Running head: COMMUNITY CASE STUDY

Community Case Study

Marvin A. Berueda
Kapiolani Community College

COMMUNITY CASE STUDY

Community Case Study

A community case study took place in order to gain an understanding of different aspects
pertaining to an individual in the community. These aspects include development, functional
ability, family dynamics, culture, and nutrition. The client participating in the case study is a 68
year old man. He is a retired truck driver who worked for Ameron, a concrete producing
company in Hawaii. Being the eldest of eight children, the client has always had a big family.
This community case study includes findings of the aforementioned aspects pertaining to his life.

Developmental Assessment
The clients age characterizes him into the final stage of theorist Erik Eriksons
psychosocial theory of development. Being 68 years old, he would be placed in the stage of
Integrity versus Despair. According to Potter and Perry (2014), most of the older generations
reflect on their lives with a sense of fulfillment despite any mistakes while some view their life
as a failure filled with regret (p.132).
During the case study, the client was asked a series of questions pertaining to his
experiences and overall value on life. When asked if he had any regrets in life, he said he wished
that he focused more on his diabetes. The client says that he has had diabetes for a long time but
wishes that he focused more on maintaining it early on. This client goes to dialysis three times a
week and has suffered a few complications because of his diabetes. He states that life could have
been better if he wasnt on dialysis but mentions that he accepts it and that it has been easier to
go through because of his support system. The client mentions that family is the single most
important thing to him. He is surrounded with people who love him and support him
unconditionally. If not for my wife and daughter taking care of me, I dont know where I would

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be. Im so proud of how my kids turned out and how my grandchildren are turning out.
Overall this client seems to be in good spirits. Although he wishes he didnt have to go to
dialysis, the good seems to outweigh the bad. The client mentions that besides being a father, one
of the best moments of his life was becoming a grandparent. He says, I love all my
grandchildren and they make my day when I see them. The clients ability to focus on the good
in his life and come to terms with minor setbacks allows this client to live life with integrity
rather than despair.
Lawrence Kohlberg is another theorist who focused more on moral development of
individuals. There are three different levels of moral development each consisting of two stages.
During the interview the client was asked what he thought about the society and generation of
today. He said that the generation now is too engulfed in their technology that they are missing
out on what is happening in front of them. The client said, The generation now is always
speeding on the road and they text when they drive. How many lives have been taken because
their eyes were on their phone instead of the road? He mentioned that he is glad that they are
fining drivers who text while driving. This demonstrates stage five of Kohlbergs moral
development theory. According to Potter and Perry (2014), Individuals recognize the possibility
of changing the law to improve society. Individuals determine what society should value (p.
136).
Functional Abilities
According to Giddens (2013) functional ability is The physical, psychological, cognitive
and social ability to carry on the normal activities of life (p.11). This client has had amputations
on both lower extremities below the knee. He requires a wheel chair to ambulate and has to be
assisted when performing some of his ADLs as displayed in Appendix A. Although he is very

COMMUNITY CASE STUDY

alert and oriented these physical attributes greatly limit his functional abilities. He says that his
wife helps him bathe by washing his backside as it is hard for him to reach. As far as toileting, he
just needs assistance getting to the toilet but is able to do everything else independently. This
client is capable of feeding, grooming, and dressing himself. There are a few things that he is
completely dependent upon his family to carry out and they include cooking, shopping, and
home maintenance. His family takes care of all the shopping and meal preparation but they allow
him to do the things he is still capable of doing. The client displays good upper body strength as
he is able to transfer himself from his wheelchair to the passengers seat and couch with
supervision.
Culture
This patient has lived on Oahu his whole life and embraces his Hawaiian culture. When
asked if there were any health practices that were related to his culture he said that his parents
would make them gargle with Hawaiian salt and warm water whenever they had a sore throat. If
the sore throat persisted they would be taken to the doctor immediately. This was the only
healthcare practice mentioned that could be related to culture. The client said, We werent too
big on herbal medication and home remedies. Whenever one of us got sick our parents would
take us to the doctors right away. His children have adopted this idea by handling sickness the
same way. They prefer being checked out by a doctor than using any kind of holistic medicine.
Nutrition
The clients BMI is about 32. This means that he is a little over the obesity range of 30 but
this may be due to his inability to do any strenuous exercises and his mobility limitations. The
client was asked to recall what he ate in the last twenty-four hours. He says he had a small
portion of corn-beef hash, eggs, and a quarter cup of rice with a small cup of tea. Lunch

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consisted of beef tomato with poi and apple sauce for dessert. Dinner consisted of beef tomato
with another quarter cup of rice and a small cup of water. All of the clients meals are small
portioned and prepared by his wife. According to MyPlate (2011), the client consumed all the
nutrients that should be in a meal including fruits, grains, vegetables, and protein. MyPlate
(2011) suggests that at least half of a meal should be fruits and vegetables. This means that it
would be recommended for the client to consume larger portions of vegetables daily. The client
mentions that he would rather eat what he enjoys in moderation. This also adheres to MyPlate
(2011) as it says to enjoy meals but eat in moderation. This client is diabetic and on dialysis
which means that he has to monitor his sugar, sodium, phosphorus, and fluid intake. The client
always eats in moderation as his wife is always monitoring what he eats. He mentions that on his
dialysis report card his lab values are always in range.
Nursing Interventions/Conclusion
Since this client has been receiving good results with his lab values no intervention is
needed for nutrition. He did mention that it has been hard to swallow some foods. This means
that he may be beginning to experience a little dysphagia. I recommended that he avoid
completely solid and dry foods. It would be easier for him to swallow moist foods to avoid pain
and choking. Although he is very alert and oriented, his physical limitations make him a
dependent for some of his ADLs as displayed in appendix A. His areas of need are fulfilled by
the strong support system his family provides. They assist him with fulfilling his ADLs and keep
up with all his medications, doctor appointments, dialysis appointments, and nutritional needs.
This client is well taken care of and continues to develop with the support of his wife, children,
and grandchildren. His family continues to keep him in good spirits.

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6
References

Giddens, J. (2013). Concepts for nursing practice. St. Louis, Mo.: Mosby/Elsevier.
Potter, P. A., & Perry, A. G. (2013). Fundamentals of nursing (Eighth ed.). St. Louis, Missouri:
Mosby/Elsevier.
U.S. Department of Agriculture. (2011). Dietary Guidelines Consumer Brocher. MyPlate.
Retrieved from http://www.choosemyplate.gov/print-materials-ordering/dietaryguidelines.html

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Appendix A
FUNCTIONAL ABILITIES EVALUATION
Optimal

Feeding
Bathing
Toileting
Bed Mobility
Dressing

4
4
4
4
4

Grooming
General Mobility
Cooking
Home Maintenance
Shopping

4
4
4
4
4

Functional level codes:

Level 0: Independent
Level I: Requires use of equipment or devise
Level II: Requires assistance or supervision from another person
Level III: Requires assistance or supervision from another person and equipment or
device
Level IV: Is dependent and does not participate
Objective:
Demonstrated ability (functional code listed above) for:
Feeding
Bathing
Toileting
Bed Mobility
Dressing

0
3
3
3
0

Grooming
General Mobility
Cooking
Home Maintenance
Shopping

0
3
4
4
4