A normally active elderly gentleman notices he is becoming weaker and more unsteady on his feet. He used to be able to go to the Senior Center three times a week for lunch and to play cards with his friends. Now, he is beginning to stumble somewhat and is afraid he may fall. He is also so exhausted when he comes home from the Senior Center that he is reluctant to attempt the outing at all. The change in his life routine is leaving him feeling vulnerable, isolated and fearful that his deterioration is an inevitable part of aging. His wife notices that he is becoming withdrawn and less likely to participate in family events.

Typical home health care response:

Skilled Nursing could be implemented. This would allow a nurse the opportunity to perform such interventions as:

• Identify any possible underlying causes for the increased weakness, such as a worsening of a previously stable cardiac condition, and report those findings to the physician.
• Identify any symptoms of situational depression and facilitate treatment, if indicated.

Physical Therapy could be implemented to address the client’s decreased strength and balance issues, with the goal of returning the client to his prior activity level.

Result: With the assistance of home health, it is established that the gentleman’s heart is stable. His decline in strength and balance eventually led him to experience an overall deconditioned state. Because of his home health physical therapy program, he was able to regain his strength and return to his previous active lifestyle. In addition, he was taught a home exercise program that will help him maintain this lifestyle on a long term basis. He feels like himself again and resumes his outings to the Senior Center.