Determine” scale score

Joan is an 82 year old woman whose husband died last year. Now, she lives alone in a small apartment with no money for “luxuries.” She has no family or friends in the area, having relocated for her husband’s job. She takes medication for type 2 diabetes but has had increasing difficulty controlling her blood sugar because of her “sweet tooth.” She generally eats alone and reluctantly admitted she has been drinking more than she used to (at least 3 alcoholic beverages a day). Although she is able to cook, she prefers not to and frequently skips meals. She also admits that she won’t eat anything green so her diet is lacking vegetables. She has been referred for nutritional counseling because she has lost 20 pounds this past year without dieting. She is 5’5’’ tall and weighs 110 pounds.

1. Using the “Determine” scale printed on page 279 of your text, what is her score? What does that score mean?
2. What factors contributed to Joan’s weight loss?
3. What do you think is the underlying issue causing the weight loss?
4. What should be done in the short term to help Joan with her weight?
5. What should be done long term to help her maintain good health?

ANSWER

Scale Score

Nutrition is a significant part of human development and growth which should be embraced all the time. Effective nutrition practices are linked with an enhanced infant, stronger immune systems mental health, and reduced risk of non-communicable diseases. In this case of Joan, who is an 82-year-old woman, she recorded the following score as retrieved from the “Determine” scale printed:

• +2 is for too much alcohol consumption; she takes more than three drinks of alcohol every day.
• +4 is for lack of money to get the food she wants and other luxuries. The death of her husband caused this.
• +2 she has diabetes and cannot lower or control her habit of consuming sweet meals.
• +2 this is for her decision not to cook for herself even though she has the capability of doing so.
• +2 this is for her weight loss, where Joan has been able to shed off 20 pounds in a year without dieting.
• +3 this is for her habit of skipping meals and not being ready to cook. She consumes less than two meals a day.
• +1 this is for eating alone because of a lack of friends and family members.
• +2 this is for not taking green vegetables.

The score totals 18, which is an indication of high nutritional risk

Factors Contributing to Joan’s Weight Loss

These factors range from excessive consumption of alcohol, old age, constant skipping of meals, Diabetes to lack of green vegetables in meals, and lack of enough finances.

Underlying Issue

Diabetes is the underlying problem causing weight loss because body cells lack adequate glucose attributed to a lack of insulin receptors that enable glucose uptake by cells.

Short Term Action

She should be kept under a high fibre and protein diet. She should also have regulated carbohydrates only if the glucose levels are kept at a constant level. Joan should also be refrained from alcohol consumption and consistently advised to take small meals.

Long Term Action

Joan’s long-term actions include entirely avoiding alcohol, maintaining active, healthy eating habits, taking a balanced diet, and taking her diabetes medications on time.