Older Adult Monologue.html
For this assignment you will listen to the audio clip below (it will take a few minutes to load; can also copy and paste into a new window, need Quick Time to download):

http://www.nln.org/docs/default-source/professional-development-programs/henry.wav?sfvrsn=2  

 (If you prefer to read a script rather than listen, it follows this file in the Content for this week)

While listening to the audio clip be thinking about how you can apply the ACES Essential Actions to Henry 

Essential Nursing Actions

When you are finished listening you will write a response that discusses each of the following as in the Grading Rubric below: 1) assessment of the older adult in the monologue, 2) concerns you have about the older adult, 3) possible causes of the concerns you have, 4) information you feel is missing but necessary, and 5) possible problems the older adult in the monologue is experiencing. Submit the word document containing your response to the appropriate Assignments folder by 2359 on March 22nd.

Use the grading rubric to guide your response:

Monologue for Older Adult Grading Rubric – Henry Williams

Criterion

Satisfactory (2 pts)

Needs Improvement (1 pt)

Unsatisfactory (0.5 pts)

1. Assess the older adult’s functional status and strengths in your assigned monologue

3 or more possible strengths are briefly discussed

2 possible strengths are briefly discussed

1 or fewer possible strengths are briefly discussed

2. Discuss concerns you have about the older adult in the monologue

3 or more concerns are briefly discussed

2 concerns are briefly discussed

1 or fewer concerns are briefly discussed

3. Discuss possible causes of the concerns you identified in 2

1 possible cause for each concern identified in criteria 2 is briefly discussed

Not applicable

Does not briefly discuss the possible cause of all concerns identified in criteria 2

4. Discuss information you feel is necessary but not provided in the monologue

3 or more pieces of needed information are briefly discussed

2 pieces of needed information are briefly discussed

1 or fewer pieces of needed information is briefly discussed

5. Identify possible problem(s) the older adult in the monologue is experiencing

2 or more possible problems experienced by the older adult in the monologue are identified

1 possible problem experienced by the older adult in the monologue is identified

Possible problems are not identified

EssentialNursingActions

ACES
Essential Nursing Actions

The Essential Nursing Actions enable nursing students and practicing nurses to translate their knowledge of
individualized aging, complexity of care, and vulnerabilities during life transitions into actions that promote high
quality care for older adults. Use in clinical experiences, skills lab/simulation, and lecture develops students’
knowledge, skills, and abilities related to the care of older adults, while promoting positive perceptions of aging.

Assess
Function
and
Expectations

Assess, respond to, and respect an older adult’s functional status and strengths,
wishes, and expectations.

Determine the older adult’s function and expectations, along with cognition,
mood, culture, physiologic status, and comfort to obtain a comprehensive
assessment of health care needs.

Use standardized assessment tools to assess the older adult’s individual aging
pattern.

Coordinate
and
Manage Care

Manage chronic conditions, including atypical presentations, in daily life and
during life transitions to maximize function and maintain independence.

Assist older adults and families/caregivers to access knowledge and evaluate
resources.

Advocate during acute exacerbations of chronic conditions to prevent
complications.

Use
Evolving
Knowledge

Understand geriatric syndromes and unique presentations of common diseases
in older adults.

Access and use emerging information and research evidence about the special
care needs of older adults and appropriate treatment options.

Interpret findings and evaluate clinical situations in order to provide high
quality nursing care based on current knowledge and best practices.

Make
Situational
Decisions

Analyze risks and benefits of care decisions in collaboration with the
interdisciplinary team and the older adult, family, and caregivers.

Evaluate situations where standard treatment recommendations need to be
modified to manage care in the context of the older adult’s needs and life
transitions.

Consider the older adult’s wishes, expectations, resources, lived experiences,
culture, and strengths when modifying care approaches.

