Assessment of a 68-year-old Independent Client
Body Mass Index (BMI):
The client’s BMI is 37.3. This falls into the obese category according to the National Institutes of Health (NIH).
Screening Tools for Nutritional and Exercise Knowledge:
- Short Nutritional Assessment Questionnaire (SNAQ-C): This quick and easy tool assesses the risk of malnutrition by looking at factors like appetite loss, weight change, and difficulty eating.
- Rapid Eating Assessment for Patients (REAP-5): This tool helps identify potential eating problems related to speed, such as difficulty chewing or swallowing.
- Physical Activity Recall Questionnaire (PAR-Q): This simple questionnaire assesses a person’s level of physical activity and helps identify any contraindications to exercise.
- Brief Exercise Attitudes Questionnaire (BEAQ): This tool explores a person’s attitudes and beliefs towards exercise, which can influence their participation.
Rationale for using these tools:
These tools provide a quick and efficient way to assess the client’s nutritional and exercise knowledge. They can identify potential risks like malnutrition or sedentary lifestyle and inform further interventions.
Outcome/Goal, Intervention, and Rationale:
Outcome: The client will participate in at least 30 minutes of moderate-intensity exercise most days of the week (at least 5 days) within the next month.
Intervention: The nurse will provide education on the benefits of exercise for weight management, overall health, and independent living. The education will include demonstrations of safe and effective exercises tailored to the client’s abilities and interests, along with resources for finding appropriate exercise programs (e.g., senior fitness classes, walking groups).
Rationale: Exercise is a crucial component of weight management and overall health. Educating the client about its benefits can empower her to make informed choices and increase her motivation to participate. Providing tailored options and resources addresses the client’s independence and increases the likelihood of adherence.
Weakness Potentially Impacting Activity and Diet:
The client’s weight (obesity) might be a weakness impacting her activity level and potentially her dietary choices. Obesity can lead to joint pain, shortness of breath, and fatigue, hindering physical activity.
Referral Considerations:
- Registered Dietitian (RD): An RD can provide personalized dietary advice to help the client manage her weight and improve her overall nutrition. They can create a meal plan that considers her needs and preferences while promoting healthy eating habits on a fixed income.
- Physical Therapist (PT): If the client experiences limitations due to joint pain or other physical conditions, a PT can develop a safe and effective exercise program tailored to her needs. This can help her increase activity levels while managing any limitations.
Additional Considerations:
- Mental health screening: Social isolation, despite having family and social support, is a potential concern for some independent older adults. A brief mental health screening can identify any underlying issues that might be impacting her motivation or ability to participate in activities or seek support.
- Social worker: A social worker could connect the client with resources for social activities, transportation assistance, or other support services that may enhance her well-being and complement her independent lifestyle.
By addressing the client’s weight management, knowledge base, and potential social factors, a holistic approach can be taken to promote her continued health and independence.
