Question 1

You are a Health Coach at a Senior Activity Centre. You have just met Mr Ahmad at the Centre for the first time. Mr Ahmed is a 68-year-old retired cleaner who is currently unemployed. He has been referred to your Centre for health coaching. He is severely obese and has several health and social issues. He had a stroke a few years ago and now walks with an umbrella. Apart from the stroke, he has been diagnosed with diabetes, hypertension, and heart failure due to hypertensive heart disease. He has been prescribed several medications including a blood thinner. He is non-compliant with all his medications.

Mr Alunad has had urinary incontinence for the last 2 years. He has not sought treatment and thus he faces various risks due to his incontinence.

Socially, he is single and lives in a one-room rental flat. He depends on Public Assistance for financial support. He has no other relatives and is socially isolated. He does not talk to anyone including his neighbours. He keeps to himself most of the time.

(a) Based on the information provided, discuss the biopsychosocial issues in the case of Mr Ahmad.

(b) Polypharmacy is harmful to seniors, especially in the presence of multiple chronic diseases and frailty. Examine what is polypharmacy, what are the problems associated with it and how to reduce polypharmacy and its adverse outcomes.

(c) A few days later, you notice that Mr Ahmad is more listless and quieter. He seems to walk more slowly and is having cold sweats. You ask him if you could be of help. He says that he was so busy this morning and he missed his breakfast. You check his capillary blood glucose level with a glucometer. It reads 1.5mMol/L. He seems to be suffering from hypoglycaemia or low blood sugar level.

(i) Discuss how as a Health Coach you can provide immediate management for Mr Ahmad to reverse his condition.

(ii) After your initial intervention, Mr Ahmed was sent to a nearby GP. You come to know that the doctor has treated him for recurrent episodes of low blood sugar before. Utilising a multidisciplinary team, formulate and develop a health education plan for Mr Ahmad and analyse what are the other community services that that would benefit him.