Gerontology Assessment
Hannah Forbes
Gerontology
06/27/2014

The goal of this assessment is to look in to the life of Sarah Halbert, my grandmother on my mom’s side. She is 79 years-old, and lives with her husband Robert and her sister Lois, whom she takes care of. She is in good physical shape and does everything on her own, but her short term memory is starting to go downhill. She was just diagnosed with COPD not too long ago due to her closet smoking that she thinks no one knows about and she just had a clot removed from her neck vein, but other than that she has no other limitations. In this assessment, I want to learn more about her life and, also make some suggestions to her on things that can improve her quality of life. While spending four days with my grandmother we went through a serious of questions, recommendations, and improved on some small changes around the house and in her daily life.
We first talked about her view on health and wellness. She started off by saying that, a healthy attitude is the key to accepting changes in cognitive and physical function. She also said when she was younger she defined health and wellness as the ability to be at an ideal weight, exercise daily, and having no physical limitations. She says as you age so does your mind set on health and wellness. Her idea of health and wellness now is just being able to do everything she needs to do without help. She stated, “I am 79 years old and a lot of people do not make it to my age and if they do they are not in the physical shape that I am in, so now my goal is to stay in the rare percentile of 79 and in good active shape.”
Even though she is 79 years old she still worries about her image just as much as any other female. She makes statements like “I’m getting too fat” or “I have to put on makeup before I leave the house”. Sarah does not belong to any health promotion group, but she tends to find ways to stay active on her own. Her husband has poorly controlled diabetes and has had a serious of mini strokes over the past two years. She manages his medicine and physically supports him at times to get up stairs, get dressed, or get in and out of his vehicle. Her sister has lived with them over the past 10 or so years and she also has poorly controlled diabetes, severe kyphosis, and can’t really go outside the house without a wheelchair. Sarah is responsible for getting her from point A to point B in her wheel chair and also responsible for assisting her around their house. Also my grandparents own a 100 acre farm where they run 30 cows, produce tobacco, and roll and sale hay. Since Robert over the past two years has had these serious of mini strokes, Sarah has had to step in and help with the farm more such as stripping tobacco, driving the tractor for hay hauling, and getting up cows. With all of this going on in her life Sarah says, “I don’t have time to participate in a set exercise regiment and I don’t need to. My life right now consist of more health promotion activities than most my age.” While talking to my grandmother about her physical activities I noticed everything she did was for someone else. I suggested she make time doing activities that she enjoyed, such as walking to the creek, riding a bike, or getting in the pool more. I also suggested that she take thirty minutes to herself daily to do some kind of activity she enjoyed.
After talking about her physical activities to improve her health and well being we switched to nutrition. Sarah prepares all her own food and even grows a garden with a variety of vegetables such as tomatoes, cucumbers, and squash. They also kill their own beef, and since they live at home they have control over their menu. I asked her to perform one daily food log (which is presented on the last page) so we could examine if there was any way we could improve on her nutrition. Overall, her daily intake choices were not too bad but there were some definite improvements that could be made. Her calorie intake was adequate for her age and size and did not need to be improved upon. The suggestions I made known was she was not consuming enough water. Her daily intake was 48 oz; I suggested she start off by supplementing one of her daily fruit juice intakes for an additional water intake. Next Instead of having 8 oz of 2% milk switch to skim milk. She did not take to this suggestion well, so then I suggested 4 oz of 2% mixed with 4 oz of skim milk. For dinner a steak seemed like a good choice, but I informed her a better choice would be boneless skinless chicken breast. The last suggestion I had about her nutrition was to try to avoid the mayo she was putting in her tuna salad and try to cut her bread from 2 slices at lunch to 1 slice. In her food log she states her two slices of bread were whole wheat. This is questionable because they have always been a two loaf household, white and wheat, and one day while talking to her during this assessment she ate a ham and cheese sandwich on white bread. During the four days I visited my grandmother to take on this assessment I carefully inspected her home for any safety or hazardous issues. The first thing I noticed was how tight the space was in her kitchen. Her kitchen is very small and there is a huge dinner table right in the middle of it. With this dinner table it makes it hard to maneuver around especially if you are older and can’t squeeze in tight places as swiftly as you used to be able to. There is a sitting room right beside the kitchen that only gets used during the holidays, so I suggested we move the table in there to free up some space. Next, their house is a two story and the living room is down stairs while the kitchen is upstairs. The stairs has never had adequate lighting, especially for my grandfather, who uses the stairs the most; this is an important feature that needs to be updated. On the fourth day I was there Sarah and I went to the store and picked up some halogen lights and a new light fixture (which over 30 years the old one got really cloudy) and I installed it. I checked all of the fire alarms and they all had batteries that worked and functioned just fine. I took the fire extinguisher out of the closet and placed it in a proper location in the kitchen that would provide them with easy access if they ever needed it. The last thing that threw up a red flag for me was both of their entry ways were entered via steps. Right now the immediate concern for that is how hard it makes it on my grandmother to get her elderly, disabled sister in and out of the house when she has doctor’s appointments. My later concern would be when all three of them can no longer use the steps any more. I suggested she look into getting at least one of the entry ways wheelchair accessible by building a ramp. I looked up the name of a business for her and called to get a quote on what it would cost to build one. Even though I don’t think she will be building one in the next year, she said she was surprised on how affordable it was and stated she would keep that in the back of her mind for the near future.
