Assignment On World Health Organization

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

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Introduction
According to the World Health Organization (WHO) (2017), with advancing age,
older adults experience gradual decline in the mental and physical health capacities and they
also become victims of non-communicable disease and other long-term health condition
leading to the development of functional disability. The effects of these changes can be easily
mitigate with the help of person-centred approach and by promoting education about the
concept of health ageing. The following essay is based on the analysis of an interview
conducted with an older adult. The interview analysis will be directed towards development
of person-centred care plan for the older adult.
Critical reflection of interview
WHO (2017) stated that personalised care approaches differ from the conventional
approach of care delivery. The personalised care approach for the older adults deals with
valuing of the need of the people, respecting patients' autonomy, taking into consideration of
the life-experiences, understanding the relationships and the surrounding environment.
Valuing people can be done with respecting their thoughts and personal perspective.
Throughout the interview, Rosy has expressed her personal fetish for spicy food and deserts
and she cannot she cannot live without it. Yu et al. (2018) stated that tendency of the
consumption of spicy food among the Asians (older adults) increases the risk of developing
cardio-vascular disease. Though I am aware of the harmful effects of spicy food, I did not
dis-respect her personal preferences and listened with utmost attention. Thus I think in order
to make change in food habits for Rosy proper education for health awareness must be
conducted. In the interview Rosy indicated that she knows that spicy thriving on spicy food is
not good for her health. This indicated that Rosy has minimal health literacy and all she needs
is independence in order to promote autonomy. Life experience of Rosy indicated that she is

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strong woman as she lost her husband in war and raised her son by working as a school
techer. She however, has no hopes for further living as she feels that living while staying
dependent to others is shameful. In understanding of relationships, it can be said that her
level of social connection is poor after shifting to Australia and she feels lonely in the
absence of her son who is her only companion after the death of her husband. Peerenboom et
al. (2015) stated in their cross-sectional study that depression is strongly associated with
emotional loneliness and not with social loneliness. Rosy is emotionally lonely after her son
shifted to new place and she is being detached from all her friend. The surrounding
environment is also failing to assist her in the process of healthy ageing. For example, Rosy
loves to do gardening but is unable to do so due to lack of support and companion. She is
losing her eye sight to read books or do stitching. This is making her feel futile to lives longer
or she is thinking that she is now dependent on others. The positive aspect aging of Rosy is
she can understand her physiological problems and aware of the resources that she might
need in order to conduct the process of healthy living. She also understands that importance
of healthy lifestyle but negative aspect is she is unsure regarding where to start.
Critical review of the current literature
The first person-centred care plan for Rosy will be focus to her mental health and
well-being. The findings of the study conducted by Chen and Feeley (2014) indicated that
support from partner or spouse and friends helps to alleviate the constant feeling of loneliness
among the older adults. The study also showed that higher support and lower strain coming
from various sources either directly or indirectly helps to improve the mental health and well-
being of the older adults. Rosy needs a constant support at home. She knows no one in
Australia, getting round the clock manual support at home will help her to communicate and
discuss her concern and practice her passion her gardening or reading books. There are

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various NGOs or social service organizations in Australia. These organizations provide
manual support for older adults in order to execute their hobbies and activities of daily living.
In relation to gardening Wood, Pretty and Griffin (2016) highlighted in their case-control
study that assisting the older adults in the process of gardening plays an important role in
promoting mental well-being and this can be used as a preventive health measure. Rosy loves
to do gardening but unable to do so due to lack of assistance, getting manual assistance will
help her practice her favorite and thus creating an event of engagement and improving her
mental health and well-being. Gardening activities among the older adults helps in improving
of the physical health. According to the theory of geriatric, both physical and mental health
are important for older adults (Nicklett, Anderson & Yen 2016). In case of Rosy, physical
health is particularly important as she is suffering from diabetes and obesity. The
improvement in physical activity through gardening for Rosy will help in reducing her body
weight and thus helping to reduce the blood glucose level. Promotion of physical activity will
also help to promote proper hand eye co-ordination and thus helping to reduce the chances of
accidental fall. Another person-centered care plan for Rosy will be to provide assistance in
following healthy living activities. Terada et al. (2013) stated that in order to improve the
quality of life of the older adults’ assistance must be given for practicing healthy lifestyle
habits. The assistance must be given either in the form of personal assistance or mental
motivation in a person-centered format. Gell et al. (2015) stated mobility devices used by the
older adults help in reducing the chances of accidental fall. Gonzalez-Campoy et al. (2013)
stated that use of proper dietary plans helps to reduce weight and chances of developing
metabolic syndrome among the older adults. Joyce experience difficulty in maintaining
balance thus use of mobility device will be helpful and proper diet plan will help in reducing
diabetes.

