Introduction
Nowadays, more people understand the necessity of proper nutritional habits and diets as well as physical activity. Given the benefits for both mental and physical well-being, a healthy lifestyle becomes an indispensable element of any person’s life, especially in an older life.
Case Background
In the given case study, a 68-year-old client is overserved and does not demonstrate any adverse health conditions that limit mobility. Instead, one can see the client’s independence, self-reliance, and competency. Her height is 5’6″ and weight is 210 lbs (95.25 kg).
Patient Health Goals
In order to maintain health, it is crucial to focus on nutritional and exercise approaches. Thus, when communicating with the 68-year-old patient, it is crucial to focus on her overall physical well-being and then address issues related to weight management and physical and social activity and offer referrals that can emphasize the needs and interests of the client.
Client’s BMI
Prior to making recommendations for the patient, it is first necessary to look at the overall physical health of the individual. To do so, one can calculate the Body Mass Index, which involves the weight and height of the person. For calculations, the following formula can be used: BMI = weight (kg) / height^2 (m^2) (CDC, 2022). Then, the initial step that will have to be made is to convert the client’s height from feet and inches to meters since the case only provides kilograms for the weight. If 1 foot equals 0.3048 meters and 1 inch equals 0.0254 meters, then the height of the patient in meters is 5 * 0.3048 + 6 * 0.0254 = 1.6764 meters.
Now, it is possible to calculate the Body Mass Index with all necessary variables. Using the mentioned calculation, the patient’s BMI is 95.25 kg / (1.6764 m) 2 ≈ 33.89. The optimal BMI for older adults ranges between 27 and 31 (Kıskaç et al., 2022). For men, the acceptable BMI is 31-32. For women, it is 27-28 (Kıskaç et al., 2022). As a result, the higher BMI of the patient in question indicates overweight, which requires specific interventions.
Screening Tools
Nutrition Knowledge Questionnaire
Another step in treating the patient is determining the screening tools that can be used to assess the client’s nutritional and exercise knowledge. In general, the only way to assess the experiences and habits of the patient is to rely on their knowledge and history. As a result, the first screening tool that can be used is the Nutrition Knowledge Questionnaire (NKQ).
This questionnaire can help a healthcare professional determine dietary habits and knowledge of the patient as it relates to nutrition (Kapellou et al., 2022). The questionnaire consists of a series of multiple-choice questions and is helpful in evaluating basic nutritional principles that the patient possesses (Kapellou et al., 2022). After reviewing the answers provided by the patient, it will be possible to analyze the strengths and weaknesses of the client.
International Physical Activity Questionnaire
Another screening tool that can be used by a healthcare professional is the International Physical Activity Questionnaire (IPAQ). While the previous questionnaire was aimed at evaluating the nutritional habits and knowledge of the patient, the current questionnaire focuses on an assessment of an individual’s level of physical activity across different domains (Keating et al., 2019). In other words, the tool helps one understand how active the patient is in occupational, leisure, and transportation contexts.
The provided tool has been suggested as a practical, cost-effective tool that can be used (Keating et al., 2019). After conducting the questionnaire, healthcare professionals will determine not only the amount of time dedicated to physical activity but also its intensity and frequency, which are crucial components of well-being (Keating et al., 2019). Therefore, both questionnaires are useful frameworks, the application of which can be important in determining the areas where additional education and intervention are required.
Outcome/Intervention/Rationale
After considering the screening tools as well as the BMI for the client, it is necessary to determine the goal and outcome for the individual that will be aligned with their needs and interests. For instance, the patient in question is an older adult, which means that an increased consumption of vitamins and micronutrients is expected. In elderly persons from Western industrialized nations, eating fruits and vegetables has been found to improve mental and cognitive health (Gehlich et al., 2019). As a result, the goal for the patient is an increased daily intake of fruits and vegetables. The outcome is reasonable, measurable, and realistic since the patient will be able not only to increase the intake of fruits and vegetables gradually but also measure their prevalence in diet, which will lead to better health outcomes.
The nursing intervention that is aligned with the chosen outcome is patient education. Finding new techniques to educate patients is crucial because doctors are facing increasing difficulties due to the evolving medical field while trying to teach them about a healthy diet (Ardoin et al., 2022). The current intervention will emphasize the importance of vegetable and fruit consumption and the possible outcomes. Besides educating the patient on the nutritional benefits of the required foods, the intervention can offer recommendations on how to incorporate them into meals and snacks. Additionally, recommendations on recipes and meal planning can be provided to the patient.
The reason why the intervention of patient education was chosen is due to its influence on patient’s understanding of basic nutritional principles and their impact on their well-being. Patient education on diet through a variety of formats, such as a patient-centered film and handouts, has proven to be successful in teaching, inspiring change, and fostering communication between patients and doctors (Ardoin et al., 2022). By offering educational materials and resources, it is possible to raise awareness of the 68-year-old client. Overall, it can be claimed that the intervention promotes a healthier lifestyle and can contribute to weight management, which can reduce health complications as well as higher risks of mortality.
