Holistic Nursing & Functional Assessment

What does Holistic Gero Care include?
1. Physical
2. Psychological
3. Social
4. Spiritual

How does the Holistic care heal?
Heals the whole person rather than just one disease or symptom and focuses on the person rather than the curative effort for the disease.

What is the goal of Holistic Gero Care?
Heal the whole person

What is the central focus of the comprehensive evaluation?
Functional Abilities

Where can Geriatric Evaluations be conducted?
1. Acute Care Hospitals
2. Outpatient Ambulatory Clinics
3. Home Settings
4. Various settings of the long term care system

What is the role of the Nurse in Geriatric Evaluations?
1. Individual assessment and intervention
2. Consider culture: edu, reading level, language
3. Confidentiality

What is a Functional Assessment?
An evaluation of a person’s ability to carry out basic tasks of self-care.

What are the 3 test’s that measure Functional Assessment?
1. Index of ADL’s (Katz ADL)
2. Barthel Index of ADL
3. Instrumental ADL’s

The following is an example of what Functional Assessment?
1. Measure the person’s ability to perform basic self-care: Bathing, Dressing, Toileting, Transfer, Continence, Feeding.
Index of ADL’s (Katz ADL)

The following is an example of what Functional Assessment?
1. Measure the amount of physical assistance when the person cannnot perform: Feeding, Bathing, Grooming, Dressing, Bowels/Bladder, Toilet Use, Transfers, Mobility on level surfaces, Stairs
Barthel Index of ADL’s

The following is an examples of what Functional Assessment?
1. Evaluates tasks needed for independent living: Telephone, Traveling, Shopping, Meal prep, Cleaning, Meds, Money
Instrumental Activities of Daily Living

How is the Katz ADL measured and what do the scores mean?
1. Dependent= 0
2. Independent = 1
3. The higher the score the more Independence

How is the Barthel ADL measure and what do the scores mean?
1. Dependent= 0
2. With Assist= 5
3. Independent = 10-15
4. The higher the score the more Independence

How is the Instrumental Activities of Daily Living Functional Assessment scored and what do the scores mean?
1. Dependent= 0
2. With assess= 1
3. Independent = 2
4. The higher the score the more Independence.

Where is the Barthel’s ADL Functional Assessment used more?
Used In Rehab Settings b/c changing classification can reflect the person’s progress.

Where is the Instrumental Activities of Daily Living Functional Assessment require?
Requires a higher level of cognitive function than the other assessments because the person is conducting things on there at home.

What are the 3 Cognitive Assessments?
1. Mini-Mental status Exam (MMSE)
2. Short Portable Mental Status Questionnaire (SPMSQ)
3. Short Orientation- Memory-Concentration (SOMC)

What does the MMSE do?
Screen cognitive deficiencies.

How is the MMSE scored?
30 items are scored with one point each. A score of less than 26 means the patient is cognitively impaired.

What is the Mood Assessment?
Geriatric Depression Scale (GDS)

What is the Geriatric Depression Scale?
It is a long form with 30 items or short form with 15 items and was developed for older adults to accurately measure for depression

What are some drawbacks of the GDS?
Cannot apply to people with cognitive impairment

What does a high score mean?
A high score (ten or above) indicates depression

What does the Tinetti Balance and Gait Evaluation measure?
Mobility and Stability

How is balanced assessed?
Sitting, arising, standing, and turning

Explain the Tinetti Balance and Gait Scored?
20 or Less indicates a client at risk for fall (Out of 28)

Explain the Balance Instructions?
Have the subject sit in a hard armless chair and cross arms across chest.

Explain the Gait Instructions?
Ask the subject to walk briskly across the room, turn and walk back, and keep doing this while all the following parameters are evaluated.

What does a high score on Nutrition indicate?
Risk in Nutrition

If you are assessing an older adult living in their home what Functional assessment would you use?
Instrumental Activities of Daily Living Functional Assessment.

What is culture ? the system of shared ideas , rules , and meanings that influence how we perceive the world What are the aspects of culture that relate to health assessment ? Communication/language , kinship/social networks , educational background …

Nursing Process 1. Assess 2. Diagnose 3. Plan outcomes 4. Plan interventions 5. Implement interventions 6. Evaluate Interventions What is Assessment? The systematic gathering of information related to the physical, mental, spiritual, socioeconomic, and cultural status of a person, community, …

It is a care model that uses the division of labor according to specific task and technical aspects of the job. It has been defined as work assignment by functions or tasks, such as passing medicines, doing dressing changes, giving …

First level Priority Problem -those that are emergent, life threatening, and immediate, such as establishing an airway or supporting breathing Second level Priority Problem Are those that are next in urgency-those requiring your prompt intervention to forestall further deterioration. Ex:Mental …

assessment First step of the nursing process. Activities required in the first step are data collection, validation, sorting, and documentation. The purpose is to gather information for health problem identification. back channeling includes active listening prompts such as “all right,” …

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