Sample Assignment - Geriatric Syndrome

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Geriatric Syndrome conceptual model

Geriatricians use the term geriatric syndrome to understand the unique features of certain health conditions that are common in elderly like delirium, falls, frailty and incontinence. These syndromes are highly found among aged people, is multi factorial and there is a substantial level and there is substantial level of morbidity along with poor outcomes. There is no particular conceptual model or series of guidelines available for diagnosing geriatric syndrome, so as per the article by Sharon Inouye, there are four risk factors that should be tested for geriatric syndrome (Inouye, Studenski, Tinetti & Kuchel, 2007). These factors are older age, cognitive impairment, functional impairment and impaired mobility. But the major setback is that focusing on one syndrome may result in wrong diagnosis and if all syndromes are considered, there will be less focus.

The client selection is of my friend’s grandfather who is a senior citizen. From past few months he is finding problem in driving and now from last 2 months he is not able to do his routine chores like taking bath or eating food. For assessing whether he is suffering from geriatric syndrome, instead of analyzing the syndromes, a rolling approach is chosen (Elsawy & Higgins, 2011). In this approach instead of treating a patient in one sitting, multiple sittings will be arranged. The four important syndromes identified in article by Sharon Inouye can be discussed in each sitting respectively. Even a complete questionnaire will be made ready to make the task speedy. The assessment for geriatric syndrome will begin with the review of two important functional ability of an individual. The first is daily living activities that are done by a person like eating and dressing. The second is the instrumental activities in daily living that an individual does like doing housework and preparing meals.

The second step is to analyze the physical health of an individual which is very important where patient’s past and present physical conditions is analyzed. The grandfather was not able to cleat both the test and it seems both the symptoms showed he had geriatric syndrome. The third step involves identification of other risk factors. The final evaluation on mobility impairment showed that though there were many syndromes of geriatric disease present in patient, there was a sign that these may relate to some other disease also. So the outcome came to be poor as it was confusing and showed signs of depression due to which the patient was not able to perform his routine activities.

For improvement of geriatric syndromes, it is better to apply a holistic approach and draw a well defined guideline that could help in better application. Through following a better guideline for identification so geriatric syndrome and a similar approach to it, current practices can be improve in this field.

Research methodology analysis for “Views of First Nation Elders on Memory Loss . . .”

Memory loss is such a disease that having a study on that requires understanding and interpreting what a patient with memory loss feels rather than analyzing the facts and figures. Choosing the right methodology is very important for undertaking a research as this decides the level and authentication of research conducted.

In the article “Views of First Nation Elders on Memory Loss . . .”, an exploratory research is conducted to identify the gap that exist between the theory and actual views of the patient. The research was conducted on 21 patients using the grounded theory for research where interviews of patients were taken and coded to interpret resuls (Taylor, Hulko, Camille, Amouse, Bachynski, & Antifeau, 2009).


The grounded theory is used in this research as it is deemed to develop a better understanding of conducting this research on actual patients. Grounded theory is a general research method which does not belong to any discipline. This method has strict procedure for data collection and has well defined guides in place (Carmaz, 2006). Constant comparison is the process used in this theory which enables to seek and conceptualize the social patterns. Various components of grounded theory in this research are:

  • Real time involvement in data collection: This is very much visible as the samples are interviewed and constant analysis is done.

  • Construction of coding: data coding was done on concept and categories.

  • Constant comparative method: constant comparison is done with theory, life circle and the responses.

If some other theory of research was used, then it could have resulted in different outcome. If a quantitative theory was used, it would have covered collecting data through closed end questionnaires that could have restricted its results to just outcome of those questions. Similarly, the recommendations would also depend on the limited questionnaires provided and so the entire research would be highly dependent on the researcher and the limited questions asked.

Dementia 

People are considered elderly due to their aging in the culture which results in some disease that can be associated with their age. There are various issues raised in dementia care. Once the aged are diagnosed with dementia, the first thing that happens in culture is the shock that comes to their family. Considering the culture and care giving, there is a lot of stress related to care giving which results in abuses and neglect. When care givers are pushed to meet daily demands of older person without proper training, it results into heavy frustration and anger which leads them to abusive behavior.

When an older person is sick or not well, mentally challenged or physically challenged, there are more chances of abuses by care giver. In such situation, caregivers find them in very stressful condition like being trapped. This results in them being unaware of resources and assistance with proper training. Due to lack of skills to handle such situation, caregivers feel being physically forced especially when the resources are short which results into neglectful situation. Sometimes it happens that the self image of a caregiver of a “dutiful child” may increase the problem as they feel that it is their duty to take care of elderly and any interval taken in it is breach of elder’s trust.

Besides this, even the societal attitudes make a contribution towards violence against elders making an easy way for continuing of elderly abuse without any intervention. In such cases, the elders are devalued, demeaned and are not respected and it is the societal thinking that what is going in a person’s house is private and their family matter.



Nurse plays a very important role in diagnosis, assessment and treatment of dementia. Once a person is identified with dementia, family of the patient is the first to get affected. Dementia is a very common disease among the elderly people; still it lacks awareness which results in non caring attitude and shock from the family (Michelle, 2009). There are many questions and queries that could be asked by family regarding the disease and how to take care of such patients. It is the nurse that comes to the rescue fo family and patients in such atmosphere. Nurse is considered responsible to ensure that family and patient both are at ease after identification of dementia.

Nurses provide treatment, care and support with people suffering from dementia. Assessments are carried out by nurse at their home. After conducting assessment, they provide advise them on dementia and advice their caregivers on methods of coping with such patients, handling them and ways of improving the quality of life and health of dementia patients. But considering the physical nursing tasks, the nurses do not do them. Examples of such tasks are changing of bandages or catheters.

During assessment period, nurse remains with the patient round the clock to observe and analyze the symptoms seen in them. Besides this, nurse is the person who handles the patient, takes care and ensures all of their needs are satisfied. Nurses are mentally and physically drained while handling dementia patients. After assessment, even the work plan for dementia patients is prepared by nurses who ensure the same is implemented when the patient is staying at service centers and even when they are home through involvement of family member.

Thus nurse plays very important role in assessment, diagnosis and treatment of dementia patients as they are with them and takes care of their need including preparation of work plan.

References
  • Carmaz, K. (2006). Constructing Grounded Theory: A Practical Guide through Qualitative Analysis.  Thousand Oaks, CA: Sage Publications.
  • ELSAWY, B. & Higgins, K. (2011). The Geriatric Assessment. [ONLINE]. Available on http://www.aafp.org/afp/2011/0101/p48.html. [accessed 5 November 2014].

  • Inouye, S., Studenski, S. Tinetti, M. & Kuchel, G. (2007). Geriatric syndromes: clinical, research and policy implications of a core geriatric concept. The American geriatric society.

  • Michelle, S. (2009). Dementia From Diagnosis to Management - A Functional Approach. Hoboken : Taylor & Francis.

  • Taylor, D., Hulko, W., Camille, E, Amouse, M., Bachynski, N. & Antifeau, E. (2009). Views of First Nation Elders on Memory Loss and Memory Care in Later Life. Springer Science+Business Media, LLC