Reflection Paper Based On a Real Interview of an Older Adult
Introduction
As one grows older, there is a stark difference in one’s nutritional needs. This is chiefly because of the changing physical condition of the body, resulting in changes in many bodily functions (1). Additionally, their ability to perform tasks that they performed erstwhile is greatly reduced. This is either due to reduced convenience or decreased mobility. Whatever the reason may be, it is important for clinical staff in addition to family members to show concern and sensitivity to the unique needs of the elderly population. This can only be developed by attaining an understanding about their needs in order to develop positive connections.
The importance of this cannot be underscored more. The population of older adults is growing exponentially in Canada. While most of them are healthy presently, it is expected that as they grow older, their health will deteriorate, hence requiring interventions from health care professionals. In this regard, this project is of utmost importance because it recognizes the basic truth health care providers are almost certain of working with older adults during their professional lives. As such, the project allows one to develop core competencies in the care of the elderly population.
Part of this interview involved performing an interview with an elderly person preferably over 65 years of age. There are many approaches one can employ when performing an interview. Even with the various advantages each approach presents, nothing comes close to the face-to-face interviews. This is the approach that I employed in my interview with Mick Brumby, a seventy-two year old former military commander. The interview took place on Monday, the twenty fourth day of March 2014. I contacted him three days prior in order to check his availability. I visited him at his home at nine o’clock in the morning just like we had agreed over the phone.
Upon arrival at his homestead, I was greeted by a hearty woman; someone I suspected was Brumby’s wife. My suspicions were later confirmed after the formal introduction. The interview took place in the living room over a cup of tea brewed by Brumby’s wife. In the moments leading to the interview, I realized that Brumby walked with a hutch on his back. There was a large bowl on the living room table filled with an assortment of fruits. There was an electric blender, with I resumed was used for blending the fruits into an edible pulp. From her appearance, his wife looked significantly younger than Brumby. Nonetheless, there was a nip of familiarity between the two as was felt in her high pitched laughter and his deep grunts.
During my planning, I had scheduled the entire interview into three distinct parts. In the first few minutes of the interview, I administered the mini-nutritional assessment tool. It was important for me to seek his informed consent. He was tolerant, accommodating and cooperative when I required him to disrobe so that I could take accurate weight and height measurements. He confided that he understood why I made such requirements since he had been monitored severally at the local hospital. He answered the questions asked with relative ease. The second part of the interview involved the administration of 24-hour food recall.
It was evident that Brumby had a good memory owing to the ease with which he remembered the food items for the 24 hour dietary recall. From where I was seated, I could see his wife, who was working nearby, nod in agreement. While performing the interview, it was evident that Brumby was a vibrant man with a lot of life despite his advanced age. His joy lit the room, and their union with his wife seemed strong. After the interview, Brumby showed me around his homestead. There were gardens with rush green vegetables. He confided that he liked gardening in his free time. The produce was used at home to prepare meals at home.
I vacated their premises at twelve o’clock since they had to visit a neighbor for a housewarming party. The interview took an hour and twenty minutes. The rest of the time was spent talking in general. He intimated that, at times, it felt lonely at home since their children were all grown and gone. Overall, Brumby looked physically fit for a man his age. The only apparent physical concern was the slight hutch on his back. From a psychological perspective, he looked joyous and at times playful with his wife. He talked openly and fluently, with intermittent jokes.
Reflection
The experience at Brumby’s was very informative. I learned a lot about gardening from the conversation we had while walking around the homestead. The relationship between Brumby and his wife was particularly striking. This is because, in my neighborhood, I see many elderly people living isolated life away from the nuclear or extended families. Even those living with their spouses seem more alone than together. The Brumby’s looked happy together and in complete synchrony. This was extremely amusing. Prior to the interview, I had reservations about the visit. This was because I was going to conduct an interview with a seventy-two year old man. I expected that would be some lack of cooperation and the interviewee to be extremely reserved. On the contrary, Brumby was chirpy and extroverted. He volunteered the information on the topics of discussion during the interview. I felt that this was because I genuinely tried to fit in his schedule as opposed to trying to speed things up.
This reminded me of an experience I had at a community survey some time back. I had limited time to conduct a lengthy interview. Logically, I tried to speed things up so that I could finish within the time allowed. The feeling then was that I lost the connection with my interviewee, and that affected the results from the interview. Thinking retrospectively after applying today’s experience, I reckon that I appeared far removed from the interviewee’s situation, hence the loss of connection.
It has been argued that working with elderly people is tiresome. Going by today’s experiences, I disagree vehemently. It is expected that all professional encounters with the elderly population will not turn out as well as today’s interview. It is my feeling that by exercising restraint, tolerance and accommodation, healthcare professionals can have better experiences when dealing with the elderly. I feel comfortable working with the elderly population due to the lessons I picked today.
