Question

History of present illness: Client sustained hip fracture and open reduction internal fixation of left hip approximately 2 weeks ago.Admitted now for rehabilitation.Concern may exist regarding current living arrangements. Findings: Patient currently lives with 50-year-old son, Mark Doyle, and has so for past 9 months. Up until that time,she lived and managed her own home--husband died approximately 2 years ago. Patient indicates living with son was his idea--She did not feel she should live alone at her age. She sold her home and although she has her own checking account,for the most part her son manages nearly all her finances.Living arrangement with son was acceptable to patient until about 4 months ago--Mark's"new girlfriend"Staci(patient states her age is about 34)and her 17-year-old son Trevor moved into the home .Since girlfriend has moved in,she feels Mark ignores her and her needs. States Mark has become increasingly controlling,does not allow her to do anything without his permission,and does not allow her to drive. Client also indicates she is some what afraid of Trevor--she denies he has hurt her,but suspects he has taken money from her .Client indicates she has attempted to talk to Mark about this situation,but he is not receptive to any criticism involving Staci. Client indicates she is not sure she wants to return to Mark's home,but does not feel she has many options at this point. Impression:Possible or potential l elder neglect. Plan: Plan meeting including me,Mark Doyle,Ms.Doyle,physician,and the nurse discharge coordinator to discuss post discharge needs and current or optional living arrangements.

1, Nursing diagnosis: Fear R/t --------

As evidence by---------

Goals: long term, short term

Nursing intervention

Rationale

Evaluations

Answer 1

Nursing diagnosis

Fear related to physical threat or loss of money

As evidenced by

Verbalisation of the patient that she has doubts that Trevor abducts her money

Goal - short term

To ensure that the patient is safe from physical threat or loss of money

Long term

To ensure a safe place for stay of the patient

Nursing interventions.

Ensuring her that her money is safe

Rationale- to reassure the patient

Family therapy with Trevor,wife and with the patient

Rationale- to build a good and string bond in family

Helping her to make a new bank account and transfer her money

Rationale- to ensure safety of patient

Educate her of the legal aspects

Rationale- to provide knowledge if she want to move legally

Evaluation

If the patient has relived from the fear related to physical threat or loss of money