Psychiatric Disorders Case Study

The worker met with Mrs. Marilyn Beaird on 8/18/15. She is bed and wheelchair bound and requires two assists when transported. Mrs. Beaird has diagnoses of Vascular Dementia and is unable to answer questions

“The medical necessity criteria for coverage have not been met in this case. As a result, we are unable to

Mrs Gale is a 70 year old widow and retired unskilled worker. The patient lives alone and relies on her son to provide basic care,

Member experienced moderate pain due Dx. Osteoarthritis, have an unsteady gait, experiences dizziness (new medication Flomax 0.4 milligram) and is a risk of falling (score 11). He needs assistance of daily living. Goes to bathroom frequently due to Enlarged prostate.

Introduction: Jessie Buchanan, an 80-year old female, was admitted to Bethany Care Society in room 3088-1 at the center unit. She is an extensive assist, requires 1 staff assistance and uses the transfer belt to transfer from bed to her wheelchair. She was admitted here because none of her family members can look after her because they are all busy with their own personal life. Jessie prefers to stay at Bethany because she receives full-time care from the health care providers. Jessie had a history of edema on her right ankle because she was experiencing hyponatremia. Currently, she is on fluid restriction and every morning I would put her compression stockings to prevent the occurrence of edema. Her condition worsens when she was diagnosed with osteoarthritis(OA), delirium, depression, type 2 diabetes mellitus, schizophrenia, hypertension, and urinary tract infections. Her recent urine culture shows that she is positive for urine nitrite and urine leukocyte which caused the UTI. Jessie is incontinent and she wears an indwelling catheter. Jessie said that sometimes her knees are painful. She takes an analgesic to relieve the pain that she feels. Jessie 's blood sugar level is within the range. She is not taking insulin or any oral medications like metformin because she knows how to control it, by following the proper diet. Jessie always have a good sleep and never complains about her sleeping pattern. She is taking medications for GERD, iron supplement, bone health,

Simon is a 47 y/o male that was admitted to RGSC on July 22, 2010. Simon is verbal and his primary language is Spanish; he is able to communicate his needs and wants verbally. He is able to perform daily activities independently; however he needs prompting and supervision for completion of task. Simon does not have any mobility conditions and is able to ambulate without difficulty. He did not sustain any falls within the past 11 months; His last documented fall was on 1/21/15 which was presumed to be due to over sedation caused by medications.

Medical Diagnosis: Client was diagnosed with a fractured right tibia bone, and fractured right radial bone. Client has diabetes mellitus type one. Client has history of hypertension and was admitted with chest pain following accident. The client fell off her bicycle while walking her dog.

no problems with mobility noted, patient ambulates w/o assistance, ROM of joints intact, patient pt able to rotate feet,

Patient denies smoking and alcohol use. She is disabled and lives at home with her husband.

Psychosocial: Ms. W is a 67 year old female patient who was admitted into the palliative homecare program after a recent stroke. She lives with her daughter who is the primary care giver and is often daily visited by her son, who acts as her secondary care giver. Her daughter’s family also lives with her, whom consists of her son in law, two young grandchildren and a toddler. Ms. W requires full assistance with ADLs which her daughter attends to. However she was previously fully independent with ADLs prior to stroke.

Demographics: Patient is a 32-year-old, moderately built Caucasian female; separated once with 2 children. She lives with her children in her mother’s town house in the North-eastern part of the province. She is currently unemployed and receiving disability from the state from sustained back injury. She has Medicaid insurance; speaks English and practices the Baptist religion.

The clinical theme identified for my review of Dr. Toto's work is on geriatrics and gerontology. Its primary focus is on several issues such as prevention of falls through modification of areas of residence, development of exercise programs for improvement of physical activity and many other sensitive areas in the field to improve the well-being of the elderly. The theme also advocates for early identification and early screening in order minimize disabilities common in community-dwelling adults (Toto, Raina, Holm, Schlenk, & Rogers, 2011)

Jones is a 64 year old well nourished man with a history of long-standing non-insulin dependent diabetes mellitus (NIDDM). He had an open heart -surgery bypass graft 7 weeks ago. The graft site got infected and had to undergo an emergency surgery to improve circulation to his left lower limb. Mr. Jones is relieved that his leg was saved and he is now being prepared for discharge. He wants to regain his strength so that he can start doing the things he loves. Currently Mr. Jones needs moderate assistance depending on his level of pain or fatigue and ambulates with a walker. Mr. Jones still needs help with activities of daily living. He has urinary and bowel control problems as side effects from multiple antibiotics. Mr. Jones is married and has 4 grown children that provide him with love, care, and support. The nursing staff is teaching Mrs. Jones how to perform sterile wound care for her husband as he will need dressing changes three times a day, blood glucose monitoring and a healthy diet. Social service is helping to keep communication channels open between Mr. Jones, his family and the nursing staff to maintain psychological and emotional health.

Average number of fall was 4.3 per month according to NCH’s statistical records. Compared to 1,500 senior residents in Florida who were injured from a fall 2008 and 41,464 Florida residents who were hospitalized from fall related injuries, females accounted for 51% of fall related deaths and 73% of fall related hospitalizations (Florida Injury Facts, 2010). In 2008, the number one leading cause of death in those 65+ was falls, with approximately 1,511 that year (DOH (2), 2008).

S.P. is admitted to the orthopedic ward. She has fallen at home and she has sustained an intracapsular fracture of the hip at the femoral neck. The following history is obtained from her: She is a 75-year-old widow with three children living nearby. Her father died of cancer at age 62; mother died of heart failure at age 79. Her height is 5’3 and weighs 118 pounds. She has a 50 pack year smoking history and denies alcohol use. She has severe Rheumatoid Arthritis (RA) and had an upper GI bleed in 1993 and had Coronary Artery Disease with CABG 9 months ago. Since that time, she has engaged in “very mild exercise at home.” Vital signs are 128/60, 98, 14, 99 degree farenheight (32.7 degrees C) SAO2 94%