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Discussion
For the effective implementation of person-centred care plan for Rosy, supports from
multidisciplinary professionals are important. First member will include psychologist who
will interact with Rosy and will help her recover from depressive state of mind and loneliness
(Koenig et al., 2013). The second member will include community health nursing
professional who will motivate Rosy to indulge in healthy living activities and other social,
group based activities. The third member will include professional dietician for planning of
anti-diabetic diet while not compromising of Indian taste. The fourth member will include
occupational therapist who will help in proper planning of gardening activities and prevention
of the chances of accidental fall (Koenig et al., 2013). Evidence-based practice suggests that
for the development of person-centred care approach for older adults, support from
multidisciplinary team members are important (Hartgerink et al., 2014). The main care
setting for Rosy will be community-based care settings as condition or Rosy is not alarming,
otherwise she should be shifted to residential care setting. The challenges of implementing
the care plan under community based setting is presence of other service users from different
cultural background creating a gap in effective participation of Rosy. The presence of
culturally competent nurse will be helpful in this case.
Conclusion
Thus from the above discussion and analysis of the interview it can be stated that
loneliness and lack of social support can hamper the overall quality of life of the older adults.
Proper support from multidisciplinary team of healthcare professionals will help to design
person-centred care plan. Moreover health literacy and personal motivation are also
important. In this case, the main members of multidisciplinary team include dietician,
occupational therapist, psychologist, community health nurse.

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References
Chen, Y. & Feeley, T.H., 2014, ‘Social support, social strain, loneliness, and well-being
among older adults: An analysis of the Health and Retirement Study’. Journal of
Social and Personal Relationships, vol. 31, no. 2, pp.141-161.
Gell, N.M., Wallace, R.B., Lacroix, A.Z., Mroz, T.M. & Patel, K.V., 2015, ‘Mobility device
use in older adults and incidence of falls and worry about falling: findings from the
2011–2012 National Health and Aging Trends Study’, Journal of the American
Geriatrics Society, vol. 63, no. 5, pp.853-859.
Hartgerink, J.M., Cramm, J.M., Bakker, T.J.E.M., Van Eijsden, A.M., Mackenbach, J.P. &
Nieboer, A.P., 2014, ‘The importance of multidisciplinary teamwork and team
climate for relational coordination among teams delivering care to older patients’,
Journal of Advanced Nursing, vol. 70, no. 4, pp.791-799.
Koenig, T.L., Leiste, M.R., Spano, R. & Chapin, R.K., 2013, ‘Multidisciplinary team
perspectives on older adult hoarding and mental illness’, Journal of Elder Abuse &
Neglect, vol. 25, no. 1, pp.56-75.
Nicklett, E.J., Anderson, L.A. & Yen, I.H., 2016, ‘Gardening activities and physical health
among older adults: A review of the evidence. Journal of Applied Gerontology, vol.
35, no. 6, pp.678-690.

