Community Nursing Case Study
You are working in Home Care as an LPN, and you are visiting your last client of the day on Friday afternoon. This is a routine visit for a dressing change on your client's left foot ulcer. Your client, Charles Bingham, is an 85-year-old gentleman with a history of diabetes type 2, hypertension, and liver cirrhosis. Mr. Bingham moved to Prince Edward Island when he retired 20 years ago from a fast passed job as a factory worker for a car parts factory in Toronto, Ontario. He is widowed, has no children and lives on a fixed income. Mr. Bingham quit high school when he was 16 to go work in the factory to help support his family. He lives in a small house in a rural community which was damaged in Hurricane Fiona last fall (2022). His roof has been leaking since the event which he has not been able to repair on his fixed income.
When you walk into the home you notice a strong odor of alcohol, several empty liquor bottles on the kitchen countertop along with several dirty dishes and old food. There is a distinct odor or mold and noticeable mold staining on the interior walls of the kitchen. Mr. Bingham is unshaven, with an uncleanly appearance. His dressing has fallen off his wound and there is a foul green discharged at the wound site. You look in Mr. Bingham's chart to see if there is any mention of infection of the wound and when it was last changed. You note that he has been refusing visits from the nurse for dressing changes for the past week. When you ask him about the wound, he states that it is fine, it's just a little infection that will clear up on its own. He states he doesn't want to be a bother. Upon speaking to Mr. Bingham, you notice he is intoxicated with slurred speech, and he is stumbling when he walks back to the couch to sit down.
1. Using the resource in this module from the World Health Organization on Determinants of Health, choose 4 of the determinants and explain how these impact Mr. Bingham health.
2. You speak to Mr. Bingham about his foot ulcer, express your concerns about infection and encourage him to see his family doctor. You are also concerned about his physical state of unwellness, his alcohol consumption, and the condition of his home.
3. What resources may be appropriate from the community to address these concerns? Chose 2 community resources and explain in detail why you have choses these resources and what they can do to help Mr. Bingham.
4. If Mr. Bingham declines any help or resources that you recommend and there is a clear concern for his safety and well-being, what other options would you consider in his best interest? Explain what you would do next and how your decision would impact Mr. Bingham's best interest.