Personal Narrative: One-Time Wellness Checks

Mrs Gale is a 70 year old widow and retired unskilled worker. The patient lives alone and relies on her son to provide basic care,

Pt is a 84 year old Cascasion female living with her husband in their home. Husband reported the Pts Alzhemers has be pergresing for the last 8-9 years. Pt had open heart surgery in 2012, which contributed to the memory loss decline and increasing level of Alzhemer symtoms, husband verbalized. Husband reports they have been married for 19 years. Pt has a sister living Florda, two daughters living in Texas and Wyoming and one son in New York. The children stay in contact with them every other day. Pt reports she worked as a RN at the VA Hospital in New Mexico. Pt is not independent in the home without the husbands assistance. Pt does ambulate well in the home, but does have a walker in needed. Husband assists the Pt all her ADL's in the home and drives her to the store and for MD appointments. Husband currently suffers from Hemochromatosis (too much iron in one's body). Husband reports he manages well with his illness while taking care of Pt at the sametime. Husband reports the Pt's Alzehmers level appears to be stable at this time, but is quite forgetful at times and needs his assistance. Husband said they are managing

Kathy has a weight bearing restriction in place, is currently utilizing a wheelchair for mobility, and is a hands on one person assist with transfers. Judy shares that the previous day Kathy and the physical therapist worked with Joe and herself on transfers into and from the car so they can take her to her scheduled appointment with the orthopedic doctor on Friday. Judy shares that it is expected that the doctor will modify the weight restriction at the appointment. Judy and SSA spoke about a time frame for discharge. Judy shares there is no time frame established. Per Judy, Kathy’s private insurance only has twenty days of physical therapy remaining in the plan and does not know what happens at the end of the twenty days if Kathy needs additional therapy. She has plans to contact Humana later this day to discuss Kathy’s insurance benefits. We discussed that Kathy believes she has an UTI and that a sample of her urine was taken before lunch for testing. We discussed that Kathy is satisfied with the Care Springs facility, the food served, and nurses assigned to work with her. During the visit, Kathy asked about Wildey staff and of all who was aware of her injury. We discussed her

The patient is very independent in his home and is able to perform all ADLS within the home without any addtional assistance. MSW asked patient if he was interested in any addtional care giving support in the home, but patient declined addtional support at this time. Patinet stated he gets transportation from his neiabors to the store when needed. MSW offered the patient additional transportation services, but the patient declined needing any addtional transportation services at this time.Patient reported falling back in 2004 off the steps and was air lifted to the hospital. Patient reports having diffculty paying doctors and helicoter bills. Patinet's only income is through SS for $847. Patient reported that was the only time he was fallen in his life. Patinet has only been in the hospital two times during his lifetime. MSW offered life alert services, but the patient was not interested. Patient stated his only concern was being able to afford his doctor and helicotor transportion bills. MSW connected AHCCCS and spoke to represtative regarding getting patient signed up for the medicare savings program. Representative stated the patient has already applied for AHCCCS back in

“Liz”, the helpee, is a 30-year-old female. “Liz” is a full-time live-in caregiver and advocate to 2 elderly relatives, ages 89 and 83, both with multiple health issues. “Liz” is responsible for managing household finances, needs of 2 family dogs, household chores, all doctor’s appointments and medication management for both of her grandparents. “Liz” has been in this position of responsibility for 3 years.

Ms. Drake has been diagnosed with morbid obesity and has difficulty caring for herself. The victim could do more but chooses not to and doesnt suffer from any mental imcapacities. On 10/07/15 the victim was discharged from Winston Medical Center and became angry. Ms. Winston wants to remain admitted to receive care from the hospital but refuses recommendations that have been made for nursing home care. The victim has wheelchair and wheel chair ramp accessibility at her home and her daughter also assists in making sure her basic needs are met. Ms. Drake is non compliant with the care she needs at this time. It is the hospital's professional opinion that the victim does not live alone and chose nursing home placement to help with her ADLs.

Pa's informal support is providing assistance during non-aide hours. Pa also continues to receive ERS from Medscope, which he uses in the event of an emergency. SC will continue to see Pa based on the agreed upon contact plan of home visits every three months, calls every month and annual reassessments. Base on the H.V. Pa is requesting stair ride a service increase to ensure his health and safety. Pa had reported 3 falls in the last three months and complained about the difficulty climbing stairs unsteady gait, severe pain, SOB, and generalized weakness. Nevertheless Pa's is satisfied his services. SC reviewed backup plan with Pa and Missy, and Stepdaughter (Natalya) or spouse Missy, will assist if PAS is not available. Pa denied any changes to backup plan this time and Pa denied having to use backup plan. SC provided and reviewed the "Who do I contact if. . ." form with Pa. There is no duplication of services. Waiver continues to be the payer of last resort. Pa remains NFCE Waiver appropriate. Note documented on 1/12/16 8:53-9:08

