Running head: SENIOR HEALTH PROMOTION PROJECT PART 2 1

Senior Health Promotion Project Part 2

Anna Read Barth

Bon Secours Memorial College of Nursing

NUR 4113

April 18, 2017

I pledge. Anna Read Barth

SENIOR HEALTH PROMOTION PROJECT PART 2 2

Senior Health Promotion Project Part 2

The client I used for my Senior Health Promotion Project was a sixty five year

old, Caucasian male. He lives with his wife in a neighborhood they have called home

for twenty-two years. The home they currently reside in includes all of the main living

areas, such as master bedroom, kitchen, and laundry room, on the first floor. Fortunately,

the clients gait is not of a concern, but this house was built to accommodate any changes

for the couple, should they arise. The only impairment he has is vision. However, this is

something he routinely manages through yearly appointments with his optometrist and

has been doing so since his teenage years. The client is currently self-employed. He

manufactures furniture at a factory that always smells like cigarette smoke and has

been a partner in the company for almost thirty years. The decision-making in the family

is egalitarian and results indicate that the client is future minded. The client laughed

when he states, I enjoy working still, even though my wife wants me to retire like her. I

know the time will come eventually, but for now work keeps me occupied.

The nursing diagnosis created for the client was Ineffective self-health

management related to perceived seriousness as evidenced by ineffective choices in daily

living for meeting healthy goals (Doenges, Moorhouse, & Murr, 2013). This applied to

the clients situation because he did not take the initial steps to lower his blood pressure

when he first started meeting with his primary care doctor about this topic. Also, I was

able to infer that the client was unaware of the complications that hypertension can cause

if it is untreated. He seemed very surprised when I told him that this complication is the

number one primary diagnosis that older adults require medical attention (Douglas &

Howard, 2015). It is also one of the most common silent killers for older adults. It was
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the first time he had been told this information, and I think it definitely sparked his

interest to take action with the teaching plan. The short-term outcome created for the

client was The client will verbally identify a food from each food group on the MyPlate

handout titled Find Your Healthy Eating Style & Maintain It For a Lifetime by the end of

the teaching session. This goal was fitting for the clients needs. We discussed how

healthy eating is very important for everyone but even more so as you age. Obtaining an

adequate amount of nutrients from each food group will promote optimal functioning of

the body as it changes with age. The long term goal used with the client was The client

will utilize and follow through with the calendar created by the student and client that

plans the use of weight baring exercises twice a week as recommended by the handout

titled 10 Tips to Help Adults Include Physical Activity into Their Lifestyle for two weeks.

The client will record the machines used and the amount of weight used at each machine

(lbs) in an exercise journal. Promoting exercise in the clients weekly activities would

ensure that bones stay dense and healthy. There are also numerous benefits to the

cardiovascular system when physical activity is completed. Incorporating this action plan

was important for the patient as indicated by Healthy People 2020 stating, Physical

activity can help prevent disease and injury. However, less than 60% of older adults

engage in physical activity and strength training (Healthy People 2020, n.d.) This was

information I passed onto the client in hopes that it would inspire him to take action. I

was hopeful because I could sense his constant interest when he asked questions

The teaching plan created for the client revolved around self-health management.

This was an area that has been of concern for the client over the past couple of years as

he routinely watched his blood pressure elevate gradually during each doctors visit. The
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practitioner first suggested changing his dietary habits and participating in physical

activity to avoid putting the patient on medications. However, the suggestions were

never implemented fully because the client felt as if his hypertension and moderately

unhealthy eating habits were not a serious issue. As a result of all of these things, the

client is now on hypertension medication. The teaching plan was developed mutually

with the client as he revealed all of this information to me. I was able to identify areas of

his lifestyle that would benefit from change. I also tried to think of the most appropriate

method to relay this information to the patient. I wanted the teaching I provided to

remain with him, even after my project was complete. My goal for the teaching plan was

to help the client better understand the importance of nutrition both at home and away, as

well as the benefits from physical activity and weight baring exercises.

The content and approach used for the teaching plan included four handouts from

Choose MyPlate as well as creating a short and long-term outcome for the client. I felt

that handouts would be the best teaching method for the client because he scored almost

equally in all three categories of the Survey of Preferred Learning Methods. Two

copies of each handout were printed so that he could read and listen to the information I

shared with him. He also enjoyed that these handouts were something he could keep in

case he needed to refer back to anything. The topics covered in the handouts were

nutrition and exercise. After meeting with the client, I concluded that both of these were

areas that he needed additional information in. Using the handout titled Choosing

Healthy Meals as You Get Older I helped the client identify changes he could make to

promote optimal health. A few areas I highlighted from this handout included the

importance of adequate water hydration and the reading nutrition labels (Douglas &
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Howard, 2015). In another handout named Find Your Healthy Eating Style & Maintain It

for a Lifetime, I reviewed different foods that are healthy for the client according to each

food group. During our first meeting, the client expressed struggles with healthy eating

when he is traveling for work or with his wife. By using the Eating Foods Away From

Home handout, I gave the client suggestions on how to maintain nutritious eating, even

when you are away from your everyday environment. Lastly, I reinforced the importance

of physical activity along with incorporating weight baring activities into a weekly

exercise regimen to control hypertension (Douglas & Howard, 2015). This information

was provided through the Be Active Adults: 10 Tips to Help Adults Include Physical

Activity Into Their Lifestyle handout. Utilizing the information in each of these

handouts would have a positive impact on controlling his hypertension I covered each

area of the handout thoroughly with the client to ensure that he understood all the

information provided. Before I left, I reminded him that blood pressure could be lowered

through the use of effective self-health management. Other examples I gave of self-

health management included moderation in alcohol intake and using a low sodium diet

(Douglas & Howard, 2015). I also made sure to answer any questions the client had

through out the teaching session or after it was completed.