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Peerenboom, L., Collard, R.M., Naarding, P. and Comijs, H.C., 2015, ‘The association
between depression and emotional and social loneliness in older persons and the
influence of social support, cognitive functioning and personality: A cross-sectional
study’, Journal of affective disorders, 182, pp.26-31.
Reedy, J., Krebs-Smith, S.M., Miller, P.E., Liese, A.D., Kahle, L.L., Park, Y. & Subar, A.F.,
2014, ‘Higher diet quality is associated with decreased risk of all-cause,
cardiovascular disease, and cancer mortality among older adults’, The Journal of
nutrition, vol. 144, no. 6, pp.881-889.
Terada, S., Oshima, E., Yokota, O., Ikeda, C., Nagao, S., Takeda, N., Sasaki, K. & Uchitomi,
Y., 2013, ‘Person-centered care and quality of life of patients with dementia in long-
term care facilities’, Psychiatry research, vol. 205, no. 1-2, pp.103-108..
Wood, C.J., Pretty, J. & Griffin, M., 2016, ‘A case–control study of the health and well-being
benefits of allotment gardening’. Journal of Public Health, vol. 38, no. 3, pp.e336-
e344.
World Health Organization. (2017). Person-centred assessment to integrate care for older
peopl e. Access date: 13th August 2019. Retrieved from:
https://www.who.int/ageing/health-systems/icope/icope-consultation/ICOPE-Global-
Consultation-Background-Paper-2.pdf
Yu, K., Xue, Y., He, T., Guan, L., Zhao, A. and Zhang, Y., 2018. Association of Spicy Food
Consumption Frequency with Serum Lipid Profiles in Older People in China. The
journal of nutrition, health & aging, 22(3), pp.311-320.

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Appendix I
Interview
Could you tell me about yourself and any changes you have noticed as you have grown
older?
Hi my name of Rosy (name changed). I am an Indian by birth and I have recently
shifted to Australia after my son only got posted here. My husband is a war martyr. Within 3
months of my shifting, my son got transferred to another state in Australia. He is arranging
new residence so that he can take me there, but at present due to some financial crisis, he is
unable to so do. Thus I stay alone in this rented house in Queensland. I was x-English teacher
in a convent school in India and is 75 years old. I don’t know anyone here locally. I son calls
me daily and pays a visit each weekend. He is desperately trying for shift. I have never stayed
alone. After my husband passed away, I had my son to company me. But right now I am all
alone. I have eye sight problem, I no longer practice my favourite time pass, stitching and
reading books. I face difficulty in walking as I have osteoporosis. My maid assist me in day
time. Life has changed after I step on to 70 and it changed complete after we move to
Australia.
What are some of the best things about growing older for you?
There is nothing fascinating of getting old. I am can’t see properly, I problem in
hearing, difficulty in maintaining body balance, frequent indigestion. I also tend to forget
things, take medication. I am detached from my friends and I do not known any one here. I
love to eat spicy Indian food, sweets and deserts but I asked not to do so at present due to
obesity and diabetes. However, I love playing with my grand-children that is the best part of
ageing. Moreover, I do not need to go to work every day that is also very relaxing.

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What are some of the hardest things you have found in relation to growing older?
I hardest thing that I found growing older is detachment from friends. I feel lonely
here. Moreover, taking help from others in order to accomplish activities of daily living is
what I hate in aging. It is very demoralizing. I know that maintaining healthy life style is
recommended for aging but I just cannot live without my spicy food and deserts.
What is important for you now and into the future? Do you foresee any need for support in
achieving these goals?
I need to stay in my country and if not possible at least with my son. I think going
forward I would need walker as I am to maintain body balance while walking. I also has
hearing impairment and thus might need hearing aid. I love to do gardening and I find
Australia very suitable for gardening I would love to receive assistance of gardening as alone
I can’t do gardening any more.
Is there anything else you would like to tell me about your health and wellbeing?
I think staying with near and dear one is what all is about health and well-being for
the older adults. I also known that good diet and physical activity are also important, but I
just cant stay without spicy food and deserts. Thats why I feel why to lead life like this, alone,
starving for food, it is better to die and rest in peace.

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Appendix II
Summary of the interview
In the summary of the interview, I would like to highlight that in the telephonic
interview, I found Rosy struggling to cope up with her food preferences and her current
physiological state as she is suffering from obesity and diabetes. She also feels lonely in this
new place as she do not known anyone her in Australia and also misses her homeland India.
Communication cannot be a barrier for her as she was an English teacher and interacted with
me over phone in fluent English. She miss her son and loves her grand children. she also
loves to do gardening. She also capable to highlighting her physiological needs like walker or
hearing as resources to assist in the process of healthy aging.

