Jun 19, 2020 in Informative

Health Assessment

Health History

The problem of aging is supposed to be the subject of a special interdisciplinary branch of knowledge g, i.e. gerontology. It focuses on the biological, psychological and sociological aspects of aging. In fact, aging is viewed as the natural process that occurs during the postnatal life of the body and accompanied by the specific biochemical, cellular, tissue, physiological and system levels changes. In contrast to the diseases, the process of aging it affects all members of the population without exception. In fact, it is the progressive continuous process, accompanied by the degenerative changes opposed to the changes in the organism during its development and growing up. Thus, human aging is a universal basic biological process, which, however, is realized within specific socio-cultural conditions. Therefore, gerontology sees aging as a complex phenomenon that includes personal, social and even economic aspects of human life. Taking into account mentioned above, the following paper is aimed to provide the health history and psychological assessment of an older adult, i.e. Mrs. J. M.

Mrs. J. M. is 75 year old retired attorney with a long history of diabetes mellitus. Such group of endocrine disease, develops as a result of an absolute or relative (violation of interaction with target cells) deficiency of the hormone insulin, causing hyperglycemia  develops - a persistent increase in blood glucose. The disease is characterized by chronic course and disturbance of all types of metabolism: carbohydrate, fat, protein, mineral and water-salt etc. In case of Mrs. J. M., the diabetes was caused by the obesity which followed as the result of overeating and wrong nutrition pattern.

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3 year ago Mrs. J.M. was diagnosed the type 1 diabetes used to describe a group of disorders that develop as a result of the progressive destruction of pancreatic beta cells, which led to a deficiency of proinsulin synthesis and hyperglycemia requires hormone replacement therapy. Nowadays, Mrs. J.M. suffers from type 2 diabetes, i.e. refers to a disease developing in individuals with an excessive accumulation of adipose tissue with insulin resistance, whereby there is excessive synthesis of proinsulin, insulin and amylin pancreatic beta cells, a so-called comparative deficiency. The medical history of Mrs. J.M. includes the prescription of insulin as well as special diet to control the blood sugar rate. The social history of Mrs. J.M. is characterized by the efficient conditions to hold the healthy lifestyle. The family and friends always support her as well try to help her to overcome the consequences of the disease. The family has above the average income so that money for treatment is not the issue.

Functional Assessment

However, it should be borne in mind that any scheme of allocation and classification of age changes can be viewed as conditional. However, it is believed that the regressive changes in biochemical, morphological and physiological characteristics are statistically correlated with the increase in chronological age. While talking about Mrs. J.M.’s functional assessment there should be noticed that even despite the old age the overviewed patient is characterized by the ability to do ADLs independently. It means that Mrs. J.M. does not need any additional assistance in conducting her daily routine. Even home care services, including housekeeping and meal preparation, are performed by Mrs. J.M. without need of any help.

To assess the level of the functional state of the organism and its degree of adaptability, as well as to identify possible deviations, the commonly used practice is based o the specially selected Extras's trials and tests with dosed physical load. For example, to carry out rapid tests, there are constituted the small personal collection of a few simple techniques:

  • Orthostatic test (when rising from a prone position).
  • Single-stage test for quickening the heart rate (the frequency of contractions of the heart muscle) after the squat or climb the stairs to the top floor of the building.
  • Determination of heart rate recovery time (after exercise).
  • The sample of Genchi (exhale).

The heart rate is calculated in wrist artery, middle and ring finger of the other hand, so it is possible to diagnose high / low blood pressure (hypertension / hypotension) and notice disruptions of the heart.

Psychological Assessment

Individual aging process in the modern society includes biological, psychological, social and cultural development processes, which have their own determinants and effects and, of course linked. Therefore, an adequate identification of the age of the person occurs at the intersection of the trajectories of these processes, which take place at different speeds. A constant value is only chronological age.

So far, science has not formed a generally accepted definition of elderly. In fact, old age is the most paradoxical and contradictory human age. Sometimes I feel that old age, in the first place it is a biological phenomenon, which is accompanied by serious psychological changes. Many researchers consider it as a collection of loss or losses - economic, social, individual, that can mean a loss of autonomy in this period of life. At the same time it is noted that this is a kind of climax of the accumulation of experience and knowledge, intellect and personal potential of older people, enabling them to adapt to age-related changes.

Human Socialization in any society takes place in conditions that are characterized by the presence of numerous hazards that have a negative impact on the development of the individual. Therefore, an objective of the population becomes, or may become a victim of unfavorable conditions of socialization.

In old age, there are formed the psychological characteristics of the human person, which must be considered in the design and implementation of individual rehabilitation programs. At this age, it formed the hard structure of the internal order of the person, and people respond differently to their internal difficulties. Some elderly people, denying the existence of problems that inhibit their aspirations, which bring them discomfort, and reject them as unrealistic and impossible. The assessment in this case is achieved by the provisions of the level of claims. The downside is the denial that requires effort. An elderly person can gradually get used to this orientation is indeed necessary to give up and proceed as if there was no demand. 

From the perspective of humanistic psychology, self-critical condition (at any age), personal growth and mental health are based on the positive acceptance of the man himself, which is possible only with the unconditional positive acceptance on the part of significant others. Apparently, for the elderly due to the acceptance of self unconditional positive acceptance of their way of life (family, career, leisure, life values etc.). For the majority of the elderly are almost exhausted the possibility of any major changes in your life. But the old man can endlessly work hard on themselves in the ideal plan internally. It is in that he needs psychological help, it becomes the dominant activity for the adoption of internal work of his career. We must not forget that older people are "guardians of fire," the bearers of moral norms and values of society. Thus, the advanced cultures are characterized by the dominance of nursing support and respect for the elderly people.

The appearance posture, body movements, dress, grooming and hygiene of Mrs. J.M. prove the conservativeness of her character. However, the person is not characterized by the fast changes in the mood. She is always cheerful and positive as well as ready to help others. The cognitive functions, including orientation, attention span, recent and remote memory, new learning, judgment, are well performed and are characterized by the high rate of efficiency. The suicidal thoughts are absent. The self-concept and self-esteem thoughts are characterized by the high rate of self perception. Mrs. J.M. values honesty and all human moral values trying to avoid the pessimistic thoughts.

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