NSG4067 Assessing and Planning for Elderly Persons Essay

NSG4067 Assessing and Planning for Elderly Persons Essay

            The elderly are a group of vulnerable populations in most societies. They have complex health needs that may predispose their dependence on others. Therefore, this research paper summarizes an assessment performed on an elderly client. It explores different assessment tools’ outcomes and identifies issues, alterations, and interventions needed to promote the client’s health.

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Comparison

The assessment of the elderly client using the Tinetti Balance and Gait Evaluation showed that he was highly at risk of falling when undertaking his routines. The balance assessment demonstrated that the client rises from the chair using arms to help him. He also requires assistance as he attempts to rise from a chair. The client’s immediate standing balance is steady but uses a walker. He uses a walker to maintain standing balance with some evidence of staggering. He, however, works steadily with eyes closed and when turning through 360 degrees. He uses his arms to maintain a smooth motion when sitting down. The assessment of gait also revealed that the patient-initiated gait without hesitancy. His step length and height were asymmetrical. For example, the right swing foot failed to pass the left stance foot with step. The right and left step lengths were also asymmetrical. The trunk had marked sway, as evidenced by his use of a walking aid. The above balance issues were attributed to the reduced elasticity of the tendons and ligaments of the bones.

The Katz Index of Activities of Daily Living assessment showed that the client performs all the activities of daily living independently. The client reported bathing independently and only needing help bathing the lower extremities. He also dresses independently and may need help in tying his shoes. He also reported being able to toilet, transfer himself in bed unassisted, and does not experience incontinence problems. He also feeds without any assistance. Based on the above, the client can perform all his daily living activities without any help from his family members.

The Barthel Index confirmed the client’s independence in undertaking his activities of daily living. The assessment demonstrated that the client is independent in feeding, bathing, dressing, bowels, bladder, toilet use, and transfers. He, however, uses a walking stick for mobility and assistance in climbing stairs. The client reported during the interview that he engages in regular walks to strengthen his bones and muscles. However, he was diagnosed with dementia one month ago and had to minimize walking out of their compound because of fear of getting lost. He reported that he takes a healthy, balanced diet to minimize health problems like cancer, diabetes, and fractures. He also has a diabetic foot, which is dressed weekly in a nearby public facility. The assessment showed the increased need for family involvement in the management of diabetes and promotion of his safety in familiar and unfamiliar environments to promote safety.

Home safety assessment showed the home to be moderately safe. The home had a fire extinguisher at the point of entrance with working smoke and carbon monoxide detectors at every house level. Flammable objects were distantly located from the stove area. The family reported that chimney sweeps are performed yearly. The home has an accessible phone for the emergency dial, with emergency numbers posted near the phone. The home also has a first aid kit and assistive devices for the elderly such as a walking stick. The electrical appliances are safely covered with plate covers with cords not being cracked or frayed. The floor and hallways are adequately lit, with carpeting secured and indoor stairways having side rails. The kitchen has adequate space and lighting. The parking area is safe, as evidenced by sufficient lighting and having a reasonable level.

Identified Issues

Several issues were identified during the assessment. One of them is the inadequate support from the family members on diabetes management. The elderly client has diabetes with a diabetic wound. He visits a nearby public facility for the dressing of the wound regularly. He is also expected to monitor his blood glucose levels daily. However, the client reported that he receives minimal support from the family members in monitoring his blood glucose levels. He also attends the weekly hospital visits alone. The client also does not have a spouse to accompany him to the hospital or walk him around the community as part of his physical activity daily.

The second issue identified from the assessment is the client’s risk of injury. The client was recently diagnosed with dementia. He reported getting lost in his familiar environments. The family also reported that he often forgets their identity. The memory loss predisposes the client to risk harm due to falls and getting lost in his environment. The family should therefore ensure the prioritization of his safety needs.

The third issue identified from the assessment is the lack of awareness among the family members on diabetes and dementia. The client has diabetes and has dementia. The family members have limited knowledge on the effective management of diabetes and dementia. They also do not understand their increased predisposition to diabetes and dementia. They should therefore be educated about the risks and ways of minimizing them.

The last issue that was identified from the assessment is the need for dietary supplementation of calcium to prevent fractures in the client. The Tinetti Balance and Gait Evaluation demonstrated the client to be at a high risk of fractures. Therefore, the client and the family should be educated about the importance of increased intake of foods rich in calcium. They should also be educated on the strategies to minimize the risk of falls in the home environment.

