Question

CANADA – Mrs. Margaret Jones

Mrs. Margaret Jones is 82 years old. She was widowed when she was 56 and since then has enjoyed living independently, initially in the family home and, more recently, in a two-bedroom apartment in the center of a city of about 1,000,000, where she can walk to carry out most of her errands. She has enjoyed her life as a widow, has traveled extensively, and enjoyed both visiting and entertaining friends. Over the past few years, she has had two hip replacements, but each time, she has regained her independence after an appropriate stay at a convalescent home, and with help from her two daughters (who both live nearby) with grocery shopping and rides to doctor’s appointments. She has recently slowed down physically to some extent and has not been traveling but is mentally sharp.

            Mrs. Jones awoke with severe back pain one morning, with no warning. She has been slightly stooped over for most of her adult life, although her daughters noticed the stoop becoming more pronounced recently. She made an appointment to see her family doctor at the hospital-based family practice clinic; the appointment was about a week after the pain started. In the meantime, Mrs. Jones started sleeping on a reclining chair because it was so painful to get up from a prone position. Her daughters arranged to rent a hospital bed, and they resumed helping with household tasks as well.

            At her appointment, the doctor found her dehydrated, which she admitted was because she had reduced her fluid intake to avoid trips to the bathroom. The doctor recommended that she be hospitalized while the reason for the pain was diagnosed.

Critical Thinking Questions

1.      Based on aging theory and the diagnosis, as part of Mrs. Jones’ hospital team, what course of action would you recommend regarding Mrs. Jones’ living arrangements if her diagnosis was increasingly severe arthritis?

2.      What course of action would you recommend if her diagnosis was multiple myeloma?

Answer 1

1. Recommendations regarding her living arrangements if she has arthritis :-

- keeping all frequently needed equipments nearby to her

- avoid stress

- avoid straining

- walking with assistance to avoid injury

- provision of adequate lighting and spacing

- keeping the floors dry

- attaching side bars in the bathrooms / toilets

- avoid too much hot and cold

2. Recommendations regarding her living arrangements if she has multiple myeloma :-

- assist while walking

- provision of adequate lighting and spacing

- keeping the floors dry

- attaching side bars in the bathrooms / toilets

All these measures to avoid pathological fracture due to multiple myeloma.