Patient Advocacy Case Study

Your patient is Mrs. Qi. She is a married mother of 7. She was born on May 15th, 1934. She lives at home independently and has not claimed any issues with maintaining her independence. Her children are not currently concerned with her ability to care for herself. 

Your primary care assessment of Mrs. Qi finds that she is independently mobile with no gait issues, warm affect with some minor challenges in her English language understanding, however you feel confident she has understood your questions. Her vital signs are: BP 132/62 Left Arm Sitting, HR 61bpm strong pulse with normal rhythm, SpO2 97% on RA, RR 21bpm - even normal breathing. Mrs. Qi says she has occasional pain in her knee joints that she needs no medication for. Her routine lab work shows no abnormal results and her routine ECG is normal.

In your conversation with Mrs. Qi the only time she seems uncomfortable is when you ask about her husband.  Mr. Qi recently moved into Long Term Care after 7 years of increasingly unsafe behaviour due to his advancing dementia. Mrs. Qi and Mr. Qi were married for 69 years this year (2021). Mrs. Qi was a teacher at an elementary school and Mr. Qi was a mechanical engineer that worked with their community planning office. They had 7 children together who remain a very close family and all live within a 10 min drive from their parents home. Mr and Mrs. Qi have actively taken care of their grandchildren for many years and have a very close relationship with their grown grandchildren. At this appointment is Mrs. Qi, her eldest daughter Susan and her eldest grandson Froh. They express worry that Mrs. Qi is becoming more and more depressed since Mr. Qi went to LTC. They have also noted that Mr. Qi has still not settled in his LTC and Mrs. Qi routinely receives concerned calls all day and night from nurses at the LTC, as he will only settle or eat once he hears Mrs. Qi's voice.

At the end of your assessment, Mrs. Qi breaks into tears and tells you that she is worried her husband will die from heartbreak and that she won't be there with him. She wishes she were "sick enough" to move with him. She feels that although she is well enough to be at home, she no longer enjoys it without him there.

Her children have told her that she can't move in, as she doesn't qualify for LTC.

Using all of the information in this primary care initial assessment, design a care plan that addresses Mrs. Qi's fears by advocating for her mental health. Example: Does Mrs. Qi have to be significantly physically impaired to be able to apply for LTC? If not, how would you advocate for her? Who would you advocate to?