Healthcare Assignment: In-depth Analysis of Joyce's Health Conditions

This healthcare assignment analyzes the case of Joyce, an elderly patient, addressing various health conditions. It begins by examining the impact of aging on Joyce's skin, including dryness, wrinkles, and changes in hair and nail color, explaining the underlying physiological factors. The assignment then explores Joyce's slow wound healing process, detailing the four phases of wound healing and how aging and potential complications impact each stage. It further investigates the effects of drugs on Joyce's digestive system, including diarrhea and constipation, and recommends personalized dietary changes to mitigate these adverse effects, emphasizing the importance of fiber, probiotics, and adequate hydration. The assignment also delves into Joyce's osteoporosis, discussing its causes, including estrogen deficiency and lack of exercise, and recommending interventions such as vitamin D and calcium supplementation, while considering potential risks like kidney stones. The analysis highlights the importance of a holistic approach to Joyce's care, considering her specific needs and the impact of aging on her overall health.

Running head: HEALTHCARE
Healthcare
Name of the Student
Name of the University
Author Note

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1.1. Age has a direct effect on skin and in case of Joyce, it is distinctly identified. Her skin
was dry, loose, wrinkled and has very less elasticity. This condition can occur due to the
decreased production of natural oils in skin due to age. Apart from that, collagen and elastin
fibers got break down as result the flexibility of skin got reduced. Joyce’s skin gets wrinkled
due to lack of the connective tissues. Dehydration in epidermis and dermis is also an
important factor which causes the wrinkles in the skin of Joyce. Apart from that, a visible
factor in Joyce’s skin is the color of hair and skins along with her nails. The colour changes
occurs due to reduced production of eumelanin because of age. Therefore these changes in
Joyce’s skin are natural and occurred due to age. Skin covers the whole surface of human
body and it is made up of two layers Epidermis and Dermis. Epidermis is the outer layer of
skin while dermis is the inner layer of skin. Epidermis primarily functions as the physical
barrier which restricts the microorganisms to enter inside the skin (Proksch et al. 2019)
Dermis on the other hand, contains sweat glands sebaceous glands, fat cells and hair follicles.
Secretions from sebaceous glands helps to maintain the hydration of the skin by restrict the
fluid loss (Proksch et al. 2019). Apart from that Fascia, is the tissue which connects the skin
with the muscles. It involves in providing protection against physiological stress (Prokschet
al. 2019). In case of adults, these componenets of skins are functioning efficiently which
leads to the normal condition of skin.
1.2. In case of Joyce, the wound healing process is comparatively slower than the adults.
Age plays an important factor in slow wound healing process (Gould 2016). However, the
wound healing process depends upon the type of wound and how it damages the skin. Joyce
was faced wounds related to fall which leads to fracture. Therefore, it her case, the
complications are severe. Wound healing process occurred in four different phases. Firstly
Homeostasis phase which starts when there is a wound in the body. This phase obstructs the

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blood flow followed by platelet accumulation at the wall of blood vessels near the wound.
Finally the platelets involved in obstructing the lesion by coagulation. In adults homeostasis
phase starts directly after the formation of wound. However, in case of Joyce, it will take
further time as she lacks efficient immune components which triggers this stage. Secondly,
inflammation phase, localized swelling occurs. This step involves maintaining the blood flow
and restricting infections related to the wound. In normal individual, inflammation starts after
1 to 2 hours of the wound and occurred fully within 1 day. In case of Joyce, it will take
around 2-3 days to show inflammatory response. Thirdly, proliferative phase, where, the new
tissues are formed by collagen and extracellular matrix. This step often takes a little longer
time. In adults the step completes after 2-3 days of the wound, while in case of Joyce, it will
take around 5-7 days.Finally, maturation phase, where the wound healed properly due to
involvement of collagen. In this phase, cross linking of collagen occurred which reduced the
scar line and makes the skin area as it was before the wound. Joyce, will face problem in this
final stage as she lacks the collagen and it will take around 7 days in complete maturation of
the phase (Norman et al. 2016, p.303). In case of Joyce, there can be several factors which is
related to the slow wound healing process. Firstly, the Joyce lacks skin elasticity due to the
degradation of the outer layer of the cell. In cell, the elastic tissue and collagen fibre involves
in providing flexibility and strength to the cells which helps to maintain the normal shape of
the skin (Khalil et al. 2015, p. 550). As these components lack its ability of efficient
functioning, speed of wound healing got reduced. Therefore, Joyce might face similar
situations which reduces the wound healing procedure. Apart from that Joyce might face
difficulty in collagen replacement at the wound as the replacement procedure reduced with
increasing age (Gould 2016).
2.1. The human digestive system involves in proper digestion of food. However, it can be
hampered by adverse drug effects. There are several organs which play significant role in the

