Question

Paragraph Styles Ed Transitional Care Case Study Mrs. Helen Stanley is an 84-year-old woman with current osteoporosis, lumbar compression fractures, and chronic pain. She also has Giant Cell Arteritis (GCA)/Polymayalgia rheumatica (PMR)-treated with steroids since 2001-and a colo-vesticular fistula since 2002. She also has diabetes, COPD and hypothyroidism, all controlled with multiple medications. She also suffers from notable depression since the death of her spouse 5 years ago. Her medications are: . • Metoprolol SR 25 mg qd KCI 80 mEq ad • Alendronate 70 mg qweek Ca/D 500/200 TID • Morphine IR 5 mg 94h prn Mirtazapine 15 mg qhs Senna ?tabene . • Furosemide 80 mg qd • Prednisone 10 mg qd • Calcitonin NS 200 IU qd • Morphine SR 30 mg BID • NPH insulin 18 • Warfarin 2mg ghs Calaca 100 RIN . Focus 9 e W

Case Management Assignment

Answer 1

1. As Mrs. Stanley has multiple disease conditions both physical and psychological , its not appropriate to discharge her but she wishes to be at her home . It would be better to shift her to a tertiary level nursing home where she would be under the continuous monitoring of the medical staff and also the medical resources would be available so that necessary emergency actions can be taken care of .

2) The resources needed for Mrs. Stanley are :-

- Aids to perform activity of daily living

- Physical care

- Psychological care and therapy

- Personal assistance

- Spiritual support

3) Three functional issues include :-

- Inability to do ADL

- Pain which is acting as a hinderance

- Respiratory depression

All these needs to be managed before she is discharged

4) Three psychological issues are :-

- Depression

- Delirium

- Feeling of Loneliness

All these needs to be managed before she is discharged