness can cause great suffering and lead to impaired functioning in everyday activities.
Discussion
Based on the information provided in the interview and current literature review there
can be some interventions implemented. Through this, we came to know of many issues that
makes the old population more vulnerable to isolation. It must be ensured that they follow a
balanced diet and actively participate in social activities. Health care settings can improve
mental health among the aged population by community-regulated programmes. These
programmes must spread awareness about the common health issues that they generally face
and promote mental health (Gonyea et al. 2018). Nursing interventions must include
assessing the risk factors and changes in mental status or symptoms related to diseases. Mr
John must be encouraged to ask for assistance whenever needed. Social services are there
which can be availed by Mr John. Many communities organise events that can have positive
impact on Mr John’s mind. Light exercises or meditation can be practise, as this would also
enhance his physical health. He must be encouraged to do energy conservation techniques
like sliding instead of lifting. This techniques would help him decrease the amount of oxygen
enable them for continued activity. In the conversation I realised that he has a short span of

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attention which is indicator of memory loss. Health care setting must arrange short
programmes annually that would help to minimise the communication between health carers
and aged population. This kind of monthly appointments may involve psychological
counselling where Mr John may be intervened for his mental health. Discussion of past
events must be encouraged as it would help to promote sense of continuity in his life (Kiosses
et al. 2015). Aged person often have tendency for memory loss, therefore patient must be
encouraged to speak about his feelings of anxiety or depression. It is important to have a
fixed routine for the elderly people as this would help to reduce confusion regarding their
routine.
Conclusion
Aged person must have adequate rest and needs to be kept away from stress as this
would enhance their life and ageing process. Depression in aged person have very silent
symptoms and difficult to address. Changes in behaviour must be recognised at early stages
for efficient treatment. Depression can make the aged persons suicidal so it must be ensured
that they do not show such symptoms. Close supervision must be provided to him as Mr John
lives alone and has no one to take care of him. Frequent assessment of neurological status
must be done as early detection would help to determine the treatment.

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References
Dias, A., Azariah, F., Anderson, S.J., Sequeira, M., Cohen, A., Morse, J., Cuijpers, P., Patel,
V. and Reynolds, C.F., 2019. Preventing major depression in older adults living in low-and
middle-income countries: a randomized controlled trial. JAMA Psychiatry, 76(1), pp.13-20.
Donovan, N.J., Wu, Q., Rentz, D.M., Sperling, R.A., Marshall, G.A. and Glymour, M.M.,
2017. Loneliness, depression and cognitive function in older US adults. International journal
of geriatric psychiatry, 32(5), pp.564-573.
Dunietz, G.L., Swanson, L.M., Jansen, E.C., Chervin, R.D., O’Brien, L.M., Lisabeth, L.D.
and Braley, T.J., 2018. Key insomnia symptoms and incident pain in older adults: direct and
mediated pathways through depression and anxiety. Sleep, 41(9), p.zsy125.
Foster, A. and Wells, M., 2019. Modifying CBT for Cognitively Impaired Older Adults with
Depression.
Gatchel, J.R., Rabin, J.S., Buckley, R.F., Locascio, J.J., Quiroz, Y.T., Yang, H.S., Vannini,
P., Amariglio, R.E., Rentz, D.M., Properzi, M. and Donovan, N.J., 2019. Longitudinal
Association of Depression Symptoms With Cognition and Cortical Amyloid Among
Community-Dwelling Older Adults. JAMA Network Open, 2(8), pp.e198964-e198964.
Gonyea, J.G., Curley, A., Melekis, K., Levine, N. and Lee, Y., 2018. Loneliness and
depression among older adults in urban subsidized housing. Journal of aging and
health, 30(3), pp.458-474.
Kiosses, D.N., Ravdin, L.D., Gross, J.J., Raue, P., Kotbi, N. and Alexopoulos, G.S., 2015.
Problem adaptation therapy for older adults with major depression and cognitive impairment:
a randomized clinical trial. JAMA psychiatry, 72(1), pp.22-30.

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Kok, R.M. and Reynolds, C.F., 2017. Management of depression in older adults: a
review. Jama, 317(20), pp.2114-2122.
Laborde‐Lahoz, P., El‐Gabalawy, R., Kinley, J., Kirwin, P.D., Sareen, J. and Pietrzak, R.H.,
2015. Subsyndromal depression among older adults in the USA: prevalence, comorbidity,
and risk for new‐onset psychiatric disorders in late life. International Journal of Geriatric
Psychiatry, 30(7), pp.677-685.
Leyhe, T., Reynolds III, C.F., Melcher, T., Linnemann, C., Klöppel, S., Blennow, K.,
Zetterberg, H., Dubois, B., Lista, S. and Hampel, H., 2017. A common challenge in older
adults: Classification, overlap, and therapy of depression and dementia. Alzheimer's &
dementia, 13(1), pp.59-71.
Schuch, F.B., Vancampfort, D., Rosenbaum, S., Richards, J., Ward, P.B., Veronese, N.,
Solmi, M., Cadore, E.L. and Stubbs, B., 2016. Exercise for depression in older adults: a meta-
analysis of randomized controlled trials adjusting for publication bias. Revista brasileira de
psiquiatria, 38(3), pp.247-254.
Titov, N., Fogliati, V.J., Staples, L.G., Gandy, M., Johnston, L., Wootton, B., Nielssen, O.
and Dear, B.F., 2016. Treating anxiety and depression in older adults: randomised controlled
trial comparing guided v. self-guided internet-delivered cognitive–behavioural
therapy. BJPsych open, 2(1), pp.50-58.

