Case-Scenario Client Rose is a 65-year old who is a member of the Indigenous community

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Case-Scenario

Client

Rose is a 65-year old who is a member of the Indigenous community. Rose lives in a rural area in Northern Ontario.

Health History

Rose is a 65-year old with a history of gestational diabetes with her first pregnancy in her early twenties. She has had six pregnancies and with each pregnancy her diabetes became worse.

Present Health

Rose now has Type 2 Diabetes that is hard to control. She has had her right foot amputated

below the knee and has had a prosthesis since the age of 60. Rose is 175 cm tall. Rose weighs 110 kg. Rose also has a history of osteoarthritis, osteoporosis and high blood pressure.

Social situation

Relationships

Rose is a widow, her husband died in his forties as a result of uncontrolled diabetes and alcoholism.

Children

Rose was a single parent raising her children after her husband died and she raised them on social assistance. Two of Rose's children died, one in a car accident caused by drunk driving and one child died from suicide. Her other children except for one daughter left her and Northern

Ontario. They do not keep in touch and she does not see them. Rose is caring for her five grandchildren while her one daughter who stayed with her goes to a nursing school 400 km away.

 

Rose is fighting depression, is taking Prozac and sleeping pills and is struggling with alcoholism to help with her health and her situation. The anti-depression pills are not working.

Cultural History

Rose was taken from her community and was put in a residential school from the age of six until the age of 13. Due to this Rose is not as close to her community and culture as she might have been. She has had trouble relating to her community's culture, cultural values and spiritual beliefs.

Housing

Rose lives in a small, poorly insulated, mouldy, overcrowded two-bedroom house in a First Nations community in northern Ontario.

Present Situation

There is a new Community Health Center with a traditional circular healing room where traditional healers as well as a Nurse Practitioner, nurses, community health representatives, a nutritionist and a social worker are available. Rose has been coming to the health center on a more or less regular basis and has found herself drawn to the traditional healers. Rose has come to the health center because she is experiencing breakdown of her stump which is cracked, painful and is draining pus.

The Nurse Practitioner advised Rose that she may need to travel south to the hospital if the infection persists. Rose has no family members in the community and worries about who would care for her five grandchildren if she has to fly out of Northern Ontario for hospital care. Rose's granddaughter has come to the clinic with Rose. She is extremely overweight and given her family history is at high risk for diabetes.

Through her involvement at the Community Health Center and interactions with the traditional healers Rose has begun to become more active in the community and has joined a woman's drumming group.

She has found regular gatherings with her drumming group comprised of women of varying ages to be helpful with her struggle with alcoholism and depression.Her drumming group performed the opening welcome at an evening heart health talk held in her community for First Nations women and during that event, Rose discovered that diabetes is a major risk factor.

As a result of her experiences at the Community Health Center and in her drumming group, Rose has become involved in self-governance and has joined a group in the local band office particularly focusing on health issues such as diabetes, alcoholism and depression.

 

1.Using the nursing process develop a plan of care for Rose and her family.

2.Investigate how you would integrate Indigenous health beliefs into your nursing care plan for Rose and her family.

3.Investigate how you would integrate your knowledge of colonization and residential schools into the care for Rosa and her family.

4.Explore how you would integrate Rose's new appreciation of traditional healing into her care plan.

5.As a healthcare provider, what questions would you ask Rose about her family, community, and diabetes?

6.Identify Call to Action (s) needs for Rose and her community using the Call to Action Document