Bon Secours Memorial College of Nursing

Nursing 4113 Gerontological Concepts and Issues

SENIOR HEALTH PROMOTION PROJECT

The Senior Health Promotion Project is an in-depth look at how nurses deliver health or wellness education. As nurses who interact with elderly
clients every day in various settings, it is necessary to adapt the approach to the clients or family members individual needs in order to deliver
culturally-sensitive, effective nursing care and health teaching.

Directions: Identify a client over 65 years of age from any setting. Identify an area where teaching could be beneficial and provide teaching using
the nursing process: assessment, diagnosis, intervention, and evaluation. Multiple client visits are required to carry out and evaluate the teaching
plan the number of visits will depend on the clients attention span, motivation, and ability to learn the material. Remember an important
component of this assignment is the collaboration between the students and the client in developing a teaching plan. The clients input is essential in
developing helpful interventions for that individual.

The student will evaluate the project through reflective writing. Please follow APA format rules, except you can write in the first person. There is no
minimum or maximum length requirement for this paper as long as the required information is included.

It is imperative that the student follows the rubric attached to this document. Please note that full discussions must be present for each section for the
student to receive full credit a simple mention of a topic/idea is insufficient.

Part I, which includes: Transcultural Assessment Tool, Assessment Data Collection Tools, Survey of Learning Methods
Hard copy only no need to type this information
Data Analysis Sheet with Nursing Diagnosis/Outcomes

Part II, which includes: Final paper and all tools used in project
Be certain to include each aspect as outlined in the Evaluation Rubric

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 PART I of Senior Health Promotion Project
Transcultural Assessment Tool
Data Analysis Sheet with Nursing Diagnosis/Outcomes
Assessment Data Collection Tools
Survey of Learning Methods

