Amalie’s Case: Nursing Priorities, Goals, and Actions

This paper used the case study of Amalie to showcase how nursing care can identify her problems, prioritize, and address them adequately. From the case, it has been discovered that the main issue facing Amalie is the social isolation/helplessness/loneliness. This has caused her a lot of derived problems, and hence there is a need to solve this problem so that she is restored or reintegrated back into the community.

Running head: AMALIE’S CASE 1
Amalie’s Case
Name
Institution

AMALIE’S CASE 2
AMALIE’S CASE
Introduction:
This paper used the case study of Amalie to showcase how nursing care can identify her
problems, prioritize, and address them adequately. From the case, it has been discovered that the
main issue facing Amalie is the social isolation/helplessness/loneliness. This has caused her a lot
of derived problems, and hence there is a need to solve this problem so that she is restored or re-
integrated back into the community.
Part A: Identify there Nursing priorities in Amalie’s case
Consider Facts:
This an 89-year-old woman-Mrs. Amalie who has migrated to Australia from Germany
forty years ago. She lives alone following the death of her husband. She has retired from primary
school teaching and has stopped doing the things she loved like traveling and volunteering. She
is no longer able to participate in German Association actively. Her health is gradually
deteriorated and has since forced her to withdraw from the activities she loved and engaged in so
many years.
She is lonely and feels isolated and helpless. She has developed dry macular degeneration
due to age and can no longer drive. She faces difficulty with her mobility because of substantial
problems with rheumatoid alongside osteoarthritis. She rarely leaves the house and has lost
physical contacts with many friends and German Association members. Her house remains
unkempt with bare cupboards. She still feels attached to the community and wishes to stay there,
but she needs helps. She feels more of a burden to her daughter Tracy. She is not eating well,
fast-losing weight and becoming increasingly isolated.
Collect Information:

AMALIE’S CASE 3
Amalie had a medical history of arthritis, hypothyroidism and macular degeneration. She
isolated and helpless following the death of her husband. She can no longer drive and even leave
the house. There is a need for ADLs performance because Amelie seems to be suffering from the
risk of being isolated socially and depression (Miller, 2015).
Process Information:
Health deterioration is related to her socially isolation. Amalie feels isolated from doing
what she loves most including actively participating in German Association or even volunteering
in the community. Her lack of mobility is related to the age-associated illness including
rheumatoid and osteoarthritis. Her development of macular degeneration is linked to her inability
to walk or even drive around. Her lack of eating, loss of weight and isolation contributes to her
continued health deterioration (Dawes et al., 2015).
Identify the Problem
Amalie is suffering from isolation. This is greatly contributing to her deteriorating health.
For example, being lone in the home and despite being sick, Amalie is unable to do most of the
things she used to do before. This has even made her lose weight because she cannot even eat
well. Therefore, the first nursing care priority Amalie needs is to work towards eliminating her
isolation (Levett-Jones, 2013). This is because Amalie loves her community and she would wish
to stay there. However, she needs help. Therefore, there is a need for someone who can help her
including driving her around and even taking her to the German Association since this is one of
the things she loves most.
She also needs treatment for her deteriorating health. As has been seen in the case she has
a medical history of arthritis and even hyperthyroidism. This must have been persisted due to the
information is given in the referral letter from the GP and even the medications. By doing this,

AMALIE’S CASE 4
her deteriorating health will be curtailed, and Amalie will be able to get back to her life once
again.
Amalie also lacks dietary, and this is why it is indicated by the case that she is not eating
and even already losing weight. Therefore, the nurses need to ensure that Amalie will henceforth
be in a position to take her meal well. This will help her restore her weight and improve her
deteriorating health. She is also in need of physical exercise because she has not even been
leaving her house and hence physical activities need to go in hand with the diet.
Part B
Top priority:
Amalie is suffering from isolation or helplessness. This is greatly contributing to her
deteriorating health. For example, being lone in the home and despite being sick, Amalie is
unable to do most of the things she used to do before. This has even made her lose weight
because she cannot even eat well (Licón et al., 2015). Therefore, the first nursing care priority
Amalie needs is to work towards eliminating her isolation. This is because Amalie loves her
community and she would wish to stay there. However, she needs help. Therefore, there is a
need for someone who can help her including driving her around and even taking her to the
German Association since this is one of the things she loves most (Nightingale, 2016).
Establish Goals
The goal to address this top priority is to have Amalie given a helper in her own house. In
the next few days, the nurses will contact her family so that it will be possible to arrange for her
get a helper for Amalie. She needs to stay with someone who can drive her around, keep her
house clean, make food for her, take her out for physical exercises, and drive her to the German
Association to restore her lost physical contact. Because of her age, Amalie is unable to do these

AMALIE’S CASE 5
by herself and, therefore, her isolation and helplessness is the mother of all the resultant
problems she is faced with. Therefore, the nurse must accord her this top priority and help her
solve the problem while maintaining her dignity. This is because Amalie has stated clearly that
she loves her community and hence her respect and dignity will be achieved only if she is left in
the community and taken around to see and do the things she has been doing in her many years.
Take Actions:
As has been seen in the case of Amalie, she is suffering from the social isolation and
helplessness that have even contributed to the associated problems. This social isolation denotes
that lack of contract or even support. Indeed, she feels isolated, and this describes the act of
loneliness. This is a multifaceted matter and hence is never simple to resolve by addressing a
single action or aspect (Meltzer, 2018). The GP is well placed to identify how Amalie is at risk
of loneliness, helplessness and even socially isolated. This has been identified as Amalie has not
only lost her physical contacts but also does not even leave her house yet she loved going to
German Association.
Thus when taking action, group-based activities and support will suffice as this will
provide opportunities for social interactions appear to demonstrate some promise in tackling
Amalie’s case of loneliness, isolation, and helplessness. Therefore, the best action to be taken
here will be Activity Daily Living (ADL) assessment. This will give the best overview of Amalie
and the specific actions needed to take to solve her problem. As has been noted above, she is
even never eating, and she is already losing weight. Thus such an assessment will be effective in
ensuring that all these problems are restored. Therefore, best strategy or framework will be
organized to help Amalie solve her problems.
Evaluate Goals:

