Reference no: EM133507661

Antonia is an 89 year old widowed Italian woman who recently moved in with her daughter, Maria, and son-in-law, Vince, after sustaining a fall in her home. Seven weeks ago, she fell in her bathtub and fractured her left hip. After surgical repair of her hip, she recovered slowly and spent several weeks in a rehabilitation facility. After this time, it was determined that she was unable to return home due to ongoing weakness. She was then discharged home to her daughter and son-in-law's bungalow in Woodbridge, with a home care nurse visiting twice weekly. Prior to the fall, she was very active outside her home in East York. She liked to go to the library every day, often met with friends to play cards, attended church every Sunday and bowled once a week.

During the interview with Antonia and Maria, Maria frequently interrupts and answers for her mother. She tells her mother to change positions several times. Maria says "My mom won't do anything she's supposed to. If the doctor tells her one thing, she does the exact opposite. She won't eat right, take her medication or do her exercises. I'm at my wit's end". Antonia became irritated and snapped at her daughter, who then left the room. Antonia admitted that she doesn't always take her medications but responded positively when shown a medication planner so she could take her medications without help. She says she is alone during the day while Maria and her son-in-law, Vince, are at work. She says she spends most of her days just watching television until they return home from work and misses her church friends and activities. Antonia also says she really misses her home in East York because her husband built it and "that is where my best memories are."

Maria and Vince have both said they are happy to have Antonia living with them, but have found it exhausting to always have to "keep an eye" on her. They don't like leaving her alone during the day, but they both have to continue to work for financial reasons. Their neighbors sometimes will check on Antonia for them during the day, but they feel like they are burdening them and don't want to rely on them for this. Maria says she has 2 brothers who both live in the United States. She says they visit their mother on holidays and phone regularly once a week, but "they don't understand how she has changed so much. My mom didn't used to be like this." Both Maria and Vince say they know Antonia isn't happy with them and Maria says that maybe her mom would be better in a nursing home. However, she says that this isn't an option for her to consider because Antonia had always said she never wanted to be "dumped in one of those places."

Identify one significant determinant of health that is influencing the family relative to chronic illness/condition. State how this is a positive or negative influence on the family's health.Explain why this is a significant determinant using relative case study data and professional literature.Make sure your discussion adresses the family situation.