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89 year old Female

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UTI

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blood vessels in the retina are damaged by high blood sugars

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Joints have decreased collagen as we get older

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decreased contractability of the bladder as you age

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-lives alone

-experienced trauma through residential school

-depressed

-Flat affect

-anxiety when leaving her building

-social isolation

-depression

-cognitive impairment

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-speaks cree

-seeks spiritual cultural care

-once a week attends an indigenous community centre (pt has social support with like individuals)

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-A X 1 with 4WW

-ROM & strength in right UE very limited

-LE general weakness (min-mod) bilaterally

-no stairs at home

-independent with aid of device

-needs homecare services

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-Daryl Plante (nephew), James (son), Connie (daughter)

-decreased sleeping (comfort levels at night compromised)

-attends native service center on Wednesdays

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-macular degeneration bilaterally

-hearing aid (right and left)

-HOH

-Uses a magnifying glass to assist with reading

-Decreased sensation LE bilaterally

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-lives alone

-2 living children with strained relationship (emotional loss)

-1 deceased child (grief)

-widowed for 10 years (no intimate connections)

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-pt has fear of going outside alone and getting lost

-pt able to call 911 if she identifies she is in trouble

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-dinner meals provided by facility

-elevator access

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-pleasant when communicating with others

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-nephew visits pt (emotional support, takes her to appointments)

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-bruising over extremities, scars to humerus and deltoid

-pt. has mobility issues

-pt. has age-related decline to muscle and bone strength

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-pt has difficulty recalling medication information (eg. right route, right time, right dose)

-pt has difficulty taking medications at right time

-pt has challenge with meds as she wishes she didn’t have to take them

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-pt taken to residential school at age 7

-experienced immense trauma

physical abuse

spiritual (spoke Cree until assimilated into English)

emotional (stripped of identity)

mental (pt doesn’t want to speak on trauma further—> painful)

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- pt sometime skips meals (not meeting daily nutritional standard for age)

-only lunch and supper meal are provided

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-pt lack of attendance to appointments (her nephew lives far away and is not always able to assist her on getting to appointments)

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aware of own cognitive state—>self awareness important as she lives alone and doesn’t have another reorienting her constantly

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isolation increases depressive state

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pt is able to share her grief and loss with others

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abuse

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missed health consultations —>prolongs positive health outcomes

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able to share experiences and build relationships

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not taking Heart medication

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medications affect all chronic conditions —-> timely and proper administration vital for maintenance of health

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damages nerves

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support from like-individuals aids in healing from past traumas and connecting back to roots

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being uncomfortable can create emotions of sad, mad, depressed

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due to old age, chronic conditions, living alone

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weakness in extremities

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decreased nutrition= low blood sugar levels

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strained relationship with kids ——> finds outside support through nephew and community

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has someone to talk to

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pts. health changes can be caught earlier with proper medical follow-ups

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no worries of food security while living alone

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able to be taken anywhere with the help of transportation

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able to leave home safely for visits to indigenous center

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decrease risk of falls through facility support

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Continuous follow up with eye changes can lead to fewer falls

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monitor and manage blood glucose levels 

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monitor and manage blood glucose levels 

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vascular resistance

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continue consultations with PT & OT to improve mobility through appropriate ROM exercises  

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continue consultations with PT & OT to improve mobility through appropriate ROM exercises  

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increased blood sugar levels

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debrief with pt on spiritual and cultural experiences at community 

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debrief with pt on spiritual and cultural experiences at community 

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family share same spirituality beliefs

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recall past experiences to maintain spirtutal practices

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due to old age

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Proper nutrition decreases high sugar levels, decreasing a negative fluctuation in other dx.