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 Transcultural Assessment Tool
CLIENT INFORMATION
Age 65___Gender M______ Race __Black__________
Ethnicity African American__________________________
Length of time in country (if applicable)______________________
Past or current jobs: _________________________________________
COMMUNICATION
How does client like to be addressed? First Name Formal Name
English Skills: Speak Read Write Understand
Other Languages spoken: ___________________________
Will a Translator be needed? Yes No Uncertain
Speech Impairments _____None________________________
Hearing Impairments ____None_________________________
Vision Impairments Yes. Wear eye glasses_______
Any communication styles/techniques that seem to make client feel
uncomfortable? [e.g. eye contact, touch, silence, hand gestures]
Client was not comfortable with salience while I was writing. Liked
continued mutual conversation.___________
Is it necessary to vary the technique and style of communication with
the client to accommodate his/her cultural background?
_No______________________________________________________
________________________________________________
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OTHER INFORMATION
Students Name _April Fraser_____________________________
Dates of Client Visits: _10/03, 10/10, 10/29________________
Location of clients home: Urban Rural House Apartment
Does the client have any transportation issues? Yes No Unsure
SPACE
What is the clients degree of comfort with personal space? Does client
move away if space is invaded? Client does tend to lean back if space is
invaded too much, however does seem to be comfortable with a slight
level of close contact.
Does the client have preferences for gender of his/her healthcare
workers? ____Client does not have preference on gender_______
Does the client have preferences for ethnicity of his/her healthcare
workers? Client does not have preference on ethnicity of healthcare
provider_______________________________________
__
Other comments related to Communication or Space:
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 SOCIAL ORGANIZATIONHealth Beliefs
Clients Perception of his/her normal state of health:
Poor Fair Good Excellent
How does the client define good health? _Healthy state of mind,
positive self-thinking, good spiritual foundation, eating healthy, and
being happy.
How does the client define bad health? _Being symptomatic, or
having a health diagnosis and not doing nothing about it. Patient
believes you can be sick but still be in good health.
What home remedies does the client use? Will do an apple cider drink,
uses olive oil, and coconut oil, and jojoba oil for any skin dryness or
rashes. Use garlic in diet to keep blood pressure normal. Baking soda
and water for indigestion.
Any special practices that hasten healing and recovery? Patient
exercises, and stretches regularly to help prevent shoulder and back flair
ups.
What does the client do to promote personal good health? Exercise
regularly, try to maintain a healthy diet, attends church regularly, prays
and reads the bible, tries not to worry about things she cannot change.
Tries not to take on too much of other family member problems.
Does the client believe in prayer or supernatural forces or a Supreme
Being? If so, how important are these in the maintenance of good
health? Yes, client does believe in supernatural forces. Patient believes
in God is a Christian. Believes has to have a relationship with God in
order to manage life well. Her belief in God helps her to manage her
life in difficult times. She has been able to be in good health, and deal
with things like losing her first husband to cancer because of her
relationship with God.
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SOCIAL ORGANIZATIONFamily
Current Living Situation: Single Partnered Married Other
Number of Children: __2______
Parents/Siblings Living? 1 parent living. 1 sibling living_______
What is the clients role in his/her family? _The client is a retired mom,
grandmother, and wife, and also care taker of her mother.
How would the client classify the decision making in the family:
patriarchal (male-led), matriarchal (female-led), or egalitarian (equal
between genders)? __Equalitarian between genders. _____
Does the client make his/her own personal decisions about health care
or should the family be consulted?
_The client makes her own decisions.________________
Does the client want to have any family members present during the
teaching project? _The client does not want to have any family
members present during the teaching project.
Does the client have any illnesses that he/she does not want the family
to know about? The client does not have any illness she does not want
the family to know about.
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 ENVIRONMENTAL CONTROL BIOLOGICAL VARIATIONS
Pertinent Physical Assessment/Review of Systems Data
Locus of Control (check all that apply): Height _______ Weight_____ BMI_____
x Client feels in control of his/her environment (internal) Body Type: well-developed well-nourished cachectic obese
x Client believes his/her decisions are important for BP__________ Skin Color__Normal for ethnicity
determining health (internal) Gait__Steady______
Client has a strong belief in fate, luck, or chance (external) Skin problems ___None__ Incontinence problems _None________
x Client believes that illness is Gods will (external) Use of Assistive Devices for Mobility:__________________________
Get Up and Go Test: Pass Fail
Locus of control is: Internal External Recent Falls _none______
Any confusion __none___ Forgetfulness some forgetfulness
TIME Client uses: Hearing aids Glasses Dentures
Orientation to time (check all that apply) Food or Medication Allergies: _none______________________
_________________________________________________________
Client relies on traditions and rituals to pass cultural
Family Medical History: Mother breast cancer, diabetes, alzheimers,
heritage to successive generations (past)
arthritis, heart disease, believes mother had depression but was never
x Client lives for the here and now (present)
diagnosed. Did not know biological father too well, but has heard he
Client plans extensively for the future (future)
died from stomach cancer, and heard that he was an alcoholic.
Client does not tend to make appointments (past)
x Client finds it acceptable to be late for appointments Current Medical Conditions: chronic, back, shoulder, and neck pain.
(present) Patient is also obese.
Client finds it unacceptable to be late for appointments
(future) Past Medical History: None_______________________
Past Surgical History: No previous surgeries______
Time Orientation is: Past Present Future _________________________________________________________
Current Medications: (Put a * by any meds that are on BEERS List)
Sleeps: Poorly Fair Very Well Medication Dosag Action
e
Does the client wear a watch? __No_______________ Piroxicam 10mg
Vitamin D3 600mg
When asked to take a medication 3 times a day, does the client tend to:
Magnesium 500mg
a) take it with each meal (socially oriented)
Womens Multivitamin 2tablet
b) take it at 8am, 2pm, and 8pm (clock oriented)

Adapted from: Giger and Davidhizars Transcultural Assessment Model and Welch Culturologic Traditional Family foods? Soul Food
Assessment Tool. Modifications added. Favorite Foods? Mustard or Kale greens, mac and cheese, and steak.
Dietary Restrictions r/t culture or religion? None
Any problems with eating or feedi
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 Assessment Data Collection Tools

The following assessment tools are to be completed on your

client:

Mini-mental (MMSE) or Mini-Cog (If is frustrated easily or has

dementia)
Geriatric Depression Scale (GDS)
Katz ADL
SPICES (If a client has any of the six geriatric syndromes, choose
an appropriate assessment tool for further evaluation of the client
problem.)

