Comprehensive Plan of Care for Geriatric Patient

Topic: Geriatrics
Words: 1223 Pages: 4


The case of the patient under consideration requires a thorough examination due to the presence of numerous factors which can adversely affect the outcome of the planned treatment in the future. They primarily include her age, sex, medical history, cultural and religious background, and the existing conditions, and the analysis of their combination should be used to suggest modifications in the provided services. In addition, it is critical to propose the appropriate diagnostic testing, medication management, referrals to specialists, and education with regard to emerging problems in order to prevent complications. Therefore, this paper aims to address the above aspects of the matter and design the first steps in preparing further care.

Essential Circumstances

The selection of measures suitable for improving the condition of the patient depends on her principal characteristics, which can potentially influence the treatment process. First, the main risk factor belongs to the population group of elderly women, who are reported to be the most vulnerable category of hospital visitors (Katz et al., 2021). Second, the presence of other health issues, more specifically, type 2 diabetes, hypertension, and dyslipidemia, should be taken into account to avoid negative interactions between the used medications and those to be prescribed (Lange et al., 2018). Third, it is critical to consider the low levels of income of the elderly female population from Iran and their high reliance on religion, which can present an obstacle to well-being (Nosratabadi et al., 2018; Haifizi & Steis, 2021). Finally, the symptoms, which the patient reports, seem alarming from the perspective of their ambiguous nature and the possibility of attributing them to various conditions, and this fact should define further measures suitable for the woman.

The Suggested Evaluation

Diagnostic Testing

Considering the above conditions, the initial testing should be performed with a focus on the most likely diagnosis, which is knee osteoarthritis. In order to diagnose this issue, it is critical to use radiography to detect the possible “marginal osteophytes and joint space narrowing” ascribed to this problem (Katz et al., 2021). As an option, it can be substituted by ultrasonography, which is proved to have greater sensitivity when examining the mentioned problem (Brom et al., 2020). Subsequently, the risks of cancer should be eliminated by examination, but the main orientation of practitioners should be osteoarthritis as the most likely source of pain affecting the determined population group in the first place.

Medication Management

The management of the woman’s condition will be performed with regard to the existing problems and the hypothetical presence of knee osteoarthritis, which is to be confirmed in the course of the examination. The best option for this objective is the use of opioids for pain relief since they reduce the risks of polypharmacy in elderly patients, and their dosage is easier to determine (Ali et al., 2018). Thus, acetaminophen can be prescribed as the first-line agent for addressing the problem, and it can be replaced by non-steroidal anti-inflammatory drugs, such as ibuprofen or naproxen, if needed (Ali et al., 2018). Moreover, it is possible to select tapentadol in the case of pain increases over time (Lange et al., 2018). The treatment will be modified in the future if any complications emerge.

Referrals to Specialists and Patient Education

The process of planning treatment for the elderly woman requires visiting various specialists who should not only conduct the selected tests but also thoroughly explain the situation to the patient. This initiative is critical since she confirmed the events of skipping the medications in the past, and the responsibility of healthcare practitioners is related to the need to clarify the possible consequences of such events. Thus, the treatment should start with a visit to an orthopedic physician to reveal the causes of pain in the knee after performing the diagnostics (Brom et al., 2020). This specialist will help confirm the presence of osteoarthritis in the patient and inform her of the necessity to regularly take the medications described above in order to address the symptoms and improve their quality of life. In addition, it will be necessary to consult with a radiologist for further examination and specification of the type of issue which the patient faced. In this way, the main focus should be on the application of complex measures and the awareness of the woman regarding the connection between her well-being and the consumption of medications.