Weakness in the Client’s Life
Nevertheless, after reviewing the case of the patient one more time, it becomes evident that the client can experience negative consequences. On the one hand, the woman is described as self-reliant and independent. On the other hand, such extreme self-reliance and independence of the patient can lead to limited social interactions. Although the patient has support and family systems, she seems to be distant from them, being proud of her dependence on herself. It is crucial to understand that social isolation can lead to deterioration in the mental well-being of the individual, causing stress and depression (Donovan & Blazer, 2020).
Additionally, due to a lack of communication and interaction with others, there might be a need for physical activity. If the patient experiences a reduced willingness to connect with others, there might be fewer opportunities to leave the house (Donovan & Blazer, 2020). Given the age of the client, it is necessary to incorporate interventions aimed at boosting both social and physical activity.
Referrals
After close consideration of the client’s health indicators as well as social activity, several referrals can be made for the patient. The first referral is connected to social support groups or community programs. Such initiatives seem to effectively assist middle-aged and older persons in connecting with local social events, which in turn makes them feel more socially engaged, active, and less alone (Giebel et al., 2022). It has been mentioned that despite having support and family systems, the patient is reluctant to rely on them, which can be detrimental to mental well-being. By being engaged in community programs, the patient will have more opportunities to communicate with people of her age and interests. Besides opportunities for better communication and engagement with peers, such programs can offer physical activities or group exercises that can also benefit the client. With such a referral, the 68-year-old woman will have a healthier lifestyle.
Besides a referral to a local community program, another one can be recommended, such as a referral to a registered dietitian or nutritionist. In healthy behavior treatments that enhance glycemic control, weight management, cardiovascular health, and likely comorbidity management, registered dietitians may be key players (Dobrow et al., 2022). These experts are crucial in diet instruction and nutrition evaluation (Dobrow et al., 2022). Although a regular physical can make recommendations on dietary habits and overall nutrition, a registered dietitian can deliver an individualized nutrition plan that will align with the patient’s needs.
Moreover, such a plan will help the patient focus on weight management without much stress. In other words, a healthcare professional will address the woman’s concerns and challenges. Such referrals are holistic since they focus not simply on the mental wellness of the patient and physical activities but also on the dietary needs of the older adult. Thus, for better results for older persons, they should be routinely included in interprofessional teams.
Conclusion
In summary, focusing on the 68-year-old patient’s general physical health is essential when communicating with her. After that, a healthcare professional should discuss difficulties with weight management physical and social activities and provide referrals that help highlight the patient’s needs and interests. The patient’s BMI of 33.89 suggests overweight because it is greater than the normal BMI.
Choosing the screening instruments that can be used to evaluate the client’s understanding of nutrition and exercise is another stage in treating the patient. The International Physical Activity Questionnaire and Nutrition Knowledge Questionnaire are two tools considered.
The patient’s goal is to consume more vegetables and fruit each day. Patient education is the nursing intervention that is in line with the desired goal. Weaknesses can be noticed after once again evaluating the patient’s case. Limited social connections may result from the patient’s extreme self-reliance and independence. Several referrals might be made for the patient after carefully examining the client’s health indicators and social activity. In addition to referrals to local community programs that can engage the patient in social activities, a referral to a registered dietitian is crucial for weight management and other risks.
References
Ardoin, T. W., Hamer, D., Mason, N., Reine, A., Barleycorn, L., Francis, D., & Johnson, A. (2022). Effectiveness of a patient-centered dietary educational intervention. The Ochsner Journal, 22(2), 113–128. Web.
CDC. (2022). Calculating BMI using the metric system. Centers for Disease Control and Prevention. Web.
Dobrow, L., Estrada, I., Burkholder-Cooley, N., & Miklavcic, J. (2022). Potential effectiveness of registered dietitian nutritionists in healthy behavior interventions for managing type 2 diabetes in older adults: A systematic review. Frontiers in Nutrition, 8. Web.
Donovan, N. J., & Blazer, D. (2020). Social isolation and loneliness in older adults: Review and commentary of a national academies report. The American Journal of Geriatric Psychiatry, 28(12), 1233–1244. Web.
Gehlich, K. H., Beller, J., Lange-Asschenfeldt, B., Köcher, W., Meinke, M. C., & Lademann, J. (2019). Fruit and vegetable consumption is associated with improved mental and cognitive health in older adults from non-Western developing countries. Public Health Nutrition, 22(4), 689–696. Web.
Giebel, C., Hassan, S., Harvey, G., Devitt, C., Harper, L., & Simmill-Binning, C. (2022). Enabling middle-aged and older adults accessing community services to reduce social isolation: Community Connectors. Health & Social Care in the Community, 30(2), 461–468. Web.
Kapellou, A., Silva, G., Pilic, L., & Mavrommatis, Y. (2022). Nutrition knowledge, food choices and diet quality of genotyped and non-genotyped individuals during the COVID-19 pandemic. Nutrition and Health, 28(4), 693–700. Web.
Keating, X. D., Zhou, K., Liu, X., Hodges, M., Liu, J., Guan, J.,… & Castro-Piñero, J. (2019). Reliability and concurrent validity of global physical activity questionnaire (GPAQ): a systematic review. International Journal of Environmental Research and Public Health, 16(21), 4128. Web.
Kıskaç, M., Soysal, P., Smith, L., Capar, E., & Zorlu, M. (2022). What is the optimal Body Mass Index range for older adults? Annals of Geriatric Medicine and Research, 26(1), 49–57. Web.