In addition, the student will choose an additional assessment

tool to complete, related to a client problem that has been
identified in the assessment data. You may not use any of the
above assessment tools, including SPICES, as your additional
assessment tool. You MUST identify a different client problem
than above and choose a different assessment tool, ie: hearing
screen, alcohol screen.

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 DATA ANALYSIS SHEET
HEALTH PROMOTION AND TEACHING NEEDS: based upon your discussions with the client and the information found above, identify
Topic(s) that the client would like to/ needs to learn about:
My client would like to learn about natural, unmedicated methods of controlling chronic back, neck, and shoulder pain. My client would also like to learn about
safe effective ways to lose weight at an older age.

How do these topics relate to Healthy People 2020 and/or USPSTF:

Healthy People 2020 have a goal to Increase the proportion of older adults with one or more chronic health condition report confidence in managing their
conditions. A second goal is to reduce the proportion of older adults who have moderate to severe functional limitations. My client being able to manage her back
pain indecently, and ensuring that she is able to limit her back, and neck pain will help to ensure both of these goals are met.

Variables which may impact the clients learning and how this can affect your teaching plan (SYNTHESIZE & remember to discuss these in your paper):
Economic: The client does not have any economic limitations. She has a fair retirement amount, and her husband also receives a good pension and
retirement. They live very comfortable in their retirement.

Cognitive: My client does not any cognitive limitations. However I do need to consider my clients learning style, and that it seems if she is not taught with
by demonstration, and writing she may not accurately recall what is being taught. She admits to also occasionally having some memory problems.

Hearing/sight impairments: My client wears glasses, and needs them to appropriately function, drive, and read.

Sensory-motor capabilities or deficits: My client does not have any sensory-motor deficiencies.

Education Level: My client has a Bachelors Degree in Social Work from Alcorn State University, and a Masters in Social Work from Virginia
Commonwealth University.

Family System/Support: My client has a big support system. Her husband has a few health problems, but is still very independent, and can support my
client in any health or personal situation. My client also has two children that are involved in her life, and are very support of her. She states her children always
check up on her, and ask questions to keep up to date on her health.

Significant variables identified above (communication, space, social organization, environmental control, biological):
Significant variables would be memory, weight, and chronic back, shoulder, and neck pain.

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NURSING DIAGNOSIS:
Nursing diagnosis for the client that addresses their health promotion learning needs, including related to and as evidenced by. You also may use
at risk for nursing diagnosis.
Chronic pain related to inflammation of the lumbar spine, neck and shoulder as evidence by patient reporting consistent lower back, neck and shoulder pain for
more than a year, disruption of social and family relationships, depression, fatigue, beaten look, and rubbing of painful part.

Desired Measurable Short-term Outcome(s) with time frame and method for evaluating outcomes:
The patient will verbalize expectation of course of pain treatment and his desired outcomes of treatment goals. At initial visit on 10/

Desired Measurable Long-term Outcome(s) with time frame and method for client to evaluate outcomes:
The patient will list 3 noninvasive pain relief measures to help manage the pain.

Survey of Preferred Learning Method(s) *

DIRECTIONS: Read the following statements. If the statement is mostly true for you, then circle the letter that follows the statement.

1. Once Ive done something, then Ive got it.K True

2. I must look directly at the speaker to understand him or her..V False
3. My handwriting is quite good.K True
4. I can spell words out loud better than when I have to write them downA False
5. If someone asks me to spell a word, I have to write it down to answer..V False
6. I would rather listen to tapes then view slidesA False
7. I remember a lecture better than what I read..A False
8. I understand material better if I read out loud.....A True
9. I am often the last person to notice that something has been added to a room...A False
10. I learn better if I see and hear the material at the same time.V&A True
11. I often need to ask people to repeat what has just been said...V True
12. Sometimes in a lecture I tune out even when I am really trying to pay attention...V True
13. I use my hands a great deal when I speak...K False
14. I can tell if Im doing a new physical skill right by the way it feels...K True
15. I would rather demonstrate how to do something than explain it...K True
16. I have trouble remembering unless I write things down...V&K True
17. A page full of print is too much for me to read...A False
18. The easiest way(s) for me to learn something is to:
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 a. Read itV False
b. Hear it.A False
c. Try itK True
d. Write it in my own words...K True
e. Explain it to someone..A True
f. Draw a picture or diagram of it...K False

TOTAL EACH OF THE LETTERS YOU CIRCLED: Vs __4__ As _3___ Ks __7__

Vs indicate visual method; As indicate auditory method; Ks indicate kinesthetic method. Add up the number of As, Ks, and Vs. The
highest total indicates your preferred learning method.

