Mdm Anita is a 68-year-old retired teacher with 2 grown children. Although she lives alone, she is fully mobile and able to complete all activities of daily living independently. However, since she has retired and most of her friends have passed on, she usually stays at home. In addition, since her children are busy with their own lives, for the most part, she does not see them much. Consequently, she sometimes feels lonely.

She drinks wine occasionally, smokes 5 cigarettes per day, and does not exercise regularly. Her blood pressure is 144/93 mmHg. As she lives alone, her meals are often taken at the neighborhood coffee shop, which usually consists of porridge with vegetables like cabbage and salted egg. Her intake of dietary fat and sodium exceeds the recommended amount per day. She does not like dairy products and water is her main source of fluid intake. She is also underweight.

She has had asthma since childhood and has been on steroid treatment throughout her life. She reached menopause at age 43 and had a left wrist fracture at age 67 years. Her sister has rheumatoid arthritis while her mother is osteoporotic and has sustained a hip fracture at age 80.

Recently, she was admitted to the Accident & Emergency department after sustaining a hip fracture following a fall after showering in her bathroom.

Part 1

With reference to preventive strategies and risk factors for the development of heart diseases, select and explain which one of the following strategies should Mdm Anita’s doctor work with her FIRST to reduce her risk of developing heart diseases:
i) increase her physical activity levels,
ii) treat her with hypertension drugs, OR
iii) advise her to quit smoking.

Part 2

a) What is the most likely condition that Mdm Anita has which led to her fall?

b) Identify and explain six risk factors based on Mdm Anita’s profile as described in the passage.

c) Based on the context of the passage, explain five strategies to reduce Mdm Anita’s chances of falling.

Part 3

a) Discuss three possible barriers that are preventing Mdm Anita from achieving optimal nutrition?
b) Suggest and explain three ways to help Mdm Anita eat more healthily in order to achieve optimal nutrition

Part 4

Identify and explain three strategies that can help Mdm Anita improve her mental well-being