Problem statements:

-Urinary incontinence
--Elderly patients suffer from urinary incontinence limiting their functional and social independence

-Recovering from hip fracture
--One of the leading cause of catastrophic events in elderly
--Point of entry for severe decline

-Humidifier for oxygen tank
--Patients with oxygen without humidifier suffer from drying of mucous membranes leading to discomfort

-Bed mobility
--Weak truncal strength limits bed mobility which leads to pressure ulcers
--What do bed-bound patients do for bowel and bladder?

-Diabetes
--Finger sticks are invasive and uncomfortable
--Difficulty with self-administration of insulin
---Independent insulin management is challenging without proper finger sticks and insulin dose calculation

-Hydration status
--Elderly patients are not sensitive to thirst (don't remember to drink), limited access to water, difficulty swallowing

-Serious falls in the elderly

-IADLs
--Difficulty with use of smart phones due to impaired speech, dexterity, visual acuity
--Managing finances
--Transportation
--Preparing meals
--How to get elderly set up with different services as there are many out there
--Elderly patients are unable to manage medications and doctor's appointments

-Social isolation
--Skype? There are services that connect people who want to learn a language
--Nutritional status. Elderly patients eat less when they are eating alone.

-Eye drops
--Elderly patients have decrease manual dexterity leading to difficulties applying eye drops and managing Glaucoma

Preliminary finalists:
1. Social Isolation - informal support system to support each other, to get others to remind elderly about meds/eating... etc
  Why does the problem occur:
    -decreased mobility, functional capacity, inability to drive, fear of fall, incontinence
    -institutionalization
    -memory problems
  Medical implication
    -depression, decreased nutrition, cognitive impairment, increased mortality
  Women, older age, less education, lower wealth, marital status (single, widowed)
  Evidence:
    -60% have mobility impairment
    -Change or loss in social network, social role, physical or mental health and resources
  Effective intervention
    Group activities: discussion, self-help, bereavement
    Specific population: women, widow, mild cog problems
    More than one method
    Allows participants some level of control
    Process of evaluation throughout the intervention
  Aim of intervention
    Reducing loneliness and or depression
    Increasing the social network size
    Improving the quality of supports
    Increasing the frequency of social contact
    
  Questions to ask:
    -Age, marital status, family members, member of organization in community, previous occupation, level of education, sources of income, spiritual/religious, exercise, nutrition
    -Ask about IADLs
    -Who in your life do you interact with the most?
    -How often do you get to see your family?
    -Do you use your telephone to talk to them? Is it video?
    -Number of new relationships, in past year?
    
    (When did you start feeling like you losing social interactions?)
    Social isolation questionnaire:
      First, how often do you feel that you lack companionship: Hardly ever, some of the time, or often?    1    2    3    
      How often do you feel left out: Hardly ever, some of the time, or often?    1    2    3    
      How often do you feel isolated from others? (Is it hardly ever, some of the time, or often?)    1    2    3
  2. Hydration issue - a concrete problem

3. Urinary incontinence - most common problem that can lead to social isolation