• Provide background on the topic as it relates to the older adult or its applicability to the older adult.
• What is the role of the APRN as it relates to the topic?
• How will you make changes to your practice with regards to the topic?
• What assessment tool if any is appropriate to assess the topic/conditio

 

Outline: Nursing

1. First question: Definition

1. Falls refer to a loss of balance and stability among individuals, resulting in them dropping to the ground.
2. Falls are so prevalent among older adults, and they are determined by a person’s cognitive abilities. There exists a direct relationship between falls and cognitive abilities
3. On the other hand, cognition refers to mental processes responsible for comprehension, understanding, and gaining knowledge

2. Second question: Background and its relation to older adults

1. As people get older, their cognitive and mental capabilities decline.
2. That results in falls, depression, and in some cases, dementia. Falls are a common occurrence among elderly patients, with so many new hospital cases reported annually.
3. For instance, according to the Agency for Healthcare Research and Quality (2019), between 700,000 to 1 million hospitalized patients fall annually.

3. Third question: The role of the APRN as it relates to the topic?

1. APRNs have a role to play in promoting mental wellbeing among patients, which reduces the rate of falls, depression, dementia, and cognitive decline.
2. APRNs can use various assessment tools to determine the cognitive abilities of a person.
3. For instance, the Mini-Mental State Examination assesses orientation, calculation, attention to detail, and copying. A clock drawing test is also used to assess cognitive capabilities.

4. Fourth question: How will you make changes to your practice?

1. . As a nurse practitioner, I will ensure patient’s mental history is determined as part of their treatment process.
2. Patients suffering from depression will undergo several forms of therapies to relieve them from depression.
3. Particularly, I will conduct brain stimulation therapies to assist depressed patients.

5. Question five: Appropriate assessment tools

1. There are numerous assessment tools to determine cognitive defects, depression, and dementia among patients.
2. The Rowland Universal Dementia Assessment Scale (RUDAS) is used to assess dementia. The mini-Addenbrooke’s Cognitive examination (M-ACE) is also useful in assessing dementia
3. To assess cognition abilities, tools such as the Nurses’ Observation Scale of Cognitive Abilities (NOSCA) is used

Nursing

Falls refer to a loss of balance and stability among individuals, resulting in them dropping to the ground. Falls are so prevalent among older adults, and they are determined by a person’s cognitive abilities. There exists a direct relationship between falls and cognitive abilities (Allali et al., 2017). Falls are influenced by both intrinsic and extrinsic factors. Intrinsic factors are internal, and they include advanced age, sensory decline, muscle weakness, and impaired balance. Extrinsic factors environmental hazards, footwear, etc.

On the other hand, cognition refers to mental processes responsible for comprehension, understanding, and gaining knowledge (Cherry, 2020). Cognition involves processes such as thinking, remembrance, problem-solving, and judgment. Depression is related to cognition processes. However, depression refers to a persistent feeling of sadness, loss of interest or pleasure, and being emotionally down. Its symptoms include depression, lack of appetite, restlessness, abnormal weight loss or gain, etc. Dementia refers to the deterioration of cognitive abilities in terms of memory, behavior, thinking abilities, and the ability to undertake everyday activities (World Health Organization, 2019). Although depression and dementia mainly affect older people, they are exceptional cases and not part of the usual aging.

As people get older, their cognitive and mental capabilities decline. That results in falls, depression, and in some cases, dementia. Falls are a common occurrence among elderly patients, with so many new hospital cases reported annually. For instance, according to the Agency for Healthcare Research and Quality (2019), between 700,000 to 1 million hospitalized patients fall annually. Falls are mainly influenced by cognitive decline. According to Allali et al. (2017), falls affect at least 30 percent of older adults and are a leading cause of morbidity, mortality, hospitalization, and disability. A decline in cognitive abilities causes impaired executive function, which increases the rate of falls in older adults. Dementia is also prevalent among the older population and is known to contribute to falls. For instance, older adults who have dementia are likely to fall 2 to 3 times more than cognitively healthy individuals (Laboni et al., (2013). Aging is associated with the decline of several systems such as Musculoskeletal, visual, coordination, and cardiovascular. A decline in such systems results in increased falls among the older population. Besides, cognitive decline due to old age causes gait impairment and increases the risk of falling. Although the above conditions are more prevalent in old age, they do not occur to all people.

APRNs have a role to play in promoting mental wellbeing among patients, which reduces the rate of falls, depression, dementia, and cognitive decline. APRNs can use various assessment tools to determine the cognitive abilities of a person. For instance, the Mini-Mental State Examination assesses orientation, calculation, attention to detail, and copying. A clock drawing test is also used to assess cognitive capabilities. The Rowland Universal Dementia Assessment Scale (RUDAS) is useful in assessing dementia (Nursing Times, 2019). The scale has items such as memory, judgment, praxis, drawing, judgment, and body orientation. The role of APRNs is to use the above tools to diagnose patients and address their situations. APRNs have an obligation to address the mental health of their patients for better health outcomes. For instance, failure to address depression and dementia among patients would lead to increased falls among patients, causing deaths and injuries.

I have noted that falls, depression, cognition, and dementia are highly prevalent among the old population. As a nurse practitioner, I will change my practice by incorporating mental health as part of medical care for any older person seeking medical treatment. Therefore, all individuals aged 60 and above will undergo mental assessment using the Rowland Universal Dementia Assessment Scale (RUDAS) to determine if they have dementia or any other mental condition (Nursing Times, 2019). Besides, all older patients will be subjected to physiotherapy to reduce the chances of falling. As a nurse practitioner, I will ensure patient’s mental history is determined as part of their treatment process. Patients suffering from depression will undergo several forms of therapies to relieve them from depression. Particularly, I will conduct brain stimulation therapies to assist depressed patients. For instance, I will administer repetitive transcranial magnetic stimulation to help patients with cognitive challenges. Such a process sends magnetic pulses to the brain and helps to treat major depression. Besides, I will use electroconvulsive therapy to treat depressed patients that do not respond to medication. Therefore, as a nurse practitioner, I will focus on addressing mental health among the older population, which has been a major challenge over the years.

There are numerous assessment tools to determine cognitive defects, depression, and dementia among patients. The Rowland Universal Dementia Assessment Scale (RUDAS) is used to assess dementia. The mini-Addenbrooke’s Cognitive examination (M-ACE) is also useful in assessing dementia (Nursing Times, 2019). To assess cognition abilities, tools such as the Nurses’ Observation Scale of Cognitive Abilities (NOSCA) is used. NOSCA has been proven as an excellent, valid, and reliable test for cognitive abilities. There also exist numerous tools for testing depression among patients. Key among them are the Geriatric Depression Scale, the nine-item Patient Health Questionnaire, and Beck et al.’s Depression Inventory (Nursing Times, 2019).