Running head: CASE STUDY I	

Case Study I
Mbinglo Peter
Lakeview College of Nursing
N309, Nursing of the Gerontological Client
 May, 19, 2011

CASE STUDY I
Case Study I	
	Mr. Dea is dealing with both psychological and sociological issues. He is worried about activity engagement and positive adaption to aging. He is equally worried about remaining active in when older and most of all, being independent. He is worried about loneliness which ties with the disengagement theory of aging as he is now living a solitary life and withdrawing from activities of daily living. The death of his wife shows that he suffers from mal-adaptation to stress; the continuity theory supports this because life is continuity and he worried about continuity. He is equally worried that he has not search for the meaning of life since he finds it hard to depart from his job according to the individualism theory. With regards to the stages of personality development theory, he is in the struggle to let go and refuses to accept care as well as worrying about physical decline. 
	I would recommend that he retires, if he thinks he can no longer support the stress of his job, and especially as he is experiencing weakness in his body due to aging, this is supported by the wear and tear theory. I would equally recommend that before he retires, he should try to find an activity like volunteering that would still keep him busy, supported by activity theory. I would encourage him to renew his membership in the difference groups he had belonged to and then retire so that he can continue to stay busy, thus having a feeling of accomplishment. Most of all as I advise him to retire, I would encourage him to exercise and eat right since he is now gaining weight because of poor food choices, supported by immunological theory. (Mauk, 2010)
	I would not recommend that he moves out of his house nor sell it but I would encourage him to joint support groups in the community so that members can check on him. There are several resources within his community that he has been using till the death of his wife; so 
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instead, I would encourage him to rejoin those groups and continue to partake in activities. By remaining occupied, he will be satisfied in later life which is supported by the activity theory. I would ask him which of his family is close by that could stop in from time to time to make sure he is recovering well and following his medication regimen. 
	Since he has a daughter who is very caring, I would recommend that he moves in with her or have her move in with him if she is single and willing to. By staying with his daughter, he will be well taken care of which leads to general well being supported by immunological theory (Mauk, 2010). In that case I would advise the daughter to use adult day care services as an option when she goes to work. Or I could suggest that the daughter hires someone to live with and take care of Mr. Dea on days that she may not be present. That way, she can be assured that he will be well taken care of. If all of the above does not seem right, then I would suggest assisted living as the last option for Mr. Dea considering his fractured rib. 
	I would strongly suggest that both Mr. Dea and the daughter sit down and discuss what living option is best for Mr. Dea and the daughter to facilitate his convalescence. This is because as a family, their decision will be final. As a nurse I can only make proper suggestion which I think is great for the both parties but they have a choice of implementing my proposal or implementing theirs. However I will encourage them to ask me any question and encourage Mr. Dea to speak up what he has in mind for further clarification. (Chitty & Black, 2011, pg. 217)
	The priority need for promoting the health of Mr. Dea is good eating habits. He needs to reduce his consumption of fast food since he seems to be gaining weight already. Eating foods high fats can contribute to free radical formation which tend to accelerate the aging process. He needs to perform range of motion exercises to promote circulation and muscle relaxation. He 
CASE STUDY I
needs to follow his medication regimen to reduce pain as well as follow up with his physical therapist to recover properly. He needs to increase his fluid intake and exercise briskly for thirty minutes every day or every other day. Though exercise promotes free radical formation, it equally strengthen muscles and promotes circulation; this promotes general well being which is supported by the immunological theory. He, most of all, needs to stop smoking as tobacco is major cause of health related issues with aging. I would manage this by reminding the daughter to constantly check on his Mr. Dea to make sure he is eating right and taking his medication as required. I would also check on him during my routine check up to make sure he is following what I have prescribed especially smoking cessation. Overall, I would encourage him to do this because he has the ultimate decision, if he does not have the will, then my outcomes would be a failure. However I would discuss his improvements every time I meet him and how we can improve on areas that he is lagging in.
	I think that the sociological theories do support his disengagement from his relationship with the society because he has withdrawn from the Lion club, he no longer attends church regularly, and he does not go out socially like he use to do. This confirms that he is indeed aging and his inability to adjust to it. He is gradually going to retire from his job which is a requirement by the society because he is considered old for his responsibility which confirms the disengagement theory. He is gradually withdrawing from activities he normally did through no fault of his but because of the fact that the society has placed a certain age that when individuals attend that age, they are considered old. He is qualified as passive-dependent under the continuity theory because he is uninterested anymore in the external world. With his fracture rib, 

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he is going to be very dependent and will sure need assistance with almost everything that he has to do. It is very imperative that his daughter considers taking him in or moving in with him. (Mauk, 2010)
	According to Erikson model of integrity versus despair, Mr. Dea still has not resolvef all issues like coming to terms with retirement which can lead to feelings of emotional desolation and bitterness. With respect to Maslow hierarchy the loss of his wife has challenged his love and belonging which explains why he is withdrawing from the community. His esteem needs especially those associated with the purpose of life have decreased. (Arnold & Boggs, 2011, pg. 371-372) 

CASE STUDY I
References
Arnold, E. C. & Boggs, K. U. (2011). Interpersonal relationship: Professional communication 	skills for nurses (6th Ed). St. Louis, MO: Elsevier Saunders.
Chitty, K. K, & Black, P. B. (2011). Professional nursing concepts & challenges (6th Ed). 	Maryland Heights, MI: Saunders Elsevier. 
Mauk, K. L. (2010). Gerontological nursing: Competencies for care (2nd Ed).Boston: Jones & 	Bartlett.