Alterations and Interventions

Utilization of Screening Services

One of the required alterations for the client and the family is increased utilization of screening services. The client and the family should be encouraged to utilize screening services for health problems such as diabetes, hypertension, different types of cancers, and eye problems. The elderly client has diabetes. As a result, the family members should be encouraged to undergo annual diabetic screening due to their genetic predisposition. The client should also be educated on the importance of screening for prostate and colon cancer, renal and eye problems due to the increased risk of diabetic neuropathy and retinopathy. The client should also undergo regular checkups for blood pressure since he is highly predisposed to hypertension as a comorbidity of diabetes (Ishak et al., 2017). Community health nurses should also educate the community members about the importance of screening services. Health education will raise awareness among the community members, hence, increasing the uptake of screening services and early identification and management of potential cases.

Family Involvement in Client Care

The second alteration identified from the analysis is the need for family involvement in caring for the elderly client. The effective management of diabetes and dementia requires the active participation of the family members. Family members should assist the client in undertaking daily glycemic monitoring and attending the weekly dressing for the diabetic wound. Family involvement will minimize the risk of hypoglycemia, hyperglycemia, and worsening of the diabetic foot. Therefore, family members should be educated about their critical role in promoting the effective management of diabetes. The client is also at risk of injury due to dementia. The family should be involved in promoting the client’s safety. They should be educated about the importance of ensuring that the client lives in a well-lit and familiar environment. The community nurse should also link the client and his family to the available social support systems in the community for diabetes and dementia (Caner & Cilasun, 2019). Social support networks will assist the client and family learn about effective ways of coping with their health needs.

Nutritional Modification

The assessment demonstrated the client is at an increased risk of falls. Falls contribute to adverse outcomes in elderly patients, such as fractures and loss of mobility. Therefore, the client and family should be educated about the importance of nutritional modification to strengthen the client’s bones. The family should be educated about the importance of increasing the intake of foods rich in calcium, such as milk. The client and the family should also be educated about the risks of high intake of diets that limit the dietary absorption of calcium. The client should also be educated on the importance of engaging in moderate physical activity to strengthen the bones and minimize calcium loss (Bischoff-Ferrari et al., 2018). The client was also educated about the signs and symptoms of bones’ low calcium levels, such as bone pain and easy fractures.

Conclusion

The elderly comprise the vulnerable populations in our societies. They are predisposed to health problems such as diabetes, dementia, and hypertension. The assessment of their health needs guides appropriate interventions to promote their health. Therefore, this exercise has increased my understanding of how the health needs of the elderly populations can be met.

References

Bischoff-Ferrari, H. A., Bhasin, S., & Manson, J. E. (2018). Preventing Fractures and Falls: A Limited Role for Calcium and Vitamin D Supplements? JAMA, 319(15), 1552–1553. https://doi.org/10.1001/jama.2018.4023

Caner, A., & Cilasun, S. M. (2019). Health Care Services and the Elderly: Utilization and Satisfaction in the Aftermath of the Turkish Health Transformation Program. Gerontology and Geriatric Medicine, 5, 2333721418822868. https://doi.org/10.1177/2333721418822868

Ishak, N. H., Mohd Yusoff, S. S., Rahman, R. A., & Kadir, A. A. (2017). Diabetes self-care and its associated factors among elderly diabetes in primary care. Journal of Taibah University Medical Sciences, 12(6), 504–511. https://doi.org/10.1016/j.jtumed.2017.03.008

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INTERVIEW OF CHOSEN ELDER ADULT

Name:                                                                  Age: 68 years Brief Introduction (Background information):

The client is a retired businessperson. He lived a healthy life until six years ago when he was diagnosed with diabetes. He was diagnosed with dementia one month ago. His wife died ten years ago due to heart disease.

1. Philosophy on living a long life

The client’s philosophy of a long life entails being free from diseases. He also considers a long life being able to experience the success of your children and that of others in the society. It also entails adopting healthy lifestyles and behaviors such as regular exercises.

2. Thoughts about when a person is considered “too old”

He considers that a person becomes too old if he or she is unable to meet their health needs. Being too old is a stage where one depends on others in undertaking the activities of the daily living.

3. Opinion on the status and treatment of older adults

The client believes that the elderly experience significant barriers in accessing the care they need. Issues such as cost of care and social support hinder their health status. Enabling policies should be implemented.

4. Beliefs about health and illness

He believes that being healthy entails minimizing unhealthy habits such as drinking alcohol and junk foods. He considers illness as a body’s response to unhealthy behaviors.

