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Exercise and Activity - Case Study

Tom, 75 years old, had lost his wife Ella a year ago and had been feeling down and tired much of each day. He had retired at age 70 from his job as a housing contractor and had spent much of his time with Ella. They had been married for 50 years. He now sometimes seemed to sit in front of the television most of the day without actually remembering what it was that he had seen. Many of the couple's friends had moved away or to retirement settings, and other than his daughter, who lived about 45 minutes from his house, he rarely saw anyone anymore. He had lived like this for nearly a year, and it had become his daily pattern of life. Tom took the initiative after a suggestion from his daughter to go to the local senior citizen center. He went and had lunch there nearly every day. At one point he was asked if he would allow a nursing student to spend time with him during her semester in a gerontology course. He agreed. In the course of her assessment, she (and he) found that his activity level was nearly completely sedentary. She gave Tom information about the ramifications of such a sedentary life. She pointed out that the center had an exercise class every day between 10 AM and 12 noon. Because he came every day (except Saturday and Sunday) for lunch, it seemed a good thing to do. Tom said to his nursing student, "This isn't anything I am really interested in doing, but I will give it a try." Though he did not admit it, he was also worried because he usually felt weak and listless during the day after his lunch. When he did attend the first class, he found that there were basic exercises and more advanced ones for elders who had participated regularly for 6 months. He found after a few weeks that he was enjoying the social aspect of the exercise if not the exercise itself. After nearly a year of fairly regular participation, Tom began playing golf with some of the men from the center.

QUESTION: Review the Functional Consequences Theory for Promoting Wellness in Older Adults. Describe the functional consequences and the associated age-related or risk factors that lead to the functional consequence. Describe nursing interventions and outcomes. 

The Functional Consequences Theory for Promoting Wellness in Older Adults

Nursing theories describe, explain, predict, or prescribe nursing care based on scientific evidence. Recent nursing theories focus on models that connect theory, research, and nursing practice. Miller (2014) proposed a model for gerontological nursing in 1990. The model has been revised over the years and the current model is now called The Functional Consequences Theory for Promoting Wellness in Older Adults.

Functional consequences are observable effects of actions, risk factors, and age-related changes that influence the quality of life or day-to-day activities of older adults.

Negative functional consequences interfere with the older adults functioning or quality of life

Positive functional consequences facilitate the highest level of functioning, the least dependency, and the best quality of life.

The Functional Consequences Theory is based on the following:

·       Holistic nursing care addresses the body-mind-spirit interconnectedness of each older adult and recognizes that wellness encompasses more than physiological functioning.

·       Age-related changes are inevitable and most problems affecting older adults are caused by risk factors.

·       Older adults experience positive or negative functional consequences because of a combination of age-related changes and additional risk factors

·       Interventions can be directed toward alleviating or modifying the negative functional consequences of risk factors.

·       Nurses can promote wellness in older adults through health promotion interventions and other nursing actions that address the negative functional consequences

·       Nursing interventions result in positive functional consequences, also called wellness outcomes, which enable older people to function at their highest level despite the presence of age-related changes and risk factors.

Wellness outcomes resulting from nursing interventions include improved safety, function, and quality of life. Examples may include:

·       Teaching about environmental modifications to improve function and safety

·       Teaching older adults about the importance of having their eyes evaluated at least annually

·       Providing medication information to promote safe medication administration and knowledge of side effects to report

·       Discussing the importance of annual vaccinations for preventable disease

·       Sharing information on activities and/or exercise and healthy living

Age-related changes and risk factors combine to cause negative functional consequences. Nurses holistically assess older adults and initiate interventions to counteract or minimize negative functional consequences.

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Exercise and Activity - Case Study Tom, 75 years old, had lost his wife Ella a year ago and had been feeling down and tired much of each day. He had...
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