An assessment tool for the older person with spinal cord injury.
Normal aging changes intensify the chronic problems that are experienced by individuals with spinal cord injury (SCI). These changes place them at greater risk for developing vital systems failure and functional impairments, which if unrecognized, may lead to institutionalization or death. Understanding the trajectory of aging, and its impact on structure and function, is paramount in caring for individuals with SCI. Moreover, trends in health care toward capitation, managed care systems, and shifts to outpatient care portend a delivery system with more limited resources and greater restrictions (Lubitz, Greenberg, Gorina, Wartzman, & Gibson, 2001; National Institute of Aging, 2000). These trends potentially compromise health care access, quality, and cost for at-risk populations, especially for individuals aging with an SCI. Therefore, it behooves SCI nurses to develop a comprehensive approach to assess individuals who have chronic and debilitating injuries such as SCI. More importantly, assessing these individuals will require SCI nurses to adapt current tools that will aid in this endeavor and perhaps create new ones that will reflect the magnitude of SCI presentations and care. Employing the nursing process, SCI nurses will need to gather data from a myriad of sources. The first important step is establishing a baseline. Using a functional health pattern tool (FHPT) developed by Gordon (1987), and adapted from the North American Nursing Diagnosis Association (1987), is one such method of constructing a database and formulating diagnoses (Gordon, 1994). The FHPT provides a holistic view of individuals and families in any practice setting and it can be easily adapted to specialty areas within nursing. Therefore its application to both SCI and aging is fitting (Popkess-Vawter, 1997). These authors adapted the FHPT format to create a tool that will make it more reflective of changes that occur in individuals who have SCI and are aging.
Grudinskas
Lucille V
LV
Department of Geriatric Research Education Clinical Center (GRECC), VA Boston Healthcare System, Boston, Massachusetts, USA.
Nee
Maura A
MA
D000368:Aged / Q000502:physiology / Q000523:psychology; D015577:Geriatric Assessment; D006694:Holistic Health; D006801:Humans; D024802:Nurse's Role; D009730:Nursing Assessment / Q000379:methods*; D019145:Rehabilitation Nursing / Q000379:methods; D013119:Spinal Cord Injuries / Q000451:nursing* / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation