Visit #3
Part 1- Description of work
When visiting with Randi for the third time our schedules didn’t coordinate as well as they had in the past but we managed to get together for a short time. Talking with her this time we discussed her falls risk, her activities and any new things that she was doing. She has been trying to bike ride 6-8 miles per day in order to maintain her health, keep her balance but she said mostly because she enjoys the scenic route that she mapped out.
She continues to play scrabble, cross word puzzles and attempts to play Hearts with her boyfriend. She says that although she still doesn’t play the game very well, she enjoys the mental challenge of remember all the rules and playing it. Because our schedules did not coordinate as well this time we did not play any games like we did on the last visit. Instead after talking for a short while we started the assessment portion of the visit.
The health history was long, and we were both sure that we had already completed one on the last visit, but because we weren’t sure we continued and finished it. Taking her history was like taking one from a young adult. She doesn’t complain of any problems, past health issues other than arthritis in her fingers and some vision changes that have occurred with age. We discussed maintaining her prescription for her glasses and if it was easy for her to get to the doctor. She rides her bike to her doctor’s office and ophthalmologist’s office; both are about half a mile away. She says that if she needed to drive she could borrow her son’s car.
Performing the Tinetti Balance test was interesting and although she wasn’t sure about some of the things I was asking her to do (close her eyes and turn in a circle) she was a good sport, participated and did very well.
Overall this visit was successful, out dialogue was smooth and it was very clear that we have been able to develop a trusting relationship. I was disappointed that she had not filled out the Living will paperwork yet, but she said that she would do it when her daughters came to visit. At our next visit I plan to sit and fill it out with her if it isn’t’ done at that time.
Synthesis of Visit 3’s Experience
I tend to feel the same way that I felt after our last visit in that I don’t see a need to change my perceptions of older adults and their communication skills. Maybe I am visiting with the best older adult, but we communicate easily, honestly and we seem to enjoy our time together. I still feel as though there is so much that I can learn from them, and so much that they can learn from me. I need to learn how to express myself and my ideas in a way that doesn’t come across like I am teaching, but rather talking and have them learn from me that way. Sometimes I feel like if I am always trying to teach someone in a formal way that they tune me out. If we are able to have a conversation that flows smoothly and has good dialogue I think that they will learn more and remember more of what I am trying to teach them. I do realize that I might not have done as well a job as I thought on our last visit when discussing the importance of living wills and so this time I tried to stress that again, but as I said before, if it isn’t done at our next visit I will sit with her and try to complete it with her.
I still see that the concepts I have learned in this class help me with my Community Elder Project because I understand the importance of remaining healthy, staying active and doing activities that will strengthen not only their body but also their minds as well as enabling them to maintain as much of their independence as they can. Because I have taken this class I am able to help the elderly when I’m at work and in other settings remain independent and encourage them to be active not only physically but also mentally.
I don’t think that I will ever feel like I know enough about the elderly community that I need to stop learning. Everyday I learn new things whether it has to do with my children, my job, the elderly or myself and I know that as long as I am open to learning opportunities and take advantage of them that I will continue to grow and develop my skills.
As always, I still need to work on listening. I think that this will be something that I struggle with my entire life. I find that I always want to say something even when I should listen. I still need to practice being comfortable around the elderly. I’m afraid I’ll say or do something that will offend them or make them think I’m a silly young girl and so I come off as awkward and uneasy.
Visit #3
When assessing my client’s level of pain and amount of pain I found that she has a slight amount of pain in her fingers that she thinks is from arthritis and sometimes her legs hurt after she is really active throughout the day. The pain is tolerable and she manages it with Ibuprofen as well as Bengay rub. It doesn’t prevent her from performing her activities of daily living or her leisure activities.
After using the Health history form found in the text on page 60-62 I found that she is generally very healthy and takes an active role in her own health and health maintenance. She is retired, takes care of herself as well as babysitting her grandchildren. She doesn’t have problems with nutrition and states that she tries to eat a balanced diet including fruits, vegetables, dairy and keeps away from sugars and sweets. Her only complaint at this time is that she feels like she needs a new prescription for her glasses. We discussed the importance of keeping her prescription up to date as it would reduce her risk of falling and improve her ability to stay active and maintain her independence.
When discussing and evaluating her falls risk we found that it was low. She does not suffer from neuropathy, joint problems, pain in her feet, vertigo, hearing or balance problems. As stated before, she requires prescription glasses and has slight pain in her hips after an active day, but again, it does not limit or prevent her from doing her ADLs. I performed the Tinetti Balance and gait evaluation to assess her fall risk and was pleased to have her get a perfect score. She easily maintained her balance, steadiness, and gait and attributes it to the fact that she tries to stay active on a daily basis.
Due to her active lifestyle we have been able to maintain the same plan of care, only adding a few other activities that will help maintain her cognitive and physical abilities. She continues to play scrabble, cross word puzzles and says that although she hasn’t gotten very good at the game “hearts” she still enjoys playing it as it is a challenge for her mentally. She will continue with her daily exercises to maintain her strength and agility and help her to prevent falls and other injuries. We discussed the living will at our last visit, I printed a copy off of the Internet and she has not yet filled it out. I offered to help her fill it out, but she declined saying she will do when her daughters come to visit in a few months. She has been lucky to have avoided any chronic illness or health problems to date and by keeping up with this plan we hope it will prevent any future health problems from occurring.
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