Henry Williams: Script for Introductory Monologue

(stops frequently during his story to breathe, O2 nasal cannula, coughs, appears hypoxic)

Hello, my name is Henry Williams. Life sure has changed over the last two, three years,
retirement just isn’t what we thought it would be… we… that would be Ertha and me. I
spent my life working for the Transit Department, as an engineer for the rail system. I’m
pretty proud of this accomplishment. I was on the forefront of desegregation in college and
the workplace. Ertha and I have always been active and independent, so we thought we
would retire to this nice apartment and do some traveling since it’s just the two of us. We
haven’t done much of this with my health and now Ertha’s. It’s been a change moving from
our nice home and gardens to an apartment but we have adjusted to that OK, I guess.

We lost our only son 10 years ago to the Gulf war – that really changed our lives as well; I
don’t think Ertha has ever been the same. He left us a lovely daughter-in-law, Betty and a
grandson, Ty, but they live a couple of hours away in the city and it’s hard for us to get there.
And now, Ertha is getting forgetful and it’s hard to leave her. We go to the Baptist church
regularly but I can’t let Ertha go alone to the ladies’ stuff anymore. She used to go every
Tuesday. But I guess you are here to learn more about me and what’s going on with my
health.

Well, no one could tell me to stop smoking you know, especially when I was younger. I
started smoking when I was a teenager, everyone smoked back then. I have had frequent
‘bouts of colds, bronchitis, asthma and so forth but now they tell me it’s COPD, whatever
that means, but it sounds scary. I also have a little high blood pressure, but it’s not too bad.

I get so anxious now and I’m worried all the time about my wife, she is good some days and
other days she can’t remember things and she asks for Anthony, our son. That is so
upsetting for both of us and she cries when I tell her he is gone. He was so proud to be in
the armed forces but he had to go and serve overseas, he never came home to us.

I really lose my patience sometimes with Ertha. She forgets the stove is on, can’t find her
keys, forgets what day it is, and thinks Betty and Ty haven’t visited us in years, when they
were just here. I’ve had to watch her when she cooks, take her with me on walks. We just
can’t be apart and that gets frustrating. I worked every day so we were busy until we retired,
now all of this heartache. Betty took Ertha home with her while I am sick here in the
hospital but we need to think about a new plan so Ertha is cared for and I am too. I don’t
want a nursing home but I hear there are some of those apartments where they help you
some. Maybe that would be a good place for us.

I sure feel bad today; I am so tired and short of breath. The doctor sent me here last night
after I called his office and told him I couldn’t catch my breath. My neighbor was home so
she brought us in to the emergency room and took care of Ertha until Betty got here. I
should be resting now; Ertha is in good hands with Betty the next few days, Betty is a nurse
and can help her while I am in the hospital. I need to get some strength back. I hope my
insurance will pay for this oxygen and these inhaler things I have to use when I go home. I
already take two pills for my high blood pressure and a cholesterol pill, aspirin and a

breathing pill. Now they want to add inhalers and oxygen? What next? I already have an
inhaler I use at home and it doesn’t help. Ertha needs to take a bunch of pills too.

The social worker lady said we might have to go on a waiting list before we can go into those
apartments where they help you with a bath and some food. Ertha doesn’t eat so well and
can’t cook so well anymore so help would be nice. I suppose they will put me on some diet
for my breathing now and Ertha can’t manage that so we could let them do our meals. I
wonder if they help with the medications and baths. Ertha gets upset when I make her
shower. I have to rest now; you will have to ask me questions later.

For this assignment you will listen to the audio clip below (it will take a few minutes to load; can also copy and paste into a new window, need Quick Time to download):

http://www.nln.org/docs/default-source/professional-development-programs/henry.wav?sfvrsn=2

 (If you prefer to read a script rather than listen, it follows this file in the Content for this week)

While listening to the audio clip be thinking about how you can apply the ACES Essential Actions to Henry 

Essential Nursing Actions

When you are finished listening you will write a response that discusses each of the following as in the Grading Rubric below: 1) assessment of the older adult in the monologue, 2) concerns you have about the older adult, 3) possible causes of the concerns you have, 4) information you feel is missing but necessary, and 5) possible problems the older adult in the monologue is experiencing. Submit the word document containing your response to the appropriate Assignments folder by 2359 on March 22nd.

Use the grading rubric to guide your response: