Assessment on Chris Beckingham
Introduction
The aim of this essay is to present a comprehensive functional assessment on Chris Beckingham a 55 year old caucasian male. The purpose of this assessment is to gather information concerning Chris' ability to self care, detect areas of functional assessment on Chris is to gather data about that begins with the building of a relationship with a patient, followed by 11 steps that are carried out in a systematic process.
This process is designed to allow the flow of information in a natural manner and support a holistic view of patient assessment. It will include four basic skills of observation/inspection, palpation, percussion and auscultation.
The collection of both objective and subjective data will be used in conjunction with clinical judgment in the decision making process to evaluate and provide an overall health assessment of the patient.
The function assessment will be conducted on Chris Beckingham a 55 year old Caucasian male living in Airlie Beach Queensland. Before beginning the assessment it is important to introduce yourself to the patient and provide Chris with an explanation of the purpose of the assessment and what he can expect.
By approaching Chris in a warm and friendly manner and answering any questions he may have, the chance of misunderstandings will be minimised, it will also reduce anxiety and provide an atmosphere of trust that allow for the flow of information.
Step 1 in the functional assessment is to determine Chris' health perception and health management. By beginning the assessment here we are able to develop an outline of Chris' current health status, health history and any ongoing illnesses.
This is also able to give us an idea of how any problems he may have are managed and identify any areas of concern.
Chris explains that "I think I am pretty healthy, I don't take regular medication however sometimes I need to take antacid for upset stomach." He explains that "I visit my GP once every year for blood tests and overall physical and the only thing that I have to do from time to time is get sun spots cut or burnt off my skin".
On observation it is noted that Chris has a very fair complexion, "I spent a lot of years in swimming training and sailing on yacht's when I was younger and it's just something that I have to keep an eye on" Chris said. He added that " I have had so may cut out and burnt off over the years, I can tell straight away when they are bad and I go and see my doctor straight away". "I always wear a hat and protective clothing and SPF sunscreen when out in the sun now. (Beckingham, C. Participant, 14/8/09)
This indicates that Chris is able to manage the damage that has been done to his fair skin by sun exposure. He takes all the precautions in reducing any further skin damage and uses self-examination, detection, evaluation and prompt medical treatment to prevent the development of skin cancers.
On asking Chris to tell me more about the "stomach upsets" and medication he takes he explained that "I had an endoscopy about 10 years ago because I was getting really bad pains and upset stomach all the time, after that my doctor put me on Losec". Chris explained that "from time to time whenever I get an upset stomach I just take Losec for a day or so and it goes away, it's just from excess stomach acid and the Losec really helps"(Beckingham, C. Participant, 14/8/09).
It would seem that Chris understands the use of Losec and is able to use this successfully to manage his increased stomach acidity. The education given to Chris concerning this would include the importance of consulting his GP if the Losec did not elevate his symptoms including a discussion regarding the need for any follow up endoscopy.
Step 2 in the functional assessment deals with nutrition and metabolism. Jarvis (2008) describes a person's nutritional status as the degree of balance between nutrient intake and nutrient requirements. Nutrition and metabolism is associated with the digestive and urinary systems in the body and plays a major role in maintaining the body's hemostatis.
Chris explains during the interview that " I have been a vegetarian for over 30 years, I have a good appetite and eat a quality cereal for breakfast, lots of salad, rice and bread and have fresh fish once or twice a week" (Beckingham, C. Participant, 14/8/09).
Chris' height weight ratio is well within normal range, and a recent increase in weight of about 1kg he explains is due to "giving up smoking". Chris has no allergies, swelling of hands or feet, dry or itchy skin and he has good peripheral return. Chris explains that his last blood test from GP showed his cholesterol was "excellent" and his BP is also "excellent" (Beckingham, C. Participant, 14/8/09).
When assessing a patient's dietary history it is important to take heredity, age, culture, religion, and medical problems into consideration. These factors impact on individuals eating patterns and type of food consumed. For elderly patients or people with reduced mobility, referrals to community health nurse, meals on wheels and dietitian would be necessary to assist the patient maintain healthy eating patterns (Tucker, 2000).
Step 3 elimination examines the body's ability to eliminate waste.
Chris explains that he opens his bowels every morning and urinates about 6 times a day. He drinks about 3 cups of tea a day and 1 cup of coffee and admits that he should drink more water as he only drinks about 3 glasses a day.
Any difficulties experienced in elimination such as incontinence, constipation, diahorrea, polyuria, painful urination, change in stream or difficulty urinating (for men may indicate enlarged prostate) are a good determinant for problems associated with the digestive system, urinary system, metabolism and imbalance in body hemostatis (Jarvis, 2008).
Step 4 is concerned with activity and exercise. This is an important indicator in assessing a patients level of self-care and mobility (Gordon, 1994).
Chris is self sufficient in all his activities of daily living, he lives on his own and works as an architect from home. His job is often very demanding however in the last year he has "tried to slow down and semi retire". He describes his leisure activities as "boating, spear fishing for fresh coral trout and spending time with his partner and family" (Beckingham, C. Participant, 14/8/09).
Chris describes his exercise routine as something he has maintained for over 30 years. He details this in his explanation as "mediation for 1 hour every morning, 1 hour of exercise in the afternoon from home, that includes a combination of lap's of the pool, exercise bike and or rowing machine, I also do about 10 to 20 min of yoga" (Beckingham, C. Participant, 14/8/09).
