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 client’s or family member’s 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 client’s 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 client’s 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 providing 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
Can Scan Hand Written Copy – 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”

NUR 4113 Rev. April 10, 2018 1

 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 OTHER INFORMATION
Age __81__Gender _female__ Race __Caucasian_________ Student’s Name ___Chelsea Acree________________________

Ethnicity ___German_______________________________ Dates of Client Visits: _10/20/17, 10/25/17, 11/1/17, 11/4/17_______

Length of time in country (if applicable)__since birth, 81 years Location of client’s home: Urban Rural House Apartment

Past or current jobs: Currently retired; past work includes management Does the client have any transportation issues? Yes No Unsure
position at State Planters Bank_______________________________
COMMUNICATION SPACE

How does client like to be addressed? First Name Formal Name What is the client’s degree of comfort with personal space? Does client
move away if space is invaded?
English Skills: Speak Read Write Understand
No, the client prefers conversation to take place while sitting close,
Other Languages spoken: __None_________________________ holding your hand.

Will a Translator be needed? Yes No Uncertain

Does the client have preferences for gender of his/her healthcare
Speech Impairments __None______________________________ workers?

Hearing Impairments ___None____________________________ No

Vision Impairments __None_______________________________
Any communication styles/techniques that seem to make client feel
uncomfortable? [e.g. eye contact, touch, silence, hand gestures]
______Hand holding while talking________________________
Is it necessary to vary the technique and style of communication with
the client to accommodate his/her cultural background?
Does the client have preferences for ethnicity of his/her healthcare
workers?
No, the client does not have preferences regarding ethnicity of their
healthcare providers, unless strong accents are not able to be
understood.
Other comments related to Communication or Space: N/A

Yes, due to the client’s age and time period in which they grew up in,
they do not prefer use of technology to facilitate communication (i.e.,
emails, FaceTime, etc.). Also, use of simple, direct language is preferred
as millennial terms are not understood.

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 SOCIAL ORGANIZATION—Health Beliefs SOCIAL ORGANIZATION—Family
Client’s Perception of his/her normal state of health:
Poor Fair Good Excellent Current Living Situation: Single Partnered Married Other

How does the client define “good health”? Waking up in the morning Number of Children: __3______

Parents/Siblings Living? None

How does the client define “bad health”? When someone doesn’t want
to get out of bed What is the client’s role in his/her family?

What home remedies does the client use? Heating pad The client is a widowed mother, grandmother and great-grandmother.
Due to physical decline, she is dependent upon a caretaker to assist in
Any special practices that hasten healing and recovery? Whiskey for a activities of daily living, meal preparation and transportation.
sore throat

What does the client do to promote personal good health? Weekly hair How would the client classify the decision making in the family:
appointment patriarchal (male-led), matriarchal (female-led), or egalitarian (equal
between genders)?

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, the client believes that God is the ultimate healer. Faith and prayer
are essential to the client’s wellbeing.
Before becoming widowed, family decisions were mainly patriarchal.
She sought advice and followed recommendations made by her
husband. The responsibility of making major life decisions and deciding
matters regarding healthcare is fulfilled by her children now. However,
all matters are discussed with the client, and children abide by her
wishes.

Does the client make his/her own personal decisions about health care
or should the family be consulted?

The family should be consulted.

Does the client want to have any family members present during the
teaching project?

The client wishes to have daughter present during patient education as

she acknowledges her need for help in managing health.

