Nursing Case Study

Scenario: Hello, I am Isabella. I am 72 years old and a recent widow after the death of my husband Ben, 6 months ago. I have to tell you, things have not been easy for me in this life. But I have always believed you have to take care of yourself. Even when times get rough, I do as much as I can. I might be a little unorganized sometimes so don’t ask me what day it is!

Back when Ben got really sick, we decided it was best for me to stop working so I could take care of him. I loved my job at Sears. I had worked there more than 20 years, ever since Sandra my daughter was in high school. I loved being with people and helping them find just exactly what they were looking for.

At first, Ben could still do things for himself. He had his little daily routine of things to do. He would get up and read the paper, walk down to the little breakfast diner to have some coffee and talk to all his friends there. In the afternoon we would go to doctor’s appointments and do the shopping and other errands. He was still real handy around the house. As time went on, Ben got a little sicker everyday, to the point where in the last year I was doing everything for him. I have to tell you, I was getting so tired and run down, never being able to sleep the night through or have a restful meal.

Our daughter Sandra, as busy as she was with her own life—it being a mess and all—would still try to help out as much as she could. Usually, she would come over with a meal once a week, and stay with her Daddy while I went to mass or had a cup of tea with a friend. Her daughters would come and read stories to their “pa-pop” and sit near him. The smile on his face during those visits made the whole day better.

Ben’s medications and equipment were really, really expensive. Now, since he worked for the Railroad he had a pretty good pension and health benefits in retirement, but they would not cover the cost of everything, even after he got Medicare when he retired. Pretty soon we were nearly completely out of money. Outside of the house, we owned an old car.

One day, one of the neighbors told me about a program which was helping one of her sisters in another state, PACE. She said they did wonderful things for both the patient and wife. Well, I asked Sandra about it, and she looked on the computer at the library and found out that PACE had a program here, Total Longterm Care. Well, Ben called TLC and someone came out to the house to talk with us about it. We filled out the form to see if we were eligible, and we were! Everyone there was so helpful!

They told us that TLC would take care of Ben’s medication and equipment, his doctors would even give him a place to go visit and spend a few hours when he wanted. To top it off, they would come pick him up for visits or doctor’s appointments and bring him home. The social worker, Cindy, also told me that they would send someone to help clean up the house a little and take care of some of his needs on days he was at home. They helped out so much let me tell you!

But now I’m back to watching every penny since Ben’s death. Just my arthritis medication is over a hundred dollars a month. I try to stay with the pills. But if I bought them all like the doctor says, I’d be broke. So I break them in half or skip a day here and there to help stretch them out. Sandra has told me I should get Part D insurance for my medications, but it is just too confusing and overwhelming to me.

See, since my Ben died, Sandra has been helping me. I never even wrote a check before because Ben always did that. But now that he is gone, there just isn’t enough money for food and medicine and taxes and everything. I think Sandra is stealing from me though because I think I should have enough money. But since I don’t know much about the bank account, I can’t argue much and have to do what she says.

Sandra and the girls moved in just last week. But now I think Sandra is stealing from me. She came home from shopping or work or something, I don’t remember for sure right now. Well it must have been shopping because she was going to get her shopping bags out of the trunk. I came to the door to see what she was doing. I noticed the mail was in the box by the front door. I opened one bill and it said over $100 was due! How could it be $100? She must not be paying the bills. So when she was buying more stuff but not paying my bills, I just had to tell her off.

See, she keeps telling me lies. I just can’t take it anymore. She is just getting too big for her britches I tell you because she told me if I didn’t like it I could leave. Right then and there I told her she needed a good spanking. Oh the neighbors heard it alright. And they called the police for me too. They know. I bet one of their children is stealing from them too. But Sandra got to talk to the police first. And get this, they arrested me! How humiliating!

I spent the night in jail. I was so mad and scared. My sister, Rosella, came and got me from jail —which was Sandra’s fault in the first place—and then Sandra made it so I couldn’t go into my own house! That was the last straw. I fainted and was taken to the emergency room. They said I had a panic attack this morning. Somebody from social services came while I was at the jail, but I said I’d rather live with my sister than to go with them. Now my sister’s husband won’t let me stay there. The only thing I could think to do was call Cindy, the woman at TLC who was so helpful with Ben. She is going to meet with me and Sandra at the house this afternoon.

Instructions:

1. Read the scenario above, and then answer the following questions:
   1. What problems are specifically Sandra as far as her caregiving role?
   2. What describes the health prevention/promotion interventions that Sandra needs to consider for her mother?
   3. What specific assessments should Sandra consider that she can find on Hartford Institute for Geriatric Nursing (name and describe at least six)
   4. Should Sandra try to make any adjustments to repair her relationship with her mother? How will this help to fulfill her role as a caretaker for her mother?
2. Your paper should be:
   • One (1) page or more.
   • Use factual information from the textbook and/or appropriate articles and websites.
   • Cite your sources – type references according to the APA Style Guide