The client achieved the short-term goal. After we had reviewed all four of the

handouts, I asked him to name a fruit, vegetable, grain, protein, and dairy product that he

will include more frequently into his dietary intake. The examples he gave for each

category was strawberries (fruit), sweet potatoes (vegetable), beans (protein), whole grain

pasta (grain), and fat free milk (dairy). To ensure that the client would follow up on his

long-term goal, his wife is going to review the preplanned calendar days in which the
SENIOR HEALTH PROMOTION PROJECT PART 2 6

client has designated for physical activity. The wife is going to going to keep a copy of

his schedule for herself too. At the end of each week, she will follow up with the client at

dinnertime and ask him if he had completed his scheduled physical activity. The wife

ensured me that this would be an easy way for her to manage this plan because she is

home most of the day, so he will have to be honest with her.

The short and long-term outcome for the client could be classified as primary

prevention when related to his weight. The teaching session provided information to

reduce the chance of the client becoming obese. Promoting physical activity and weight

baring exercises into a routine will also increase the clients metabolism. This is

important because as people age, the metabolism slows down and the body will hold on

to unhealthy nutrients. This is what leads many people into renal and cardiac disorders.

These same outcomes could also be classified as tertiary prevention in relation to his

cardiac symptoms. It is tertiary prevention because the client has already been diagnosed

with hypertension and is taking medication for it. Promoting healthy eating habits and

exercising will decrease the chance of clot formation or other heart defects to develop.

The teaching plan created for the client was effective in promoting optical self-health

management. The short-term outcome I created ensured that the focus was on the

information being discussed. I could tell that the client was generally interested in the

handouts when he asked, Can I keep these for myself in case I forget anything that we

talked about? I eagerly said yes. The long-term outcome I created required him to take

responsibility for his actions. I was excited to see that his wife wanted to get involved

too. She was very appreciative of me coming over. Right before I left, she pulled me

aside and said Exercise and healthy eating are always difficult for my husband to do and
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of course he never wants to hear it from me. Your handouts really grabbed his attention

though. He was excited to show me them after you left from the teaching meeting. This

made me feel successful in completing my goal. However, there are also a couple things

I would have done differently. I would have liked to include videos to show the client

different weight baring exercises that are effective for his age group. This would be

another method to promote physical activity. Also, encouraging the wife to participate in

the exercise regimen could be another way to ensure that the client takes responsibility

for this new lifestyle. Having a partner is also a form of motivation for each participant.

The handout I provided on exercise also discusses the benefits of having a partner to

exercise with.

This project taught me a lot about working with a geriatric patient, as well as

constructing patient teaching. Patient teaching is one of the most important jobs as a

nurse. In order to make teaching effective, a therapeutic nurse client relationship must be

formed. This can be done through the presence of trust and honesty. Both of these were

incorporated into the meetings with the patient. Therefore, I feel confident that a

therapeutic nurse client relationship was developed, as I encouraged the client to

complete the outcomes created for him. I was very thrilled by the input I received from

both the client and his wife regarding the handouts I provided. I feel confident that the

client will maintain the changes to the nutrition and exercise regiment to achieve

effective self-health management.

SENIOR HEALTH PROMOTION PROJECT PART 2 8

References

Be Active Adults: 10 tips to help adults include physical activity into their lifestyle

[Brochure]. (2013). Retrieved March 18, 2017, from

https://www.choosemyplate.gov/sites/default/files/tentips/DGTipsheet30BeActive

Adults.pdf

Choosing Healthy Meals as You Get Older: 10 healthy eating tips for people age 65

[Brochure]. (2015). Retrieved March 18, 2017, from https://choosemyplate-

prod.azureedge.net/sites/default/files/tentips/DGTipsheet42ChoosingHealthyMeal

sAsYouGetOlder.pdf

Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2014). Nursing Care Plans:

Guidelines for Individualizing Client Care Across the Life Span (9th ed.).

Philadelphia, PA: F.A. Davis.

Douglas, B. M., & Howard, E. P. (2015). Predictors of Self-Management Behaviors in

Older Adults with Hypertension. Advances in Preventive Medicine, 2015, 1-6.

doi:10.1155/2015/960263

Eating foods away from home [Brochure]. (2016). Retrieved March 18, 2017, from

https://www.choosemyplate.gov/sites/default/files/printablematerials/DGTipsheet

41EatingFoodsAwayFromHome.pdf

Find Your Healthy Eating Style & Maintain it for a Lifetime [Brochure]. (2016).

Retrieved March 18, 2017, from

https://www.choosemyplate.gov/sites/default/files/printablematerials/MyPlateMy

Wins.pdf
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Older Adults. (n.d.). Retrieved March 12, 2017, from

https://www.healthypeople.gov/2020/topics-objectives/topic/older-adults