use Beattie’s Model of Health Promotion. In a written report of no more than 2 pages (title and reference page excluded) include the following: Identify the ACES aggregate and particular case you are using. Select one of the four quadrants from Beatties Model which could be utilized to address issues within the selected case study? In your report, identify and briefly describe that quadrant. You may choose any quadrant, but do not automatically assume the only approach is at the individual level. There may be good interventions for the aggregate level or some health policies which should be proposed. Use your imagination. Once you choose the quadrant you believe could be utilized to address issues within case study, propose at least one idea for health promotion that could be done. Use your imagination and what you have gleaned from the Week 1 resources. Specifically include: Your idea. What do you think could be done, large or small? Is your idea health promotion, disease prevention, or health protection. Briefly describe in what way.
case chosen
Ertha describes her journey over the past year. She talks about Henry’s hospitalization and says she doesn’t know what she will do if she ever loses her Henry. She relates that she has some good days and some bad days, and gets very anxious and cries when she recognizes she is confused and realizes that she has forgotten some important life events. Ertha tries to describe what it’s like to know she is getting confused and forgetful and how it feels to be so dependent on others. She is hoping the doctor can give her some medicine to help her get better. She says she likes the new apartment and she gets to go in the van a few days a week to a nice center where they have a lot of activities.
scenario 1
The staff at the assisted living facility has noticed that Henry covers for Ertha a lot. Henry admits to the staff that his concerns about Ertha are increasing. He says that recently he has had trouble convincing Ertha to bathe and change her clothes and he doesn’t sleep well because he hears Ertha up at night wandering in the apartment. He has put chairs in front of the door and uses the chain lock so Ertha doesn’t get out. Ertha’s physician prescribed a sleeping pill, Ambien, but it hasn’t helped. Henry has been giving her Benadryl during the day when she is “anxious.” During the scenario the nurse will visit Henry and Ertha in their apartment and will do several assessments including the Mini-Cog, review Ertha’s medications, applying the Beers Criteria, and explore what additional care options can be provided at the assisted living facility and what is available in the community.
senario 2
It is six months later; Henry passed away three months ago. Ertha is more confused, cries frequently, and looks everywhere for Henry. She is not eating well and has lost weight. The nurse at the assisted living facility does not feel she meets their guidelines any longer and will need a higher level of care. She asks Ertha’s daughter-in-law, Betty, to come in to discuss a move to a long-term care, skilled nursing facility. During the scenario Betty reports that Ertha calls her frequently every day, forgetting that she has called earlier. The nurse will repeat the Mini-Cog and administer the geriatric depression scale. At the end of the simulation the nurse will be expected to contact the primary care provider and use SBAR to report Ertha’s behavior and the results of the assessment. The nurse will also discuss her medications and request a transfer order.
scenario 3
It is four months after Ertha’s transfer to the long-term care facility. She is even more confused, going into other patient’s rooms looking for Henry and stealing items. She recently began striking out at other residents, and staff finds food stashed under her mattress. She has been taking two antidepressant medications, an anti-anxiety agent and Aricept for the past four months but there has been no improvement. During this scenario the nurse will review Ertha’s medications and assess her using the SPICES tool to determine if she should be moved to a behavioral health unit for Alzheimer’s patients. She will report her findings, using the SBAR communication tool, to the primary care provider.
Learners have now seen Ertha at three snapshots in time. What do they think her life will be like three months from now?