5. Health promotion activities he or she participates in

He engages in regular walking in the home compound and at the community. He also eats fruits and vegetables. He minimizes eating red meat and sugar. He routinely monitors his blood sugar levels and blood pressure. He adheres to the prescribed medications.

6. Something special that helped the person live so long

He reported that he lived a healthy life free of alcohol and maintained active physical activity.

 

7. Life span of other family members

Father                                80 yrs Deceased

Mother                              76 yrs Deceased

Wife                                  54 yrs Deceased

Son                                    47 yrs Living

Grandson                          18 Yrs Living

Granddaughter                  14 yrs Living

8. Special dietary traditions in patient’s culture attributed with aiding long life

He prefers boiled eggs to fried eggs. He also drinks fresh milk to enhance his bone strength.

9. Any remedies/medications that have been handed down in family/group. If yes,

Incorporating different foods to achieve the desired nutritional status and minimize risk of diseases.

10. Patient’s description of current and past health status

He is suffering from diabetes and dementia. He is using diabetic and dementia medications. He goes for wound dressing and assessment after every week.

11. The values that guided life so far

Eat healthy, love wholly, and engage in active physical activity

Additional Questions

1. Despite observing good eating habits and healthy living, how did the patient feel when he was diagnosed with diabetes?

I was shocked because I have lived a healthy life throughout my life. I however came into terms with the disease after learning that it can be genetic. I think my case is attributed to genetics, as my brother died due to diabetes.

2. Are there other family members with the condition?

His brother died of diabetes. He is worried that his grandchildren and son may also suffer from diabetes and dementia. He therefore informs them about the importance of living a healthy life.

3. According to the patient, does he get all the care he needs at the local health center?

The client is satisfied with the care he received at the local health center. He however feels that some of the specialized services such as those for diabetic patients are lacking.

 

Summary

Despite being diabetic and suffering from dementia, the client is living a healthy lifestyle and understands ways of meeting his healthcare needs.

 

Contrast of client’s responses with findings in current literature

• The Tinetti Balance and Gait Evaluation showed that the client is highly at a risk of falls. As a result, safe environment that minimizes falls should be created at home.
• The Katz Index of Activities of Daily Living assessment showed that the client can perform independently the activities of the daily living.
• The Barthel Index Test affirmed the client’s ability to perform activities of the daily living independently.

 TINETTI ASSESSMENT TOOL: BALANCE

RESIDENT NAME:                                                                                                                                                                        

Initial Instructions: Subject is seated on a hard, armless chair. The following maneuvers are tested.

TASK	DESCRIPTION OF BALANCE	Possible	Score	Date	Score	Date	Score	Date
1. SITTING BALANCE	Leans or slides in chair	0
	Steady, safe	1	1
2. RISES FROM CHAIR	Unable without help	0
	Able, uses arms to help up	1	1
	Able without using arms	2
3. ATTEMPTS TO RISE FROM CHAIR	Unable without help	0
	Able, requires > 1 attempt	1	1
	Able to rise in 1 attempt	2
4. IMMEDIATE STANDING BALANCE (first 5 seconds)	Unsteady (swaggers, moves feet, trunk sways)	0
	Steady but uses walker or other support	1	1
	Steady without walker or other support	2
5. STANDING BALANCE	Unsteady	0
	Steady but wide stance (heels 4 inches apart) and uses cane or other support	1	1
	Narrows stance without support	2
6. NUDGED (subject at max position with feet as close together as possible, examiner pushes lightly on subject’s sternum with palm of hand 3 times)	Begins to fall	0
	Staggers, grabs, catches self	1
	Steady	2	2
7. EYES CLOSED (at max position – see #6 above)	Unsteady	0
	Steady	1	1
8. TURNING 360 DEGREES	Discontinuous steps	0
	Continuous steps	1	1
	Unsteady (grabs, swaggers)	0
	Steady	1
9. SITTING DOWN	Unsafe (misjudged distance, falls into Chair)	0
	Uses arms or not a smooth motion	1	1
	Safe, smooth motion	2
BALANCE SCORES:			10

RATE 1                  RATE 2                    RATE 3

DATE OF ASSESSMENT	ASSESSOR SIGNATURE AND TITLE	LOCATION DURING ASSESSMENT
1.
2.
3.

TINETTI ASSESSMENT TOOL: GAIT

RESIDENT NAME:                                                                                                                                                                        

Initial Instructions: Subject stands with examiner, walks down the hallway or across the room, first at “usual” pace, then back at “rapid but safe” pace. Use usual walking aid.

