Case: Part One

Mr. Lee is a 74 year old retired Taiwanese businessman, living alone with no home supports in a condo with elevator. He was referred to long term care by the Emergency social worker at the local hospital because of being seen in the ER for his 3rd visit in a month due to falling and injuring himself. Also, there are concerns about his ability to manage at home given his frailty and apparent malnutrition. With this last fall, he sustained a bruised hip. X-rays revealed no fracture. He was given a prescription of Tylenol #3 to be used as needed, and released back home just as in the previous two ER visits. ER notes indicate his next-of-kin, his son, is out of town and could not be contacted.

Upon review of the case, the long term care (LTC) assessor requests home care nursing to see him first to review his ability to manage medications and personal care, prior to a formal LTC assessment which cannot be scheduled earlier than 3 weeks from now. You, as the home care nurse, see him on a home visit 6 days after he was in the ER. The place appears clean and he has food in the fridge. He appears thin, somewhat unsteady on his feet, and ambulates slowly without aides. He is fluent in English, but has some latency of speech. He is concerned about the recent falls, but is resigned to this as being a sign of aging. Overall, he appears apathetic with very little emotional expression, and somewhat distracted by the noise of construction workers repairing his “leaky” condominium complex. He acknowledges not sleeping or eating well.