Case Study: Poliomyelitis and Nursing
Jeffrey Alba is the eldest son of Jesse and Martha Alba. At twenty-four years of age, he is suffering from a permanent disability. Jeffrey has a poliomyelitis, otherwise known as polio since when he was born. Specifically, he is suffering from spinal polio, a disease that shows no symptoms 90% of the time at its early stages (Fagg, 1990, p. 21) His left leg has completely suffered from muscle atrophy for the past two decades, one of the evidences to the finding that the muscles in the left leg has been receiving little nourishment and exercise due to viral invasion in the spinal column (Beale & Horaud, 2001, p.841).
Standing at approximately six feet and weighing at about 75 kilograms, Jeffrey can barely walk without his crutches, and a short-distance walk along the streets of the neighborhood proves to be a tiresome and painful experience for him.
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The Alba family is composed of four members—parents and two siblings. Jeffrey’s sibling is Jennifer, a young girl of sixteen years. The Alba family resides in the suburban area of Detroit, Michigan and has lived there for the length of their lives. The family’s income is a little below the poverty line, living at about $20,000 annually.
The family lives in a rented apartment after their first house was sold in 1990 due to financial difficulties. Client’s Needs Based on the physical configuration of the household’s place, Jeffrey needs the space for him to be able to walk with less hindrance in his path. The fact that Jeffrey walks with the help of his crutches calls for an immediate allocation of sufficient space along the narrow room where the family lives. Unnecessary tables and chairs situated across the living room should be removed or relocated elsewhere where Jeffrey rarely goes.
Other furniture pieces such as cabinets that are too high for the client to be reached should be carefully reconfigured so that the client can be able to reach into those areas with minimal help. Since the rented apartment where the Alba household lives is only a single flat and has no stairs, Jeffrey has no difficulties accessing the other parts of the room except for the fact that there are several tables and chairs that need to be removed from his path. The belongings of Jennifer such as her school bags and books should also be removed from the floor since they can impede the movement of Jeffrey from one place to another.
Another observation made is that the rented apartment of the household rests on the fifth floor of the apartment complex. The apartment complex nevertheless has a functional elevator only that there are no emergency power supplies dedicated for powering the elevator during occasional power outages. The apartment complex also has stairs which can be used during emergencies. However, the stairs are steep and prove to be difficult for Jeffrey to use especially when there are other residents using the stairs.
Thus, it is advised that Jeffrey should seek the help from his family in using the stairs in times when the elevators are not functioning. More importantly, the underarm crutches that Jeffrey has been using for the past twelve years have not yet been replaced. Although the crutches are still functioning, the metal bars are already partly bent mainly because of the increase in weight in Jeffrey’s body as he grew up through the years. At six feet in height, the underarm crutches used by Jeffrey for the past six years in his life are only appropriate for individuals with a height of five feet and five inches.
The shorter length of his underarm crutches can result to back complications since Jeffrey has to stoop in order to adjust to the length of the crutches. Moreover, the physical configuration of his underarm crutches is a bit small compared to his physique. Thus, there is an apparent need for a replacement of the crutches in order to prevent several other complications that may arise from the unsuitable crutches that Jeffrey is using. Due to the family’s meager income and budget, Jeffrey has rarely visited a hospital and sought medical advice from a doctor.
The last time that the client visited a doctor was when he was still eighteen years of age, barely six years ago. As a result, the family has no update on the current condition of Jeffrey’s polio. From the family pictures taken within the past six years, it can be observed that the left leg of Jeffrey has greatly decreased in size. While the rest of the body of Jeffrey has developed through the years, the muscles of the left leg of the client have continuously shrunk in mass. The need of the client for medical advice is of utmost importance so that further medical problems can be looked into and averted.
Budget for the Changes and Evaluation Most of the proposed changes in the Alba household do not require a significant amount of financial funding. The proposed changes in the setting of the apartment room can be done almost immediately and very minimal help from paid professionals. The parents can transfer the tables and chairs inappropriately situated in the living room into the bedrooms. Meanwhile the school belongings of Jennifer such as bags, books and notebooks scattered in the different parts of the floor can be transferred into the empty cabinets.
The family can easily provide assistance to Jeffrey when he is using the emergency stairs given the fact that the family is oftentimes idle for several hours during the day. Moreover, the parents can request for the construction of a specialized platform just outside the main entrance to the building from the apartment manager or caretaker. The platform will serve as a safety entrance built especially not only for Jeffrey but also for the rest of the other residents of the apartment complex with permanent disability.
The family can also request from the building manager several signs just before the elevator entrance such as signs which inform the public to give sufficient space to or prioritize the permanently disabled residents. This proposed change is also relatively free of charge as far as the Alba household is concerned. There are a few things, however, which need financing on the part of the Alba household in addressing the health condition of Jeffrey. For one, the provision of a new pair of crutches for Jeffrey requires payments ranging from $50 to $100.
Nevertheless, the family can contact several non-government organizations which provide new crutches to deserving individuals either free of charge or at a lesser purchase price. The family can also send personal letters to government officials requesting for a new pair of crutches that are not only sturdy and can last a lifetime but are also suitable to the physique, height and weight of Jeffrey. Given the need for medical advice from a medical practitioner, the family can decide to bring Jeffrey to a healthcare facility that is funded by non-profit organizations.
If possible, however, the family can also resort to medical advice from doctors in private hospitals within Detroit. Medical advice can run to a few hundred dollars, depending on the severity of his spinal poliomyelitis and the equipments which will be used in assessing his condition. As far as the planning, completion and evaluation of the client is concerned with respect to nursing diagnosis, there are little to very minimal expenses which may barely include transportation costs, meal expenses and purchases for documentation purposes.
The duration of the execution of the case study will range from two weeks to a full month, depending on the results of medical advice sought by the Alba household for Jeffrey from either the non-profit healthcare organization or private hospital. The complete valuation will be composed of at least three visits a week to the household for two weeks to one month, with one to two hours duration per visit.