Posted: August 26th, 2016
Case Study 1 Mrs. Martinez is an 83yearold Mexican American widow who lives in her own home and is cared for by her adult daughter. Mrs. Martinez owns the home, and her daughter lives with her and provides the care. Her daughter brought her mother to the clinic today to ask to speak to the social worker. She requests that her mother be placed in a nursing home. The daughter states that her mother has nothing to do during the day. The television is on The Weather Channel most of the day because Mrs. Martinez has limited English capability and is unable to read closedcaptioning. Mrs. Martinez also has two sons who do not live in the local area, but they do call regularly and check in with their mother and sister. The two sons are opposed to moving their mother to a nursing home because they had promised her that they would “never put her away.” ============================================================================================================ Case Study 2 Mr. Williams, a 79yearold African American widower, resides in a foster care home. He has lived there for 4 years since his wife died. He is a former minister. His medical history includes longterm diabetes, high blood pressure, and benign prostatic hypertrophy. The home care provider has requested a home visit to evaluate Mr. Williams’s ability to remain in the home. The provider states that because Mr. Williams’s vision is seriously compromised (he is nearly blind), and because he has been unable to get to the toilet as quickly as necessary (he is very unsteady on his feet), his care is becoming burdensome. According to the home care provider, for safety reasons, Mr. Williams may not fit the criteria for remaining in the foster care home. ============================================================================================================ Case Study 3 Mrs. Randall is a 77yearold female who resides in a longterm care facility. She has a history of frequent falls and is severely cognitively impaired. The nursing staff at the longterm care facility called the nurse practitioner at the medical home office to report the recent development of productive cough and high fever. There have been cases of flu in the facility; however, Mrs. Randall has had a flu shot. The nurse practitioner in the office requests a chest xray in the longterm care facility. The nurse on duty in the facility states that there is no portable chest xray equipment available. She further requests that Mrs. Randall be transferred to the emergency room of the local hospital. Mrs. Randall’s daughter has durable power of attorney for health care decisions for her mother. The longterm care facility has notified the daughter of the change in her mother’s condition. The daughter says whatever the nursing home wants is fine with her. ============================================================================================================ To prepare: Research models of interdisciplinary geriatric care teams that are used at various sites, such as assisted living, home care, hospitals, longterm care, and rehabilitation facilities. Consider the model used for the interdisciplinary geriatric care teams at your current practicum site. Compare this model to models used at other sites. Reflect on how the role of the advanced practice nurse differs according to the site of care. SELECT ONE of the three case studies. Consider how care should be facilitated for the patient in the case you selected based on the model used for the interdisciplinary geriatric care teams at your practicum site
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