Care Over Three Decades Freda B, Age 75

Freda B. lives alone in her small low income housing unit. She has difficulty keeping up her place because of the advancement of her degenerative joint disease and her shortness of breath. These affect her to the degree that it is extremely difficult for her to go out. The friend who previously took Freda shopping and to appointments has passed away and Freda is increasingly isolated and rarely goes out. Her arthritis has become particularly severe in her left hip and both knees. She cannot afford the expensive anti-inflammatory medicine prescribed by her physician, and is reluctant to undergo hip replacement surgery because her Aunt Mary never walked again after her hip operation. Her pain waxes and wanes, is helped somewhat by aspirin, but never completely subsides. Freda dozes off and on during the day and sleeps poorly at night.

Her daughter visits occasionally, and the family is generally together for Thanksgiving or Christmas. Her son in Colorado has offered to take her in several times, but she is very reluctant to give up her independence and the way of life and surroundings she is familiar with. She worries constantly about her children and grandchildren and their many problems.

Medical History

BP 180/90 Weight 185 lbs. Height 5'3"

She had a mild stroke one year ago. After a brief hospitalization, she regained most of the function on her left side except for some clumsiness in her left hand. She no longer smokes. She takes hydrochlorothiazide and Aldomet for her hypertension.

Surgery for her stress incontinence was initially successful, but the problem has returned and is worse than before the surgery. She now has daily urinary incontinence.