Question

Geriatric Case Study Worksheet
Case Study #1
Mr. S is a 79-year-old with multiple medical problems, but primarily suffering from heart disease. He is retaining fluid in his legs and feet, sometimes limiting his mobility. Mr. S has difficulty keeping his multiple medications organized and taking them as prescribed. He lives with his daughter, who is balancing the needs of her young family with her aging father. Mr. S hates burdening his daughter with his medical problems and tries to help by assisting with some of the daily house chores. He seldom leaves the house, as most of his friends have either moved away or have died. Most of the time he stays in his room to not get in the way of his daughter.
Case Study #2
Mrs. M is a 90-year-old woman and has been a resident of a long-term care community since her husband died 8 years ago. Her health status is fair. She has DM2 (controlled by oral medication) and rheumatoid arthritis. At the community center, she has her own apartment, which she maintains with minimal assistance, receives one hot meal each day in a common dining room, and has access to a full range of services, such as a beauty shop, recreational facilities, and a chapel. She is generally happy in this setting. She has no immediate family nearby, and the cost of the facility was covered by a large, one-time gift from her now deceased husband. Recently, she has become weaker and has had difficulty walking, attending activities including meals, and doing some of her ADLs due to her RA.
Questions:
1.   As the NP and primary care provider (PCP) for these two individuals, compare your delivery of care for these two situations. Select a nursing theory or model for each case study, and apply their principles to these case studies.

2.   Describe how you would apply the biopsychosocial model (BPSM) to the healthcare management of these patients. Make sure that you include the concepts of client, health, environment, and nursing.

3.   As an advanced practice nurse, select and apply a behavioral change theory to manage these patients’ cases and situations.

4.   Discuss some of the financial constraints in managing healthcare for the geriatric population.

5.   What are some ethical challenges that could be encountered in caring for the geriatric population?

Answer 1

For the first case in the aspect of general nursing care legs swelling must be taken care of which means legs must be elevated and kept in the night time so that swelling reduces.crepe bandage has to be applied from ankle to the knee so that swelling reduces.medication box must be kept that is medicines must be arranged day wise such as sunday , Monday etc and organized and kept. Hence by doing this it will be easy for him to take medications. Mobilization is must atleast 15 to 20 min of walking must be done so that swelling reduces.. regarding the diet he has to have check on salt so that it reduces the chance of water retention.

Moving on to the 90 yr female patient, as she is suffering from DM it is necessary to take meals at correct time followed by oral DM medications, an maid has to be appointed to prepare meals and serve her . She has to do minimal muscle strengthening exercise so that it will be convenient for her to walk.she has to get exposed in early mornig sunlight so that the stiffness reduces and her body can observe vitamin D also...

Hence these are the basic care that must be done...