NCS2201 Assignment: Risk Factors, Diabetes, Aged Care, and Reflection

This assignment, focusing on older adult health (NCS2201), explores several key areas. It begins by examining the risk factors associated with elder abuse, including living arrangements, social isolation, and individual characteristics, supported by existing literature and research. The assignment then addresses risk assessment, detailing a case study involving an elderly patient with cognitive communication impairment and constipation, including the pain assessment method used and interventions implemented. Furthermore, it discusses Type 2 diabetes, its prevalence among older adults, and effective health promotion strategies. The assignment also considers an individual's preferences for a residential aged care facility, including desired room attributes, meal services, social activities, and care services. Finally, the assignment concludes with a reflection on the unit's impact on the student's understanding of aged care, highlighting new knowledge gained, surprising insights, and intended changes in practice when caring for older adults, also including the impact of cultural competency.

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Older Adult Health
Unit code and Title:
Lecturer:
Student Name:
Student Number:
Date of Submission:
Word Count:

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Elder abuse
The risk factors that make the senior adults more susceptible to elder abuse include living
arrangements, social isolation, and the individual. Existing literature shows that living in a shared
house is a significant risk factor for elderly abuse than when they live alone. The study by
VandeWeerd, Paveza, Walsh, and Corvin (2013) found out that older adults diagnosed with
Alzheimer’s disease were much more mistreated by care providers when they lived with close
family members. A shared living arrangement increases the chances of association and conflict
and mishandling.
Social isolation is as a result of hiding behaviors that are prohibited and once such actions
are detected then the family members may initiate informal sanctions. Such incidences of
mistreatment are rare in families with strong social networks (Yan, E., Chan, & Tiwari, 2015). A
prospective study by Post et al. (2010) found out that elders with poor social networks reported
significant incidences of mistreatment which were mostly verbal and physical.
An individual himself/herself can be a risk factor for mistreatment from the perspective
of mental health, conduct, and gender. If the abused has mental health issues, then he/she may be
mishandled in the effort to contain the older adult (Yon et al., 2017).
(White Ribbon Australia, 2019; Blakey, 2016)
Risk Assessment
The elderly patient that I had taken care of had an average cognitive communication
impairment that I assessed using the Iowa Pain Thermometer which is an adapted descriptive
verbal scale (Ware et al., 2015). I asked the patient to describe the intensity of his pain from
seven options namely no pain, slight pain, mild pain, moderate pain, severe pain, very severe

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pain, and the most intense pain imaginable). I also gave the patient an option to identify the scale
that well represents his pain intensity from a scale ranging from 0 to 12 which are indicated next
to the pain thermometer also. I then showed the scale to the patient and repeated to him how the
temperature rises in the instrument and requested him to perceive the increase in body pain as the
reading in the thermometer increases. After which the patient was requested to point out to the
level of his pain intensity.
The patient was experiencing constipation after long-term use of opioid which further led
to bowel obstruction. Due to the increased risk of constipation among older adults, the patient
was administered with a bowel program of laxatives in addition to the opioids to help avoid
bowel obstructions (Dalacorte, Rigo, & Dalacorte, 2011).
(Campbell, 2016; Dukes, 2017)
Type II diabetes
Type 2 diabetes mellitus is a chronic condition caused by the ineffective use of insulin by
the body. It is a disease that was commonly prevalent among adults but also affects young
children these days due to childhood obesity. The condition is commonly caused by excess body
weight and living a sedentary lifestyle (Sharma, Nazareth, & Petersen, 2016). Type 2 diabetes is
prevalent among senior adults and increases with age. 1 in 6 people aged 65 years and above
were reported to have type 2 diabetes. The elderly aged 85 years and above had the highest
prevalence of type 2 diabetes (19.4%). 55% of the cases were men aged 65 years and above with
the rest being women. Type 2 diabetes accounted for 90% of diabetes among older adults aged
65 years and above (AIHW, 2019). Three most effective strategies to promote health among
diabetic older adults include the educational approach, strengthen community action, and the

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creation of a supportive environment. Educational approach involves awareness and sensitization
on self-care, diet regulation among others. Community action and provision of supportive
environment are critical in mobilization and maintaining an active life (Pham, & Ziegert, 2016).
(Resnick, 2014; Resnick, 2012)
Growing Old
Aged care homes do assist with daily duties, individual care, and nursing care. However,
my preferences for the residential aged care facility include my room and all that comes with it
such as beddings, furniture, and entertainment set such as television and music system. The
rooms should have high ceilings with floorboards that are thoroughly furnished. The room
should also have original fireplaces and beautiful courtyards. Regarding my meals, I would
prefer hotel-type services consisting of adequate meals and laundry. Some of the social activities
that I would prefer to include swimming and enough and maintained ground for strolling. The
residential aged-care facility should as well offer cleaning, heating and cooling services. I will
often need care services depending on the status of my health. Personal care services include
assistance with medications, eating, and bathing.
The facility should also offer clinical care services twice a week. I would need speech
therapy once every week due to my hoarse voice and physiotherapy twice a month. I would also
like to costs associated with the above services or their standard rates. For example, their basic
daily fee, accommodation fee, and the procedure for applying.
(County Council, 2013; ADHERe, 2020)
Reflection