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Appendix 1
Discussion
The old person was being interviewed about the experiences he gained throughout the aging
process and the various aspects of the aging process that affected the psychological process of
the person during the entire phenomenon. At the time of interview it was noticed that the
person was not very sure about the process aging. He was skeptical discussing the same and
the experiences that went through him at different phases of life. When asked about the
various changes that has been noticed as he grew older the man told us that at every stage of
life he experienced a number of changes. He said that when he was young he was filled with
energy and enthusiasm. He used to be very excited about each and every new thing in life.
However as the days passed by the enthusiasm was decreased and he said that he was
becoming very less active. When he was young he used to do cycling and also liked to do
swimming. He has to change his habits of cycling and swimming as they create impact on his
health and he also gets exhausted easily.
Later during the interview it was asked that was the best thing about getting old and in
response to that the man said that staying with the family and enjoying with the grand
children are the best part of getting old. He can spend a lot of time with his family which he
could not do when he was young as he used to stay away from his family due to his job and
in order to earn money. However, he also emphasized on the fact that there are a number of
factors that are very hard about growing old. This includes the instances of falling sick,
having loss of memory, lesser chances of getting involved with the people in the social
meetings.
The man also told me that there are a number of things that were important to him in the past
but have no relevance now as his priorities have changed. These change is due to the fact that

9NURSING CARE FOR OLD PEOPLE
at the younger age having a car, buying a house and earning a lot of money was much more
important to him. However as the days passed by the priorities changes and now staying
healthy and fit and staying with the family is much more important to him.
In addition to that the interviewee told that in order to maintain the health he had to take
complete care of his daily routines that also includes taking the medicines at proper time.
This also includes having proper diet and the proper exercise for maintaining a healthy life.
Whenever he skips his meal or forgets to take his medicines he suffers from certain minor
health problems. Thus, now he needs to keep a proper check on the medications and the diet
that he intakes which was not the case earlier.

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Appendix 2
Authors Study
design
Sample Intervention Findings Implications
Dunietz et
al. 2018
The
researchers
conducted a
non-
randomised
longitudinal
survey by
including
the National
Health and
Aging
Trends
Study.
Total 2239
community-
dwelling
Medicare
beneficiaries
were
selected as
the
participants
of this study
so that the
implication
of the
insomnia
symptoms
and incident
pain could
be observed
in the
selected
participants
The study
conducts a
longitudinal
survey of
2239
participants
among which
one third of
the
participants
belonged to 65
years age
group. The
researchers
conducted
aspects such
as annual in-
person
interviews
with
assessments of
sleep initiation
and
maintenance;
depression,
and anxiety
(using the
Patient Health
Questionnaire-
2 [PHQ-2] and
the
Generalized
Anxiety
Disorder
Scale-2
[GAD-2]
respectively);
and
bothersome
pain with the
patients so
that the
implication of
All these
aspects
indicted to
the fact that
more than
24% of the
patients are
associated
with the
process of
sleep
initiation and
depression,
further the
baseline of
insomnia
helped to
identify that
the
development
of pain was
observed in
the
participants.
Therefore, from
this research it
was evident that
majority of the
patients that are
associated with
critical
conditions such
as old age and
insomnia
symptoms and
incident pain are
among the
aspects that are
responsible for
the critical
conditions faced
by the patients.

11NURSING CARE FOR OLD PEOPLE
there could be
understood.
(Neves,
Sanders &
Kokanović,
2019)
The primary
aim of this
paper is to
provide a
detail of the
processes
like
loneliness
and social
isolation so
that the
reason of
their social
exclusion,
reduced
well-being,
and
significant
health
problems
could be
identified.
No
participants
has been
selected for
this
descriptive
paper
This study
aims to
provide
effective
reasons due to
which
loneliness
and/or social
isolation were
associated
with the
patients or
older adults.
It helps to
provide an
effective and
richer
understanding
of the lived
experiences
of loneliness
and social
isolation
among frail
older people
From the
complete
descriptive
paper, it was
observed that
majority of the
older adults
suffer from
critical health
condition.

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(Dias et al.
2019
This paper
discusses about
the aspects that
is responsible
for the
depression in
older adults
living in low-
and middle-
income
countries. For
this aspect,
they conducted
parallel-group
randomized
clinical trial
with masked
outcome
assessment
was
performed.
81 older
adults (≥60
years) with
subsyndromal
depressive
symptoms at
rural and
urban
primary care
clinics in
Goa, India
were selected
for this
purpose.
brief
behavioural
treatment
for
insomnia,
education
in self-care
of common
medical
disorders
such as
diabetes,
and
assistance
in accessing
medical and
social
programs
were
selected for
this
process.
Major
depression
episodes are
associated
with this
health
condition
This helped
to understand
the fact that
old age is
associated
with
depression
and anxiety.
Franck,
Molyneux
and
Parkinson,
2016
Reviewer
extracted data
at study level.
Reviewer then
checked it.
Researcher
conducted it.
To report
isolation
and
depression
in older
person.
Group based
reminiscence
therapy aids
in reducing
isolation.
There msut
be more such
therapies that
can get them
rid of
isolation.

13NURSING CARE FOR OLD PEOPLE
Stein et al.
2019
Literature
review.
706
individuals
were
interviewed
about the
social
isolation.
To report
social loss
of
experiences
that
contributes
to
depression.
It was found
that personal
loss could
contribute to
depression.
This findings
can
contribute to
new
interventions
to help them
get rid of
personal loss.
Jonsson et
al. 2016
Systematic
review
Electronic
database was
searched for
controlled
trials and
then
reviewed.
To
synthesize
published
trials and
find the
efficacy of
the trials.
Problem
solving
therapy was
found to be
more
efficient to
overcome
depression
in aged
people.
Psychological
treatment can
be implicated
to cure for
depression in
aged
population.