Judith Byrne is an 81 year old woman who experienced a haemorrhagic left CVA twelve months ago.

This has left Judith with an altered gait, a right-sided hemiplegia and an expressive dysphasia. Judith is a single woman with an estranged 45 year old daughter and grandchildren who live interstate. Judith has been unable to forgive her daughter for abandoning her mother when Judith needed her help a number of years before. Judith lives in a small, rented house, with a range of community services supporting her, including homecare (shopping, cleaning and washing), meals on wheels, as well as a carer coming twice a week to assist with personal hygiene. Judith has refused any other assistance being adamant that she is OK. Judith is able to ambulate for short distances on her own using a walking stick. A ramp has been installed to assist her to get up the ten stairs into her house. Judith smoked cigarettes for 30 years and only stopped when she was hospitalised following the CVA as she was unable to access cigarettes. She has some residual shortness of breath as a result, and finds walking and talking to be particularly challenging. Her blood pressure is usually around 150/90 and she develops ankle oedema when sitting for a prolonged period. Her current medications are: ¢ Aspirin 150 mg daily ¢ Paracetamol 1 gram PRN ¢ Salbutamol 2 puffs PRN ¢ Telmisartan and Hydrochlorothiazide 80/12.5 mgs mane The carer that attends to Judith’s hygiene is attached to the community health centre where you work. She reported to you that she is concerned Judith may have fallen a couple of times because she has bruises on her body that are in varying stages of healing and she has observed Judith stumbling even with her walking stick.

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