Chapter 7 Holistic Assessment and Care Planning

Terms to Know Holistic: pertains to whole person; body, mind, and spirit Presence: being totally “with” or engaged with another individual

Introduction Accomplishment in surviving to old age Coping with adversities, adjusting to change, and learning new skills Inner resources to meet life’s challenges Need to empower the older adult: Mobilize older adults’ strengths and capabilities Promote normalcy, independence, and individuality Honor their wisdom, experience, and capabilities

Question Is the following statement true or false? Older adults may unnecessarily develop feelings of dependency, uselessness, and powerlessness during times of illness and stress if they become passive recipients of care.

Answer True Rationale: The feelings of dependency, uselessness, and powerlessness may develop if the older adult’s inner resources for self-care are identified, and they are not allowed to be active participants of their own care.

Holistic Gerontological Care Integration of biological, psychological, social, and spiritual dimensions of person Health promotion through balance of the body, mind, and spirit Healing versus curative most beneficial Self-discovery in final phase of life

Holistic Assessment of Needs Hartford Institute for Geriatric Nursing: has comprehensive listing of evidence-based assessment tools Tools can supplement holistic assessment Holistic assessment: Identifies patient needs related to health promotion and health challenges Identifies older adult’s requisites to meet needs

Health Promotion–Related Needs Basic life-sustaining needs Views of health vary from person to person and at different times in life of person Optimal health for the older adult: physiological balance, connection, and gratification

Question Is the following statement true or false? The appropriate definition of health is “the absence of disease.”

Answer False Rationale: Viewing health as “the absence of disease” does not take into consideration needs beyond physiological balance. Connection with ourselves, others, a higher being, and nature are also important factors that have a role in the integration of the body, mind, and spirit.

Health Challenges–Related Needs Needs related to chronic conditions and health challenges: Education: for understanding Counseling: for dealing with feelings Coaching: for motivation Monitoring: for tracking progress Coordination: informing all Therapies: both conventional and complementary

Requisites to Meet Needs Physical, mental, and socioeconomic abilities Variety of nursing interventions Knowledge, experience, and skills Nursing considerations for enhancing self-care Desire and decision to take action Values, attitudes, and beliefs established Rights of individual respected

Question Is the following statement true or false? The desire to take action is affected by the value a person sees in performing that action, as well as the person’s knowledge, attitudes, beliefs, and degree of motivation.

Answer True Rationale: The value a person sees in performing an action, as well as his or her knowledge, attitudes, beliefs, and degree of motivation will influence the desire and decision for action. If an older diabetic patient does not have the knowledge or belief that monitoring blood glucose is necessary, complications may result.

Gerontological Nursing Processes Evaluate effectives in meeting needs related to health promotion and health challenges Assess ability for self-care Direct nursing interventions at empowering older adults: Strengthen self-care capacities Eliminating or minimizing self-care limitations Providing direct services

Examples of Application Implement actions for health conditions. New health-related challenges bring new needs. Assess the impact of the health challenge on self-care capacity. Promote health as well as manage new health challenges through new interventions.