Running head: CASE STUDY III	

Case Study III
Mbinglo Peter
Lakeview College of Nursing
N309, Nursing of the Gerontological Client
 June, 2, 2011

CASE STUDY III                                                                                        
Case Study III		
	Mr. and Mrs. Boyd are both young older adults; however that does not mean that they cannot start having problems especially considering the fact that most problems within the human system start to surface as humans grow older. In performing their assessment, I would first take their vital signs and then assess their circulatory function especially the heart function. Then move over to assess respiratory status because these are the two major system that keep humans alive (Taylor, C., Lillis, C., LeMone, P., & Lynn, P., 2011). Then I would assess their sensory system. With regards to sensory I would assess hearing, vision, and tactile sense for both partners paying particular attention to Mr. Boyd since his wife complains that he does not seem to hear well. I would then assess their neurological system paying more focus on Mr. Boyd since based on his wife’s statement, he appears be to be losing his memory. Under neurological, I am going to assess for delirium, dysphagia and agnosia. I am also going to ask about medications if any while observing how both of them are behaving. Next I am going to assess the gastrointestinal function of both though more emphasis will be laid on Mr. Boyd, during which I will ask about appetite changes and oral health. Next I am going to assess the genitourinary function for both parties. Sometimes an infection in an older adult can change their behavior pattern. Most of all, I am going assess both for pains. (Mauk, 2010)
	When performing an assessment on an older adult, the best way to evaluate the assessment is through observation (Jarvis, 2008). So I will use self-report, both from Mr. and Mrs. Boyd, and performance measures which are based on my observation (Mauk, 2010). So what I will do is make sure I utilize my time judiciously by noting involuntary movements which tell the true story of how they are feeling (Jarvis, 2008). The fact that Mrs. Boyd is concerned that I intend to direct some of my questions to Mr. Boyd does put some doubts in my mind. (Taylor et al, 2010).	
	With Mrs. Boyd dominating the assessment, it would have a lot of implications for both me and Mr. Boyd. First Mr. Boyd would feel neglected especially as some of these questions relate to him but his wife does not want him to answer. The wife has complained of him having memory issue, that would be my place to confirm that based on my interview and observation of Mr. Boyd. Thus if the wife were to shadow the assessment, I may not be chanced to make my own personal observation and inferences (Taylor et al, 2010). Besides it is unethical that Mr. Boyd is right there but I am channeling his questions to his wife. I would ask him questions and if he is unable to answer, then I can direct the questions to his wife (Chitty & Black, 2011). Most of all, it does not show any respect to Mr. Boyd who appears to be the patient. It would appear like the wife and I am ignoring Mr. Boyd. 
	I think several health professionals should be involved and these include a nutritionist, who can help identify foods that can be of help to improve Mr. Boyd’s appetite (Taylor et al, 2010). I would also request assistance from a social worker to help their IADL since Mrs. Boyd said that she needs help with outdoor work plus the fact that they are no longer out going as in the past. Next I will enlist the help of a psychiatrist to assess Mr. Boyd for signs of dementia and depression. On the side I will suggest that Mrs. Boyd take some time and care for herself so I not to be strained with caregiver burden. This can be achieving by leaving the husband at an adult day facility for part of the day (Mauk, 2010).  It is quite unfortunate that Mr. Boyd’s problems started showing up just 6 months ago. It can be hard on Mrs. Boyd and thus I will request that she seeks help from her spiritual adviser which can be her pastor, priest or rabbi. (Taylor et al, 2010)
CASE STUDY III
References
Chitty, K. K, & Black, P. B. (2011). Professional nursing concepts & challenges (6th ed). 	Maryland Heights, MI: Saunders Elsevier. 
Jarvis, C. (2008). Physical examination & health assessment (5th ed). St. Louis, MO: Saunders 	Elsevier.
Mauk, K. L. (2010). Gerontological nursing: Competencies for care (2nd ed). Boston, MA: Jones 	& Bartlett.
Taylor, C., Lillis, C., LeMone, P., & Lynn, P. (2011). Foundation of nursing: The art and 	science of nursing care (7th ed). Philadelphia, PA: Lippincott Williams & Wilkins.