Case Study: Social determinants of Health Assignment
Case Study: Social determinants of Health Assignment
Case Study: Social determinants of Health
Maria Santos is an 85-year-old, Spanish-speaking, Venezuelan immigrant. She lives with her husband, who also only speaks Spanish, on a farm on the outskirts of a small town comprised mostly of migrant farm workers. The downtown area has a grocery store, a gas station, and a small Hispanic restaurant.
Two days ago, Maria’s husband arrived by taxi to the hospital to pick her up. She was being discharged after a 9-day stay. Her primary diagnosis was “viral pneumonia.” She has secondary diagnoses of “dysphagia” and “osteoporosis,” and she ambulates using a walker. During the hospital discharge process, the respiratory therapist, along with a language interpreter, ensured that Maria could adequately breathe the room air. The nurse ensured that the correct oral and inhaler prescriptions were issued. Maria would receive a follow-up appointment with the primary doctor and a referral for home care services.
After Maria arrived home, her prescriptions were never filled and she ate very little. Today, when the home care nurse arrives at the farm home, Maria is in bed and breathing with labored breaths. The nurse notices that Maria’s husband is acting odd. He appears to have early dementia. Clearly, the husband is incapable of assisting Maria with even the most basic tasks for daily living. Maria’s discharge plan failed.
Nurses need to understand how social, economic, and environmental factors, also known as social determinants of health (SDOH), impact chronic morbidity, survival, and the well-being of older adults. In Maria’s case, obvious and unique health challenges are present in her environment. Support systems, personal lifestyle, cultural beliefs, and language barriers impact her health behaviors.
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- Identify two socioeconomic-related questions that the nurse could have asked Maria that fall under the umbrella of SDOH.
- Describe how the nurse could have addressed one of the following areas to better prepare Maria for discharge.
- Language/literacy
- Culture
- Social norms and attitudes (e.g., discrimination, racism, and distrust of government)
- Socioeconomic conditions (e.g., concentrated poverty and the stressful conditions that accompany it)
- Access to healthcare services
- Availability of community-based resources in support of community living and opportunities for recreational and leisure-time activities
- Transportation options
- Public safety
- Social support
- Exposure to crime, violence, and social disorder (e.g., presence of trash and lack of cooperation in a community)
- Residential segregation
- Access to mass media and emerging technologies (e.g., cell phones, the Internet, and social media)
- Culture
- Discuss a health policy currently in place or a health policy that is needed that would support Maria as she transitions back to her home environment. Case Study: Social determinants of Health Assignment
Socioeconomic-related questions
Social Support – The nurse should have asked Maria whether there is someone at home, whether a family member or friends, whom she can fully rely on to help her take her medication on a regular basis.
Language/Literacy – The second question that the nurse should have asked her is whether her language barrier may act as a hindrance in the administration of her medication while at home.
Social Support
If the nurse had asked Maria the first question posted above concerning social support, he or she would have discovered that the patient’s husband is suffering from dementia. She would also seek to find out whether there is someone else besides the patient’s husband that was capable of helping her meet her basic needs. According to this particular scenario, Maria only lives with her husband, who is the immediate source of social support. In this case, however, he has been deemed incapable of providing the adequate support needed for Maria’s successful recovery.
A social support network would be the most appropriate route for the nurse to take. This network may comprise of friends, other members of the family and peers (sometimes coworkers). It is not necessarily a support group, which is more of a structured meeting headed by a mental health professional or lay leader. A social support network helps relieve the patient from stressful situations since they are surrounded by people who love and care for them (Cherry).
In Maria’s case, the nurse should have contacted her next of kin or close friends who live near her. On the other hand, those who live far from her may also offer moral support by contacting her regularly. Friends and members of the family that live close to Maria’s home may take turns to visit them (Maria and her Husband) to ensure that she has taken her medication and has had something to eat.
Transition Policy
Discharge planning, when conducted effectively, plays a crucial role in the continuity of care after patients have been discharged. There are several procedures and activities associated with the discharge planning process. These take place on admission, during admission, at least 48 hours before discharge, day of discharge, and follow-up care (Waring et al.).
On admission, nurses are required to prepare an accurate and detailed patient record. They should also review assessment information and come up with a plausible date of discharge. During admission, they should conduct multidisciplinary assessments of the patient’s condition so as to classify and assess the conditions of discharge. The patient and their family should also be informed of the ongoing needs. At least 48 hours to discharge, the multidisciplinary team should be informed of the estimated date of discharge. The nurse should then initiate referrals to social care agencies. Any agencies concerned with ordering or installing medical equipment at home or conducting home modifications should also be contacted. On the day of discharge, the nurse in charge of the patient should contact the patient’s family or carers to confirm matters related to the follow-up arrangements, to ensure the completion of medical documentation, and to confirm transport. During follow-up care, the nurse should assess the continuing health-care package. When necessary, they should consult with a general practitioner (GP) (Waring et al.)
Works Cited
Cherry, Kendra. “Social Support Is Imperative for Health and Well-Being.” Verywell Mind, 2018, www.verywellmind.com/social-support-for-psychological-health-4119970. Accessed 10 Mar. 2021.
Waring, Justin, et al. “Hospital Discharge and Patient Safety: Reviews of the Literature.” Nih.gov, NIHR Journals Library, Sept. 2014, www.ncbi.nlm.nih.gov/books/NBK259995/. Accessed 10 Mar. 2021. Case Study: Social determinants of Health
