Case Study 1

Anna Giannopoulos, age 85 years of age, lives alone in the family home. Her Husband, Kostas was admitted into Care Shore Aged Care Facility, two weeks before his 87th birthday. They have been married for 60 years and have never spent long periods of time away from each other. Anna enjoyed working in their vegetable and flower garden together. This is where Anna and Kostas spent their time talking fondly about their life, children and grandchildren. Anna prided herself on her cooking skills, especially when Kostas brought in fresh vegetables from their garden. After dinner, Anna and Kostas would spend the evening, having a cup of tea whilst they watched a movie.

Anna has stopped shopping and cooking due to her worsening arthritis. She finds it difficult without Kostas as she speaks very little English. Kostas have always driven Anna to the local fresh produce market, where Anna loved wondering around the markets, chatting with people and picking her ingredients. Anna has always loved cooking for Kostas and her family.

Since Kostas has gone, the family do not visit as often as they did before because they now must share their time between visiting Kostas in the Aged care facility and Anna in her home. Anna refuses to visit Kostas and has told Julie, that she feels bad about not being able to care for him at home.

Anna is constantly worried about her finances. Kostas took care of all the finances and bill paying. Even though Kostas had retired, he often made little amounts of money selling his produce at the local market and working in his friend's garden for a small fee.

Anna is often short of breath and dizzy but she has refused to see her GP about her chest pains as she always visited the GP with Kostas.

Anna spends time in her room and is often found crying and seems very sad. She is reluctant to leave her room after having several falls recently. Her daughters have bought Anna a walking stick, which she refuses to use as she has stated ""...she feels very embarrassed about the walking stick at her age...and she feels people have treated her differently when she uses it"". She has not seen her friend, Dulcie and her husband, Frank for weeks. Since Kostas left, they hardly come around anymore. Anna tells Julie she feels unkempt, Kostas would drive her to the hairdressers and nail technician.

Julie has observed these changes in Anna and has documented it in her progress notes several times. Her daughters, Irene and Sia confide in Julie that Anna is quite often wearing dirty clothes and the house is unkempt, her garden is overgrown, and she does not spend any time in her vegetable and flower garden. They have offered to help; however, she does not want to be a burden to them.

After speaking to Sia and Irene, Julie rings and reports this to the team leader and RN that visits Anna once a month. The RN has documented that Anna's blood pressure is low and shows signs of dehydration and weakness. She has lost 12kgs in the 3 months Kostas has been away. Her joints are stiff and painful first thing in the morning. Anna is not moving around as much and has stopped attending her aqua-aerobics classes with her friend Dulcie.

Anna is very religious and finds comfort by gong to the Greek orthodox church. This is where Anna comes together with her lifelong friends. They enjoy having a cup of tea after mass. They sit and reminisce about the mother land; this brings Anna great joy. Irene and Sia, think Anna should stay at home and not maintain her social networks at the Greek orthodox church during this time as socialising and praying is not important at her age.

Anna refuses to use her walking stick and Anna's daughters are afraid she may fall.

Julie reports this to her supervisor and Registered Nurse. A case conference is scheduled with Anna and her Daughters Irene and Sia. The purpose of the case conference is to involve Anna and her  daughters in the identifying of needs, reviewing her care plan and the implementation process.

   state why is it important that the care teamwork in collaboration with Anna to identify her physical, psychological and social needs. Consider why it is important to implement effective support services, according to preferences, likes and dislikes.?"