 

TASK	DESCRIPTION OF BALANCE		Possible	Score	Date	Score	Date	Score	Date
10. INITIATION OF GAIT (immediately after told to “go)	Any hesitancy or multiple attempts to start		0
	No hesitancy		1	1
11. STEP LENGTH AND HEIGHT	RIGHT swing food does not pass left stance foot with step		0	0
	RIGHT foot passes left stance foot		1	1
	RIGHT foot does not clear floor completely with step		0	0
	RIGHT foot completely clears floor		1	1
	LEFT swing foot does not pass right Stance foot with step		0	0
	LEFT foot passes right stance foot		1
	LEFT foot does not clear floor Completely with step		0	0
	LEFT foot completely clears floor		1	1
12. STEP SYMMETRY	RIGHT AND LEFT step length not equal (estimate)		0	0
	RIGHT AND LEFT step appear equal		1
13. STEP CONTINUITY	Stopping or discontinuity between steps		0
	Steps appear to continue		1	1
14. PATH (estimated in relation to floor tiles, 12-inch diameter. Observe excursion of 1 foot over about 10 feet of the course)	Marked deviation		0
	Mild/moderate deviation or uses walking aid		1	1
	Straight without walking aid		2
15. TRUNK	Marked sway or uses walking aid		0	0
	No sway – but flexion of knees or back, or spreads arms out while walking		1
	No sway, no flexion, no use of arms, and no use of walking aid		2
16. WALKING STANCE	Heels apart		0
	Heels almost touching while walking		1	1
		Score – GAIT:		7
		Score – BALANCE:		10
		Score: BALANCE & GAIT:		17

RATE 1                  RATE 2                    RATE 3

Side 2 of 2

DATE OF ASSESSMENT	ASSESSOR SIGNATURE AND TITLE	LOCATION DURING ASSESSMENT
1.
2.
3.

 

Katz Index of Independence in Activities of Daily Living
Activities Points (1 or 0)	Independence (1 Point)   NO supervision, direction or personal assistance.	Dependence (0 Points)   WITH supervision, direction, personal assistance or total care.
BATHING   Points:  1	(1 POINT) Bathes self completely or needs help in bathing only a single part of the body such as the back, genital area or disabled extremity.	(0 POINTS) Need help with bathing more than one part of the body, getting in or out of the tub or shower. Requires total bathing
DRESSING   Points:  1	(1 POINT) Get clothes from closets and drawers and puts on clothes and outer garments complete with fasteners. May have help tying shoes.	(0 POINTS) Needs help with dressing self or needs to be completely dressed.
TOILETING   Points:  1	(1 POINT) Goes to toilet, gets on and off, arranges clothes, cleans genital area without help.	(0 POINTS) Needs help transferring to the toilet, cleaning self or uses bedpan or commode.
TRANSFERRING   Points:  1	(1 POINT) Moves in and out of bed or chair unassisted. Mechanical transfer aids are acceptable	(0 POINTS) Needs help in moving from bed to chair or requires a complete transfer.
CONTINENCE   Points:1	(1 POINT) Exercises complete self control over urination and defecation.	(0 POINTS) Is partially or totally incontinent of bowel or bladder
FEEDING   Points:  1	(1 POINT) Gets food from plate into mouth without help. Preparation of food may be done by another person.	(0 POINTS) Needs partial or total help with feeding or requires parenteral feeding.
TOTAL POINTS: 6               SCORING: 6 = High (patient independent) 0 = Low (patient very dependent

 

 

THE BARTHEL INDEX	Patient Name: Rater Name: Date:
Activity		Score
FEEDING

0 = unable

5 = needs help cutting, spreading butter, etc., or requires modified diet 10 = independent                                                                                                                                                                                                            10

BATHING

0 = dependent

5 = independent (or in shower)

5

GROOMING

0 = needs to help with personal care

5 = independent face/hair/teeth/shaving (implements provided)

5

DRESSING

0 = dependent

5 = needs help but can do about half unaided

10 = independent (including buttons, zips, laces, etc.)