While observing Sarah it concerns me on how much her life is consumed by taking care of others. She stated while she was going in for surgery to get that clot removed from her neck vein, she was worried about what would happen to her sister if something went wrong. At 79 years old it is not her duty to be taking care of others. I discussed with her the option of putting her sister in a nursing home, this idea was not perceived well by her at all. I asked her if her sister’s insurance would cover home health. She stated, “yes, and that’s a good option for when I am not here such as having that surgery, but I don’t need them all the time.” Another safety concern of mine is that her mind is starting to slowly go. Robert has parked behind her car for as long as I can remember and she has backed into his truck two times in the past year. Also, she has had a wreck in Lebanon recently. I mentioned going to the doctor to investigate her memory issues, she said the doctor blames it on the COPD and the excess CO2. In addition her mother died from Alzheimer’s and during my assessment she mentioned this is a big fear of hers.
While interviewing my grandmother she told me about her job’s she had while raising her family. Her first job was at a shoe factory in Lebanon that is now closed down. Her second job and the one she retired from was a teacher aid at Carroll Oakland Elementary School. Now that she is retired and over 65 she draws both a retirement check of $650 a month and social security of $550 a month. In addition, her sister’s old house is now in her name and Sarah rents it out for additional income of $600 a month. Robert and Sarah have a farm and their cows bring in around $18,000 a year and hay supplies around $7,000 a year. My grandfather also draws social security and a retirement check from being a retired firefighter. She and Robert built their house 41 years ago when my mother was 14 so there is no house mortgage. However, she states her water bill is usually $25 a month and electricity is anywhere from $100-$250 a month. Furthermore, she has a 2005 stratus with insurance that cost $60 a month, health insurance at $43 a month, and groceries running around $200 a month. Sarah has struggled with depression her whole life and is still on Prozac ($235.10 a month before insurance), along with hyperthyroid medication, Methimazole ($130 a month before insurance). She also takes Theophylline ($22.65 a month befor insurance) for her COPD and warfarin ($25.31 a month before insurance) a blood thinner. She tells me Blue Cross Blue Shield of Tennessee covers 80% of her medication cost so she ends up paying around $82 a month for all of her medications.
Sarah ends up bringing in $1200 dollars a month from just her retirement and social security, with an additional $600 a month from her sister’s house that will be sold and divided after her sister passes so that income will no longer be there. In just her basic necessities she spends $550-$600 dollars a month. Overall her income is plenty to support her and have a few hundred bucks to put away every month for emergencies. I do not believe her financial status affects her quality of life and she has no need to be worrying about money.
In conclusion, my assessment opened my eyes to a deeper concept of my grandmother. For a 79 year old lady she is in extremely good shape and has a very positive outlook on life. Her greatest challenges now is finding time for herself, focusing on her health problems, and ensuring the best quality of life for herself. With all of the suggestions I mad she took to most of them just fine. Her sister going into a nursing home was not up for debate and neither was moving the kitchen table into the living room. I guess we will just have to wait for an accident to happen before those changes get implemented.

Breakfast (7:30 am) ½ cup Oatmeal 8 oz 2% milk 1 banana Snack (10:00) 1 medium apple 8 oz grape juice Lunch (12:30) 2 oz Tuna fish One boiled egg 1T relish 1T mayo 2 slices of whole wheat bread 20 oz water Snack (4:00) one pack of peanut butter crackers 8 oz grape juice Dinner (8:00) 8 oz steak 1 cup green beans ½ cup mashed potatoes 20 oz of water Snack (11:00) 1 medium piece of cheese cake 8 oz of water