Mr Li was recently admitted to hospital

Mr Li was recently admitted to hospital for a colonoscopy following an episode of PR bleeding. The colonoscopy showed haemorrhoids which were banded during the procedure. Following the procedure, Mr Li was admitted for five days because he was experiencing extreme hypertension and uncontrolled (BGL) requiring him to have insulin. During his hospital stay, the nurses called three code black emergencies due to Mr Li’s distress and aggressive behaviour, he became confused and was attempting to leave the ward to go home. Mr Li was referred to a gerontologist for cognitive screening assessment and it was determined that Mr Li had signs of dementia and with a mild cognitive decline. Mr Li also has a small ulcer on his left ankle – which requires follow up with the community nurse. Mr Li’s blood pressure and BGL levels stabilised, he was discharged home. Mr Li does not currently receive any support services, nor has the family explored the options available through MyAged Care The family have stated they want to support Mr Li to stay at home OVERVIEW Hypercholesterolaemia Hypertension Trans ischaemic attack (2018) T2 diabetes mellitus (2021) PMHx Lipitor (Atorvastatin) 40mg Daily Metformin 1000mg Daily Carvedilol IR 6.25mg BD (recently commenced while in hospital) MEDICATION Two sons: Jiahui (George), Yiming (Frank) and two daughters: FeiFei (Fay) and Shuzen. All of Mr Li’s children are now grown adults with children of their own. Since his wife’s death in 2005, Mr Li has lived with his youngest daughter, Fay (FeiFei) and her husband Jason (Junxi) in their home in the metropolitan suburb of Blackwood in South Australia. Fay is a pharmacist and Jason is a social worker at the local hospital. They have two teenage children, Lily, and Cherry. Past family history Father – Myocardial infarction age 52- deceased Brother – Stroke age 60- deceased Wife died of bowel cancer 15 years ago FAMILY/SIGNIFICANT OTHERS Mr Li a widower, emigrated to Australia from Hong Kong with his wife and children in 1997. Mr Li and his family are Buddhists he attends the local Buddhist temple, however he requires one of this children or a friend to drive him Mr Li feels that the temple provides him with a sense of calm and relaxation while also providing time for meditation and socialising with friends. Mr Li supports his family by cooking and gardening – he enjoys growing the vegetables they use in their meals. Over the last couple of years Mr Li’s health has begun to deteriorate and Fay and Jason have become more concerned about his occasional periods of confusion. Over the past year or so, Mr Li occasionally awakens and cries out. He seems fearful and confused and thinks he is back in Hong Kong. Mr Li’s ability to speak English seems to be decreasing and he sometimes struggles finding the right English words to express himself, although he understands what people are saying to him. When this happens, he becomes quite agitated, not wanting to partake in any activities and stays in his room for long periods. On a few occasions Mr Li has left the stove unattended, burning the food. Mr Li has also been placing items into incorrect places i.e.: a small garden fork into the upright freezer. Recently Mr Li told Fay that the neighbour was poisoning the soil in their garden and deliberately killing some of the vegetables. Fay and Jason have been wanting to take their daughters on an overseas holiday but feel that it would be unsafe to leave their father alone in the family home. Allergies: Non-steroidal anti-inflammatory medications (NSAIDs) QUESTIONS Describe the role of the Registered Nurse working in the community in supporting people living with chronic conditions to live well at home. Include your understanding of person -centred care and critical allyship (hint: the resource is in the reading list)- make appropriate specific links to the NMBA RN Standards of practice Identify 2 person-centred support needs for the case person that will promote selfmanagement in the home. o Discuss the rationale for the chosen support needs o Briefly discuss at least one (1) of the barriers to person centred selfmanagement in the home for Mr Li o Discuss how these support needs can be enabled including which (organisational & or multidisciplinary) resources need to be engaged – for this case person o Support the discussion with current evidenced based publications (required Please add references

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