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Case Study Report: Mr. Will Alivia

Introduction

Case studies offer the advantage of understanding the complex patient situations. The in-depth results help create new theories and add strength to previous research (Krusenvik, 2016). Also, they help in preparing a proper care plan for a patient. This case study will focus on mismanaged chronic obstructive pulmonary disorder and chronic kidney disease in Mr. Will (not his real name), a 66year old patient who identifies as an aboriginal from the northern territory. Mr. Will’s identification and age group insinuates a lot about his access to healthcare and the quality of healthcare accessed in general.

Patient Overview and Current Situation

Mr. Will was admitted due to dyspnea cough, difficulty in walking with evident Edema on both feet, hematuria and hypertension. The reading was at 155/100mmHg. Mr. will has a history of chronic kidney disease (CKD). He also has a history of chronic obstructive pulmonary disorder (COPD) diagnosed at the age of 55. Moreover, he has been an active tobacco smoker since his early twenties. He resides with his son who doubles up as his primary care giver. While acquiring these pieces of information for this case study, Mr. Will was adequately educated on the implications of the study and assured of all confidentiality.

Stereotypes

Research has shown that negative attitudes among healthcare workers exist towards elderly adults especially those of the aboriginal descent (Smith, Fatima and Knight, 2017). Stereotypes of aging include assumptions and generalizations about how elderly people should behave without regard for individual differences. Failure to recognize unique differences in elderly people results in late diagnosis and treatment of illnesses. CKD and COPD are manageable and treatable conditions. However, for Mr. Will, if faced by the age and cultural stereotype, his condition is likely to deteriorate.

Health History

            One of the biggest comorbidities that faces Mr. Will is chronic kidney disease, described as presence of kidney damage. Jha et al. (2016) explains that improper management of CKD greatly increases its burden. Mr. Will’s CKD has been poignantly mismanaged for the past few years resulting in its quick progression to stage 3. According to the research by van Gaans and Dent (2018), it is typical of people of his age and background to not receive adequate and quality healthcare. He faces a risk of kidney failure if further mismanagement occurs. CKD is characterized by persistent urine abnormalities (Romagnani et al., 2017). It is also defined by edema and hypertension which explains Mr. Will’s evident edema and high blood pressure during admission (Sterns, 2019). Mr. Will faces an accelerated risk of cardiovascular disease, progression to renal failure or death as these are the major outcomes of CKD (Romagnani et al., 2017). He also faces a risk of anemia due to presence of blood in urine as reported during admission. However, as it is the typical stereotype with the elderly, mortality and remaining life expectancy is often overestimated due to age – which is problematic.

The second condition that Mr. Will faces is COPD, a common preventable and treatable disease. Apart from a constant limitation in airflow and dyspnea cough, COPD is characterized by a chronic inflammatory response in the trachea and lungs. The condition was likely developed due to smoking as exposure to tobacco smoke is a major cause of the comorbidity. Moreover, Mr. Will is well advanced in age, which is a non-modifiable risk factor for COPD. 

Impact on Mental and Physical Functional Status

            Mr. Will’s situation and co-morbidities have a negative impact on his mental and physical functional status. For one, due to the mismanagement of his situation, his physical health has adversely deteriorated for the worst. Since CKD is associated with muscle wastage, Mr. Will – in addition to his mismanagement – had deficits in his physical functions. He now needs help to perform the daily tasks of his life such as self-care activities and sometimes even feeding himself.  Mr. Will has a difficult time planning and processing any information as his mental health seems to also be negatively affected. Hence, he needs another person to make major decisions on his behalf. Even more so, he feels lonely and isolated from his friends and family, which also plays a huge role on his psychological stress. Furthermore, the situation he was in warranted Mr. Will to have negative emotional reaction towards what he was going through.

Conclusion

            In conclusion, it is evident that case studies, such as this one, aids in understanding complex patient situation. This case study has predominantly focused on Mr. Will (not his real name) a 66-year-old who has a case of mismanaged chronic kidney disease. He has had poor access to healthcare due to his aboriginal background and his age. Even more, there are several stereotypes he faces as an old person within the healthcare system. His condition, according to this study, led to adverse effects on his physical and mental status, as has been substantiated.