Does the client have any illnesses that he/she does not want the family
to know about? No
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 ENVIRONMENTAL CONTROL BIOLOGICAL VARIATIONS
Pertinent Physical Assessment/Review of Systems Data
Locus of Control (check all that apply): Height _5’7”__ Weight_155____ BMI__24.3___
Client feels in control of his/her environment (internal) Body Type: well-developed well-nourished cachectic obese
Client believes his/her decisions are important for BP_118/90 Skin Color_white_ Gait_patient unable to ambulate___
determining health (internal) Skin problems _None_______ Incontinence problems ____Yes______
X Client has a strong belief in fate, luck, or chance (external) Use of Assistive Devices for Mobility:__wheelchair________
X Client believes that illness is “God’s will” (external) Get Up and Go Test: Pass Fail
Recent Falls ___None_______
Locus of control is: Internal External Any confusion __Yes______ Forgetfulness _Yes________________
Client uses: Hearing aids Glasses Dentures
TIME Food or Medication Allergies: None
Orientation to time (check all that apply) Family Medical History: father- colon cancer; mother- cataracts,
hysterectomy, brother- multiple sclerosis
Client relies on traditions and rituals to pass cultural
heritage to successive generations (past)
Current Medical Conditions: hyperlipidemia, spinal stenosis, nerve
X Client lives for the “here and now” (present)
pain, dementia
Client plans extensively for the future (future)
Past Medical History: chronic ovarian cysts, numerous cysts present in
X Client does not tend to make appointments (past)
breast tissue, cataracts, stroke
X Client finds it acceptable to be late for appointments Past Surgical History: Cataract surgery, hysterectomy, double
(present) mastectomy
Client finds it unacceptable to be late for appointments _________________________________________________________
(future) Current Medications: (Put a * by any meds that are on “BEERS” List)
Medication Dosag Action
Time Orientation is: Past Present Future e
Oxycodone 20 mg Binds with opioid receptors
Sleeps: Poorly Fair Very Well daily in the CNS
Low-dose Aspirin 85 mg Low doses interfere with
Does the client wear a watch? ___No_______________________
daily clotting by preventing
formation of platelet-
When asked to take a medication 3 times a day, does the client tend to:
aggregating substance
a) take it with each meal (socially oriented)
Simvastatin 20 mg Inhibits HMG-CoA
b) take it at 8am, 2pm, and 8pm (clock oriented)
daily reductase, an early step in
cholesterol biosynthesis
Duloxetine * 20 mg May inhibit serotonin and
daily norepinephrine reuptake in
Adapted from: Giger and Davidhizar’s Transcultural Assessment Model and Welch Culturologic the CNS
Assessment Tool. Modifications added. Gabapentin * 600 mg Unknown; structurally
daily related to GABA, but
doesn’t interfere w/ GABA
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 receptors, inhibit reuptake,
or prevent degradation.

Traditional Family foods? Corn pudding

Favorite Foods? Blueberry oatmeal, strawberry jello salad

Dietary Restrictions r/t culture or religion? No

Any problems with eating or feeding? Patient aspirates drinking thin

liquids

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: Signs/symptoms of aspiration and methods of prevention

How do these topics relate to Healthy People 2020 and/or USPSTF: Teaching preventive methods of aspiration relates to the Healthy People 2020 goal of
increasing the proportion of older adults who are up to date on preventive measures.

Variables which may impact the client’s learning and how this can affect your teaching plan (SYNTHESIZE & remember to discuss these in your paper):
Economic: N/A

Cognitive: Patient experiences impairment due to dementia

Hearing/sight impairments: N/A

Sensory-motor capabilities or deficits: N/A

Education Level: High School

Family System/Support: Education must be provided to the client’s family members and caretaker.

Significant variables identified above (communication, space, social organization, environmental control, biological): N/A

NURSING DIAGNOSIS: Risk for aspiration related to impaired swallowing and advanced age.
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.

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Desired Measurable Short-term Outcome(s) – with time frame and method for evaluating outcomes: Patient will maintain a patent airway as evidenced by normal
breath sounds, absence of coughing, no shortness of breath and no aspiration by 1400 on Oct. 21. Monitor respiratory rate, depth, and effort. Note signs of
aspiration such as dyspnea, cough, cyanosis, wheezing or fever.

Desired Measurable Long-term Outcome(s) – with time frame and method for client to evaluate outcomes: Patient is free of signs of aspiration and the risk of
aspiration is decreased by 1400 on Nov. 4 as evidenced by normal respiratory status, absence of cyanosis, adventitious lung sounds and fever, and active
participation in implementing the treatment plan to optimize safe nutritional intake. Methods to evaluate outcomes include the following: physical assessment and
patient and caretaker identify proper feeding techniques, appropriate positioning, and signs/symptoms of aspiration.

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 I’ve done something, then I’ve got it…………………………………….…K

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

TOTAL EACH OF THE LETTERS YOU CIRCLED: V’s _3___ A’s __7__ K’s __0__
V’s indicate visual method; A’s indicate auditory method; K’s indicate kinesthetic method. Add up the number of A’s, K’s, and V’s. 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)
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  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 (3)
III. Teaching 27
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 utilized—in 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 goals—this 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 teaching—how did the client respond to the teaching? (4)
-- Provide details, using client’s 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 references—at 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 utilized—if creative aids were developed, share copies with group if appropriate
 Evaluation of teaching plan

Instructor Comments:
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