Case Study: Mary is a 76-year-old lady. She lives on her own in a small rural town outside of Galway city

Case Study:

Mary is a 76-year-old lady. She lives on her own in a small rural town outside of Galway city.  She has been recently bereaved following the sudden death of her husband two months ago. Mary had a great relationship with her husband and he looked after meals, shopping and the day to day chores. They have one son Darren who lives in Dublin with his wife and children. Mary sees her son and her grandchildren’s during holidays times and acknowledges that they have to live a life of their own. Mary moved to Galway from Dublin fifteen years ago at her husband’s wishes, Mary has no other family in Galway and has made very little friends since moving to Galway. Mary is not familiar with the community services in her area and feels there are probably supports and services in the city that she could access if she was familiar with them.

Mary’s own health has deteriorated over the last few years with a medical history of congestive cardiac failure, chronic obstructive airways disease and irritable bowel disease. She is registered with her local GP however she does admit that she rarely visits him unless she is quite ill with her chronic obstructive airways disease. She has had a number of admissions to the acute hospital setting as a result of her chronic obstructive airways disease and she finds this condition the most challenging to manage. She acknowledges that her lack of exercise is not helping her condition. She said that she would like to make a change in this area and she feels she is now in a better place to make a change.

Mary smokes 35 cigarettes a day. She is thinking of giving them up as she feels her health is deteriorating. She acknowledges that she would like help in giving them up and would like support in making this change.

Mary has a mental health history suffering with depression. Her last admission to the mental health services was in 2014.  Mary takes anti-depressant medication. Sometimes she forgets to take them and says this is not good for her health. She attends the psychiatrist yearly and admits when she feels down she gets into bed and hopes this feeling will pass. Mary said her husband was a great support to her during these difficult times. She has expressed that she misses his support and that she really misses him and is finding it hard to cope without him. She does worry about her mental health and hopes she won’t need any admissions to the acute mental health services. She has relied on alcohol in the past to assist her in coping with stressful situations. She is not drinking at present however she admits that she can be tempted when she feels lonely and has no one to talk to.

Mary feels her weight has increased over the last year.  She feels the increase in weight has affected her mobility and her ability to maintain her independence and said it possibly is affecting her physical health. Mary feels that it is difficult cooking for one and as a result she relies on a lot of unhealthy foods. She has expressed her need to lose weight and would like support in this area of her health.

Critically discuss the role of the community general nurse in supporting Mary’s health and wellness in the community setting.