Comprehensive Care

Plan Development
Case Study 37:
Mr. Nakamura with Chronic Hepatitis

Presbitero, Keiye Nadine I.

DATE : MARCH 28, 2024
 Name: Mr. Nakamura
Age: 76 year old
Health Condition: Chronic
Hepatitis C, liver Cirrhosis
Living Situation: Live in a high-
rise Senior living building

Medical History: Background: Recent Developments:

Chronic Hepatitis C diagnosed Worked in commercial fishing, now Increasing fatigue and weakness,
20 years ago, managed with retired. with concern over potential
antivirals, has progressed to Has a supportive community within esophageal variceal bleeding.
cirrhosis the senior living building, including Difficulties maintaining a
Regular monitoring of liver other retirees with similar balanced diet due to ascites and
function to manage cirrhosis backgrounds. fluid restrictions. Expressed
and screen for hepatocellular concerns about losing
carcinoma independence as his condition
Complication includes requires more intensive medical
esophageal varices and mild management
ascites
Daily Care Requirements
Personal Hygiene

Mr. Nakamura requires a gentle reminder about his chronic health

conditions, such as hepatitis C and liver cirrhosis, to ensure his comfort and
independence. He needs personalized attention for his personal hygiene,
including bathing, oral care, and grooming. Establishing a consistent routine
for his personal hygiene is essential to reduce his confusion and stress.

Dressing

It is important to choose clothing made of cotton, which is less likely to

irritate or infect sensitive skin affected by chronic disease.
Daily Care Requirements
Eating

It is recommended for Mr. Nakamura, who is facing

complications, has to maintain a balanced diet. This can
be achieved by eating small and frequent meals
throughout the day that are rich in protein. He should limit
his salt intake to avoid any further complications, Mr.
Nakamura must focus on nourishing fluids like milk-based
drinks or supplements, avoid tea, coffee, water, or diet
drinks, and always drink water. It is important for him to
maintain a healthy and balanced diet to manage his
condition effectively.
Daily Care Requirements
Mobility
Mr. Nakamura's chronic Hepatitis C and liver cirrhosis
conditions require critical support to maintain his stability,
independence, and safety in his living environment. To
achieve this, it is necessary to install grab bars in critical
areas such as the bathroom to aid with balance, clear clutter
and trip hazards from pathways, provide mobility aids such as
a walker or cane, and consider moving his living space to a
lower floor to minimize the need for stair climbing
Daily Care Requirements
Environment Modification
1. Ensuring a space for living that is easily accessible with
minimal obstacles
2. Install grab bars in the bathroom, bedroom, or around the
house to assist with mobility and prevent falling.
3. Provide a comfortable seat and bed.
4. It is important to create chances for residents to socialize
within the senior living community.
Communication Strategies

It is important to allocate some time to actively

listen to his concerns and frustrations about his
current health condition.

Avoid using medical jargon. Use simple

language with Mr. Nakamura.
Communication Strategies

Using a visual aid such as a diagram, chart,

or written instructions can enhance verbal
communication.

It is important to involve Mr. Nakamura's

family in discussing his care plan.
Communication Strategies

It is important to encourage him to ask questions

and voice any concerns he may have regarding
their condition or treatment.

It is important to respect Mr. Nakamura's autonomy

and involve him in decision-making related to his
care, whenever possible.
Medication Management

Create a schedule to organize Mr.

Nakamura's medication. The
schedule should be easy to read
and indicate the times and dosages
clearly to ensure that he can easily
access and follow it.
Medication Management

Use alarms, apps, or a

smartwatch to remind Mr.
Nakamura and his caregivers
when to take his medication.
Medication Management

It's important to regularly go over

medication instructions with Mr.
Nakamura and his caregivers,
answering any questions or
concerns that may come up to
ensure they understand and follow
the instructions correctly.
Medication Management

Organize and secure sharp

objects by assessing the cabinet
space, selecting suitable
containers, segregating sharp
objects, and labeling containers.
Place frequently used items within
reach and maintain them regularly.
Emergency Response Procedures

Ensure that Mr. Nakamura has easy access to

emergency contact numbers

Mr. Nakamura should have access to a reliable

communication method during emergencies, such
as a cell phone or landline with large buttons and
clear instructions for dialing emergency numbers.
Emergency Response Procedures

Consider enrolling Mr. Nakamura in a medical

alert system that he can easily access in case of
falls, sudden illness, or other emergencies.

Utilize the supportive community within the senior

living building to establish a network of neighbors
who can assist Mr. Nakamura during emergencies.
Emergency Response Procedures
Make sure to keep an easily accessible list of
Mr. Nakamura's current medications, dosages,
and any relevant medical information in case of
emergencies.

Develop a personalized emergency response plan

for Mr. Nakamura, outlining specific steps to take in
different emergency scenarios such as sudden
onset of bleeding from esophageal varices or
worsening ascites.
It's important to regularly review and modify Mr. Nakamura's care
plan and strategies based on any changes in his health condition.
This ensures that he is safe, comfortable, and well-cared for.
Open communication with Mr. Nakamura and his supportive
community in his senior living building is crucial to addressing any
evolving needs or concerns. By adjusting the care plan as needed,
continue to provide Mr. Nakamura with high-quality care and
support, promoting his overall health, and maintaining his
independence as much as possible
Reference
https://www.cdc.gov/hepatitis/hcv/hcvfaq.htm
https://liverfoundation.org/liver-diseases/complications-of-liver-disease/cirrhosis/
http://www.liverwellnessprogram.com/nutritional-advice-for-advanced-liver-disease.html
https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uf7910
https://youtu.be/5ClB3C622Q4?si=bKhsbZoj32DR6qx6
https://youtu.be/gamxKsaLbhs?si=4B0d7XHOAzztQQUS