10

BOWELS

0 = incontinent (or needs to be given enemas) 5 = occasional accident

10 = continent

10

BLADDER

0 = incontinent, or catheterized and unable to manage alone 5 = occasional accident

10 = continent

10

TOILET USE

0 = dependent

5 = needs some help, but can do something alone 10 = independent (on and off, dressing, wiping)

10

TRANSFERS (BED TO CHAIR AND BACK)

0 = unable, no sitting balance

5 = major help (one or two people, physical), can sit 10 = minor help (verbal or physical)

15 = independent  15

MOBILITY (ON LEVEL SURFACES)

0 = immobile or < 50 yards

5 = wheelchair independent, including corners, > 50 yards

10 = walks with help of one person (verbal or physical) > 50 yards

15 = independent (but may use any aid; for example, stick) > 50 yards                                                                        15

STAIRS

0 = unable

5 = needs help (verbal, physical, carrying aid) 10 = independent

TOTAL (0–100):    85    

Home Safety Assessment

FIRE HAZARDS / CARBON MONOXIDE	Environment Safe	Environment Unsafe	Comments
1. There is an up to date fire extinguisher present on every level of the house or apartment.	√
2. There is a smoke detector in every level of the house including areas such as the garage, bedrooms, and basement.	√
3. Smoke detectors, are working and tested if possible.	√
4. There is a carbon monoxide detector present on every level of the house or apartment.	√
5. Carbon monoxide detectors are working and are tested if possible.	√
6. Portable heaters, ashtrays, candles, and other fire sources are located away from flammable objects including oxygen tanks.	√
7. Flammable objects are located away from stationary fire sources such as fireplaces, stoves, or radiators.	√
8. Flammable objects such as towels, curtains and oxygen tanks are located away from the stove area, and are at least 12” from the baseboard or portable heater.	√
9. Chimney sweeps are conducted as follows: 2 times per year for wood and coal; Yearly for oil, gas, and any other fuel that does not produce smoke- if frequently used.	√

 

EMERGENCY / MEDICAL	Environment Safe	Environment Unsafe	Comments
10. At least one medical alert device (such as life alert or a phone) is on each level of the house, and may be reached without significant risk of physical injury.	√
11. At least one accessible phone is on each level of the house.	√
12. Important numbers are posted on or near the phone, or are easily accessible without significant risk of physical injury (i.e. primary physician, pharmacy, closest family member, emergency 911, etc.).	√
13. Flashlights are accessible and functional, available on each level of home, and may be reached without significant risk of physical injury.	√
14. Assistive devices are available on each level of home (i.e. walkers, canes, wheelchairs, low vision equipment, augmentative devices, long handled reacher, etc.).	√
15. Medications are kept/stored properly in a dry, accessible, safe area (out of reach of children), and are no older than the expiration date.	√
16. All areas of home are free of hazardous clutter.	√
17. A first aid kit containing simple instructions is easily accessible and may be reached without significant risk of physical injury. Contents of first aid kit are not expired.	√

 

ELECTRICAL	Environment Safe	Environment Unsafe	Comments
18. Major appliances such as microwave oven, washer, dryer, and refrigerator are accessible with or without use of ambulatory devices in a safe manor.	√
19. All outlets and switches have plate covers, so that there is no exposed wiring and are in easy reach. *Consider if outlets are up to code (3-prong). Educate resident if necessary	√
20. All the cords are placed out of walkways.	√
21. Cords, if attached to walls or baseboards, are affixed using appropriate insulated staples.	√
22. Electrical cords are not frayed or cracked.	√
23. Electrical cords and appliance cords are located away from the heat or water sources such as sink and stove.	√
24. Ground fault switches are present in bathroom and kitchen outlets as well as any areas that could be exposed to water.	√
25. Small electrical appliances (such as hairdryers, crock pots, toasters, irons and electric shavers etc.) are unplugged when not in use and away from water sources.	√
26. Outlets are not overloaded (i.e. there are not multiple power strips/extension cords per outlet).	√

 

FLOORING / HALLWAYS	Environment Safe	Environment Unsafe	Comments
27. Floor surfaces are level with no more than ¼ to ½ inch beveled transitions. If transitions are present they are well lit and identifiable.	√
28. Carpeting is secure and level with no fraying or lifted edges.	√
29. Unnecessary throw rugs are removed. If present, they have a slip-resistant backing and edges are tacked down.	√
30. Hallways, passageways, and stairways are free of clutter.	√
31. Hallways, passageways, and stairways between rooms have lighting available.	√
32. Night lights are available in all frequently used areas.	√
33. Indoor stairways have a secure railing on at least one side.	√

 

KITCHEN	Environment Safe	Environment Unsafe	Comments
34. Dials are labeled on stove.	√
35. There is no grease or clutter on or around the stove area.	√
36. Commonly used items are stored in accessible locations and may be reached without significant risk of physical injury.	√
37. Garbage cans, pet bowls, and other objects are not located in the walking path.	√
38. The countertops are free of rough or sharp edges.	√

