Instructional Strategies

Mr. T.G.

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Case Study 1: Mr. T.G.

Mr. T. G., an Alaska Native patient/client in his mid 70s was referred to the public health nurse for assessment. He was recently diagnosed with Type II diabetes, is overweight, and has emphysema from smoking 1 to 2 packs of cigarettes a day. He has been “coughing” often and seems to be getting worse. He has a history of latent TB and binge drinking between ages 20 to 30 (around 1950 to 1960).

He did not complete the INH treatment for latent TB at that time due to his active addiction. He has been alcohol-free for 30 years.

Mr. T.G. lives in the village with his adult daughter and grandchildren in a small home without running water. Two of his school-age grandchildren had a positive PPD (12mm) during school screening performed by the PHN.

There is a strong history of TB in the family. A grandmother died of the illness between 1930-1940, and several extended family members received treatment in a sanatorium away from the village.


Questions for Discussion

Questions for Discussion

1. Using the cohort analysis model, list some of the historical factors that may impact Mr. T.G. and his family’s healthcare attitudes towards accessing western healthcare services.2. Examine the list you generated and provide a brief explanation of why you think these events may impact his and his family’s healthcare attitudes?

3. What kind of questions would you ask to elicit the patient’s experiences with the healthcare system and what he thinks about his illness?

4. Based on your discipline, what types of information would you include in a geriatric assessment for Mr. T.G., and propose culturally acceptable interventions for problems areas that you identified.