Comprehensive Case Study: 73-Year-Old Female with Weakness and Family Dynamics
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This case presentation details a 73-year-old Filipino widow suffering from weakness, connected to her medication and underlying health conditions like hypertension and congestive heart failure. The analysis includes her physical examination results, family dynamics affecting caregiver burden, and the psychosocial environment impacting her health. Significant challenges arise from shifting family roles as younger members seek independence while elderly care needs increase. The case emphasizes caregiver fatigue and the importance of effective health-seeking behaviors within the framework of family support systems.
Comprehensive Case Study: 73-Year-Old Female with Weakness and Family Dynamics
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Presentation Transcript
CASE PRESENTATION BAUTISTA, BERNARDINO, PALARCA, RAMOS, ZABALLA
General Information • V.O. • 73 year old female • November 4, 1941 • Widowed • Filipino • Roman Catholic • Gawad Kalinga, Payatas
Physical Examination Musculoskeletal Exam and Reflexes: good muscle tone (5/5 on all extremities) Neurologic Examination: Cranial Nerves I, II: not assessed III: intact extraocular muscle IV, V, VI: not assessed VII: no facial asymmetry VIII: intact gross hearing IX, X, XI: not assessed XII: tongue midline Motor: 5/5 on all extremities Sensory: no sensory deficits
Initial Impression Hypotension probably secondary to Anti-Hypertensive Medication Overdose Congestive Heart Failure NYHA II Hypertension Stage II, controlled
ORDINARIO FAMILY February 21, 2014 73 5 44 42 22 23 12 10 7
Family with Adolescents • Young children are getting older and turning into more independent individuals
Issues • Shifting of parent-child relationships to permit adolescent to move in and out of the system • Identity, autonomy and sexuality issues • Refocus on midlife, marital, and career issues • Beginning shift towards concern for the older generation
In phase or out of phase? • Out of phase hence the family has higher risk for physical and emotional symptoms • Ate Corra and her husband Danilo who both are head of their household have very little time to focus on themselves • Instead are focused on taking care of the other members of their household • Note: Burden of taking care of the kids and the grandparents.
Developmental Challenges • Shifting of parent-child relationships • Be able to balance giving independence to adolescents at the same time acknowledge responsibility roles • Changes in the caregiver role of the family • The primary caregiver burden will be upon the parents
How it relates to the patient • Important to acknowledge caregiver fatigue • Note that prognosis of the patient’s disease and the degree of care needed by the patient • Expenditures in terms for her health care vs. the adolescents eventual need to go into college.
23 73 22 44 10 12 42 7
Family Intervention Tools Home Visits, Family Meetings and Episodic Consults
Pre Home Visit • Date of Visits: February 18,20,24 • Purpose of Visit: • Information gathering • Caregiving check and evaluation • Information gathering • More extensive evaluation • Why the patient needs a home visit? • Poor health seeking behaviour and health practices