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Innovations and Efficiencies in Home-Based Care: H ...
Ralph Case Fillable Assessment and Plan
Ralph Case Fillable Assessment and Plan
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Pdf Summary
Ralph Wade, a 77-year-old African-American male, suffers from multiple chronic conditions including oxygen-dependent Chronic Obstructive Pulmonary Disease (COPD), pulmonary hypertension, and heart failure with reduced ejection fraction (HFrEF). He has a history of frequent hospitalizations for shortness of breath and was recently discharged following another episode. His recent health issues have required careful medical management and a collaborative care plan involving his nephew, Reggie, and his healthcare provider to minimize hospital visits.<br /><br />Ralph's medical history includes Stage 4 COPD, a history of a cerebral vascular accident, dependent leg edema, atrial fibrillation, contested systolic hypertension, benign prostatic hyperplasia, congestive heart failure, coronary artery disease, anemia, chronic kidney disease, osteoarthritis, vitamin D deficiency, and hyponatremia. He lives a restricted lifestyle due to his conditions, relying heavily on family members for support.<br /><br />Socially, Ralph lives alone in a high-risk neighborhood and is on Social Security benefits, which cover basic costs but make managing his myriad of medications a challenge due to financial constraints. He occasionally smokes and does not consume alcohol or drugs. His living conditions present various safety and functional challenges, with extension cords and oxygen tubing posing trip hazards.<br /><br />Ralph's current medication regimen includes furosemide, carvedilol, amiodarone, warfarin, and several other drugs, with recent additions due to his hospitalization. Despite medication management, he faces challenges in adherence due to costs.<br /><br />Mental and physical evaluations reveal decreased appetite, weight loss, mild depression, and impaired mobility, exacerbated by environmental factors within his home. His care plan emphasizes stabilizing his chronic conditions, improving compliance with medication, and addressing both his and his family's preferences for care. Identified goals include reducing emergency interventions, enhancing daily functioning, and maintaining social interactions, which he values greatly.<br /><br />Overall, Ralph's case is complex, requiring in-depth management to address medical, social, and psychological needs to optimize his quality of life and reduce emergency hospitalizations.
Keywords
Chronic Obstructive Pulmonary Disease
heart failure
pulmonary hypertension
hospitalizations
medication management
family support
social security
mental health
care plan
quality of life
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