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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. Theories to Consider: Every theory offers a different view of the problem(s). I encourage you think beyond what we can do or offer as providers, and look towards a view of inclusion and what the patient wants for themselves. Here are a few suggestions from your text: Troutman-Jordan’s Theory of Successful Aging (text, Chap 28); Watson’s Unitary Caring Science and Theory (text, Chap 18); Meleis’s Transition theory (text, Chap 20; Kolcaba’s Comfort Theory. You do not have to use any of the above theories, instead you can find others from the text or outside of nursing. One that comes to mind is the Intersectional Theory (1989, Crenshaw) that addresses how interventions from other disciplines may be appropriate and supports viewing the patient beyond just their disease process. While this theory was originally thought of as “race based” it has developed overtime to address multiple factors regarding social determinants and social impairments to health. 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?
SCIENCE
HEALTH SCIENCE
NURSING

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