 

39. There is adequate lighting where food is prepared and cooked.	√
40. Refrigerator and freezer are at an acceptable temperature with refrigerator temperature at or below 40° F and freezer temperature at or below 0° F.	√
41. The water temperature is 120° F or lower as tested with thermometer in a sink or tub.	√

 

BATHROOM(S)	Environment Safe	Environment Unsafe	Comments
42. A slip-resistant mat or surface is located inside and outside all bathtubs or showers.	√
43. A slip-resistant mat or abrasive strips are in all the bathtubs or showers.	√
44. The following bathroom areas are accessible and may be reached without significant risk of physical injury. Tub/shower: Sink: Toilet:	√
45. If needed, a properly installed grab bar is available and secure near the tub and toilet.	√

 

CLOSETS / STORAGE AREAS	Environment Safe	Environment Unsafe	Comments
46. Closets and/or storage areas are accessible and have lighting available either inside or outside of the closet.	√
47. Commonly used items within closets or storage are accessible and may be reached without significant risk of physical injury.	√
48. Walk space near closets and storage areas are free of clutter.	√
49. The garage, if used, is accessible and has adequate lighting.	√
50. The attic, if used, is accessible and has adequate lighting.	√
51. All chemical products are labeled and stored in a safe manner.	√
52. Any weapons such as guns, knives, ammunition, etc. are locked and properly stored.	√

 

PARKING AREA / ENTRANCES	Environment Safe	Environment Unsafe	Comments
53. Parking areas have working lighting.	√
54. Parking areas are reasonably level.	√
55. Walkways and sidewalks are clutter free and reasonably level.	√
56. Walkways and sidewalks have working lighting.	√
57. Doorbell or door- knocker is available, if needed.	√

58. House numbers are visible on the home or mailbox.	√
59. Outside stairways, if present, have a secure railing on at least one side.	√
60. Entrances and doorways to home are free of clutter and hazards.	√
61. Outside porches or exit areas have working lights available.	√
62. Ramps, if present, are appropriately graded and have accessible handrails which may be reached without significant risk of physical injury.	√

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Assessment overall: The home environment is safe (100%)

Week 2 Project

Instructions
Assessing and Planning Care for an Elderly Person
In order to gain an insight into the world of elder adults, it is important to understand how they view themselves and the values they hold. Additionally it is important to assess and determine his/her needs and establish appropriate interventions for this individual.

In a Microsoft Word document of 4-5 pages formatted in APA style, you will discuss your interview of an older adult. This person cannot be a patient in your clinical setting. You can use a friend, family member, or co-worker. The older adult must be age 65 years or older.
There are two parts to this assignment – the psychosocial interview component and the functional assessment.

Interview
Download the patient questionnaire. Use this format to record the person’s responses.

Include 2–3 questions of your own to get a complete picture of the older adult.
Summarize your findings.
Include the questionnaire with responses in the Appendix of your paper.
Assessment
After gaining permission, conduct a physical and mental functional assessment of the older adult you have chosen. Review your readings for the process of a functional assessment.

Use the tools discussed this week to complete a comprehensive assessment of your patient. Search the Internet for resources on these tools.
Tinetti Balance and Gait Evaluation
Katz Index of Activities of Daily Living
Assessment of Home Safety
The Barthel Index
Do not include a name on each tool, but do include professional or other designation, and age. Your name should also be identified on the tool.
Include these tools in the Appendix.
Based on your assessment:
Compare and contrast the age-related changes of the older person you interviewed and assessed with those identified in this week’s reading assignment.
Identify at least 4–6 preliminary issues.
Identify three alterations in health that you would propose and describe them.
Identify a minimum of three comprehensive interventions for each alteration.
Integrate cultural considerations in your interventions.
On a separate references page, cite all sources using APA format. Helpful APA guides and resources are available in the South University Online Library. Below are guides that are located in the library and can be accessed and downloaded via the South University Online Citation Resources: APA Style page. The American Psychological Association website also provides detailed guidance on formatting, citations, and references at APA Style.
• APA Citation Helper
• APA Citations Quick Sheet
• APA-Style Formatting Guidelines for a Written Essay
• Basic Essay Template

Please note that the title and reference pages should not be included in the total page count of your paper.

Submission Details
Name your document SU_NSG4067_W2_Project_LastName_FirstInitial.doc.
Submit your document to the Submissions Area by the due date assigned.