Visit #2
Part 1- Description of work
This time when I made my appointment to visit Randi I did not have a time frame like I did the first visit. I had an open schedule that allowed me to visit for as long as needed without feeling like I was rushing through my assessments or cutting off her answers. When I got to the appointment she was reading a book and waiting for me. She mentioned that she was learning to play the card game hearts and wanted to try and teach me how to play it. I tried to play the game with her, but I wasn’t good at it and so the game didn’t last very long. We did laugh a lot while she was trying to remember the rules and teach them to me.
After the unsuccessful card game we started in on the OARS and DETERMINE assessments which went faster than I had planned. Originally I planned for a break in between those and the activity assessments but since it was so quick I went through and completed them all. When I started to talk to her about Living Wills she didn’t have one and assured me that her kids would take care of her if the time came when she couldn’t make her won decisions. I talked to her about it and why it is important to have one. We got online at her house and printed one off of the Internet. I stressed the importance of having one just in case her kids were not all on the same page as she was. I encouraged her to fill it out and offered to help her but she said that she would do it later.
Things went really well this visit. Our dialogue was open and honest, I felt like she trusted what I was saying and that we are starting to bond with each other. She invited me to look at pictures of her family and shared stories about them. We played scrabble again and before I left we arranged a time when we could meet again for our next visit.
Synthesis of Visit 2’s Experience
I don’t necessarily see a need for a change in my perceptions of older adults and their communication skills. I think that I have always appreciated their life and stories and enjoy when they share stories with me. Some times I think that because I am younger they might not think what I have to say is important, and so if I was to learn better ways at expressing important issues without seeming forceful maybe they would respond better to what I have to say. For instance when I was discussing the importance of Living Wills, I caught myself where it seemed like I was being forceful when really I was just trying to emphasize the importance of them.
I can see that the concepts in this class tie together with my Community Elder Project because I understand the importance of remaining active, remaining social in one’s later years, the importance of cognitive function and keeping the elderly’s cognition sharp as well as maintaining as much independence as possible. I think that because I have taken this class I am able to help the elderly when I’m at work or in other settings remain independent and encourage them to be active not only physically but mentally as well.
I know that there is so much more that I need to know. Every day is a learning experience and every time I have the opportunity to interact and spend time with my elderly patients and neighbors I find that there is one more thing I learn that I didn’t know before.
I still need to work on listening more. Sometimes I find that I want to say something when really it would be OK if I just listened. I also need to practice becoming more comfortable around the elderly. I find that I am uneasy because I’m not sure what to do and I try not to offend them. I realize that we are different generations and there is a difference in how we were raised, so I tend to get uncomfortable when there is an awkward silence or wonder if something I said is being taken the wrong way or even if they think that I have bad manners or am immature.
Visit #2
When assessing my client’s level of support, although she is divorced, she has a boyfriend that she is able to talk to and do activities with on a daily basis. In addition to her boyfriend, she has great family support in the form of her daughters, her son (she has 4 sons, three are unreliable, one is very reliable and she talks to him daily), her grandchildren and her sisters and has no problems finding someone she can trust and confide in. If she were to need to be cared for she has several family members that would care for her indefinitely taking care of her meals, cleaning and helping with her medical needs as well.
The DETERMINE nutrition scale did not find anything significant. She is capable of cooking and buying food for her meals. She does not have a chronic illness that inhibits what she can eat. She enjoys cooking and tries to cook 1 new meal per week or try one new food. She does not take medication besides a daily multivitamin.
No deficits were found when using the Barthal scale as well as the independent activities of daily living scale. She is able to perform all ADL's independently.
She has good sleep habits and patterns. She gets at least 8 hours of sleep per night. She has a nightly routine that includes her hygiene, yoga and light reading before bed. She does not report waking up or other sleep disturbances. She has a tempurepedic mattress that she states is very comfortable, she sleeps with a white noise machine and has found that having her her room dark and cool helps her sleep better.
She does not have a living will. Right now she is not interested in making a living will and says that her children can take her of her and know what she wants.
The plan to help her maintain her independence is still to continue with her cognitive activities such as scrabble and cross word puzzles. Recently she has picked up the game "hearts" and is trying to learn that as well. She will continue with her daily exercises to maintain her strength and agility and hopefully prevent falls or other injuries. She will also continue to cook one new healthy food recipe per week and has decided that she would like to try the new meal out on her son and his children. I printed out a copy of a living will from online and encouraged her to fill it out and give a copy of it to her children so that they are aware of her wishes.
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