Chris explains that he developed a strong ability for discipline during his early yeas of swimming training and this has enabled him to include a consistent exercise routine into his life ever since.
It is important to identify any problems a patient may be experiencing with activity and exercise. A person suffering from arthritis, chronic illness or disability may experience pain on movement and a decrease in level of activity resulting in self-care deficit. These issues should be addressed with review of medication, referrals to physical therapist and occupational therapist (Jarvis, 2008).
Step 5 is concerned with patterns of normal sleep and rest and any recent changes that have been experienced.
Chris admits that "I only have problems sleeping if away from my own bed, like when I sleep in a hotel room, or if I am really stress or concerned about something and just can't let it go, this doesn't happen very often though."
Chris admits to resorting to a temazapam to help him get to sleep when away from his own bed, but said that he "never takes pills at home and generally get between 7 to 8 hours of sleep a night" (Beckingham, C. Participant, 14/8/09).
Because Chris' problem with insomnia is not an ongoing problem it would fall within normal range of sleep disorders. An imbalance in sleep or would be associated with sustained patterns with insomnia, apnea, snoring, difficulty remaining asleep or nightmares. Patient education may be required for assistance in developing sleep patterns, exercise, medication, lifestyle and intake of stimulants. Referrals to sleep clinics are recommended for patient if disturbed sleep patterns are effecting their daily life.
Step 6 Chris's congitive and perceptual ability appeared normal, he had excellent interpersonal skills, has a higher education level, was well educated on health and lifestyle issues, wore prescription glasses for reading, and experiences no abnormal pain, sensitivity, dizziness or hearing loss.
Step 7 Chris described himself as a "stable personality" and a "high achiever" he has experienced a change in lifestyle over the last year with a deliberate decrease in work commitments and has suffered no adverse effects. (Beckingham, C. Participant, 14/8/09).
He is currently enjoying having more time to spend on his boat, however due to his high achieving personality admits to considering taking on another semi big work project.
Chris said he did not suffer from frequent feelings of anger, "I get a bit grumpy sometimes, mostly due to the fact that I am a perfectionist and get frustrated with other peoples inability to do a good job" (Beckingham, C. Participant, 14/8/09).
He does not suffer from anxiety, fearfulness or depression (Gordon, 1994).
Step 8 Role- Relationship
Chris lives on his own, he is in a long term relationship lasting for over 10 years with his girlfriend who has 2 children to a previous marriage. He describes his relationship with his girlfriend and 'step children' as important to him. He attempts to have only a positive impact on their lives by assisting financially and helping to bring a level of emotional stability to their lives. "Especially for my girlfriend who can be a bit… inconsistent" (Beckingham, C. Participant, 14/8/09).
He said that any conflicts are always resolved, he only has a couple of close friends and considers his girlfriend to be his best friend.
Step 9 He admits to being sexually active, however interest in sex has declined over the last couple of years. His girlfriend is his only sexual partner, he is not overly concerned with a decrease in sexual interest as he does not place as much importance on it as he did when he was younger.
Step 10 Coping Stress Tolerance.Chris said he copes with stress extremely well, he maintains that his daily meditation allows him to quiet his mind and thoughts and this reduces obsessive and unproductive thought patterns. It enables him to be more mindful of his thoughts and actions, and allows a deeper appreciation of the present. Chris said that although he has meditated for may years he is still a "student" when it comes to the mysteries of life.
Step 11 Value Belief
Chris describes his success in work as simply "really hard work". He always insisted on a "high level of integrity and quality in my designs and buildings."
He explained that he tried to incorporate his Buddhist philosophy of mindfulness in all his dealings with clients and tried to used the beauty of nature to make the biggest impact in his work rather than an overstated and tricky building design.
He believes that Buddhism plays a big part in his life, "not as a religion but as a way of living" and considers himself fortunate in that "my girlfriend and I are connected through our understanding of a common belief system and each other" (Beckingham, C. Participant, 14/8/09).
Chris' plans for the future include "another work project coming up soon", "to visit the continental shelf again and do more spear fishing" and "assisting wherever I can, in making Kerry's life more harmonious" (Beckingham, C. Participant, 14/8/09).
Conclusion
On assessing Chris I identify a strong work ethic, a stable relationship, compliance with a good and balanced diet, regular exercise, active interests, and his choice to give up smoking and manage his health problems in a mature and responsible manner.
It would seem that from reviewing the collection of data on Chris that he has achieved a unique balance in today's society that rewards him with a stable mental capacity, good physical health, independence and emotional and spiritual wellbeing.
It would seem that from interviewing Chris that he has achieved a unique balance within his life, through a strong value system, a compliance with good diet, regular exercise and outside interests the decision to give up smoking.
Today's society finds many people avoiding the necessity to care for their bodies and minds. The consumption of processed food high in fats and sugars, taking of stimulants, excessive use of tobacco and alcohol, and non-compliance with primary health care practices. As individuals living in a free society the risk of making poor health choices increases with the increase in poor quality food choices, especially for the most vulnerable in our society our children.
With functional assessment it is important to determine any deficit to functional ability, whatever the underlying reason, and attempt to compensate for this deficiency with safety measures that exist within the health care system to improve health outcomes and standards of living for those in need.
On questioning Chris, he said "I am in good health and I have a consistent routine that incorporates one hour of exercise and one hour of meditation every day that I have maintained for over 30 years". He explains that "I have been a vegetarian for about 30 years, however eat fish once or twice a week, I smoked rollies for 30 years and have given up in the last six months and hardly ever drink alcohol".