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This unit has been beneficial to me as a future practicing nurse in aged care in multiple
ways. I have learned that perhaps the most susceptible people to abuse are the older adults. I had
thought that living in a shared house with the elderly is much better than living alone or in
residential aged-care facilities. To my surprise, adults that live together with their family
members are more likely to be abused through isolation than those living alone. I have also
learned of other instruments of pain assessment during my research. This has increased my
knowledge in the area of working with the aged. I have also observed that older adults have
multiple forms of health complications some of which might be diagnosed or not. This has
completely changed my attitude and I intend to be more cautious and patient when working with
the aged patients.
In the unit of multicultural aging, I learned that the perception of the older adults is
shaped by their culture which also influences their thinking. As a result, I have decided to
explore more on cultural competency because I am likely to meet elderly patients from diverse
cultural backgrounds

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References
ADHERe. (2020, March 4). Residential aged care facility [video file]. Retrieved from
https://www.youtube.com/watch?v=9GP9Oa39UAA
Australian Institute of Health and Welfare (AIHW). (2019). Older Australia at A glance.
Australia’s health series. Cat. no. AGE 87. Canberra: AIHW. Retrieved from
https://www.aihw.gov.au/reports/older-people/older-australia-at-a-glance/contents/health-
functioning/diabetes
Blakey J. (2016, Jan 31). Elder Abuse [video file]. Rederived from
https://www.youtube.com/watch?v=k3Uv9ppp_dk
Booker, S. S., & Herr, K. (2015). The state-of-“cultural validity” of self-report pain assessment
tools in diverse older adults. Pain Medicine, 16(2), 232-239.
Campbell J. (2016, July 15). Pain Assessment in older adults [video file]. Retrieved from
https://www.youtube.com/watch?v=vFon_eUu6do
County Council. (2013, May 20). Residential and nursing home cares [video file]. Retrieved
from https://www.youtube.com/watch?v=UfoSv_MCRBo
Dalacorte, R. R., Rigo, J. C., & Dalacorte, A. (2011). Pain management in the elderly at the end
of life. North American journal of medical sciences, 3(8), 348.
Dukes KC. (2017 July 14). Geriatric pain assessment [video file]. Retrieved from
https://www.youtube.com/watch?v=rTLfmoFLP4Y

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Pham, L., & Ziegert, K. (2016). Ways of promoting health to patients with diabetes and chronic
kidney disease from a nursing perspective in Vietnam: A phenomenographic
study. International journal of qualitative studies on health and well-being, 11, 30722.
https://doi.org/10.3402/qhw.v11.30722
Post, L., Page, C., Conner, T., Prokhorov, A., Fang, Y., & Biroscak, B. J. (2010). Elder abuse in
long-term care: Types, patterns, and risk factors. Research on Aging, 32(3), 323-348.
Resnick B. (2012, Jan 18). Complications of diabetes in older adults [video file]. Retrieved from
https://www.youtube.com/watch?v=wNoTY5Kps1w
Resnick B. (2014, April 24). Managing type 2 diabetes in older adults [video file]. Retrieved
from https://www.youtube.com/watch?v=vaGRV6lTffk
Sharma, M., Nazareth, I., & Petersen, I. (2016). Trends in incidence, prevalence and prescribing
in type 2 diabetes mellitus between 2000 and 2013 in primary care: a retrospective cohort
study. BMJ open, 6(1), e010210.
VandeWeerd, C., Paveza, G. J., Walsh, M., & Corvin, J. (2013). Physical mistreatment in
persons with Alzheimer’s disease. Journal of Aging Research, 2013.
Ware, L. J., Herr, K. A., Booker, S. S., Dotson, K., Key, J., Poindexter, N., ... & Packard, A.
(2015). Psychometric evaluation of the revised Iowa pain thermometer (IPT-R) in a
sample of diverse cognitively intact and impaired older adults: a pilot study. Pain
Management Nursing, 16(4), 475-482.

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White Ribbon Australia (2019, May 29). Elder Abuse [video file]. Retrieved from
https://www.youtube.com/watch?v=AsLG-L_xZCwhttps://www.youtube.com/watch?
v=AsLG-L_xZCw
Yan, E., Chan, K. L., & Tiwari, A. (2015). A systematic review of prevalence and risk factors for
elder abuse in Asia. Trauma, Violence, & Abuse, 16(2), 199-219.
Yon, Y., Mikton, C. R., Gassoumis, Z. D., & Wilber, K. H. (2017). Elder abuse prevalence in
community settings: a systematic review and meta-analysis. The Lancet Global
Health, 5(2), e147-e156.