Question

Case Scenario:

The patient is a 72-year-old widowed Native American woman named Rose Smith.  Mrs.Smith lives alone near Traverse City.  Her son, daughter-in-law, daughter and their children all live outside of Michigan.  

Her income is $15,000 per year and her healthcare coverage is traditional Medicare (Parts A, B and D).  She does not have access to a car.   Mrs. Smith is diabetic and routinely receives care at the local health clinic.  For hospital care she must travel to Traverse City.

Mrs. Smith tripped in her home and broke her left hip.  A surgical repair was necessary and was performed at Munson Medical Center for surgery with a 7-day inpatient stay.  After Mrs. Smith’s inpatient stay, she was discharged to Munson Health and Rehabilitation for short-term rehabilitation stay of 14 days.  Upon discharge from Munson, in-home physical and occupational therapy was scheduled for a period of 2 months.  The discharge plan for Mrs. Smith anticipates that she will be able to be discharged from home care post evaluation.  After that date, it is anticipated that she will live independently and care for herself at home.

1. Please identify the main case issues/concerns of this case.

2. Recommendations regarding effective solutions/strategies to address identified issues/concerns.

Answer 1

The main case issue or concern which is identified here is lack of support after the home care evaluation. Generally in hip replacement surgery patient will be able to resume their normal but minimal activities after 3months.From 4-6 months it is essential for the patient to continue the physical therapy .This will be helpful to strengthen ,maintain balance and improve movement. The risk of fall is high during this time .Simple this patient will be in need of an assistive personnel or a care giver to help with daily activities .

2.The better way to tackle this to address this issue is arrangement of a support worker like personal support worker who can assist her to do her daily chores in home. This can reduce the workload of the patient in the home and enhance her daily activities without the risk of future fall.