Question

Read and review chapter 31

Analyze the following case study and answer the question bellow

CASE STUDY

Mrs. Angstrom is an 83-year-old patient who was admitted to the hospital after she fell outside her home and broke her hip. She has been living alone in her apartment since her husband died 4 years ago. Mrs. Angstrom has no long-term history of mental illness, but she has recently shown signs of cognitive impairment and dementia, according to her neighbor Jeanine Finch, 63, who called 911 after Mrs. Angstrom’s fall. “She wanders around outside sometimes and doesn’t always know how to get back home,” says Mrs. Finch. “My husband and I try keep an eye out for her, but we’ve been worried something like this might happen.”

Mrs. Angstrom will need to undergo surgery tomorrow morning. The nurse on shift, Greg, is new at the hospital and surprised when the supervising RN asks him to discuss advance directives with the patient, who denies having one. When Greg explains to Mrs. Angstrom that he needs to discuss some confidential matters with her, she asks that Mrs. Finch, who is in the room visiting, be allowed to stay. “I haven’t been remembering things lately,” she says, “so I’ll rest easier if Jeanine knows what’s going on.” Deciding that the patient’s permission is adequate to continue, Greg explains Mrs. Angstrom’s rights and options in regard to treatment decisions in the event that she is unable to make such decisions on her own. Mrs. Angstrom says that she has no living family members and that the only person she trusts is Jeanine. “Can I put her in charge of those decisions?” she asks.

“No,” Greg replies. “I’m sorry, but since Mrs. Finch is not a family member, she can’t be designated to act on your behalf. If you don’t have any family member to assign a durable power of attorney, I think you’ll need to sign a directive to your physician or agree to a guardianship. If you choose the guardianship, you can revoke the decision at any time, but the directive to a physician is binding until you legally have it changed.”

Has Greg provided accurate information concerning Mrs. Angstrom’s options for advance directives? If not, what’s wrong with what he said? What options would be more appropriate to suggest to her?

Mention at least 4 facts and 4 myth about aging, and explain one of then.

Read and review chapter 31

Analyze the following case study and answer the question bellow

CASE STUDY

Mrs. Angstrom is an 83-year-old patient who was admitted to the hospital after she fell outside her home and broke her hip. She has been living alone in her apartment since her husband died 4 years ago. Mrs. Angstrom has no long-term history of mental illness, but she has recently shown signs of cognitive impairment and dementia, according to her neighbor Jeanine Finch, 63, who called 911 after Mrs. Angstrom’s fall. “She wanders around outside sometimes and doesn’t always know how to get back home,” says Mrs. Finch. “My husband and I try keep an eye out for her, but we’ve been worried something like this might happen.”

Mrs. Angstrom will need to undergo surgery tomorrow morning. The nurse on shift, Greg, is new at the hospital and surprised when the supervising RN asks him to discuss advance directives with the patient, who denies having one. When Greg explains to Mrs. Angstrom that he needs to discuss some confidential matters with her, she asks that Mrs. Finch, who is in the room visiting, be allowed to stay. “I haven’t been remembering things lately,” she says, “so I’ll rest easier if Jeanine knows what’s going on.” Deciding that the patient’s permission is adequate to continue, Greg explains Mrs. Angstrom’s rights and options in regard to treatment decisions in the event that she is unable to make such decisions on her own. Mrs. Angstrom says that she has no living family members and that the only person she trusts is Jeanine. “Can I put her in charge of those decisions?” she asks.

               “No,” Greg replies. “I’m sorry, but since Mrs. Finch is not a family member, she can’t be designated to act on your behalf. If you don’t have any family member to assign a durable power of attorney, I think you’ll need to sign a directive to your physician or agree to a guardianship. If you choose the guardianship, you can revoke the decision at any time, but the directive to a physician is binding until you legally have it changed.”

Has Greg provided accurate information concerning Mrs. Angstrom’s options for advance directives? If not, what’s wrong with what he said? What options would be more appropriate to suggest to her?

Mention at least 4 facts and 4 myth about aging, and explain one of then.

Answer 1

Everything that Greg told Mrs. Angstrom about the advance directives is true. Mrs. Finch cannot make decisions on behalf of Mrs. Angstrom because she is neither a family member nor a guardian. For Mrs. Finch to take decisions on behalf of Mrs. Angstrom, She needs to be registered as a guardian for Mrs. Angstrom to the Attorney and in the medical records.

Since Mrs. Angstrom has no family and there is no registered Guardian, Mrs. Angstrom can sign a directive to the physician stating her wishes of how the treatment should be done and whether to use or avoid the artificial methods of keeping her alive. If the directive is to be signed, It should be informed to the physician and should be signed in presence of two witnesses.

At least one witness should be a person who is not related to the patient by birth, or is the attending physician or has a claim on the patient's property.

Though the directive to the physician is binding, the wishes of the patient supersede any directive, should they be able to make a decision on their own.

If the directive is to be revoked at any point in time, It should also be informed to the attending physician. And "Void" should be mentioned on every page of the directive.

The more viable option for Mrs. Angstrom would be to go for guardianship and to get Mrs. Finch assigned as the legal guardian who can make decisions on her behalf. Since Mrs. Angstrom has no family, Mrs. Finch is the only person that she trusts and would want to make decisions on her behalf.

Facts:

1. 4 in 5 older adults will be battling a chronic disease such as arthritis or heart disorders.

2. By the age of 75, 1 in 3 men and 1 in 2 women don't have any sort of physical activity.

3. 99% of people over 65 years old have health insurance, with 93% having government-sponsored Medicare.

4. People over 75 years old visit the doctor 3 times more often than people 22 to 44 years old.

Myths:

1. Depression and loneliness are common in older adults.

2. The older I get, The less sleep I need.

3. Older adults can't learn new things.

4. It is inevitable that older people will get dementia.