Running head: NURSING
Appendix 3
Annotated bibliography
Authors Study Design Sample Intervention Findings Implications
Chen, Y. &
Feeley, T.H.,
2014
Observational
study
A national sample of
adults who are aged 50
years ad above were
observed
The study observed the older adults (N =
7367) from Health and Retirement Study.
The observational study was selected for this
approach as this kind of study helps in
understanding relationship between two
variables
The study highlighted that
presence of partner or spouse
and friends helps to alleviate the
constant feeling of loneliness
among the older adults. The
study also showed that higher
support and lower strain coming
from various sources either
directly or indirectly helps to
improve the mental health and
well-being of the older adults
Thus the care planning
of Rosy will involve
support coming form
her son and her friends.
Here her friends who
are there in India will
be contacted wither
through social media or
through phone. Rosy
misses her friends. Her
son will help to fetch
the contact details of
Rosy’s friends. Getting

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re-connected with the
friends will give her
positive motivation to
live
Wood, C.J.,
Pretty, J. &
Griffin, M., 2016
Case-control
study
7 days of gardening
session studied over 136
allotment
The main intervention used is gardening and
in order to measure elevation in the mood,
self-esteem, mood and general health was
taken into consideration.
The findings of the study
highlighted that practice of
gardening under assistance help
in improving the mental health
and well-being of the older
adults.
Rosy loves to do
gardening thus if she is
giving assistance in
executing her
gardening hobby then
her loneliness will get
reduced and her mental
health will improve.
Getting weekly
assistance from her son
will further help in
alleviating her mood
Nicklett, E.J.,
Anderson, L.A.
A systematic The review is based on
the analysis of the eight
The main intervention selected is gardening The gardening activities among
the older adults helps in
Rosy stated that she is
unable to walk

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& Yen, I.H.,
2016
review papers that are published
within 2000 to 2013.
improving of the physical health
by improving the body balance
and accidental fall
independently as she is
needs walker has faces
difficulty in
maintaining body
balance and thus
practising gardening
will help to improve
her physical strength
Terada, S.,
Oshima, E.,
Yokota, O.,
Ikeda, C., Nagao,
S., Takeda, N.,
Sasaki, K. &
Uchitomi, Y.,
2013
Qualitative
study with semi-
structured
interview
conducted with
open ended
questionnaire
The sample accessed was
older adults with
dementia admitted in the
geriatric ward or in out-
patient department.
The nature of the intervention that will be
helpful for the older adults was accessed by
conducting face to face interview. The
interview session helped in understanding
the emotional consequences and thought
process of older adults thus helping to
identify person-centred intervention
Physical or mental
(motivational) assistance is
important for the older adults in
order to practice healthy lifestyle
habits
Rosy is aware of her
health needs but is
unsure to follow the
same. Taking assistance
from trained nursing
professionals will help
her improve her dietary
habits and will motivate
her to take part in

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physical activity
Gell, N.M.,
Wallace, R.B.,
Lacroix, A.Z.,
Mroz, T.M. &
Patel, K.V., 2015
Cross-sectional
longitudinal
study in which
the self-reported
questionnaire is
used
The main sample
population used in this
study include people who
are under the Medicare
benefits in the USA
during the tenure of 2011
to 2012
The main intervention used for reporting of
the data is self-reported questionnaire. The
intervention for which the study is being
undertaken include importance of mobility
devices in maintaining the body balance
The survey result highlighted
that the use of mobility devices
help in reducing the chances of
accidental fall among the older
adults via helping to maintain
the body balance.
Rosy has reported that
she is unable to
maintain body balance
and demanded for
walker in the near
future thus the use of
mobility devise will be
helpful for her in
prevention of
accidental fall
conduction of the
activities of daily living
Reedy, J., Krebs-
Smith, S.M.,
Miller, P.E.,
Liese, A.D.,
Kahle, L.L., Park,
Prospective
cohort study
The participants were
selected from U.S NIH-
AARP Diet and Health
Study
Higher diet quality Higher diet quality helps in
reducing the chances of
cardiovascular disease, diabetes
and cancer development
Effective diet plan is
important for Rosy as it
will help her to recover
from current state of

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Y. & Subar, A.F.,
2014
diabetes.

Running head: NURSING