You will be using the following scenario to complete your clinic assignments.
Please note the area the patient lives in when you are recommending resources for this patient. Since you are
not going to clinical, I expect you to research the resource that you are recommending and provide a
convincing argument on how this resource will benefit your patient.Scenario B- Older adult violence.
History: Family Violence
Mrs. Robb, a recently widowed 84-year-old woman, moved to her son’s apartment 3 months
ago in Pasadena, Texas. She had been living in her third-floor walk-up in Houston. Because
of her declining health and crime in the neighborhood, she went to live with her son, John.
He and his wife, Judy, who have been married for 20 years, have five children 6 to 18 years
of age, all living in a rather cramped three-bedroom apartment.
Ms. Green, a visiting nurse, monitors Mrs. Robb’s blood pressure. Over a series of visits,
the nurse notices that Mrs. Robb is looking unkempt, pale, and withdrawn. While taking her
blood pressure, Ms. Green observes bruises on Mrs. Robb’s arms. When questioned about
the bruises, Mrs. Robb appears anxious. She says that she slipped in the bathroom. Mrs. Robb
stiffens in her chair when her daughter-in-law, Judy, enters the room. The nurse notices that
Judy avoids eye contact with Mrs. Robb.
When the nurse asks about the injuries, Judy responds with anger, blaming Mrs. Robb for
causing so many problems. She will not explain the reason for the change in Mrs. Robb’s
behavior or the origin of the bruises to the nurse. She merely comments, “I have had to give
up my job since my mother-in-law came here. It’s been difficult and crowded. The kids are
complaining. We are having trouble making ends meet since I gave up my job, and my
husband is no help at all.”
Self-Assessment
Ms. Green has worked with violent families, but this is the first time she has encountered
older adult mistreatment. She discusses her reactions with the other team members. She is
especially angry with Judy although she can understand the daughter-in-law’s frustration.
The team concurs with Ms. Green that this family could use some support. If abuse does not
stop, they will need to take more drastic measures and contact legal services.
Clinic Scenario assignment:

1. What are important assessment data you should obtain or document on this patient. Is there any information
   you should gather from family members or significant others in this situation?
2. Community health nursing addresses components of primary, secondary and tertiary prevention. (refer to
   chapter 27). Define one of the following concepts from your textbook (primary, secondary or tertiary
   prevention). Compare how the care you would have provided or recommended in this scenario met the type of
   prevention you identified.
3. Define case management and the duties involved. Identify case management changes that may have a
   positive impact for this patient and give rationales to support your suggested changes.
4. Community resources play a major role for patients with mental health problems. Identify resources in this
   case scenarios demographic location that would best benefit that patient. Be specific and provide a convincing
   argument on how this resource will benefit the patient or family in the scenario.
5. What specialized assessment tools/screening would be most beneficial for you to gather assessment data
   on your patient and why you think this tool would be valuable for you.