AMALIE’S CASE 6
The expected outcomes that will arise from the above actions include the following. One,
it is expected that Amalie will be re-integrated back into the society and community. For
example, it is expected that Amalie will be given someone who can drive her to German
Association. By doing this, she will be able to regain her lost physical contact. This will have a
derived effect of making Amalie feel that she can still enjoy and do things she loved doing and
hence indirectly restore her deteriorating life. It is also expected that Amalie will be able to have
some physical exercise being assisted by the helper (Liou et al., 2016). This will help boost her
mobility, and after some short duration, she will be able even to try to drive again by herself.
Further, it is expected that Amalie will feel care for and hence eliminate the feeling of
loneliness that even contributed towards her inability to eat. Thus by having a helper close to her,
Amalie will be able to have the urge to eat and hence restoring her health (Matthews et al.,
2016). Also, it is expected that Amalie will still get to travel to places and even volunteer as
these are the things she has been doing in her previous years. Even if such voluntarism does not
involve her physical undertakings, taking her to schools can still mean that she can talk to the
pupils and give them advice and this will always help her feel socially integrated (Hunter, 2016).
Reflection:
From this case, I have learned a lot. First, I have been able to appreciate the need to be
socially included and the risks associated with social exclusion. I have learned that a person must
be assisted at all levels irrespective of age to feel included in the society because, without which,
the person’s health can really deteriorate (Jais, Hignett, Habell, Brown & Hogervorst, 2016). I
now understand why the limitations of the COPD in undertaking effective ADL. If I were to
know about COPD, I would give comprehended the effects on Amalie’s ability to understand her

AMALIE’S CASE 7
ADL. I currently fathom the impacts of lack of mobility on the patients’ health and I have hence
realized that there is a need for physical exercise amongst the elderly.
Therefore, in my next encounter, I will be able to do my best to ensure that my patients
re-ushered into the community and make them enjoy all the things they have been doing in their
life (Peterson, Marcusa, Hage & Vitale, 2016). This will make them give the best in the
community despite their ages. I have also learned that a person does not have to engage in
activity to give her contribution physically. However, their presence and advice will be able to
achieve a lot even in their absentia. Thus, there is always the need to ensure that a person does
not feel lonely by making her continue being appreciated even when they have become old
enough and have retired (Ang & Van Dyne, 2015).
Conclusion
The case of Amalie has been used to show how the GP can identify the persons nursing
needs and act upon them to benefit the patient. It is expected that after the implementation of the
actions highlighted in the discussion, Amalie top priority identified above will help her get re-
integrated in the community and solve her deteriorating health.

AMALIE’S CASE 8
References
Ang, S., & Van Dyne, L. (2015). Handbook of cultural intelligence. Routledge.
Dawes, P., Emsley, R., Cruickshanks, K. J., Moore, D. R., Fortnum, H., Edmondson-Jones,
M., ... & Munro, K. J. (2015). Hearing loss and cognition: the role of hearing AIDS,
social isolation and depression. PloS one, 10(3), e0119616.
Hunter, S. (Ed). (2016). Miler’s nursing for wellness in older adults (2nd Australian and New
Zealand ed.) North Ryde, NSW: Lippincott, Williams and Wilkins.
Jais, C., Hignett, S., Habell, M., Brown, A., & Hogervorst, E. (2016). Defining activities of daily
living for the design of dementia care environments.
Levett-Jones, T. (Ed.). (2013). Clinical reasoning: Learning to think like a nurse. Frnechs Forest,
NSW: Pearson.
Licón, M. T. C., Uribe, H. E. R., Ruiz, O. C., López, E. D., & Rodríguez, J. M. (2015). The
clinical reasoning through the basic cycle, an option for the integration of the medical
sciences. Revista Educación Médica del Centro, 7(1), 18-30.
Liou, S. R., Liu, H. C., Tsai, H. M., Tsai, Y. H., Lin, Y. C., Chang, C. H., & Cheng, C. Y.
(2016). The development and psychometric testing of a theory‐based instrument to
evaluate nurses’ perception of clinical reasoning competence. Journal of advanced
nursing, 72(3), 707-717.
Matthews, T., Danese, A., Wertz, J., Odgers, C. L., Ambler, A., Moffitt, T. E., & Arseneault, L.
(2016). Social isolation, loneliness and depression in young adulthood: a behavioural
genetic analysis. Social psychiatry and psychiatric epidemiology, 51(3), 339-348.
Meltzer, L. (Ed.). (2018). Executive function in education: From theory to practice. Guilford
Publications.

AMALIE’S CASE 9
Miller, D. (2015). Critical rationalism: A restatement and defence. Open Court.
Nightingale, K.E., 2016. Embedding Simulation-Based learning in a Capstone Undergraduate
Nursing Subject to Develop Clinical Reasoning Skills.
Peterson, J. M., Marcusa, D. P., Hage, A. N., & Vitale, C. A. (2016). Artists’ Statement: ADLs—
Activities of “Disabled” Living. Academic Medicine, 91(6), 777.