Assistance in Physical Activity and Gardening for Older Adults with Dementia

This essay discusses the importance of assistance in physical activity and gardening for older adults with dementia, focusing on the case of Martin Chen. It explores the identified care needs of Martin and the resources that can support his needs. The role of a registered nurse in providing comprehensive care is also discussed. Staying at home for older adults promotes mental well-being and cultural safety.

Running head: NURSING
Nursing
Name of the Student
Name of the University
Author Note

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Introduction
Consumer-directed care (CDC) is embraced in Australia as an important means of
promoting patient's autonomy and selection of the choice of delivery of the health and the
social services (Commonwealth of Australia, 2012). The following essay is based on the
analysis of the healthcare and personal needs in order to ensure special focus over the
independence and mobility needs of an older adult named Martin Chen. The aim of the essay
is to advocate patient to stay at home not to go in an aged care facility. In doing so, the essay
will initiate analysis of the main needs of Martin followed by resources that will be important
to satisfy his needs. This will be followed by role of the registered nurse in assisting patients
and his family members to avail the service and liaising with the required health care
personnel. At the end, the essay will provide rationale behind importance of staying at home
for the older adults.
Identified care need
The analysis of the case study highlights that Martin Chen who is at present 78 years,
mild be suffering from initial stages of dementia. Brataas et al. (2010) stated the older adults
who are above 65 years of age are vulnerable towards developing neurodegenerative disorder
like dementia. As per the case study he is forgetting English terms and phrases while
communicating, while the stove remains unattended with burning food. Kosse et al. (2015)
stated that loss or fragment loss of memory is the initial stage of dementia associated with
hallucinations. Chen also hallucinates as he cries at night feels that he is back in Hong Kong
or tells daughter that someone has poisoned the garden soil. Thus the prime care needs
assistance in daily living activity in order to promote independence and mobility needs
through physical activity. According to Clarkson et al (2018), older adults who are suffering
from dementia, a neurodegenerative disorder are prone to accidental fall. Thus, safety is also

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an important concern. Assistance in physical activity will help to manage the escalating
weight of Martian and at the same time will improve the flexibility of the muscles and joints
and thus reducing the chances of accidental fall. Reduction in the body mass will help to
reduce blood glucose level (BGL), severity diabetes and cardiovascular problems and thereby
increasing the overall health status and giving independence to lead an independent life (Gill,
Bartels & Batsis, 2015).
According to Hill, Hunter, Batchelor, Cavalheri and Burton (2015), older adults who
are suffering from dementia are prone to accidental falls and thus increasing the chances of
getting injured. Injury related to accidental fall leads to pain and at the same time hampers the
independence to conduct the daily living activities. The systematic review and meta-analysis
conducted by Giné-Garriga, Roqué-Fíguls, Coll-Planas, Sitja-Rabert & Salvà (2014)
highlighted that regular practice of mild to moderate physical activity helps to reduce the
chances of accidental fall among the frail older people. Individualised home based physical
activities can helps in the improving mobility, balance and muscle strength and thus helping
to improve the physical independence (Burton et al., 2015). Blondell, Hammersley-Mather
and Veerman (2014) highlighted in their longitudinal study that physical activity in dementia
helps to reduce the cognitive decline of the older adults. The reduction in the cognitive
decline in Martin will help to improve his level of independence in conducting daily living
activities.
The case study highlights that Martin hails from a Buddhist family. He thinks that
visiting temple will provide much needed time and relaxation. However, for visiting the
temple, he needs to reply on his children. Regular visit to the Buddhist temple in Adelaide
will help to improve his mental well-being and at the same time will help to work on his
aggressive behaviour. Ennis and Kazer (2013) stated that spiritual nursing interventions helps
to improve the mental and the physical well-being of the older adults with dementia. Martin

