NU 629 Discussion 1: Elder-Specific Discussion Topics

Sample Answer for NU 629 Discussion 1: Elder-Specific Discussion Topics Included After Question

Initial Post

Please choose one of the following topics and respond to the thread corresponding to the question you select. Please include at least three scholarly sources within your initial post.

Note: As you are choosing a topic, please try to make sure that all topics are chosen at least by one person. You can see this by noting if anyone has posted to the topic within the corresponding threads.

  1. Dementia in the elderly. Discuss ways in which the cost associated with dementia can be curtailed along with maintaining the individual’s quality of life. Dementia is not only Alzheimer’s disease, so please consider multiple types of dementia within your answers (types of dementia include Alzheimer’s disease, vascular dementia, dementia with Lewy bodies [DLB], mixed dementia, Parkinson’s disease, frontotemporal dementia, Creutzfeldt-Jakob disease, and normal pressure hydrocephalus).
  2. Elder abuse. Include physical, emotional, sexual, etc. How, as an APRN, can you screen for and address elder abuse? What types of health promotion concepts can be used to help advocate for the personal safety of our elders? Are there screening tools available? In what unconventional locations within your community might an elder screening be performed?
  3. Fall prevention. What are specific geriatric risk factors that create an increase in fall risks? What can be done from a health promotion standpoint to decrease falls in the elderly? Define fall risk and what types of assessments are available in the outpatient and inpatient settings.
  4. Financials, levels of neglect in the elders. Consider financial risk, scams, family, and other pitfalls the elderly may find themselves in relating to their finances. Provide examples and ways to advocate for our patients and our communities as an advanced practice nurse.
  5. Components of a well elder evaluation. Define a well elder evaluation. Make sure you address components that pertain to the home environment and the communities in which they live. How can an APRN assist in these evaluations and promote different aspects within your community.
  6. Functional status. Consider ADLs and IADLs. What is the difference? What types of assessment can be done and by whom to determine if an elder is capable of caring for themself at home? In addition, what types of services are available to help promote overall elder health not only in their homes but when living with family or in assisted living and nursing homes? What types of supportive services are available to assist the elderly in staying in their own homes?
  7. Cognition. Describe how cognitive functioning may change as we age. What are neuropsychological examinations, and when should these be requested? Describe what this type of testing can accomplish and how, as a provider, you would use these results. Discuss ways in which we can improve and maintain our cognitive health (for example, diet, exercise). Provide specifics.
  8. Polypharmacy. Consider medication compliance, risk of adverse effects, creatinine clearance <50ml/min. As an Advanced Practice Nurse, how can you address this growing problem? What type of surveillance will you put into place within your own practice, and how can you advocate to help address this concern within your own community?
  9. Pain assessment and treatment. Discuss specifics regarding pain within the elder population: perception of pain, pain assessment scales, etc. In addition, provide evidence-based cited information relating to the opioid epidemic within your state and what percentage of addicted individuals are elderly. What type of resources are available in your community to help those with substance abuse problems? Are there any services specific to the elderly?

Reply Posts

Respond to ONE of your peers who chose a different topic and discuss two separate resources they did not mention. One resource should be aimed at patient education and the second resource should be written for the health professional. Replies to your peers must be on two separate days (minimum) and must utilize at least two scholarly references per peer post.

Please refer to the Grading Rubric for details on how this activity will be graded. You will receive points as if you submitted two peer posts as mentioned in the rubric, despite only one being required this week.

A Sample Answer For the Assignment: NU 629 Discussion 1: Elder-Specific Discussion Topics

Title: NU 629 Discussion 1: Elder-Specific Discussion Topics

Re: Topic 5: Components of a well elder evaluation

As our elderly population is living longer, patients are living with a multitude of chronic comorbidities. The American Academy of Family Physicians (AAFP) predicts that “by 2030, the population older than 65 years will double to 72 million” (Tatum et al., 2018). With this significant rise, elderly patients will represent a considerable percentage of our patient population. As this population is vulnerable to disability and poor quality of life, well elder evaluations are used to identify the needs of older adults and promote well-being.

Well elder assessments evaluate medical, physical, social-emotional, and environmental influences on health and well-being. Components of a well elder examine include functional capacity, fall risk, cognition, mood, pain, polypharmacy, social support, finances, goals of care, advanced care planning, nutrition, continence, sexual function, vision/hearing, dentition, living situation, spirituality, and driving (Lapierre, n.d.). Assessing each of these elements looks beyond just the disease process and focuses on patient’s functionality, preferences, and individualized interventions to improve overall well-being (Seematter-Bagnoud & Büla, 2018).

Advanced Practice Registered Nurses (APRN) in the primary care setting should be applying cognition assessments and screening tools. Because a comprehensive geriatric assessments (CGA) are extensive and time consuming, the AAFP recommends primary care givers to utilize a “rolling” assessment throughout multiple visits (Tatum et al., 2018). The rolling assessment focuses on one or two screenings a visit and once there is a an area of concern a CGA should be completed. An example of this would be the yearly “Wellness” visit offered for those who have had Medicare Part B for longer than 12 months (Medicare, n.d.). This is a great resource for APRNs and patients to create a personalized prevention plan based on their health and specific risk factors.

References:

LaPierre, K. (n.d.) The Well Elder Part 1- Demographics Overview [Video]. Regis College. https://myonline.regiscollege.edu/mod/page/view.php?id=405126

Medicare. (n.d). Yearly “Wellness” visits. U.S. Centers for Medicare and Medicaid Services. https://www.medicare.gov/coverage/yearly-wellness-visits

Seematter-Bagnoud, L., & Büla, C. (2018). Brief assessments and screening for geriatric conditions in older primary care patients: a pragmatic approach. Public health reviews39, 8. https://doi.org/10.1186/s40985-018-0086-7

 Tatum, P. E., Talebreza, S., & Ross, J. S. (2018, June 15). Geriatric Assessment: An Office-Based Approach. American Academy of Family Physicians (AAFP), 97(12), 776-784. https://www.aafp.org/afp/2018/0615/p776.html

A Sample Answer 2 For the Assignment: NU 629 Discussion 1: Elder-Specific Discussion Topics

Title: NU 629 Discussion 1: Elder-Specific Discussion Topics

I learned a great deal from your information on aging assessment and resources. My mom is 85 and she recently had an episode of syncope with hypoxia and it was thought that she was having an asthma attack. Turns out her Triponins were slightly elevated and that she has valvular disease in the aortic and mitral valves. Interesting that she did not have an MI and, in fact it is felt that the elevated cardiac enzymes from were the ambulance treatment for the shortness of breath. She has been telling me that she has these spells and she can’t walk far without getting short of breath and so she finally found a new PCP and was just evaluated with complete lab work about a week before this incident. According to Bickley et.al (2021), most elderly patients underestimate their health status not wanting to appear frail or needy. Some quick assessments may be done for the well elderly patient as you pointed out.

One of these tests may be the 10-Minute Geriatric Screener, for mobility and stability the Timed Get up and Go (TUG) test (Bickley et.al. 2021). And of course if the patient needs additional visits to complete an entire evaluation this can certainly be done in several visits. We are also learning immunizations in class and the elderly have a schedule as well which needs to be addressed with them and updated as needed. And we should not fail to do any screening testing that may be indicated as well such as for cancer.

Thank you again Alexander for addressing this topic and for sharing some more valuable sources.



References

Bickley, L. S., Szilagyi, P. G., Hoffman, R. M., Soriano, R. P., & Bates, B. (2021). Bates’ Guide to Physical Examination and history taking. Wolters Kluwer.