Due July 24 at 11:59 PM Assessing and Planning Care for an Elderly Person In order to gain an insight into the world of elder adults, it is important to understand how they view themselves and the val

NSG4067 Gerontological Nursing

Patient Questionnaire

INTERVIEW OF CHOSEN ELDER ADULT

Name: ________________________________ Age: ________________

Brief Introduction (Background information):

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1. Philosophy on living a long life

2. Thoughts about when a person is considered “too old”

3. Opinion on the status and treatment of older adults

4. Beliefs about health and illness

5. Health promotion activities he or she participates in

6. Something special that helped the person live so long

7. Life span of other family members

8. Special dietary traditions in patient’s culture attributed with aiding long life

9. Any remedies/medications that have been handed down in family/group. If yes, describe. ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

10. Patient’s description of current and past health status

11. The values that guided life so far

Additional Questions

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2. ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

3. ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Summary

Contrast of client’s responses with findings in current literature

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