Helen Davis is a 76-year-old female who presents to her primary doctor’s office for a routine checkup. She has a history of hypertension and hyperlipidemia (diet-controlled), and her current medications include lisinopril/HCTZ and amlodipine. Her only complaint is long-standing anxiety; you had previously placed on PRN Xanax but she didn’t like the side effects.
On exam, her vital signs are: BP 130/72 HR 75 RR 12 T 37.2C (99F) 98% RA. She has a normal physical exam, excepting an anxious affect that is consistent with her described mood. She denies AVH (auditory verbal hallucinations) or SI (suicidal ideation); no reported alcohol or other substance use.
Dr. Tanner, your clinic preceptor, reassures Miss Davis and encourages her to get plenty of rest and limit the stressors in her life. As Dr. Tanner exits the room, you (the medical student) decide to ask her a few more questions regarding her anxiety.
Miss Davis has several stressors in her life. First, she lives alone – and she reports that she lives in a "rough" neighborhood. Next, her only source of income is the $700 check she receives from Social Security. She does receive food stamps and medical assistance from the county assistance office, though despite this, she still has a hard time paying for her gas and electric bills. Her utilities are on, but she’s behind in her payments.
She also describes being behind on her rent checks, and she constantly worries about losing her apartment.
A reasonable plan to manage her issues is as follows:
Remember to look for resources under "Top 5," JeffHope spreadsheet, and CE Resources spreadsheet.
Jefferson has partnered with Aunt Bertha, a social services search engine and is a great option for searching for patient resources by zip code.