Interdisciplinary Team Care: Case 1

Summary

Mr. Appleton, a geriatric patient with a history of strokes and cognitive impairment, is admitted to the hospital after a failure to thrive episode. He's showing signs of depression, possibly due to his wife's absence. The medical team plans to stabilize him and reunite him with his wife, who is at a different facility. They are also considering adjusting his medication for his depressive symptoms and exploring financial resources for his care, as Medicare benefits have been exhausted.

Takeaways

• 👨‍⚕️ Mr. Appleton is a geriatric patient admitted from Silver Lake Nursing Home due to failure to thrive, having stopped eating for three days.
• 🏥 He is under the care of Dr. Abel and Dr. Kota and is currently staying in room 4242.
• 💊 Mr. Appleton has a history of two strokes and cognitive impairment, and he is experiencing depressive symptoms, including expressing a desire to die.
• 🍲 Despite his condition, he managed to eat 80 percent of his breakfast on the day of the discussion.
• 👥 The care team is understaffed, which may affect the frequency of patient check-ins.
• 👵 His wife, who he believes to be dead, is actually alive and staying at West Harvard Convalescence Center.
• 📞 The contact number for Mr. Appleton's wife is 310-55-1112, provided by Dr. Mitchell.
• 🤔 There is a plan to potentially get Mr. and Mrs. Appleton together to improve his condition.
• 💼 Mr. Appleton was previously an author and worked in software, suggesting he might have financial resources.
• 🏥 The discussion includes the possibility of transferring Mr. Appleton to a lower care facility at University Hospital if Medicare coverage runs out.
• 📝 The wife is the DPOA (Durable Power of Attorney) and has been managing Mr. Appleton's affairs since his stroke, but she has recently fallen ill.

Q & A

What is the room number of Mr. Appleton?

Mr. Appleton is in room 4242.

Who are the attending physicians for Mr. Appleton?

Mr. Appleton is a patient of Dr. Abel and Dr. Kota.

What was the reason for Mr. Appleton's admission to the hospital?

Mr. Appleton was admitted due to failure to thrive, specifically, he stopped eating for three days.

What was the plan for Mr. Appleton's care after his admission?

The plan is to get him up and start with a cardiac chair until BT sees him.

What mental health issues is Mr. Appleton experiencing?

Mr. Appleton is showing signs of depression, including expressing a desire to die.

Why does Mr. Appleton believe his wife is dead?

Mr. Appleton's wife has stopped visiting him, leading him to believe she is dead.

Where is Mr. Appleton's wife currently located?

Mr. Appleton's wife is at the West Harvard Convalescence Center.

What is the phone number to contact Mr. Appleton's wife?

The phone number to contact Mr. Appleton's wife is 310-55-1112.

What is the current status of Mr. Appleton's pain?

Mr. Appleton does not seem to have too much pain, but it is difficult to pinpoint due to his Aphasia.

What is the plan to address Mr. Appleton's depression?

The plan includes getting him on the phone with his wife, potentially adjusting his medication, and considering a referral to the psychiatric department.

What is the financial situation regarding Mr. Appleton's care?

Mr. Appleton has used up his Medicare days and is now considered self-pay. He is believed to have resources due to his past work as an author and in software.

What is the role of Mr. Appleton's wife in his care?

Mr. Appleton's wife is the DPOA (Durable Power of Attorney) and has been managing his care since his stroke.