Running head: CASE STUDY PART THREE



Running head: CASE STUDY PART THREE

Case Study Part Three: Late Adulthood

Alyson Marczynski

Western Washington University

Grandma is 90 years old with failing health, and this places her in the development stage of late adulthood and also among the oldest-old (Overstreet, 2007). According to the case study she rarely leaves the home and is also presenting signs of dementia such as forgetting or mixing up names. However, she is still able to perform most of her daily functions, although the case study indicates that she needs more attention as her health slips. She is having trouble keeping food down, and is currently eating a concoction of “thin oatmeal mixed with a heavy serving of butter and mashed fruits,” as well as a watered down cup of coffee. It is also stated that she doesn’t like to be left alone, and has become quite talkative.

As Grandma continues to age she will probably need more care, and this can be a stressful process for the entire family. I’m sure the family would like to provide a comfortable environment for their grandmother, and Grandma would probably appreciate fulfilling activity during the day. However, with Paul and Phyllis working and the children in school, plus the new addition of a baby, it seems that there is little left over for Grandma. Essentially the family could use help in meeting the caretaking needs of Grandma, and by looking for some outside help options there will likely be many benefits along with it.

With the continued mention of Grandma’s failing health, it is probably important for her to receive a health evaluation including an assessment of her cognitive abilities. The case study says that she is presenting signs of dementia and it would probably be quite helpful to uncover what the cause of these symptoms is. There are many diseases and circumstances that can cause dementia, all of which result in similar symptoms of impaired judgment, memory or problem-solving ability. There is a chance she could be showing signs of Alzheimer’s disease, which is the most common form of dementia, but unfortunately is incurable. However, other circumstances can also lead to dementia such as malnutrition or depression, which can be resolved, and this could also be a likely cause of Grandma’s symptoms (Overstreet, 2007). The best way to diagnose these symptoms is for Grandma to see a healthcare provider for an overall physical and cognitive assessment. If the family has a doctor they normally see she could go to them, or she could also visit a place such as The Center for Senior Health at St. Joseph Hospital. They are located at 3015 Squalicum Parkway in Bellingham, and can be reached by e-mail. They provide geriatric care by a multi-disciplinary team (a physician, nurse, social worker and dietitian) and services to meet the physical, social, and emotional needs of the older adult. More information can also be found at (PeaceHealth Services, 2007).

The case study doesn’t mention whether or not Grandma has any health insurance, but she would qualify for Medicare, and also possibly Medicaid and would benefit greatly from enrolling. The Center for Senior Health, and most other facilities will cover patients with Medicare coverage and this would help offset the cost of healthcare for Grandma and the family. Medicare, like most insurance, can be a confusing process however and she or the family could contact an organization such as SHIBA (Statewide Health Insurance Benefits Advisors). They offer assistance with Medicare claims, supplemental policies and long term care insurance. They are located at 2950-B Squalicum Parkway and can be reached at (360) 715-4103 (Whatcom County Council on Aging, Consumer Assistance, 2004).

Another concern for the family might be transportation and how Grandma would get to doctor’s appointments, etc. I would recommend contacting the Whatcom Transportation Authority (WTA), and asking about specialized transportation which can assist Grandma in getting to these various places without the necessity of having a family member with her. WTA can be reached regarding specialized transportation at (360) 733-1144, or more information can be obtained online at . There are also various volunteer programs to transport seniors in the area, and more information about these different options can be obtained from the Northwest Regional Council’s Senior Information and Assistance (Whatcom Senior Information and Assistance, Transportation Options: Whatcom County, 2008).

A health evaluation will be a good start on improving Grandma’s quality of life, but there are other aspects that need to be considered for a woman of her age. Friendship is very important for this age group, and since there is no indication of a spouse or other interaction with people similar in age, Grandma might be feeling some social isolation and loneliness (Overstreet, 2007). Erikson’s stage of development during late adulthood is integrity vs. despair which involves finding meaning in one’s life, and adjusting to inevitable death. With Grandma being unable to do many things on her own now she may be feeling hopeless, bored, or lonely which is indicated in the case study by the fact that she doesn’t want to be alone and constantly talks. While it may be difficult for her to get out of the house, I think this would be a great benefit for her and also the rest of the family. Finding a social outlet that would allow her to be involved in interesting and challenging activities can also make her days more enjoyable.

An excellent option for Grandma would be to use adult day services, such as St. Joseph Hospital Adult Day Services. Here they provide a full health care team to monitor the client’s health, as well as occupational therapy. They also have a specialized dementia program, which might be a great option for Grandma considering her symptoms. There are various activities for each day and meals are provided. This would provide respite care for the family during the day and they even offer caregiver education and also a support group for caregivers, which would be beneficial for the family as well. They offer transportation options and payment plans making this a very relevant option for the entire family. They can be reached at 360-715-6410 and are located at St. Joseph Hospital South Campus 809 E. Chestnut. More information can also be found at . There are many other adult day programs in the area as well that can provide respite care, and a list can be found from Northwest Regional Council at .

Another great option for Grandma, as far as social outlets would be to go to a senior center, or become involved with a church group if that appealed to her. A list of senior center locations and hours can be found from the Northwest Regional Council at . Senior centers vary in what types of services they provide, and so the family would have to look into which center fit their needs best. A church group might appeal to Grandma if she had any religious affiliation, as this might offer her some more meaningful and fulfilling activity with women or men her age. Whatcom Senior Information and Assistance also provides a list of support groups for both older adults and also caregivers, which might be a positive option for several members of the family and another social outlet for Grandma. This list can be found at .

All of these recommendations would be beneficial for Grandma in possibly improving her health situation, and more generally improving her quality of life. More activity would likely be enjoyed by Grandma, and give her the sense of purpose and fulfillment needed at this stage in life. Getting outside the home would not only be fun for Grandma but would also provide some respite care for the family, which might allow others to pursue different interests.

If these recommendations are not followed, Grandma’s health will likely continue to deteriorate and the end of her life might not be the way she would like. With all of the recommendations made it is important that Grandma has a say in what she is going to be involved in. If she is uninterested in adult day services then this option might not be a good choice, and therefore other options of respite car and activity for Grandma would have to be explored. I think it is important for Grandma to enjoy the last part of her life and find something that she enjoys doing and is capable of doing with her current physical state. While this may be difficult considering her dependence on others, there are ways to work around this issue and provide her with a sense of independence despite her need of care.

References

Adult Day Services. (2007). St. Joseph Hospital. Retrived on May 16, 2008 from,

.

Center for senior health. (2007). PeaceHealth Whatcom Region. Retrieved on

May 16, 2008 from, .

Overstreet, L. G. (2007). Gaining perspective. Dubuque, IA: Kendall/Hunt Publishing.

Whatcom County Council on Aging: Senior Services. (2004). Consumer Assistance: SHIBA

(Statewide Health Insurance Benefits Advisors). Retrieved on May 16, 2008 from, .

Whatcom Senior Information and Assistance. (2008). Respite Care Provider Facilities.

Retrieved on May 16, 2008 from Northwest Regional Council, .

Whatcom Senior Information and Assistance. (2007). Senior Center Locations & Hours.

Retrieved on May 16, 2008 from the Northwest Regional Council at,

.

Whatcom Senior Information and Assistance. (2008). Support Groups. Retrieved on May 16,

2008 from the Northwest Regional Council at, .

Whatcom Senior Information and Assistance. (2008). Transportation Options: Whatcom County.

Retrieved on May 16, 2008 from the Northwest Regional Council at, .

Whatcom Transportation Authority. (no date). Specialized Transportation. Retrieved on May 16,

2008 from, .

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