HEALA6401 Assessment Task 4 - Personal Journal & Critical Reflection
Part 1: Personal Journal
Episode 1
100 words
Context: In this context with one fractured femur, an old lady of 84 years had been admitted. Here medical history comprises mild cognitive impairment, diabetes of type 2 and also having the condition of osteoporosis. Here in her case Renal function is slightly affected (i.e. eGFR 45), but there is no sign of challenges relating to GI.
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Assessment Strategy 1:
Comprehensive Geriatric Assessment – This concentrated strategic moves helps in recognising her psychological condition along with the risk of fall and frailty. In managing multidisciplinary actions, use of CGA was effective and beneficial.
Assessment Strategy 2:
Braden Scale for Pressure Injury Risk – This strategic implementation identifies skin breakdown as the high risk factor for this patient, suggesting special care in maintaining pressure areas which greatly initiate increasing complications in the medication process.
Assessment Strategy 3:
Pain Assessment Using Abbey Pain Scale – The above stated cognitive impairment of the patient can be identified with this tool to assess pain behaviors. It was effective in guiding analgesia management in patients.
Episode 2
100 words
Context: This is the case of a 79-year-old male who is with the condition of congestive heart failure and advanced COPD, who had been admitted for worsening dyspnea as the main issue of concern. His signs are of low intake of nutrition’s and increase in fluid secretion in the body.
Assessment Strategy 1:
Malnutrition Screening Tool – This strategic implementation reveals the risk associated with malnutrition; for this a dietitian referral was suggested as to bring improvement in managing his overall health condition.
Assessment Strategy 2:
Respiratory Assessment with Auscultation and SpO2 Monitoring – This assessment mainly assesses crepitation and low oxygen saturation that is termed as Hypoxemia. Provided with appropriate oxygen therapy and use of diuretic as medication.
Assessment Strategy 3:
Edema and Fluid Balance Charting – Have proper check on fluid secretion and provide diuretic titration as medication.
Episode 3
100 words
Context: Here in this case an old female patient of 90 years who is with Alzheimer's symptoms had been admitted due to some confusion arises about her health and suspected with UTI issues. 90-year-old female with Alzheimer's disease, admitted due to confusion and a suspected UTI. She has been recognised having chronic kidney disease that was non-verbal due to her Alzheimer problem.
Assessment Strategy 1:
Delirium Screening (4AT Tool) – For the early stage differentiation of dementia from delirium this technique helps a lot. As faster identification is guided with proper medication and UTI treatments.
Assessment Strategy 2:
Skin Integrity Assessment – Helps in identifying signs of damages that are moisture-associated. As a precaution preventive barrier creams are prescribed to avoid more severe conditions of the skin.
Assessment Strategy 3:
Urinalysis and Pathology – This particular strategic initiative helps in identifying the level of deterioration in kidney functioning as well as infection level.
Part 2: Critical Reflection
Description
75 words
Here in this section I like to reflect on the assessment of the health condition of a 90 year old adult (patient). She was non-verbal in communication as suffering from Alzheimer’s disease, a suspected urinary tract infection and chronic kidney disease. This concentrated piece of reflection focuses on the evaluation of different strategies and tools in making clinical decisions considering the health condition of the patients, tools mentioned as urinalysis with pathology, a skin integrity assessment and the 4AT Delirium Screening process.
Feelings
75 words
Initially in handling her case I was quite unsure of the process in which I can differentiate the condition of dementia from delirium, as this was the case of a non-verbal patient. But with the help of different medical assessment tools which are clinically appreciated , makes me more confident in recognizing the actual changes in the correct term. Through this process I understand that a comprehensive assessment is not only a process but is a complex clinical method to have accurate understanding on early identification of health complexities. This provides benefits with timely check and care for the patients stated with the importance of these tools. This also makes me understand the issues in assessing older adult patients.
Evaluation
150 words
Here in this case an Extensive evaluation of the cognitively impaired older people comes with special challenges. New confusion was often exhibited in this instance, with this old female patient being non-verbal in communication. Focusing on Australian Delirium Clinical Care Standard which facilitate early identification and multifaceted response favours the validity of early identification tools, like the role of the 4AT in improving better results in assessing rate of delirium among the old patient suffering from different health issues, as identified by the researchers Teodorczuk, Reade, and Graham, (2023). In this concentrated patient’s case, suffering from kidney disease, required to be prescribed Urinalysis to manage risk of infection and suitable doses of antibiotics medications (Teodorczuk, Reade, and Graham, 2023). Similarly the research by the author Woodward et al. (2024), has evaluated the impact of interventions and their associated measures for healing the gaps associated with care and treatments of elderly patients. Such issues are often underestimated or have been identified after spending a huge time. This suggests providing elderly patients with a proper regime considering their medical states.
Analysis
150 words
This is the systematic model of comprehensive assessment that detects the diverse challenges in patients suffering from acute health issues. It has been stated by the researcher Lee et al., (2020), that even if it concentrates on medical conditions, it also has checks on cognitive, psychosocial and functional care approaches (Lee et al., 2020). Implementing all these assessment tools that had been mentioned above are of great importance in evaluating actual cause of health impairments in patients. Tools like the 4AT tool are one of the most suitable ones to be applied for this 91 year old woman patient, as this helps in identifying the distinct feature of dementia from symptoms of delirium.
This has been proven by different researches also that 4AT which has validated the tool in both cognitively impaired and in palliative settings, which underscores the tools quick practical application even in non- verbal patients (Arnold et al., 2024). There was also an introduction of pathological outcomes being integrated in the process of making the decision of safety of antibiotics, which proves vital in elderly aged persons having chronic kidney diseases. The skin evaluation was also another crucial aspect of her care, where early signs of dermatitis related to incontinence were identified and this gave further reason why proactive and individualized assessment strategies are needed. All these tools exhibit the overall and person-centred concept of the CGA; this confirms that there is no lack in assessing the condition of this patient and in her treatment as well.
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Conclusion
50 words
The concentrated experience highlights the fact that while gaining some foundational knowledge, somewhere I lacked my confidence in assessing the delirium test on the patient with dementia disease. Now I value the use of all these stated clinically tested and validated tools. In the future I will try to improve my skill with constant learning and practicing sessions.
Action Plan
100 words
In order to enhance my ability I will read essential details from “the Delirium Clinical Care Standard”, associated with (ACSQHC, 2021). I will also consider all the existing research that is based on evaluating non-verbal older adults with dementia conditions. I will participate in different clinical workshops on aged care considering cognitive assessment. For recording my improvement I will tackle note on my application of CGA in future practices and will seek guidance from the tutors or seniors (safetyandquality.gov.au, 2021).
References
- Arnold, E., Finucane, A. M., Taylor, S., Spiller, J. A., O’Rourke, S., Spenceley, J., ... & MacLullich, A. M. (2024). The 4AT, a rapid delirium detection tool for use in hospice inpatient units: Findings from a validation study. Palliative Medicine, 38(5), 535-545. Retrieved from: https://journals.sagepub.com/doi/pdf/10.1177/02692163241242648 [Retrieved on: 05.09.2025]
- Lee, H., Lee, E. & Jang, I.Y., (2020). Frailty and comprehensive geriatric assessment. Journal of Korean Medical Science, 35(3), pp.e16-e16. Retrieved from: https://synapse.koreamed.org/pdf/10.3346/jkms.2020.35.e16 [Retrieved on: 05.09.2025] Teodorczuk, A., Reade, M. C.,
