Paper Example on Comprehensive Screening: Addressing Elderly Health Using the SPICES Tool

Introduction

Screening of the various disorders affecting elderly individuals can be achieved by utilizing a tool known as SPICES. The tool is an acronym, which stands for eating or feeding problems, sleep disorders, incontinence, evidence of falls, confusion, and skin breakdown. Some of these problems are neurodegenerative hence considered a normal phenomenon.

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Causes of Problems in the Screening Tool

Sleep disorders, which is one of the screening tools, are caused by factors such as chronic diseases, some medications used by the elderly, pain caused by conditions such as arthritis, and frequent urination at night. Alzheimer's disease, a shift in the natural clock of the body, and various brain and nervous system problems may also contribute to sleeping disorders. Eating disorders also occur in the elderly population and can mostly be related to the decrease in appetite by the elderly population. The reduction in appetite is influenced by a reduced sense of smell and taste in the elderly, reduced sensitivity to the hunger hormone, and change in food metabolism. Social-economic inequity also affects accessibility to foods, thus reducing the intake of meals.

Incontinence, which also affects the elderly, is caused by weakened bladder muscles due to age, destruction of the nerves that control bladder muscles, and weakening muscles of the pelvic floor. Arthritis, a common disease in the elderly, could cause incontinence as it limits the ability to get to the bathroom in time. In old age, confusion is mainly due to medical conditions such as stroke, drug toxicity, and injury from a fall. Such falls in the elderly are common muscle weakness due to degenerative diseases and poor eyesight. Hypotension may lead to dizziness and eventually falls. Most geriatric patients are immobile; hence always in still positions for a long time; this may predispose them to skin breakdown. Other factors causing skin breakdown include poor nutrition, tight clothes and shoes, wheelchairs with insufficient padding, and poor circulation in the elderly.

Questions to Be Asked During Screening

Questions asked should aim to identify the specific cause of the problems in each of the screening tool areas. Asking the eating pattern and the various disturbances in the client's gastrointestinal system could help identify the problem. When identifying sleep disorders, it is essential to inquire about the multiple changes in the sleep pattern and whether there is a need to use sleeping pills. Ask the client how many times they wake up to visit the bathroom. Also, it is important to note any report of early awakening. Asking the patient is they pass urine involuntarily, and with an increased frequency and whether or not they have ever wet the bed, it could help identify incontinence. To identify any fall cases, one should ask the client whether they have a history of falls and how often it occurs. Regarding skin breakdown, the relevant question would be to ask if the client has an ulcer on the body.

Interventions for Problems in the Screening Tool

Sleep disorders in the elderly can be remedied by interventions such as having a regular sleeping and waking time, avoiding the intake of stimulants in the evening, and avoiding large meals before sleeping time (Gulia and Kumar, 2018). Clients should also not take naps as it will impact the sleep pattern. Making things familiar in the environment for patients with confusion could help resolve the problem. Such patients should also be put in a friendly atmosphere and be encouraged to participate in activities. Feeding problems can be resolved by using vitamin supplements to boost the appetite and provision of food for those unable to get meals (Fung et al., 2016). Incontinence in the elderly clients could be solved by lifestyle adjustment, timed urination, and exercises for the pelvic muscles. Skin breakdown in the elderly could be resolved by encouraging mobility, pillows between the bed and bony areas, and eliminating some of the risk factors such as incontinence.

Summary

The screening of a client involved a seventy-year-old female client who lives with her grandchild to help in daily living activities. The client is weak and reports that she hardly takes any meals due to the dwindling appetite. However, she says that she loves taking some other meals that she cannot afford due to her condition. Strategies to solve the problem included administering vitamin supplements and teaching the client various ways to afford the preferred meals. The patient was quite receptive to the teachings given. If not solved, this problem could have led to macronutrient deficiencies, hence affecting the individual's health. The screening should be repeated to analyse the intervention's effectiveness and determine new issues for the individual.

References

Fung C. H., Vitiello M. V., Alessi C.A.,& Kuchel G. A. (2016). Report and research agenda of the american geriatrics society and national institute on aging bedsidetobench conference on sleep, circadian rhythms, and aging: new avenues for improving brain health, physical health, and functioning. Journal of the American Geriatrics Society, 64(12),e238-e247. https://doi.org/10.1111/jgs.14493

Gulia K. K., & Kumar V. M. (2018). Sleep disorders in the elderly: a growing challenge. The Official Journal of the Japanese Psychogeriatric Society, 18(3), 155-165. https://doi.org/10.1111/psyg.12319