Introduction
The well-elderly interview is a chance for nursing students to practice collecting subjective data for a complete health history report. Adults aged 65 years and above tend to spend ten or even more hours every day lying or sitting down. Therefore, the group has become the most sedentary. In this case, they have been forced to incur high costs for their health status due to their inactiveness, obesity and heart illnesses. It is important to remain active in case they wish to remain healthy and maintain their independence. I was able to identify effective communication skills, evaluate my client’s activities for daily living, define self-esteem and discuss nutritional health. For this assignment I had the opportunity to interview J.J., a 72 year old male that is originally from the Ozarks in Missouri. He is a temporary resident at Delight’s Hot Springs Resort in Tecopa, California. I conducted both interview in his mobile home on January 30, 2014 and February 7, 2014. I was able to conduct the two visits at his mobile home after obtaining his full consent.
Visit One: January 30, 2014
Typical Day
This retiree stated that his typical day begins around 6-7 am. After getting dressed, he enjoys some coffee, takes morning medications as well as vitamins and prepares a breakfast. Moreover, he indicated that he enjoys being out of his house and will either go for a bike ride, a hike in the desert or walk around the town. J.J. is a friend of the people hence spends most of his time talking to those that he meets during his outings. Whenever he returns home, he engages in a light military-style workout consisting of push-ups, pull-ups, sit-ups and stretches. He enjoys his afternoons by involving himself in odd construction and repair jobs. Most importantly, he is able to prepare dinner, spend time in the mineral baths, visit his old and new friends, read and watch movies during the evening hours.
Health
The client believed that his health is “excellent.” He indicated that he never misses his six-month check-up at the veteran’s hospital. In addition, J.J handed over his latest laboratory results that he obtained from the doctor. The laboratory results were dated January 8, 2014.
What does the phrase “being healthy,” mean to you?
J.J. believed that being healthy refers to an individual with low blood pressure, a good cholesterol level, a person should do some daily exercises and being cautious of one’s diet since “the older you get the fatter you get.”
Please tell me about where you live. How long have you lived at your current address?
The hot springs devotee has currently been living at Delights Hot Springs Resort for the last three months. J.J. explained that he is a “snowbird”. According to Merriam-Webster (2014) online dictionary, a snowbird means “one who travels to warm climes for the winter.” He enjoys the solitude of the desert and healing powers of the hot mineral water. He also enjoys being around similar minded people that are attracted by the hot springs. J.J. owns a recreational vehicle and travels to locations whenever he is bored. He also indicated that before his current stay in Tecopa he was at Joshua Tree Retreat Center and Spa where he lived for almost one month. He spent his time making his way up the coast of California during the previous year. He spent a lot of time during his visit to Northern California, Oregon and Washington.
What things are most important to you?
The interviewee mentioned that his immediate family is by far the most vital thing to him. J.J. has one married daughter, a granddaughter and a grandson. I was able to spend time looking at the photos of his beautiful family. His expressions could indicate that he is obviously proud of his family. He often visits them in Arizona. J.J. is also passionate of alternative forms of preventative health care. He truly believes in the healing powers of hot mineral water and energy vortexes. The city of Sedona website (2014) defines, “a vortex as a site where the energy of an area is concentrated.” J.J. believes that these places have the power to heal his body and protect him from sickness. He spends a lot of time exploring those places around the United States.
What would you like to do that you haven’t done yet?
J.J. had the opportunity to travel across the world during his time in the military, but stated that he would love to go to the French Polynesian Island at Tahiti. He has also drunk Noni juice and stated that it provides energy that helps in the growth of his hair and nails. He has learned a lot about Tahiti and has become very interested with the culture and the beautiful beaches while doing research about the Noni berry. He mentioned that he wishes to explore more about Tahiti and its components including the people and the culture.
What are your best accomplishments?
The interviewee mentioned that raising his daughter without a mother around was his greatest accomplishment. He also spent part of his time explaining to me about his family’s struggle with alcoholism. J.J. seemed proud of getting sober after being an alcoholic since 1981. It was quite surprising that his father and his ex-wife had struggled with alcoholism and drug abuse.
Tell me about your childhood.