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also loves to do vegetable garden thus assistance in conducting gardening activities will help
to improve his self-confidence and mental well-being and can be identified one priority of
care. The last care needs will be weekly monitoring of the BGL, blood pressure and blood
cholesterol. Gonzalez and Kirkevold (2014) stated that sensory gardening and horticultural
activities in the dementia care help to improve the well-being while reducing the disruptive
behaviour.
Thus overall it can be said that main care need of Martin is restorative care through
home-based services. Cochrane et al. (2016) stated that restorative care for the older adults
helps to reduce the functional decline while improving the independence.
Identification of the resources
The main resource that will be helpful in order to support the comprehensive care
need include a home care package in order to continue living at home. Part of Silver Chain
Group (2019) in Adelaide provides personalised packages for the older adults in order to
lead a healthy life. The main support that Martin needs include allied health and therapy
services like fall prevention (by personal support and by the use of walking aids and
installation of grab rails), restorative services and physiotherapy for planning of the mild to
moderate physical exercise. Providing manual assistance to attend Buddhist temple daily or
once in a week by care as per Martin’s will. Specific support for improving his memory like
community based group activities. At present Martin’s condition does not demands personal
care services like showering, dressing and grooming and thus can be omitted for the service.
Silva et al. (2013) highlighted that elderly people needs informal caregivers in order
to maintain mental and physical well-being and at the same time lead to healthy life at home
and decreasing the need of moving to aged care facility. The informal caregivers in case are
the family members of Martin. The informal caregivers will be trained to provide Martin

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assistance to continue his hobby of vegetable gardening. However, in order to reduce the
chances of the accidental fall the pavement of the pots can be raised so that Martin is not
required to bend to water the plants or installation of pipes for watering of the plants. The
family members of Martin will be trained regarding periodic monitoring vital signs of Marin
like use of glucometer for BGL, digital sphygmomanometer to record blood pressure. For
monitoring of the blood glucose level, assistance can be taken from the Australian
Department of Health (Ageing and Aged Care, 2019). By giving a call to this toll free number
1800 200 422, help can be availed for the conduction of blood test. The Australian
Government funded initiatives, Commonwealth Home Support Programme and also be avail
in order to assist Martin to accomplish his daily living activities.
Role of registered nurse
Registered nurse plays a vital role for comprehensive service delivery to the older
adults under home settings. They hold the key management role in operational planning,
coordination in the care plan, delivery and monitoring of evidence-based practice and
creating provision for the continuous quality improvements (Goodwin et al., 2013). The
presence of the registered nurses provides clinical supervision and nursing leadership in order
to facilitate the complex health needs of the older adults like Martin. For Martin, the duty of
the registered nurse will be to design person-centred care plan. The person centred care plan
for Martin will be designed for physical activity promotion as per the mobility quotient of his
joints. This will be done by taking help from occupational therapist and physiotherapist.
Toots et al. (2016) stated that high-intensity physical exercise will be helpful of older adults
and at the same time will help to reduce the high BGL.
Person centred care plan for Martin will include developing of the gardening activity
planning for Martin under the assistance of the occupational therapist so that it might help to

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improve the mental well-being of Martin while reducing the chances of the accidental fall
(Wiseman & Sadlo, 2015).
The registered nurse will also educate the informal care givers or the family members
of Martin about the importance of the timely intake of medication and monitoring of the vital
signs of Martin in regards to his age and present status of the forgetfulness. It is the duty of
the nursing professionals to engage the patient in the care plan by disease education in order
to improve the therapy adherence (Kornhaber et al., 2016). For Martin education will be
given in the domain of effective weight management and adherence of physical exercise to
promote self-management skills and independence. Silva et al. (2013) stated that family
members at time suffer from burnout and compassion fatigue. In order to overcome the same
a holiday or day out is found to be effective. The duty of the registered nurse will be to help
Martin daughter and his family to enjoy an outing while arranging required support at home
by taking assistance from Commonwealth Home Support Programme.
Benefits of transitioning at home
Parsons et al. (2013) stated that providing restorative are while at home helps in
improving the mental and the physical well-being of the older adults. While staying at home
enable the older adult to stay under the known social support and informal carers and this
help to improve their level of confidence and inner-strength and thereby providing benefits in
the grounds of the mental health and well-being. The staying at home for Martin will also
provide him the independence. Martin is from China so staying at home will help him to
remain culturally safe and thus helping to remain high on self-esteem.

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Conclusion
Thus from the above discussion, it can be concluded that main care needs for Martin
is assistance in physical activity, gardening, visiting to Buddhist template along with regular
monitoring of vital signs. The Commonwealth Home Support Programme and other privately
funded organisation provide a comprehensive assistance to the older adults which help them
to lead to healthy life while staying at home. The duty of the registered nurse will be to assist
the allied professionals in designing of the person centred care plan along with promotion of
the disease education to both the patient and their family members. Sating at home for the
older adults help to promote mental wellbeing and cultural safety and thereby helping to
increase the physical well-being.

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