Family Health Assessment: Nursing Diagnoses for an Older Adult

Introduction

Nurses are frequently called upon to conduct family health assessments in order to develop wellness and family nursing diagnoses that can be used to improve family relationships and coping skills of family members (Smith, 2001). This paper presents the results of a telephonic family health assessment of a retired military family (names changed), comprised of Mr. Student, aged 65 years (retired military), his wife Robin (a part-time bookkeeper), and their two adult children, Barry, aged 42 years (a certified management accountant) and Jerry, aged 40 years (an animal control officer). At present, Mr. and Mrs. Student live in a modest three-bedroom ranch house in a Midwestern suburb, and their two adult sons share a home in a nearby suburban community.

The family health assessment was divided into eleven functional health patterns as follows: Values/Health Perception, Nutrition, Sleep/Rest, Elimination, Activity/Exercise, Cognitive, Sensory-Perception, Self-Perception, Role Relationship, Sexuality, and Coping. Mr. Student was asked three questions in each of these domains (see question list at Appendix A), and the results are summarized below, followed by two corresponding family and wellness nursing diagnoses based on this assessment.

Values, Health Perception, and Nutrition

When asked to rate how important maintaining a healthy lifestyle was to him on a scale of one to ten, Mr. Student stated it was very important and responded with an "8" rating. However, he also conceded that he does not receive regular check-ups from either his primary care physician or his dentist, but reports visiting a local Department of Veterans Affairs (VA) outpatient clinic on occasion when his lower back hurts. Mr. Student denies any specific injury to his lower back but notes the pain is exacerbated after sitting for long hours — for example, in front of a slot machine or at the computer.

Although Mr. Student claimed he mainly ate a balanced diet, he also reported being about 30 pounds overweight, a condition that is not uncommon among elderly Americans (Ade-Oshifogun, 2012). In addition, Mr. Student reported eating an average of two meals a day with no breakfast, but noted that he engaged in heavy snacking late at night on many occasions, including potato chips, grapes, peanut M&Ms (his favorite), sunflower seeds, and Doritos.

Sleep, Elimination, and Activity

With respect to sleep and rest, Mr. Student stated that he felt he was usually getting enough sleep, but reported drinking several cups of coffee throughout the day, including some during the evening hours, which may cause sleep disruptions. In addition, Mr. Student reports having to get up several times at night to urinate, and in some cases he is unable to get back to sleep. The family has not taken a vacation since 1999 (Las Vegas), though the entire family unit attended a three-day family reunion in 2011 in another city.

While Mr. Student reported usually being regular, he also noted that he generally avoids dark green and cruciferous vegetables because they made him feel "uncomfortable." None of the family members, including Mr. Student, have experienced any elimination problems that required medical care.

According to Mr. Student, the most exercise he gets is "walking through the casino to my favorite slot machine." He also reports enjoying other indoor activities such as playing computer games including Age of Empires and Call of Duty. Although he states he and his wife enjoy walks in the woods, Mr. Student reports that his physical limitations have restricted their outdoor activities in recent years. In addition, Mr. Student is an avid wood carver, and he reports that the family home is decorated with several of his sculptures and wall hangings.