Aging Case Study

2778 words - 11 pages

Case study-Douglas L.History on admissionDouglas is a 75 - year - old who has a history of CVA with right hemipresis, Ischaemic heart disease with associated pulmonary oedema, hypertension, hypercholesterolaemia, DVT, reflux oesophagitis, cervical spondylosis and low back pain. Douglas was admitted to the high care facility for permanent care in June 2005 after his wife found it too difficult to care for him at home. Douglas has bowel and uninary incontenience and minimal verbal communication with especially unreliable responses to yes / no questions.SocialDouglas married his wife Gloria 50 years ago when Gloria was a student nurse working in hospital. She did not work and stayed at home to look after the family after they married. They have two adult sons, Brett (45) and Warren (43). They both have their own families and live at the fringe of the Brisbane metropolitan area. Gloria developed Breast Cancer 20 years ago and responded well to surgery. Douglas, a retired small business owner, looked after Gloria for many years before his stroke. Since Douglas was in high care at the nursing home, Gloria came 4 times a week to join in on centre activities with him: bingos, concerts, mini-athletics, BBQ and half-day outings etc. One to two times a week, Gloria pushed Douglas on a wheelchair out to the local sport clubs for lunch and would be back after the afternoon tea. Douglas even took overnight leave at home with his wife during weekends when his pain on the neck was under control. Life was not perfect but the couple adapted well with their respective medical conditions. Unfortunately, Gloria died of a heart attack in September last year. Their sons, Brett and Warren, can only take turns to come and visit Douglas on Saturdays.PhysicalDouglas is 5'8" tall and weighs 53.8 kgs (down from 66 kgs three years ago). He has dense right hemiplegia and has failed at rehabilitation due to his endured chronic pain in his neck and a heart condition. Doug smokes and drinks a lot more since his wife died. He also has poor appetite and a poor dietary intake. A soft diet and thickened fluid was suggested by speech pathologist after several episodes of choking and constant coughing at meal time. However, Doug strongly refused the diet alternations and continued to consume a normal diet. Doug gets weaker and weaker and is confined to a wheelchair when not in bed. A hoist is used for all mobility and ADL's.The DepressionAfter Gloria's funeral, Douglas is very depressed and rarely leaves the centre. He asked Brett to disconnect his Foxtel T.V. and instead use the money to buy him alcohol and cigarettes. Furthermore, a couple of residents, who were friends to Douglas, died at the beginning of 2008. Douglas' mood appears to have hit the lowest point. He doesn't join the diversional therapists' programs anymore but smokes and binge drinks in courtyard. The doctor has had to increase his antidepressant (Celapram) from 10 mgs to 20 mgs and a sleeper (Temaze) from one to two...

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