CVA and the Related Concerns

Another issue worth taking under consideration when addressing the case in point is the high probability of a stroke as one of the major threat to the patient’s health. Also known as the cerebrovascular accident, or CVA, a stroke becomes a potential concern in the scenarios involving hypertension in aging patients (Kuriakose & Xiao, 2020). Specifically, the pathophysiology of the ischemic stroke suggests that the smooth muscle of intracerebral arteries may fail to perform its function as a result of hypertension, thus, causing the development of clots that are likely to cause an ischemic stroke (Kuriakose & Xiao, 2020). Additionally, other pathways of developing a stroke are highly probable in aging patients with hypertension (Kuriakose & Xiao, 2020). For this reason, the patient must be hospitalized so that her hypertension rates can be controlled accordingly and reduced with the help of medical interventions, should the need arise.

Type 2 Diabetes and Patient Education

Furthermore, the current state of the patient’s well-being, primarily the presence of type 2 diabetes, suggests that additional measures must be applied. Patient education, specifically instructions concerning the use of respective medications. In addition to the required supply of insulin, the patient must be instructed to carry a glucose testing kit and a small amount of fast-acting glucose in case of an emergency (Chawla et al., 2020). Thus, the current levels of risk to which the patient exposes herself in her daily outdoor routine will be minimized. Furthermore, an endocrinology referral will be needed to ensure that the patient’s hormonal levels remain properly adjusted. In addition, the patient must receive brief explanations as to what diabetes type 2 has been caused by, how it can be currently managed, how health risks can be identified at an early stage, and how to contact healthcare services. The issue of hyperlipidemia should also be addressed accordingly by recommending a lipid panel test. Furthermore, changes to diet must be made by excluding saturated and trans fats, reducing the amount of red meat consumed, and including a wider variety and larger range of fruit and vegetables into the menu. As a result, major risks can be avoided, and the patient’s safety will increase.


To summarize, the analysis of the case showed that the main obstacles to providing high-quality medical services to the patient are her cultural and religious beliefs and low socioeconomic status. These factors lead to the necessity to emphasize the need to take medications on a regular basis while they should be the most affordable options among the available alternatives. The suggested diagnosis is knee osteoarthritis, which correlates with the described symptoms, but the possibility of cancer should be considered as well in order to make a precise conclusion. This task can be performed with the help of radiography or ultrasonography as well as physical examination, and it implies visiting an orthopedic physician and a radiologist. In the end, if the condition is confirmed, the possible prescriptions are opioids or non-steroidal anti-inflammatory drugs.


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Brom, M., Gandino, I. J., Zacariaz Hereter, J. B., Scolnik, M., Mollerach, F. B., Ferreyra Garrott, L. G., Marin, J., Ruta, S. O., Rosa, J. E., García-Mónaco, R. D., & Soriano, E. R. (2020). Performance of ultrasonography compared to conventional radiography for the diagnosis of osteoarthritis in patients with knee pain. Frontiers in Medicine, 7, 319.

Chawla, R., Madhu, S. V., Makkar, B. M., Ghosh, S., Saboo, B., Kalra, S., & RSSDI-ESI Consensus Group (2020). RSSDI-ESI Clinical Practice Recommendations for the Management of Type 2 Diabetes Mellitus 2020. Indian Journal of Endocrinology and Metabolism, 24(1), 1–122.

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Katz, J. N., Arant, K. R., & Loeser, R. F. (2021). Diagnosis and treatment of hip and knee osteoarthritis: a review. JAMA, 325(6), 568-578.

Kuriakose, D., & Xiao, Z. (2020). Pathophysiology and treatment of stroke: Present status and future perspectives. International Journal of Molecular Sciences, 21(20), 1-24.

Lange, B., Sohns, M., Tempero, J., & Elling, C. (2018). Efficacy and safety of tapentadol prolonged release formulation in the treatment of elderly patients with moderate-to-severe chronic osteoarthritis knee pain: A pooled analysis of two double-blind, randomized, placebo-, and active-controlled trials. Current Medical Research and Opinion, 34(12), 2113-2123.

Nosratabadi, M., Nabavi, S. H., Rashedi, V., & Rarani, M. A. (2018). Socioeconomic determinants of health-care and emotional needs among Iranian older adults in Isfahan. Journal of Education and Health Promotion, 7. Web.

Risk of Falls Among the Elderly
The Stopping Elderly Accidents Initiative