Henry Williams is a 69-year-old African American, a retired rail system engineer who lives in a small apartment with his wife Ertha. Henry and Ertha had one son who was killed in th

Henry Williams is a 69-year-old African American, a retired rail system engineer who lives in a small apartment with his wife Ertha. Henry and Ertha had one son who was killed in the war 10 years ago. They have a daughter-in-law, Betty, who is a nurse, and one grandson, Ty. Henry is concerned about Ertha because she is experiencing frequent memory lapses.

Henry was admitted to the hospital last night after he called the doctor and told him that he could not catch his breath. Henry has several medical problems including COPD, hypertension, and high cholesterol. Henry provides important details of how he views his current life situation.

Hello, my name is Henry Williams. Life sure has changed over the last two, three years, retirement just isn’t what we thought it would be… we… that would be Ertha and me. I spent my life working for the Transit Department, as an engineer for the rail system. I’m pretty proud of this accomplishment. I was on the forefront of desegregation in college and the workplace. Ertha and I have always been active and independent, so we thought we would retire to this nice apartment and do some traveling since it’s just the two of us. We haven’t done much of this with my health and now Ertha’s. It’s been a change moving from our nice home and gardens to an apartment but we have adjusted to that OK, I guess. We lost our only son 10 years ago to the Gulf war – that really changed our lives as well; I don’t think Ertha has ever been the same. He left us a lovely daughter-in-law, Betty and a grandson, Ty, but they live a couple of hours away in the city and it’s hard for us to get there. And now, Ertha is getting forgetful and it’s hard to leave her. We go to the Baptist church regularly but I can’t let Ertha go alone to the ladies’ stuff anymore. She used to go every Tuesday. But I guess you are here to learn more about me and what’s going on with my health. Well, no one could tell me to stop smoking you know, especially when I was younger. I started smoking when I was a teenager, everyone smoked back then. I have had frequent ‘bouts of colds, bronchitis, asthma and so forth but now they tell me it’s COPD, whatever that means, but it sounds scary. I also have a little high blood pressure, but it’s not too bad. I get so anxious now and I’m worried all the time about my wife, she is good some days and other days she can’t remember things and she asks for Anthony, our son. That is so upsetting for both of us and she cries when I tell her he is gone. He was so proud to be in the armed forces but he had to go and serve overseas, he never came home to us. I really lose my patience sometimes with Ertha. She forgets the stove is on, can’t find her keys, forgets what day it is, and thinks Betty and Ty haven’t visited us in years, when they were just here. I’ve had to watch her when she cooks, take her with me on walks. We just can’t be apart and that gets frustrating. I worked every day so we were busy until we retired, now all of this heartache. Betty took Ertha home with her while I am sick here in the hospital but we need to think about a new plan so Ertha is cared for and I am too. I don’t want a nursing home but I hear there are some of those apartments where they help you some. Maybe that would be a good place for us. I sure feel bad today; I am so tired and short of breath. The doctor sent me here last night after I called his office and told him I couldn’t catch my breath. My neighbor was home so she brought us in to the emergency room and took care of Ertha until Betty got here. I should be resting now; Ertha is in good hands with Betty the next few days, Betty is a nurse and can help her while I am in the hospital. I need to get some strength back. I hope my insurance will pay for this oxygen and these inhaler things I have to use when I go home. I already take two pills for my high blood

NLN ACES, 2017

pressure and a cholesterol pill, aspirin and a breathing pill. Now they want to add inhalers and oxygen? What next? I already have an inhaler I use at home and it doesn’t help. Ertha needs to take a bunch of pills too. The social worker lady said we might have to go on a waiting list before we can go into those apartments where they help you with a bath and some food. Ertha doesn’t eat so well and can’t cook so well anymore so help would be nice. I suppose they will put me on some diet for my breathing now and Ertha can’t manage that so we could let them do our meals. I wonder if they help with the medications and baths. Ertha gets upset when I make her shower. I have to rest now; you will have to ask me questions later.

