Therapeutic Assessment Interview

Demographics, Life Time Education and Career/Employment

The client identified was JN, a male adult of 66 years. JN indicated that his highest level of education was a graduate level where he acquired an MBA in Business Administration. JN had been in formal employment for 15 years after which he left to run his own business. He started a chain of convenience stores, which he still manages to date.

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Most Significant Times in JN’s Life

JN indicated that the two significant times in his lives were when he married his late wife and when he finally opened his business. JN explained that he had lost his wife two years ago. He discussed how they had met in college and the experience that they had together. From his narration, it was clear that he was nostalgic and dearly missed his wife. JN indicated that the wedding with his wife marked a positive turn in his life as he became more responsible as a husband. The couple had maintained their love for each other until the demise of his wife. The other significant event in JN’s life was when he finally opened his business. This marked a major achievement of an aspiration that he had held for long. 

Past Hardships/Struggles the Client has Successfully Negotiated

JN explained that he has dealt with the loss of two family members – his 20-years-old son and his wife. His son was serving the Marine and had been sent for three tours to Iraq. Unfortunately, he never returned alive on the third tour. JN remembers with nostalgia the day that the army officials visited his home to break the news. It was a devasting moment as he realized that the dreams of his son had been shattered. The other loss is the death of his wife, which had been devastating in his life. His wife had been a close companion and his confidant in life. Her absence had a great impact on JN.

Two Personal Strengths

Among his personal strengths, JN has knowledge-based skills in business management and administration and a personal trait of being enthusiastic. Having skills in business management and administration had enabled him to steer his young business to a continuous path of growth and success. This had assisted him in expanding from a single convenience store in the neighborhood to a chain of stores well known across the cities in the state. His second strength of being enthusiastic has enabled the patient to overcome the challenges in life by always having hope for a better tomorrow and working hard towards achieving his desired goals.

Healthy versus Non-Healthy Coping Skills

JN indicated that among his unhealthy coping strategies were indulgence in alcohol and social withdrawal. JN explained that when his son passed, he engaged in a lot of drinking and had been on the verge of losing his job. He saw this as the only solution to drown his sorrow and ease his process of grieving. JN also explains that in his first few years of running his business, he had faced challenges that threatened the success of his business. This made him become socially withdrawn to avoid critics from friends and family.

Two Healthy Coping Skills

JN elaborated that over time, he had developed coping mechanisms. These included using exercises and seeking social support. The patient indicated that he regularly engages in exercises such as jogging and playing tennis. This, he notes, helps him in overcoming emotional turmoil that he might be going through and helps clear his mind. JN indicated that he is an active member of a group in his church where the members meet regularly and open up about the issues affecting them. This has helped him share his experiences and get encouragement from the group members.

Three Pieces of Advice he would give

Asked about three pieces of advice that he would give to a younger self, JN first indicated that it would be never to engage in drug and substance abuse. JN has been experiencing health problems associated with excessive alcohol intake in his younger days. The second piece of advice that he would give his younger self is that no man is an island. He points that it is important to become socially active as this offers an individual a support system that can help a person to overcome challenges and hard times. The third piece of advice would be to follow his dream as early as possible. He notes that he had stayed for too long before opening his business, which had been his dream. This would help one to self-actualize early enough and get contented with the progress in life.  

Geriatric Depression Scale, Fulmer Spices, Patient stress Findings

After assisting the patient with the Geriatric Depression Scale, the patient scored a 4. From the scale, the score was a less than 5, which indicated suggestive symptoms of depression. This implied that JN had no depressive symptoms. In the mini-mental state exam, the patient attained a score of 20. This score is below the single cut-off score of 24 and thereby interpreted as being abnormal. The patient’s score of 20 is on the range of less than 21, which highlights increased odds of dementia. Using the Fulmer SPICES assessment tool, the patient indicated to have experienced difficulties with sleep, had a poor diet, and had a scar from a fall. 

Level of Ego Integrity vs. Despair

If I was to rate the patient on a scale of 1-10 using level of integrity vs. despair by Erik Erikson, I would rate him as an 8. This scale helps the older citizens above the age of 65 to review their productivity in their lives. Jn indicated that he had led a successful life where he had accomplished his dreams of opening a business that has been thriving to date. In this case, it is clear that the patient has led a productive life and has been satisfied with his achievements. However, JN indicates that he had a few instances in despair, especially related to his past alcohol abuse. 

Two Nursing Diagnoses

From the assessment, JN can be diagnosed with a high risk of dementia. The scale indicated that the patient had increased odds for dementia. This has been seen to be influenced by a number of risk factors. The risk factors are indicated to be either modifiable or non-modifiable. The modifiable risks include personal lifestyle, medical, and dietary while the non-modifiable factors include age and genetic factors (Fang, Chen, & Ye, 2016). In this case, JN is noted to be influenced by poor dietary methods, use of alcohol, body weight, and increasing age.

Care Plan

In the care plan, the patient will receive dementia care. It has been noted that the nursing homes have capabilities of offering care to patients with dementia in their palliative care where patients are offered with special care (Cadigan, Grabowski, Givens, & Mitchell, 2012). In the care plan, the patient will be advised to seek the advice of a nutritionist to guide him on the correct diet. It is important that the patient leads an active life since lifestyle is a major risk factor. 

References

Cadigan, R. O., Grabowski, D. C., Givens, J. L., & Mitchell, S. L. (2012). The quality of advanced dementia care in the nursing home: the role of special care units. Medical care50(10), 856.

Fang, X., Chen, J., & Ye, C. (2017). Prevention of dementia and care of dementia patients from nursing perspective: best practices and development needs. Retrieved from https:/

/www.theseus.fi/bitstream/handle/10024/138324/Fang_Xiangrong.pdf?sequence=1&isAllowed=y

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