*Adaptation of the Swassing-Barbe Modality Index

Evaluation Rubric
Section Details Points
I. Assessment 14
Thoroughly complete Part I of the Senior Health Promotion Project (include with paper) (3)
Completed Survey of Preferred Learning Method(s) tool (include with paper) (1)
(4)
Completed assessment tools (MMSE, GDS, Katz ADL, SPICES) (include with paper) (1)
Completed SPICES assessment tools if indicated (include with paper) (1)
Completed assessment tool related to an identified client problem (include with paper)
Begin paper by providing brief summary of client, based upon information gained from Part I (4)
only include pertinent details that relate to your teaching plan, discuss how this plan relates to
Healthy People 2020 and/or USPSTF
II. Nursing 13
Diagnosis
In Part I of the Senior Health Promotion Project:
One nursing diagnosis for the client that addresses his/her health promotion learning needs (2)
Include r/t and AEB to support the nursing diagnosis (based on relevant info from your assessment tool) (2)
In the paper:
Discuss the choice of this diagnosis & why it is important for this client (3)
(3)
Discuss short term outcomes, with time-frames, which are easily measurable and client-appropriate
(3)
Discuss long term outcomes, with time-frames, on which the client and/or family can follow-up themselves
III. Teaching 27

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Plan (Intervention)
for Nursing
Diagnosis
Mutually Developed Plan (3)
In the paper: discuss how the teaching plan was developed mutually with client and/or family
Teaching sessions In the paper:
Describe content of teaching and teaching approach utilizedin relation to the client goals outlined above (4)
Provide details of research (from journals) to support the teaching provided (no older than 5 yrs, unless approved) (4)
Discuss all teaching aids used and their appropriateness considering various factors that may affect learning (4)
(such as education level, socioeconomic status, Survey of Preferred Learning results, etc)

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 Measurable outcomes In the paper:
Explain whether each short-term outcome was achieved (4)
Describe how desired short-term outcomes were measured (4)
Discuss the plan for helping the client follow-up on long-term goalsthis should be a plan the client and/or family can follow (4)

IV. Evaluation 16
Evaluation In the paper:
Identify if the nursing outcomes were related to primary, secondary, or tertiary prevention (4)
Describe the effectiveness or limitations of your teachinghow did the client respond to the teaching? (4)
-- Provide details, using clients quotes
Discuss what could have been done differently and how the teaching strategies could be revised (4)
Summary In the paper:
Describe your reactions and feeling in the role of nurse-teacher & what you learned from this project (4)
V. Professional 30
Format
A. Include with paper:
1. Transcultural Assessment Tool with Data Analysis sheet (1)
2. Copy of Survey of Preferred Learning Method(s) tool (1)
3. Completed assessment tools (1)
4. Copies or pictures of all teaching aids utilized (8)
B. Presentation of reflective writing paper
1. Logical flow of ideas (follows rubric) (1)
2. Minimal grammatical and spelling errors (2)
3. Confidentiality and objectivity are maintained in paper (2)
4. APA formatting within body of paper (correct title page, margins, citations, etc) ignore 1 st person rules (2)
5. Style - Overall clarity, college level of writing, word choice, descriptions (2)
C. References
1. APA format in reference list; citations listed are dated within the last 5 years (unless has prior approval by instructor) (1)
2. Minimum of 4 referencesat least one from a nursing journal (1)
3. Teaching aids used in teaching are discussed & cited in paper and listed on reference page (1)
VI. Presentation Provide brief summary of your teaching project to assigned group (in class) in less than 10 minutes. (7)
Presentation should include:
Nursing diagnosis
Teaching aids utilizedif creative aids were developed, share copies with group if appropriate
Evaluation of teaching plan

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Instructor Comments:

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