Moira Brown is 67 years old white Irish woman who lives in her own home on Apple Lane with her sister Athena Jones age 63. She is a retired Nursing Assistant who moved to London in 1970. Moira described herself as heterosexual and has had a number of relationships in her youth but nothing she describes as ‘serious’. Moira has a long standing problem with alcohol. She also has a tendency to hoard and she is known to adult social care and mental health services in the past. Adult social services have been to the property in the past to clean and tidy the house of the clutter, which has again become terribly cluttered and dirty despite efforts by Athena to keep the house clean and free of clutter. Athena came to live with her sister two years ago as support for her mental health issues for which she takes olanzapine medication and at times needs to be supervised depending on her state of mind. Moira’s drinking recently has worsened and Athena is now finding it challenging living with her sister.
Moira is a smoker and has developed a persistent cough over the last couple of months. She has also complained of dizziness , especially in the morning or when getting up from a chair. This has resulted in her stopping going out as she is fearful of falling over. A further consequence is that she is increasingly reliant on fast food delivered to her door. Athena says that Moira will not eat the food she cooks and has said that its poison and that Athena wants her dead so she can take the house. Athena believes this to be said in jest but over the last few weeks believes her sister to be increasingly confused and distressed. She has found Moira fretting about a lost cat but she hasn’t had a cat for several years. At times Moira can be her old self without any confusion so Athena puts the temporary confusion down to the effects of alcohol.
Moira has a number of friends in the local community who visit weekly. She is also a regular member of her local church although since her dizzy spells she has not been attending in person. She has attended church services via Zoom on her lap top computer and is a competent computer user.
Can you identify any issues , using Roper , Logan & Tierney , that affect her activities of daily living?
Can you identify two issues that would require further assessment, one physical and one mental health related?
How might you promote health regarding this individual?” What do you regard as important and why?