Identifying Nursing Care Priorities for an Elderly Patient with Multiple Health Issues

Running head: HEALTH CARE PLANNING
Health care planning
Name of the student:
Name of the University:
Author’s note

1HEALTH CARE PLANNING
Introduction:
The main purpose of the assignment is to review the case scenario of Mr Dinh
Nguyen, an 83 year old widower with history of health issues and ongoing symptoms
of grief and isolation and identify the main nursing care issues for the client. It
engages in critical reflection using the Levett Jones clinical reasoning cycle to
identify three nursing care priorities for the patient and then discuss on the most
important care priority. The Miller’s functional consequence theory will be utilized to
identify the important care priorities for the patient.
Consider the patient:
Mr. Dinh Nguyen is an 83 year old patient who lives alone in his two story
home. Earlier his wife used to live before she died twelve months ago. Mr. Dinh has
migrated from Vietnam in 1976 and the current health issue for him is that he is
suffering from ongoing grief and isolation. As he does not have any children,
isolation and grief has significantly affected health of the client. Currently he is also
facing issues in doing daily activities like cooking, showering and dressing because
of blurred vision, electric shock type feeling during head and neck movement and
numbness in his face. He is also experiencing urinary incontinence.
Collect cues/information:
The cause behind Mr. Dinh’s current health condition can also be understood
from review of past medical history too. Six years ago, Mr. Dinh was diagnosed with
multiple sclerosis. Four years ago he was diagnosed with osteoarthritis. In addition,
issues related to feelings of isolation and grief has emerged after the death of his
wife. As he does not have any children and do not want to involve them in his daily
life, getting no social support is also a cause behind depressive symptom for the
client. Currently he is also on three medications and one is for exacerbation of
symptoms.
Process information:
The above symptoms and current challenges for Mr. Dinh can be understood
from the application of Miller’s functional consequences theory. He has been
experiencing challenges in daily life activities because of age related changes and

2HEALTH CARE PLANNING
presence of many risk factors too. He suffered from osteoarthritis in the past. This
might have occurred because of aging related changes. Osteoarthritis is highly
recognized as an age related disease because it is the most common disorder in
eldelrly people. Anderson and Loeser (2010) explains that age is the greatest risk
factor for the development of osteoarthritis because of age related changes in the
function of cells and tissues of the body. The cells and tissues lose the capability to
maintain homeostasis due to aging particularly during stress. The same issue is not
so serious in young adults because young age adults can compensate for stress
declines compared to older adults. Hence, it can be said that decline in basic cellular
mechanism involved in homeostasis with aging is the reason for joint tissue loss and
osteoarthritis for Mr. Dinh. Urinary incontinence was also a problem for Mr. Dinh and
this also limits social activity of people. It also contributes to multiple sclerosis (Nerli
& Hiremath, 2017).
Another negative functional aspect that has been identified for Mr. Dinh based
on the review of health issues is the issue of depressive symptom in patient. His
symptom of grief and increasing isolation is an indication of depression. Depression
is a mental health condition associated with symptom of low mood, feelings of
sadness and loss of interest in activities. Lack of family member’s support and living
alone has been recognized as the risk factor of grief and isolation in patient. Another
risk factor for depression might include presence of many physical illness. Mr. Dinh
suffered from many health issues in the past such as multiple sclerosis, blurred
vision, mobility issues and gait impairment. There is a complex relationship between
physical illness, disability and depression. Evidence suggests that physical illness in
old age contribute to permanent disabilities and this negative has an impact on
mobility and self care needs of patients (Fässberg et al., 2016). Hence, they start
developing feelings of depression. It is crucial that Mr. Dinh received proper attention
at this age and his dignity be respected too so that his depressive symptoms can
alleviate.
Social isolation and loneliness is also predictive of depressive symptom in
elderly people. Lack of children, death of Mr. Dinh’s wife and lack of any other form
of support is indicative of loneliness and reduces connection with families. This might
have significantly affected emotional wellbeing for the client and eventually
contributed to depression. It has an adverse impact on functional status of elderly