1. What are Henry’s strengths?

2. What are your concerns for this patient?

3. What are you going to do about it?

NLN ACES, 2017

Millie Larsen is an 84-year-old Caucasian female who lives alone in a small home. Her husband Harold passed away a year ago and she has a cat, Snuggles, who is very important to her. Millie has one daughter, Dina Olsen, who is 50, lives nearby, and is Millie's major support system. Her current medical problems include: hypertension, glaucoma, osteoarthritis of the knee, stress incontinence, osteoporosis, and hypercholesterolemia.

Millie is at the clinic for routine examination and medication follow up. She is taking several anti-hypertensive medications, diuretics, and analgesics. During the monologue, Millie provides important details of how she views her current life situation.

I’m Millie. I have lived in the same small house for the last 50 years. Harold and I raised our dear daughter Dina here and we had many good years together as a family. Harold passed last year, he was 91 you know, and I miss him terribly. I think about him every day. We were married for 68 years, most of them were happy. We did struggle with money at times, but who didn’t? All of our family lived close by and I spent many a Sunday cooking for 15 – 20 after church. Our home was always full of people; many of them are gone now. Snuggles, my cat, keeps me company. Snuggles is about 10 years old; she is a stray who just showed up on my doorstep one day and she’s been here ever since. I’ve always kept myself busy, I sing when I can in the church choir and I volunteer in the church kitchen. I still love to cook; the church is always asking me to make my famous chicken and dumplings when we have special dinners. I can’t do as much as I used to, but that’s ok. I am fortunate to have many close friends from church. I also enjoy gardening and I am known for growing my prize roses. My rose garden is not quite as big as it used to be, but I still like to get outside and work with the soil and the flowers. The fresh air does me some good. There are enough roses to cut several large bouquets every summer and I share them with my daughter and my friends. Did you know that my roses used to win blue ribbons at the county fair almost every year? Since Harold is gone, I go over to my daughter Dina’s house every week to visit and see my grandkids. Dina is a good cook, but her dumplings aren’t quite as good a mine and I try to make a batch to take with me when I can. Dina works everyday at the school so she is busy most of the time. She is a good daughter and she helps me when I need to get to the doctor. She also picks up groceries for me once and awhile. I have three grandchildren. Jessica is 17 and she graduates from high school this year. Daniel is 14 and he is a handful! He can give his mother trouble about getting his homework done and I don’t think his grades are very good. I know Dina worries about him. Megan is 12 and she is such a sweet child. She likes to help me with my roses in the summer. I went to the doctor last week to get my blood pressure and my cholesterol checked. He wants to start me on a new pill for cholesterol. I already take about six or eight pills every day. I hope this new pill isn’t too expensive, I already have to pay a lot for my medications and I don’t get the pension anymore since Harold died. I don’t know how Harold paid all the bills, it doesn’t hardly seem like there’s enough money for all that medicine. I am lucky that I can still get around pretty well and my house is not too big. My knees are pretty bad; I think they are just worn out. They hurt a lot. I am thankful that I can still tend my roses. My bladder isn’t as good as it used to be, I have to use Depends now and I worry that someone will notice the odor. I can’t laugh anymore; the leakage is getting so bad. But things like that happen when you get to be as old as I am. I can’t complain.

NLN ACES, 2017

Discussion Questions:

1. What are Millie’s strengths

2. What are your concerns about Millie?

3. What is the cause of the concern?

4. What information do you need?

5. What are you going to do about it?

6. What is Millie experiencing?

NLN ACES, 2017

1. Identify and describe the form(s) of elder abuse experienced in the video. Give examples from the video to support your information.

2. What risk factors for elder abuse and/or neglect were evident in the video for the individuals presented?

3. What are the nurse's ethical responsibilities for a client who is a victim of abuse/neglect viewed in the video?

4. What do you think the patient is experiencing? 5. Consider the possible outcomes of implementing falls precautions or not. What

are the risks and benefits to the patient? To the nurse?