Revisiting the Real Life Scenario
Tom
We met Tom at the beginning of the chapter. He has lived on the streets for the bulk of the last 3 years. If you recall the study by Hwang et al. , (2009) the authors indicated that men only have a 32% chance of living to 75 if experiencing homelessness. At 75 years of age, he has surpassed these odds, but he still faces a very uncertain future as his physical and mental health deteriorate. The NP assessing Tom has significant concern that he is experiencing signs of lung cancer. He is also concerned that Tom may have signs of worsening dementia, making his care more complex.
We need to ask ourselves:
- What comes to mind when you think of Tom and the challenges he may be facing? How does his situation make you feel?
- What recent traumas has Tom experienced? How do you think these may be affecting his health?
- Think about the social determinants of health that may have been at play in Tom’s life prior to his wife’s death. How do you think these have changed in recent years?
- How might the diagnoses of lung cancer and dementia complicate the trajectory for Tom’s life? How might they complicate the quality of his death?
- We have learned that social inclusion is important to well-being. As the NP considers Tom’s current support system, what challenges do you see he will face in connecting or re-connecting Tom to personal and social supports?
