NUR 304 The Older Adult Case Study 

You are caring for Sherman “Red” Yoder who has come to your community health center for treatment of an open wound on his right big toe. 

Sherman Red Yoder is an 80-year-old former farmer who lives alone in the farmhouse where he grew up. It is located 20 miles outside of town. Red has been a widower for 10 years and still misses his wife. She did all the shopping, cooking and cleaning. He attends religious services “when he can.” He regularly visits his local VFW to play cards and have a beer and donut with his friends.  

Red’s current medical problems include insulin dependent diabetes complicated by an open foot wound on his right big toe. He received the wound after he wore a new pair of shoes that were tight for him. Red has been treating the open foot wound by soaking it in hot water and searching the internet for information on treating his wound. He says the photos of the wounds on the internet cause him to feel anxious about his wound. Red has a cane, but he does not always use it. He says his toe hurts him when he walks so, he has been mainly sitting in his recliner watching TV. 

He has difficulty sleeping and drinks 2 beers in the evening and takes over the counter “sleep aid” pills to helps him sleep. He gets up several times during the night to void and must walk as fast as he can to make it to the toilet. 

He tells you he feels his over health is fine. He says because of his diabetes, he tries to follow a “low sugar diet” when he can but does enjoy a piece of cake or cookie after dinner.  

Red says he wants to be independent as possible. He has hearing aids and wears glasses. He drives himself back and forth to town to get his groceries and other supplies. 

  1. Using Gordon’s Functional Health Patterns, what concerns in any/all of the following patterns can you identify?


  • Health perception/Health maintenance pattern
  • Nutritional patterns
  • Elimination patterns
  • Activity/exercise patters
  • Sleep/rest pattern
  • Cognitive-Perceptual pattern
  • Self-perception/Self-concept
  • Roles-Relationship pattern
  • Sexuality-reproductive pattern
  • Coping-Stress tolerance pattern
  • Values-Belief’s pattern


  1. What safety issues should be addressed/discussed with Red during this visit?


  1. What vaccinations/immunizations should be documented for Red? 


  1. Describe each of the following potential Barriers to Effective Communication as they relate to Red:


  • Anxiety
  • Attitudes
  • Gaps between nurse and individual
  • Resistance
  • Transference and Distorting 
  • Sensory Barriers
  • Failure to Address Concerns or Needs