Question

Case Study : SITUATIONAL PROBLEM OF ELDERLY WOMAN.

Mrs. Johnson, a recently widowed 78 year old woman, lives alone in a three bedroom house in Atlanta, Georgia. A fall 1 year ago resulted in a broken hip, and she now depends on a walker for limited mobility. Her only child, a daughter, lives in Portland, Oregon, and does not want to bear the burden of responsibility for her mother. Mrs Johnson only income is a monthly social security check for $1100. Her monthly mortgage payment, property taxes, insurance payments and utility and phone bills amount to $907.
A recent medical examination revealed that Mrs. Johnson has iron deficiency anemia and that she has lost 12 pounds during the past 3 months. Her current weight is 80 pounds and she is 5 feet, 2 inches tall. Mrs. Johnson states that has not been hungry, and her daily diet is repetitious broth, a little cottage cheese and canned fruit, saltine crackers and hot tea. She lacks energy, she rarely leaves the house and she appears to be emaciated and generally distraught.

Questions for analysis:
1. Identify Mrs. Johnson personal problems and describe how they might be influencing her eating habits. How could her physical problems have influenced her food intake?

2. What nutritional improvements could she make in her diet (include food suggestions)and how are these related to her physical needs at this stage of her life?

3. What practical suggestions do you have for helping Mrs. Johnson to cope with her physical and social environment?What resources, income sources, food, and companionship can you suggest?How do you think these suggestions would benefit her nutritional status and overall health?

Answer 1

1,Mrs Johnson is stressed and frustrated with both her physical as well as personal problems.Some of her personal problems are lack of attention and care from her daughter and the monthly dues she has to pay .Though she is getting a social security check,only a negligible amount is left after paying the bills.It has definitely affected her eating habits.Our eating habits is influenced by our social context.We tend to eat more when in company of others.The dietary choices of a person is linked with those of our close social connections.

Mrs Johnson had a fall and she now uses a walker to assist her in walking and has restricted her mobility .there is nobody to take care of her and to bring her nutrititious food.Since she is living alone ,psychologically she lacks company and depression must have taken away the apetite from her.

2.Mrs johnson is fatigued due to lack of physical activity,poor diet,stress and iron deficiency. iron is a mineral which transport oxygen throughout the body.Decrease in iron level can also be a contributing factor to fatigue.So if there is not enough iron ,body will not be able to produce adequate RBC's.The main function of iron is Oxygen transport and Immunity.Some of the foods which contain iron are Salmon,Tuna,Legumes,Whole eggs,Nuts,Leafy green vegetables,Liver,Chicken,Shellfish,Broccoli,Oats,Berries and Mushrooms.Vitamin c is an iron enhancer .So taking foods rich in vitamin C along with iron enriched foods will boost up the absorption of non haem iron.Foods containing Vitamin C are Citrus fruits and juices,STrawberries,Kiwis,Melons and Tomatoes.It is better to avoid tea and coffee as it reduces the absorption of iron.

3.Mrs Johnson can easily rent- out her home for families or students and will get an extra income ,as well as she will get the benefit of companionship and support.This will definitely have a positive impact on her health.She can also use the service of support groups .If she sets a reasonable price for renting her home she will get a generous earning to buy some decent foods and opt for a health insurance coverage which suits to her income.