Evidence-Based Geriatric Nursing Protocols for Best Practice

Introduction

A 78-year-old white male patient address an office with such complaints as unintentional weight loss of 10lb in the last year, self-reported exhaustion, grip strength weakness, low physical activity, and slow walking speed. All these indicators prove a possibility of a multidimensional geriatric syndrome known as frailty (Bond, Bolton, & Boltz, 2016). To support this diagnosis and continue working with the patient, it is necessary to pose the following questions:

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  1. Does the patient have some health problems that may limit his daily activities?
  2. Does the patient ask for additional help in his regular activities?
  3. What physical activities were the patient involved in before he started feeling worse?
  4. Do other family members suffer from frailty? Were his family members diagnosed with frailty in their older age?
  5. What was the reason for taking a multivitamin on a regular basis?
  6. Does the patient have cardiovascular problems?
  7. Do you have heart problems? Or have you ever addressed a cardiologist for the assessment?

Main body

There are many tools that can be used to identify frailty at its early stage and develop an effective treatment (Lee et al., 2017). For example, it is possible to use the Indicator of Relative Need with the help of which an understanding of the patient’s needs and the level of dependence can be achieved. The Frail non-Disabled questionnaire may be offered to the patient as a screening tool for self-completion to clarify if the patient suffers from frailty or disability. Due to the fact that no laboratory tests are taken at this moment, a care provider has to pay attention to the Supportive & Palliative Care Indicators Tool in order to identify if the patient is at risk of deteriorating or even dying and decide what kind of care is required. Frailty index and phenotype are the two screening tools that may be used to predict the outcomes of this physical problem.

In the case under discussion, there are many concerns with frailty in this patient. First, frailty is a health problem that is frequently observed among males aged 70 and older (Bond, Bolton, & Boltz, 2016). The patient is in this group of people. Second, regarding the symptoms reported by the patient, he meets all the indicators of frailty. Finally, the patient lives alone, and there is no single person who can take care of him in case of emergency. It can be hard for a doctor to communicate with a patient who lives alone for a certain period of time and does not want to leave the house. The patient does not take any medications except a multivitamin at the age of 78 years. It can mean that he does not like to visit hospitals and be dependent on some medications or treatment plans.

Conclusion

To support the patient and provide the necessary portion of help, referral to geriatric medicine is required. If a general practitioner assesses the patient, the next referral may be to a special community service where a full geriatric assessment can be developed. Sometimes, palliative care at their homes is appropriate. Therefore, referrals to home-care providers can be appropriate. Finally, regarding the age of the patient, it is also suggested to refer to a cardiologist and check the condition of the heart in order to develop further care steps and not to omit some crucial symptoms and health problems.

References

Bond, S.M., Bolton, R., & Boltz, M. (2016). The frail hospitalized older adult. In M. Boltz, E. Capezuti, T.T. Fulmer, & D.A. Zwicker (Eds.), Evidence-based geriatric nursing protocols for best practice (5th ed.) (pp. 443-456). New York, NY: Springer.

Lee, L., Patel, T., Costa, A., Bryce, E., Hillier, L.M., Slonim, K., … Molnar, F. (2017). Screening for frailty in primary care. Canadian Family Physician, 63(1), 51-57.

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