Mrs Janet Kneebone (ageing) Mrs Janet Kneebone is an 86-year-old widow who lives alone in her home about 25 kilometres from the nearest town. Her daughter, Kathy, lives 60 kilometres away and visits on weekends. Janet no longer drives due to her poor eyesight. As a result, she is home bound except for Sundays when someone from the church comes to pick her up and take her home again. Janet describes herself as “independent” and states she hates being “fussed over”. Janet does some shopping on the weekend with Kathy’s help, and gets Meals on Wheels. She has someone come in once a fortnight to clean and do the heavy washing such as sheets, but otherwise Janet takes care of her own washing and ironing. Lately there have been some problems with Janet leaving the stove on, and with washing being left in the machine for a couple of days because Janet forgot to hang it out. The house also has a faint odour of urine.
Janet has a history of gastro-oesophageal reflux and has been diagnosed with Barrett’s oesophagus. Her other medical diagnoses included arthritis and short term memory loss. Kathy is concerned that Janet’s memory problems are increasing.
Janet has spent a week in a rehabilitation ward for observation and treatment after a fall at home during which she sustained soft tissue injuries to her arm and leg. The referral letter from the rehabilitation ward to the community health centre states that Janet is becoming incontinent. During the day she regularly leaked urine and sometimes did not reach the toilet in time. Janet also complained of tiredness because she needed to use the toilet during the night. Janet’s current medications are:
Pantoprazole 20 mg daily
Panadol osteo tds
Aspirin 100 mg daily
Desmopressin 0.2mg nocte
Janet has an appointment to see the geriatrician at the memory clinic but that is not for another three months. Kathy is concerned about Janet’s safety in the interim.
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