-symptoms; acute compensated heart failure (shortness of breath), chronic (fatigue, anorexia, peripheral edema), reduction of cardiac output (fatigue, weakness)

-Main cause is ischemic heart disease

-Age also impacts CHF

-Two medications that help with CHF are Lasix and Enalapril (ace inhibitors and diuretics)

-CHF makes patient loose autonomy, harder to exercice, mobility issues, self-care difficulties, affects social life

• chronic bone disease that has no common symptoms until first fracture

• Low bone mass and disrupted architecture of bones

• Compromises bone strength

• Risk increases with age because of the progressive loss of bone mass that was builded

• Increases risk of fall and fracture because bones are weaker

• Women are more at risk than men due to decline of level of oestrogen which is an hormone slow the natural breakdown of bones

• People may lose mobility as the result of weaker bones

• Loos of ability to perform ADLs (dress, cook, bath)

• Fractures as results of osteoporosis can lead to pain, fear and restrain to activities that they might have enjoyed in the past

• is an exaggeration of the spine’s curvature

• Can occur after a trauma, tumor, or chronic diseases as tuberculosis

• Linked to apex pain

• Can moderately or chronically impact mobility depending on the type and stage of the disease

• Type 1 the deformity is more diffused whereas at stage 2 there is one column impairment and stage 3 both columns are lost

• Can lead to decrease in function such as reduced walking speed, impaired balance

• Can also increase the risk of injury and fall because vision field is reduced

• As the condition worsens, it can lead to graded increase in difficulty in physical function

• Kidney injury

• Fluid & electrolyte loss —> cardiac arrhythmias

• Allergic reactions

• Hearing loss

• Potassium loss

• With zoledronic acid, depletes calcium

It results in high urine output which can result in incontinence or falls as she hurries to the bathroom. If she takes them too late in the day it can result in her needing to pee at night putting her at risk for falls as well as sleep disturbances.

She is taking Enalapril which include side effects such as

• dizziness

• Fatigue

• Headache

These side effects also put her at risk for falls especially considering her alcohol consumption.

She is taking calcium & vitamin D

• it is important that they be taken together as vitamin D promotes calcium absorption

• They should also be taken in the morning as vitamin D is synthesized in the skin by exposure to sunlight

She is taking zoledronic acid, the side effects include:

• hypotension

• Constipation, diarrhea, nausea, abdominal pain

• Dizziness, drowsiness, anxiety, confusion, insomnia

• Muscle pain

• Skin lesions

It is stated that it’s important that she drinks lots of water before her dose but she is on fluid restriction.

Uniqueness of the person

Person & Environment are integral

-exercices can be done to prevent falls: gait and balance, strength exercices, aerobic, flexibility

-assistive devices: canes, higher toilet seats, bars

-risk factors: old age, alcohol use, cognitive impairment, vision

-complications of falls: bruises, hip and femur fractures

-alcohol use can affect gait, balance and cognition

• People with CHF are unable to function independently.

• Fatigue and shortness of breath is seen in those patients.

• They also have difficulty with self-care and have reduced ability in participating in social events.

• This can decrease their self-confidence and plays a role in the decline of their mental health.

Comorbidities:

Lead to isolation --> negatively impacts mental health

For individuals with

• chronic illnesses

• disabilities

• functional limitations

Types

• Nursing Homes:

  • Offer 24/7 nursing care

  • Support for activities of ADLs

  • Medical supervision

• Assisted Living Facilities:

  • Personal care

  • Support with ADLs

  • Residential environment (less medical care than nursing homes)

• Continuing Care Retirement Communities (CCRCs):

  • Continuum of care levels (independent living, assisted living, and skilled nursing).

Activities

• Social, recreational, and therapeutic activities to promote residents’ mental and emotional well-being.

• Exercise classes, arts and crafts, games, and social events to encourage engagement and community.

• Put mount grab bars near toilets, near the front door, and on both the inside and outside of tub shower to provide balance

• Carpet on on all surfaces that may get wet

• Use of non-slip mats and rugs

• Use of light night that turns on automatically in the dark

• Keep walkways and corridors clear and well lit

• Wear sensible shoes ( properly fitting, sturdy, flat shoes with nonskid soles) and avoid floppy slippers

• Her house is a familiar setting that offers comfort and reduces anxiety

It also reduces the risk of depression

• It reminders her of memories that she cherishes, which makes her feel more emotionally stable

Staying in her home can also

• Allow her to maintain her independence and make choices

• Preserves her established routines

  
  

  Both of which will help boost her self-esteem and give her a sense of control

  
  

• Keep her close to friends, neighbors and family which can reduce her feeling of loneliness

• Moving to a senior residence can cause stress and anxiety