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Case Study Holman Question & Answer Guide (With Explanation)

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Original Question

Case Study Mrs. Holman Normal or Abnormal? Mrs. Holman, age 84, is a regular at the senior center. On Fridays, nurses from ABC Home Health Agency visit the senior center to take blood pressures and chat with center members. Mrs. Holman has had her blood pressure taken many times but this time, she tells the nurses that she is dizzy lately. Upon further inquiry, this has led to her eat less and stay at home more than usual. Mrs. Holman tells the nurses that ‘it doesn’t matter’ as she is sure that this is just a temporary problem. Concerned, in addition to the blood pressure, Amy M., RN takes Mrs. Holman’s weight and discovers a noticeable 10% weight loss over the last 3 months and prompts Amy to ask more questions. Enquiring more, Mrs. H reports that she is no longer taking her cardiac medications and since her social security check does not last through the month and “I just don’t feel good”. Probing further, Amy determines that Mrs. H is probably a bit dehydrated and there is an audible wheeze. Concerned, she encourages Mrs. H to make an appointment with her doctor ‘just to be sure’ everything is fine. Reluctantly, Mrs. H agrees but states ‘there is nothing he (the doctor) can do for me. I am old and wearing out.’ Amy helps Mrs. H make an appointment and says she awaits her return to the senior center soon. Discussion Questions: 1. Identify normal age-related signs of aging. 2. Explain why weights can indicate decline in an older adult. 3. Identify social concerns raised in this case study. 4. What should Amy do next, if anything? Three weeks later, Mrs. Holman returns to the senior center. A bit frailer, she tells Amy that her ‘ticker’ is just not working like it used to. Weepy, she starts to cry and pours her emotions out to Amy and her few close friends. She tells her that she is on new and more expensive medications that are making her nauseous. In addition, there are no family members living close by. As a devout Catholic, she prays to find a solution to her decline but looks Amy squarely in the face and asks ‘am I going to die’? Shocked, Amy gathers her composure and they start to talk openly. Discussion Questions (cont’d): 5. What should Amy do in response to Mrs. Holman’s question? 6. Identify the physical, psychological, social and spiritual aspects of quality of life that may be distressing Mrs. Holman. 7. How does this scenario play into the need to palliative care?

 
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