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process of digestion. Organs like liver, pancreas and gallbladder plays important role in
digestion. Apart from that the gastrointestinal tract, consists of oesophagus, stomach, small
intestine, large intestine and anus involve indigestion process (Sherwood 2015). In normal
adults, the food absorption in the gastrointestinal tract is generally takes around 6 hours. Al
though, in case of Joyce, the digestive system functions differently. Several drugs made
important changes in the digestive system which leads to the adverse effect like diarrhoea
(Fragakis, Zhou, Mannan & Ho 2018). Several drugs can involve in hypomotility which can
lead to diarrhoea. Joyce faces difficulty in absorption and it takes longer time compared to the
adults and it leads to diarrhea. Several drugs can cause constipation in elderly adults
(Flanagan & Ronaldson, 2016). These drugs involves in colon to absorb maximum amount of
water. Due to the dehydration, poor muscle contraction occurs which leads to constipation
(De Giorgio et al. 2015, p.130).Apart from that, in case of Joyce, due to her age, the use of
oesophagus and spincters got reduce and these parts become inefficient in functioning. As a
result constipation can occur.
2.2. In case of Joyce, a personalized changed in diet is required to reduce the adverse drug
effect. Several studies reported that fibres play important role in bowl movement. Food
supplements like wheat, oat meal, legumes; fruits like apples berries, pears, vegetables such
as carrots broccoli green peas etc. are rich in fibre source. Dietary fibres are made up of
nondigestable carbohydrates. Fibre influences the food the acceleration of colon muscles;
therefore, these are the important food for Joyce. Apart from that, fermentation of fibre leads
to production of fatty acids such as acetate and propionate, which involve in increasing the
osmotic load and accelerate colon movement. Moreover, fibre contains a lot of water
molecules which modifies rehydrates the condition (Rao, Yu & Fedewa 2015). Adequate
intake of water and other fluids such as fruit juices are required to reduce the dehydration due
to drugs. Hence, these are important food items for Joyce. Several studies reported the

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importance of probiotics in reduction of constipation. Probiotics refers to live
microorganisms that are essential for human health. It maintains the normal bacterial flora in
digestive tract that helps in reduction of constipation. Due to the production of acids by these
bacteria, the pH of the colon becomes low which induces the peristalsis (Rao, Yu & Fedewa
2015).Joyce, need to consult with her dietician to have probiotics.In this time it is important
for Joyce to avoid packed foods, fast foods, frozen meals etc. during this time (Rao, Yu &
Fedewa 2015). Joyce, need a personalized diet plan recommended by a dietician who can
understand her condition and plan accordingly. Therefore, healthy diet plays a vital role to
overcome the adverse effects of drug.
3.1. Osteoporosis is a health condition where the bones loses its density and become weak
and brittle. Therefore, even the normal activities can also lead to fracture (Gupta & March
2016). It is a serious complication in Joyce as it causes severe pain, affects body weight and
limits mobility of a person. In case of Joyce, the diagnosis refers to weak bone condition
which occurs due to loss of bone mass. Loss of bone mass leads to weak bone structure which
in turn results as weak skeletal structure. Joyce will face pain related to the health condition
and as her bones weak, a fracture can happen even during the normal activities. Apart from
that, Joyce, might avoid healthy diet which leads to deficiency of vitamin D and calcium
which is required to maintain bone structure. Therefore, it is important to take extra care for
Joyce, as her condition is critical.
3.2. The three factors which lead to development of osteoporosis in Joyce are, firstly, lack
of Oestrogen (Black & Rosen 2016). Oestrogen plays important role in bone metabolism by
restricting bone remodelling, inhibiting differentiation of osteoclasts and reduction of bone
resorption. Joyce is an older woman and her age indicates that she faced menopause.
Therefore, there is deficiency of oestrogen which will result as osteoporosis (Black & Rosen
2016). Secondly, Joyce might have a habit of unhealthy food which can lead to this condition.

