Case Scenario: John is a 52-year-old single male who worked full-time as a forklift operator at a wholesale market. John identifies as First Nations people. He lives in a private apartment, with his partner, Tina, and their 25-year-old son, George. John left school at the age of fifteen and undertook several occupations before upskilling to forklift training about 15 years ago. His father died at the age of 67 due to cardiac complications following a transurethral resection of the prostate (TURP) surgery. His mother died at the age of 51 from metastatic ovarian cancer. After his parent's deaths, John had to take out a substantial mortgage to buy out his sister from her share of their parent's apartment. Over the last 6 months, John has noticed increased difficulty climbing stairs at work, experiencing fatigue throughout the day, and having trouble sleeping due to recurring back pain. On a "bad day" John feels that his legs are swollen. John sleeps with 2-3 pillows as he feels breathless when lying down flat to sleep. He also feels very short of breath on occasion, particularly when exerting himself. He has been previously referred to pulmonary rehabilitation because of his increased production of thick phlegm from repeated ongoing inflammation of his airways. He has only attended once and never came back because he had to work. He also self-medicates with Ibuprofen at the end of long days of driving to manage an ongoing back ache. Tina has been working as an accountant in a large firm. Unfortunately, she was made redundant last year when the company income declined. She has been unable to find another job until now. Tina has been diagnosed with depression by their local doctor and is taking medications for this. John recently suffered a Transient Ischaemic Attack (TIA) and has been discharged back home from the large acute hospital. He said that during this hospitalisation, he was found to have an undiagnosed ongoing irregular rhythm of the upper chambers of his heart and so he was started on Digoxin tablets. He weighs 115 kg, and his height is 1.65 metres. He smokes two (2) packs of cigarettes each day, drinks alcohol (usually between 2 to 3 cans of Carlton Dry beer) daily and only takes his maintenance medications for hypertension sporadically. John reported that the TIA occurred during a heated argument with Tina. He initially blamed her for all his problems, and it has been reported he initially was withdrawn and refused to cooperate with hospital staff. However, when he found out during the hospitalisation that it was caused by the partial blocking of one of the arteries in the brain due to a blood clot, he started re-engaging with his treating team. Although he agrees that he would benefit from a rehabilitation program, he openly declares that he would be unlikely to comply. He says that he really needs to be able to earn a living himself because he does not think Tina will get a job anytime soon and he feels that it is unfair to impose such a big responsibility on his s
Essay based on the scenario,
a) Identify two (2) chronic illnesses that you suspect John has. Support your answers using the data (subjective / objective) from the scenario. For each of the identified chronic illnesses, describe the potential impact on John and his family if he was to be formally diagnosed with the illnesses. Want Professional Help?
b) Identify steps required to engage John into undertaking self-management of his chronic illnesses? Support your discussion with relevant literature.
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