Case 1

Geriatrician Assessment

Mr. Anders Davies is a 78-year-old white male who resides in his own home. He presents to the office today with complaints of right sided chest pain following a fall 1-week ago. This is his third fall in 6 months. He states that he slipped on the gravel driveway as he was getting his mail from the mailbox. His visitor from Foodnet (The Tompkins County Nutrition for the Elderly Program; see also Meals On Wheels for information on the national program) found him and assisted him into the house. He states that the pain is worse when he takes a deep breath and he has noticed a bruise overlying the area. He has only gotten some temporary relief with the Vicodin, which he has been taking more frequently than originally prescribed for the osteoarthritis of his knees, and is finding it difficult to sleep in bed. For the last 5 nights he has been sleeping in his recliner chair (slide 7 in slideshow). He denies any loss of consciousness with the fall. The patient claims he “doesn’t seem as strong as he was 4 months ago.”

Past Surgical History:

Pt lives alone in a 1-story home (slideshow) in rural upstate NY. He has lived in the same home for the last 51 years. His wife of many years died about 2 years ago. He has one son who lives 2 hours away. He is a former smoker having quit in 1983. He used to work as a lumberjack and blacksmith. He denies any alcohol use.

Independent with his Activities of Daily Living except that he has some difficulty bathing and dressing. He does do a little cooking, but has a midday meal delivered to his home. Gets help from a neighbor to keep up with yardwork. Drives independently but limits his driving to daylight hours and only 2 or 3 miles. Continent of bowel and bladder. Gets up twice each night to urinate. Began using a walker (slide 15 in slideshow) in his house after his last fall, but only uses a cane when he leaves the house.