Posted: September 2nd, 2015

ageing and chronic disease.

Audrey Williams is an 89 year old lady with a history of Diabetes Mellitus Type 2, obesity, and Peripheral Vascular Disease (PVD). Audrey lives in her own home with community nursing services who assist her with meals, blood sugar monitoring, medications and showers as she has chronic pain in her legs from the peripheral vascular disease causing decreased mobility. Recently Audrey has become increasingly debilitated and severely depressed and her family want to move her into a nursing home. However, Audrey is adamant she wants to stay in her own home. She has been asking her GP to increase her opioid medication and pleading with her doctor to ‘please just knock me off’. Audrey is already on maximum pharmacological therapy and her GP is reluctant to add further medications. Both Audrey and her family are becoming increasingly distressed.

Audrey’s family are concerned for her safety and are unable to offer the necessary ongoing support so she is able to stay at home. They decide to move Audrey to a nursing home. In the home Audrey’s physical and mental health rapidly deteriorates. She becomes withdrawn and refuses to eat or take any medications resulting in increased pain, distress and malnutrition.

*Briefly discuss what assessments are necessary to enable Audrey to be admitted to a nursing home. Who does the assessments? What ongoing assessments are necessary to be conducted by the registered nurse in the aged care facility?
*Briefly discuss the loss and grief issues Audrey might encounter in moving to the nursing home. Identify and justify which model of care would be most useful to support Audrey to come to terms with her very changed life circumstances and help to improve her quality of life.
*Briefly outline issues Audrey’s family might face in this situation, what is the role of the aged care nurse in relation to Audrey’s family?
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