Henry has some strengths. His significant advantage is that he seems to have been prepared for his retirement. He states in the case study that he and his wife have always been independent and when time to retire came, they chose to retire in a beautiful apartment. He also seems to be fulfilled having worked as an engineer for many years. He is proud of this accomplishment even after retiring.
Additionally, he has surrounded himself with people he can rely on in case of emergencies and to take care of his wife in case he is not around. Among these people include his neighbor who makes him to the hospital when he develops complications and his daughter in law who is a nurse and takes care of Ertha when Henry is at the hospital. Henry also has his insurance which shows that he has his health covered as far as cost is concerned. He has some vulnerabilities as well that could have a negative impact on his health. The first one is the fact that he is a smoker. He claims to have started it as a teenager and still does it even in his old age. As a result, he has developed some health complications, and he has to be taken to the emergency room.
Additionally, Henry also has other health complications such as high blood pressure and high cholesterol level. He even loses patience with his wife from time to time which is understandable. This is still a vulnerability, however.
My primary concerns for this patient is the fact that he has numerous health complications but has no one in his house to take care of him. Additionally, he is solely responsible for taking care of his wife and has nobody in his home he can rely on. Ertha forgets to turn off the stove, and this puts both their lives in danger. Henry needs another person in the house always to monitor his wife since due to his health conditions, he may not be able to.
Cause for Concern
Henry is an older adult who has newly been diagnosed with high blood and high cholesterol level. He is at a heightened risk of re-hospitalization given that he has no one to take care of him at home firmly. This means that he is likely to face poorly managed transitions from hospital to home or other cares settings as he describes in his monologue.
Hospital Discharge Screening Criteria
Henry meets some of the high-risk criteria that show that he needs effective transition planning as shown in by Bixby & Naylor (2010). These include:
- Depressive symptoms
- Four or more active co-existing health conditions
- He has an inadequate support system
- Low health literacy since he does not know what COPD means
- He has moderate to severe functionality deficits as he can barely catch his breath.
- Further Information Needed
- According to Bixby & Naylor (2010), additional information needed for the assessment include;
- News about Henry's age
- His medical history especially regarding his body's reaction to the therapeutic regimen.
- History of any cognitive impairment.
What Henry is Experiencing
Henry is experiencing an exacerbation of COPD also known as acute exacerbation of chronic bronchitis which can be characterized by the worsening of his COPD symptoms. Proof of this is when he has to be admitted to the emergency room after calling the doctor to report that he cannot catch his breath and he also states that he occasionally experiences anxiety
COPD therapies may go a long way in relieving Henry's condition. Evidence, however, suggests that these therapies alone may not be sufficient. Instead, pulmonary rehabilitation should be significantly considered in Henry's case. According to Fried, Fragoso & Rabow (2012), this will include "lower and upper extremity exercise training, physiotherapy techniques, education, and psychosocial support" Such a health care plan are bound to improve his condition especially in regards to his functionality.
Bixby, M. B., & Naylor, M. D. (2010). The transitional care model (TCM): hospital discharge screening criteria for high risk older adults. Medsurg Nursing, 19(1), 62-64.
Fried, T. R., Fragoso, C. A. V., & Rabow, M. W. (2012). Caring for the older person with the chronic obstructive pulmonary disease. JAMA, 308(12), 1254-1263.
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