The patient is a 95-year-old female who presents to the ED accompanied by her nursing aide. The patient fell from an upright position at home while walking. She sustained an injury to her right elbow and claims that she did not lose consciousness. The patient's medical history is significant in that she is hard of hearing and she is legally blind I believe that she has had a retinal detachment in the past. The home health aide relates that the patient does not have any family members and is under a state agent whose name is Karen Sesto. Karen Sesto was contacted and she gave additional history stating the patient has been refusing 24/7 live-in help. She does not let people in the house, throws them out of the house, she finally agreed

Sw called pt to discuss the status of the home health request. Pt informed sw that he has an appt with Dr. Gabler on Monday, and will discuss the request. Pt says that he has been paying a friend to transport him to medical appointments. He will continue doing so until he is able to utilize the friends services as his provider with Medicaid. Pt did not list additional needs but states that he will contact sw if needs

07/30/15: Anita came into the office for our scheduled visit today. I checked in with Anita to how her vacation went and how she’s been feeling. Anita stated her vacation went well and that she did lots of walking while she was away. Since returning home Anita has been implementing small periods of physical activity into her daily routine; she stated that it makes her body feel much better. I encouraged her keep up the good work and to continue working towards her IFPA goal. I followed up with her to see if she received the results of her glucose test; she stated that she had received the results and that her glucose levels were within normal range. Anita has been apprehensive about her primary care physician and she wanted assistance contacting

My experience of getting a screening done made me nervous. I wasn’t quite sure what to expect. She started off with asking a few questions with my background history and if I was taking any medication. She first had me read a paragraph, second checking the strength of my tongue, and TA, TA, TAS. I started to get more comfortable about the testing. I really enjoyed how the examiner interacted. She explained what she was doing while going through the testing producers. When she started my hearing testing my right ear ended up being better than my left. I missed the 2,000 frequencies’ on my left ear. I asked her if getting tubes in my ear when I was younger a problem she said “no”. She said the only thing it would have affected is my speech

During the home health observation day, there were several opportunities to observe a variety of patients with varying levels of functioning ability, different illnesses, and different needs and levels of interaction with the nurse. The first patient seen was a seventy-three year old Caucasian female with an ulcer on her right heel. Several weeks prior, she had scratched her left leg and she also had several small wounds on her left leg. The orders were to clean and redress the ulcer. She has a history of end stage renal disease, pneumonia, weakness, diabetes, dialysis, and right hip fracture. Upon entering the home, the patient was found to be sitting in a wheel chair in the living room watching television with her husband close by her side. She greeted the nurse with a smile and began to update her on her current condition. Her heel was “hurting” and she rated her pain an 8 on a scale of 1 to 10. She also had some “swelling” that she could not “get to go away; because, she could not get up and walk. They need to fix my foot so that I can get up and get around.” She told the nurse that she had been to see the doctor “yesterday” and the doctor had given her a written order that she wanted her to see. The order was written for an evaluation for a soft pressure shoe fitting. The nurse read the order to

SC asked William is his health being moniitor William said yes. He noted the nurse checkes his medication and make sure he goes to the doctor. Willaim noted he has not be sick PROGRESS MADE ON OUTCOME because willaim has his health montoir. Supervised Living

I faced a dreaded medical test a few weeks back that required a week of waiting, the procedure and then awaiting results that could either mean clean bill of health or breast cancer. I knew that the chances that it wasn't breast cancer were good, as I'd had a breast reduction a few years back and the mass could be scar tissue. However, I was nervous for good reason. I had 7 days to worry about the needle biopsy. I relyed on consistant diffusing to keep me calm while dealing with my children, one with special needs, that was also going through a tough time, adjusting to change with summer break starting. I diffused Peace and Calming II and wore Stress Away all day long. On the day of the procedure, I became very nervous for the uncomfortableness

He is in his early 90’s, has multiple medical comorbidities, attends group exercise classes 3 times a week, very strong personality, fiercely independent, retired lawyer, now dependent on a 4-wheel walker due to multiple loss of balance(lately), and had to give up his dog (3 weeks ago) to the care of his caregiver since he was at risk of falling. According to the resident service director of ILF, patient was asked to use the walker inside the apartment which he refused to adhere to, he was told by his neurologist and his daughter to quit driving due to his neuropathy and other medical conditions, which he flat out refused to do so. He reacted very strongly by refusing to go back to the neurologist and is not on speaking terms with his daughter. He claims that he fired his neurologist since they didn’t seem to agree on anything. During the screening process, patient scored really poorly with the TUG test and the 30 sec chair rise test indicating a high fall risk category and poor bilateral lower extremity muscle performance skills sets. Physical therapist asked him about his medication management and he mentioned that his anti- depression pills were not effective at all.PT found patient crying out every time he mentioned his wife and stated that he missed his wife very much. Pt was having