Personal Aging

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Case Management
Lisa Reinback
Facilitator: Jean sherri
NUR 370: Gerontology
January 13, 2013
Case Management
A 75 year old male Hispanic male with history of chronic obstructive pulmonary disease (COPD), hypertension, glaucoma, motor vehicle accident (MVA) 5yrs ago that resulted in a chronic lumber spine pain was recently discharged from the hospital for COPD exacerbation. COPD is the fourth leading cause of death in both men and women, and it is steadily on the rise (Touhy & Jett,2010). He was sent home on home oxygen and a prescription for a sleep study test for a suspicion of sleep apnea. He recently moved to Illinois to be closer to his daughter who lives 50miles away. Due to his recent move to Illinois, he currently has no insurance and no financial means of paying out of pocket. He currently lives alone in a senior apartment building, his wife moved back to Mexico 3 years ago to be with their son who is mentally challenged and in his 20’s. He is unemployed and on a subsidy income from the government and food stamp. He feels like a burden to his family and he does not want to ask his daughter for assistance. He use to go to Catholic church every Sunday, until recently, he lost faith in God due to his increased depression. He felt like God has abandoned him. He non compliant with his medical health and smokes 1 pack of cigarette per day. His glaucoma has taken a turn for the worse and studies have shown that even when treated, glaucoma can cause blindness (NEI, 2011). His personal hygiene is poor, he does not know how to cook so he prefers fast food restaurants. Due to his financial woes, he has no means of going to and from his doctor’s appointment. The Nueman’s system model helps nurses identify a client as a unique individual with his or her own goals and coping abilities (Neuman & Fawcett, 2011). Using the Nueman’s model, the core line is his history of hypertension, MVA, COPD, sleep apnea and depression. He is 70 years of age, Hispanic male and unemployed (Neuman & Fawcett, 2011). The flexible line of defense is ; he currently lives alone, he eats unhealthy food, his daughter lives 50 miles away and he is non compliant with his medical care (Neuman & Fawcett, 2011). The normal line of defense is; he currently has no insurance since he moved out of state, lumbar pain due to his MVA and he has no retirement benefit to look forward to (Neuman & Fawcett, 2011). His line of resistance is; pain management, family support, case management, social service, physical therapy and spiritual counseling (Neuman & Fawcett, 2011). The Neuman’s system model environmental stressors is classified as intrapersonal which occurs within the boundary of the client. Interpersonal which are external environmental forces that occurs outside the client and extrapersonal which are external to the clients' boundaries (Wills& McEwen, 2011). Stressors are external stimulus that causes stress to an individual. The concepts of the client’s variables which are physiological, psychological, sociocultural, developmental and spiritual are generally understood be nurses and other health care providers. According to the Neuman’s model, the clients physiological interpersonal variable is identified as; a 70 year old Mexican male, a husband and a father and unable to ask his daughter for assistance, he feels like a burden to his family. The physiological interpersonal variable is identified as, no one to care for him after he is discharged from the hospital, he fears he might go on disability. The physiological extrapersonal variable is; He will need financial assistance because he is unemployed, he will need physical therapy at home, he will need assistance with transportation to his doctor’s appointment. The client’s sociocultural interpersonal variable is; He believes that according to his culture, he is suppose to be the bread winner of the family. The sociocultural interpersonal is, He will need additional support...
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