Question

Joan is an 85 y/o female recovering from a right total hip replacement. Her injury occurred when she tripped over a scatter rug in her living room and fractured her hip. She lives alone in a private home and anxiously tells you she is afraid of falling again, not being able to call for help and ‘dying alone on the floor’.

Her problems include decreased strength in both lower extremities (BLE) and some pain and stiffness in both hands which limits how long she manages her walker. She also has difficulty preparing her meals due to decreased standing tolerance. She enjoys painting, reading and participating in her book club

Joan is an 85 y/o female recovering from a right total hip replacement. Her injury occurred when she tripped over a scatter rug in her living room and fractured her hip. She lives alone in a private home and anxiously tells you she is afraid of falling again, not being able to call for help and ‘dying alone on the floor’. Her problems include decreased strength in both lower extremities (BLE) and some pain and stiffness in both hands which limits how long she manages her walker. She also has difficulty preparing her meals due to decreased standing tolerance. She enjoys painting, reading and participating in her book club.

1. Name two occupations would she have difficulty performing besides her ADLs or IADLs.

2. Name one ADL that she would have difficulty performing.   Why/How So?

3. Name one IADL that she would have difficulty performing? Why/How So?

4. Name a performance pattern that would be affected? Why

5. What intervention, strategy would you recommend for Martha?

Answer 1

1)Since she has pain in both wrist and also decreased BLE strength she cannot do commercial painting , since it takes long time.

Tailoring mechanical strength on joint as well as hip increases .Heavymanual work or employment in farming or the construction industry leads to hip stiffness. Other risks include blood clots in the pelvis and accidental hip dislocation.

2 )Bowel and bladder control

The ADL increase .32 percent every year with or without infection.
The odd ratio of difficulty 4.72; 95% and the confidence interval, 1.76–12.67 and the feeding odds ratio is 4.27; 95% confidence interval is 1.61–11.3 are the two strongest ADL associated with her health conditionBowel and bladder control

The odd ratio of difficulty 4.72; 95% and the confidence interval, 1.76–12.67 and the feeding odds ratio is 4.27; 95% confidence interval is 1.61–11.3 are the two strongest ADL associated with her health condition

3)Transportationand shopping:  
The ability to procure groceries
attend events and managing public transportation .Due to pain in both wrist and low BLE she cannot walk or stand or walk for long time.

4)Turning the toes inward
It causes the rotation of femur and ball outward which leads to less socket coverage on the back of the ball.
The muscles and ligaments help to keep the ball in the socket. After hip surgery, these ligaments and muscles have been stretched, so to prevent dislocation it is note supposed to rotate the toes inward