The administration of the mini-nutritional assessment is particularly challenging because the acquisition of accurate information requires the interviewee to take off some of their heavy garments. At this advanced age, temperature homeostasis may not be efficient. The elderly may also not be very cooperative, especially when they are ignorant about the reasons. The administration of the 24-hour dietary recall is a smooth process for individuals with a good memory. However, I imagine that working with individuals with dementia or amnesia, common conditions at an advanced age is very challenging. All in all, it requires intelligence and good interpersonal skills in order to maneuver the challenges.
Application
It is common knowledge that information on food choices has an influence on their nutritional status. Brumby was very informed on agricultural systems and the food choices available in the local groceries. As such, Brumby had the knowhow on the various food choices. Elderly people, just like any other age group, require optimal nutrition. In the article by Jennie and Andrea, the authors confirm that ‘nutrition is an important determinant of health in persons over the age of 65’ (1). From the food-related thoughts discussed, Brumby expressed concern over the proliferation of fast food restaurants. His particular concern was that most restaurants did not consider the elderly segment of the market when preparing their foods.
Earlier, I talked of elderly people who leave isolated lives away from their nuclear and extended families. Since most of these individuals cannot prepare meals for themselves, they eat out in restaurants close by their homes. This has an influence on their nutritional status, especially if meal preparation at the restaurants in not mindful of their nutritional needs, sentiments also echoed by Brumby. Eating foods from these restaurants, they are predisposed to under or over nutrition and micronutrient deficiencies ‘nutritional intervention can provide sufficient energy, protein and micronutrients, maintain or improve nutritional status, reduce morbidity and increase survival’ (2).
Physical activity is a very important factor in an individual’s nutritional status. Due to their advanced age, elderly people may not do track activities or visit a gym. As Hui & Rubenstein argue, ‘the benefits of increased physical activity and exercise are universally recognized, but many older persons remain sedentary, and relatively few achieve recommended levels of activity’ (3). However, small activities around the homestead can enhance physical activity. Brumby’s approach towards this is through gardening. It enables him to exercise while still remaining productive. King intimates that ‘older adults are at particular risk for leading sedentary lifestyles’ (4). From our interview, it was apparent from Brumby’s demeanor that even at an advanced age, the elderly still want to feel useful. These are sentiments that Pedersen agrees with in his article where he posits that ‘by doing some menial jobs at home, elderly people can get the exercise they require and still feel useful at the same time’ (5). These jobs include trimming hedges, watering flowers and gardening.
The administration of nutritional assessment tools to the elderly population is particularly challenging. The administration of the 24-hour dietary recall is majorly dependent on memory Ahmed & Haboubi asserts that ‘data can also be affected if the patient has cognitive impairment’. (6). Many elderly people suffer conditions that are characterized my diminished memory. It is important for healthcare professionals to allow for this during their practice. Where one is seeing a patient regularly, it could be helpful to involve caregivers, or close family relatives who might be sharing residence with an elderly person. The administration of the mini-nutritional assessment should make considerations for the elderly person even when faced by the urgent need to acquire the information.
Conclusion
Working with the elderly population requires patience and tolerance. It is important to understand that they are at an advanced age and may not perform like we would want them to due to our time limiting schedules. However, the only way of getting accurate information during engagements with the elderly population is through patience and genuine concern for their plight. This was confirmed during my interview with Brumby. I adjusted my time to fit with his schedule and met him at his own convenience. Just like other people, the elderly respond to our attitudes. Therefore, it is important to not just see them a job we have to do, but as human beings who require our love and not pity, our genuine care and not healthcare bureaucracy.
References
- Wells, J. & Dumbrell, A. (2006). Nutrition and Aging: Assessment and Treatment of Compromised Nutritional Status in Frail Elderly Patients. Clinical Intervention in Aging. 1(1):67- 79.
- Sanchez, G., Montero, E., Sanchez, C. & Cruz-Jentoft, A. (2012). Importance of nutritional support in older people. Nestle Nutrition Instution Workshop Series. 72:101-8.
- Hui, E. & Rubenstein, L. (2006). Promoting physical activity and exercise in older adults. Journal of American Medical Directors Association. 7(5):310-4.
- King, A. (2001). Interventions to promote physical activity by older adults. Journal of Gerontology And Biological Sciences and Medical Sciences. 56.2:36-46.
- Pedersen PU. Nutritional care: the effectiveness of actively involving older patients. Journal of Clinical Nursing. 2005;14:247–55.
- Ahmed,T., Haboubi,N. (2010). Assessment and management of nutrition in older people and its importance to health. Clinical Interventions in Aging. 2010:5. 207 - 216