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Several studies reported that, diet containing vitamin D and calcium can prevent the chances
of osteoporosis in women (Smee, Pumpa, Falchi & Lithander 2015). However, the exercises
need to be recommended from the physiotherapist. Physical exercises helps to reduce several
symptoms related to osteoporosis such as reduction of bone loss, improved reaction time,
reduces the chances of fracture, reduced pain etc. (Kisner, Colby & Borstad 2017). Thirdly,
Joyce, might not habituated with regular exercises. According to several studies, Regular
exercise maintains the actual structure of bone along with that it maintains the functions of
joints. Joyce was not at all involve in regular exercise and it might lead to her health
condition.
4. Numerous studies has reported about the importance of Vitamin D and Calcium in
case of osteoporosis patients. In case of patients with osteoporosis chances of fracture is high.
Vitamin D can affect the risk of fracture as it is involved in bone metabolism. Vitamin D
supplementation can reduce the bone loss rate in Joyce. One of the major source of Vitamin
D is sunlight, as Joyce has several problems in mobility it is challenging to stay at sunlight
for her.However, the dosage of vitamin D is also important and it should be provided on the
condition of the patient. Kidney stones can be formed due to high consumption of vitamin D.
Therefore, in case of Janis adequate quantity of vitamin D is highly required. Several
published literature highlighted that vitamin D has its direct effects on patients who are
suffering from hip fracture (Brincat, Gambin, Brincat & Calleja-Agius 2015). In case of
Joyce, she was suffered from several falls and fractures and these literatures supported that
Vitamin D supplement can improve her health conditions. Apart from fractures different
studies reported the association between lower serum level and weak muscle mass and
strength in older adults (Brincat, Gambin, Brincat & Calleja-Agius 2015). In case of Joyce,
vitamin D supplements can provide energy and strength to the muscles, therefore it improves
the functioning of the muscle and this can lead to reduction in falls. According to the reported

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studies, vitamin D derivatives such as alpha calcidol and calcitrol has better efficacy than
normal vitamin D in preventing bone loss and primary osteoporosis (Brincat, Gambin,
Brincat & Calleja-Agius 2015). Therefore, the studies supported the fact that vitamin D can
be an important health supplement to improve the condition of osteoporosis, however,
adequate dosage is required. However, most of the reported studies highlighted the
combination of vitamin D and calcium in case of osteoporosis (Harvey et al. 2017, p. 447).
The combination of these two supplements was reported to have more efficacy to reduce
osteoporosis. Calcium absorption in bones is mostly depended on vitamin D (Harvey et al.
2017, p. 447). Therefore, when the combination of vitamin D and calcium is provided to the
patient, the calcium improves the quality of bone and vitamin D influences calcium
absorption (Harvey et al. 2017, p. 447). Several studies reported that the risk of fractures can
be reduced in patients with osteoporosis by providing vitamin D and calcium food
supplement (Harvey et al. 2017, p. 447).However, Joyce cannot go for high consumption of
calcium and vitamin D supplement as both of these can cause problems like kidney stones as
adverse effects. Therefore, it is challenging to fulfil the demand of vitamin D and calcium
with only supplements. Adequate diet is also required for Joyce.

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