J.J. grew up in Ozarks in Missouri where they lived on a twelve hundred acre farm and reared cattle. He is the third eldest of a family of twelve children. He could not remember a time when he stayed idle and avoided work. He spent most of his time milking cows in the morning and tending their fields in the afternoons. He indicated that he hated that lifestyle altogether with the weather. The weather is humid in the summer and ranges at negative 20 to 30 degrees Celsius in the winter. J.J mentioned that he ran from the home several times since he could not stand the cold weather and work duties. He was able to enroll in the Marines and left the farm when he turned 17 years old.
Tell me about your life as an adult
J.J. joined the Marines when he was 17 years old and became a paratrooper. He proceeded to work for the Siemens Westinghouse. This is one of the largest energy technology corporations in the world. He became a millwright, part of the Millwright Local Union 1827 in Las Vegas, Nevada. He told me that a millwright does “everything.” I had no idea what a millwright does, therefore, requested for more clarification. He explained that millwrights operate in construction, building, machine erection, welding, lining, turbine work on power plants, and high pressure pipe welds. His job was to work on turbines and generators in the power plants. He traveled all around the United States handling equipment in power factories. Siemens Westinghouse’s main office is in Orlando, Florida. J.J spent three months every year in Orlando during his training. He went on describe just how precise his work had to be in that everything had to be checked through an x-ray. In this case, slight flaws in any operation required the activity to be re-done. He disclosed to me that he was able to save $150 thousand a year. He now depends on his retirement money from his retirement plan, which he had saved through work and social security.
If you could share one piece of advice, what would it be?
J.J. disclosed to me that his first wife was a drug addict after ten years of marriage. She used to crack cocaine abandoning him and his daughter. His advice to me was to avoid being married.
Looking back, what would you tell someone who is starting to plan for their retirement?
J.J. suggested that I should make good investments and buy gold and silver.
What did you do to get ready for your retirement? Would you do anything differently if you could do it over?
J.J opened up that he paid his retirement accounts through hard work. He indicated that he regrets getting married to his wife for ten years and explained that marriage is a waste of precious time.
Visit Two: February 7, 2014
Role Transitions
What have been your most significant life transitions over the past 10-15 years?
The client stated that for the past 15 years after his retirement, his daughter moved out and married. He also sold his home in Las Vegas and started living out of his motor home.
Do you miss your career?
The client explained that he currently enjoys his retirement. J.J. worked 12 hours a day, seven days a week for two-three months. He could be offered only a few weeks off his duties. He indicated that the work was difficult and could prove hard on his body. Bone spurs were removed from his neck and back through surgery in order to repair five herniated disks in 1990. People always ask him to fix stuff once they find out that he used to work in the marines. He has done some painting, built three decks and done finishing work in the last three months.
Where has been your favorite place to live?
J.J. has enjoyed living all over the United States, but some of his favorite places are Loveland, Colorado, Truth and Consequences, New Mexico, and Tecopa, California.
Have you lost a loved one, how has that affected you?
One of the client’s younger brothers died at 30. A drunk driver killed him coming from his work. Losing his brother to a drunk driver was very hard for his entire family. He explained that he did not think his mother ever recovered. I could tell that this was hard for him to talk about.
Client’s Description of Aging
How would you describe aging?
J.J. said that aging is a difficult experience. He also explained how difficult it can be to watch a family and friends deteriorate. He stated that all of his brothers and sisters are eating themselves to death. J.J. said they are overweight and have health issues related to their weight. This makes him sad since they are hesitant to change their habits.
Factors that Keep the Client Healthy and Independent
What factors do you think have kept you healthy and independent?
He believes that he is healthy and independent since he is active, eats well, and is mindful of his health. The client mentioned that his health is one of the most important elements to him. He spends a great deal of time researching on natural preventative care. He also told me that he stopped doing all the dangerous stuff he used to enjoy. I asked him what he meant by that, and he went though a long list of activities including skydiving, rock climbing, repelling off of buildings for work and tree topping.
Do you see all your health care professionals on schedule?
He told me that he goes to the nearest Veterans Administration hospital every six months for his scheduled check up. He was very happy with his healthcare. I asked him if he thought that he was missing anything, but he said ‘no’. J.J said that he likes the convenience of the veteran’s medical system.
Are you willing to make life changes if a doctor asks you to?
J.J. said that he would make changes if a doctor told him to.
