Jeanine Porter is a 75-year-old woman who was admitted to the hospital after she fell at home and sustained an intracapsular fracture of the left hip at the femoral neck. She is widowed and lives with her daughter and son-in-law and their three children, ages 15, 12, and 4. She has a 50 pack-a-year smoking history and denies alcohol use.
She has severe osteoarthritis of her knees and coronary artery disease (CAD). She underwent coronary artery bypass grafting (CABG) 9 months ago. Since her surgery, she has engaged in minimal exercises at home. Mrs. Porter underwent a total hip replacement.
Her postoperative period was unremarkable, and she was transferred to the rehabilitation facility on her third postoperative day. She did well with her therapy and was discharged home after 10 days.
At a home health visit 2 weeks after discharge, Mrs. Porter was in the living room, seated in a rocking chair. Her walker was across the room. The room smelled of smoke, and a significant amount of dust was evident on all of the furniture, as well as open bags of chips and several open soft drink cans. The floor was littered with toy trains and cars, and the sofa was full of unfolded, clean laundry.
In the kitchen, the countertops and sink were loaded with dirty dishes, pots, and pans. Mrs. Porter said, “My daughter is really doing her best. I guess I am just too much for her…what with the children and all.” Mrs. Porter’s daughter replied, “I can handle it, I just don’t get any help from anyone, including my mother.”
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