1. Chapter 7 Holistic Assessment and Care Planning

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

3. 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

4. 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.

5. 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.

6. 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

7. 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

8. 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

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

10. 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.

11. 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

12. 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

13. 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.

14. 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.

15. 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

16. 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.