Support Systems
What support systems do you have and how have they influenced your life?
The client’s support system is the Marines. He mentioned that that organization has had the biggest influence into his life. He does not worry about healthcare since he can always go to the Veteran’s hospital.
Important relationships Promoting Love and Belonging
What are your most important relationships?
The client’s most important relationship is with his daughter. His son-in-law followed in his footsteps and joined the Marines. He is also a close friend with his grandkids. He is excited whenever he talks about them. J.J. has also made friends in the United States since years of his travels from work to years of retirement.
Conclusion
Communication Techniques
The most effective communication techniques were active listening and the use of open questions throughout my interview with J.J. Active listening is a crucial communication technique in the nursing profession. It requires attention of the listener by listening to verbal and nonverbal cues. Studies “suggest that active listening responses in initial interactions increase the recipient’s perception of feeling understood compared with other response strategies” (Weger, Bell, Minei, & Robinson, 2014). During both interviews, I used “several nonverbal skills [to] facilitate attentive listening” (Burger, 2013). I sat facing J.J. at his kitchen table and was in his personal space zone. This was an indication that I was ready to listen to him and that I was close enough to hear him. I held my posture in an open position with my hands on top of the table. I also ensured that I lean towards him while he was speaking in order to prove that I was interested in his conversation. I maintained an appropriate eye contact while he was responding to my questions. Most importantly, I was relaxed with the client and this made him feel comfortable to talk. I tried to ask him open-ended questions that were focused on one main idea at a time. I paraphrased some of his answers back to him in order to make sure that I clearly received the main idea of his answer. I also asked him additional questions to clarify some of his answers.
Independence
Three factors that enable my client to maintain independence at home and in the community is that he physically active, drives himself and does not need help in his home. The client exercises every day. He goes for a walk, hikes, or bike rides and then does a light military style workout in his motor home after a breakfast. He really enjoys driving and said that he likes staying off of the main roads and takes his time. The client scored a six out of six on the Katz index of activities of daily living and needs no supervision, direction or personal assistance in his home. His appearance and house were clean and tidy. On the Instrumental activities of daily living assessment, the client does everything alone.
Self-Esteem
“Self-esteem is an individual’s overall feeling of self-worth or the emotional appraisal of self-concept” (Folse, 2013). The client seemed much fulfilled in his life and expressed a very positive self-concept. The exercise of self-esteem “model specifies that changes in physical activity brought about by exercise interventions influence the self-esteem sub-domains or perceived body attractiveness, perceived strength, and perceived physical condition esteem” (Gothe, 2011). This was especially true for my client, he was very proud of the amount and type of exercise he did every day. J.J. was also in a positive-perceived physical condition about his body and wanted me to squeeze his bicep to feel how strong he was. The client showed self-confidence by being social and easily making new friends.
Nutritional Health
The client scored 2 out of 21 on the nutritional health assessment. He got one point since he usually eats alone and at another point takes three over the counter medications. This is a very good score. He does not have an illness or condition that has made him change the kind or amount of food he eats. J.J. mentioned that he was very mindful of what he ate since he knew his family’s history of obesity. The client told me that he weighs 160 pounds and that his weight does not fluctuate. J.J. eats at least two meals a day. He enjoys going into town for shopping and cooks most of his meals. J.J. dislikes eating out since he does not enjoy when other people prepare his food. His morning meal usually consists of a vegetable omelet, a bowl of oatmeal, orange juice and coffee. He snacks on nuts, fruits and vegetables during the day. He eats chicken, steak, or fish with vegetables and a potato or rice for dinner. He does not have any problems eating and mentioned that he does not drink alcohol.
Lessons from the Experience
This experience gave me both a practical and a real-world experience to compile and organize data for a complete health history. I was able to practice therapeutic communication techniques. Such communication skills include active listening and speaking. I learned that communication skills are vital to establish a professional relationship with clients. J.J keeps his environment positive through a number of factors. He is cautious of the food that he eats, keeps his motor home clean, and travels around to places where there are like-minded people. J.J. was a delight and an inspiration to talk to. His happiness was infectious during the interview. Moreover, J.J. has changed my perceptions on health and aging. The elderly people are not as positive about getting older in my family. Most of them have some sort of chronic illness and it was a pleasant surprise to speak with a healthy elderly person.
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