Case Management Plan (Nursing) Essay Example | Topics and Well Written Essays - 2500 words

Case Management Plan (Nursing) - Essay Example Case as an organizer of care delivery and research has been commonly used in practice settings, and this is often person centred. This is one systematic approach to the presently advocated holistic paradigm of nursing care. Before going to present the assessment, analysis, and care plan based on the case management approach, it is important to know why it is important. The idea is to improve the ability of the health care systems to respond efficiently to the demands or needs of the older people like Mrs. Chang. It has greater implications than are apparent. Studies have indicated that most elderly people despite considerable debility prefer to stay at home, while the models of cost-effective care are shortening the lengths of hospital stay. Care in the community has, thus, gained significant importance. Case management approach may be the first step towards successfully achieving this (Brown et al., 2005, 1-32). Mrs. Chang is an elderly woman with 82 years of age with late stage parkinsonism. She is thin and frail. On the baseline, she has late stage parkinsonism, although the exact clinical features are not highlighted in this case study. This condition is characterized by gradual slowing of voluntary movement, muscular rigidity, stooped posture, and distinctive rigid gait. Over and above that, she has evidence of rheumatoid arthritis of both hands. As indicated in the history, she tripped and fell in the bathroom; this impairment of mobility may get accentuated with her rheumatic disease. Although not highlighted in the case history, a thorough examination of all her joints is mandatory to indicate the status of age-related osteoporosis and osteoarthritis, which would further aggravate her problem of mobility. During this admission, she was admitted since she sustained a fall at home in the bathroom, and she has been admitted to the hospital for observation and further evaluation. Her cur rent medications have not been mentioned, but she has been on ibuprofen. This indicates her baseline chronic pain, which may further compromise her mobility. The impaired mobility is further accentuated by the fact that at home, she stays with her husband who is older than her by 4 years, who himself may be frail enough to be insufficient to help her out in these activities at home. The patient will express feelings of increased comfort, decreased pain and will be able to perform activities of daily living within the confines of the disease and will maintain joint mobility and range of motion while exhibiting adaptive coping behaviour. Improvement in muscle strength and endurance would be the goal (Burgess-Limerick, 2003, 143-148). An impaired nervous system can manifest in many ways, from subtle weakness to drastic loss of