Ajit’s Story
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Aricept 5 mg po OD
Tylenol Arthritis po BID
Warfarin (dosage dependent on INR)
Metoprolol 10 mg po BID
Plavix 75 mg po OD
Allopurinol 200 mg po OD
Tylenol Arthritis po BID
Warfarin (dosage dependent on INR)
Metoprolol 10 mg po BID
Plavix 75 mg po OD
Allopurinol 200 mg po OD
Background
Ajit is a 72 year old man whose, primary language is Tamil and he is able to communicate with simple verbal and written English. He escaped to Canada with his family when the war broke out in Sri Lanka and many members of his extended family were killed. Unfortunately, Ajit was driving when he also lost his 10 year old son in a car accident. Not long after the tragic accident, he started drinking which lead to him losing his job. His wife initiated a divorce close to 15 years ago and he has two remaining daughters and one son.
Diagnosis
Aljit lives alone in senior’s social housing and can no longer drive, so has been using public transport. Since his divorce, he has been drinking more and is struggling with his IADLs. He has also been diagnosed with atrial fibrillation, alcoholic dementia, gout, previous MI with stenting, and CRD. Recently Ajit fell, fractured his hip, and consequently spent an extended time in the hospital. Ajit persuaded the doctor and the occupational therapist that he could return home and his son, who had been visiting Ajit in hospital, indicated that he will be able to help after the discharge.
Concerns
In the hospital, Ajit had his right hip pinned, that was further complicated by post-op delirium tremors and pneumonia. He also developed a DVT in his right leg which he is now on warfarin and requires regular blood work. Ajit has significant arthritis in his hands, which makes it difficult to open pill bottles and do actions requiring fine motor skills.
Formal / Informal Supports
Ajit is not close with his two daughters or their children who live out of town and the relationship with his son, Rohit, has been strained for many years with periods when they were not speaking. Rohit has a history of substance use disorder and no permanent address so usually sleeps in his car or crashes on friend’s couch. Ajit has a few friends who check in on him once and a while. There was a referral made when he left the hospital for daily home support to possibly assist him with remembering to take his medications.
Follow-up Visit
Recent service update, post hospitalization following another fall, indicates that Ajit has been recently diagnosed with multiple myeloma. He was given the recommendation of transfusion therapy. Rohit has cancelled all transfusion appointments for unclear reasons.
Reflection
01
What are your priorities for your next visit and what concerns might you identify in advance?
02
What would be your plan for follow-up?
03
What could you anticipate for the future of this client?