University | National University of Singapore (NUS) |
Subject | Nursing Patients with Chronic Illness |
Jason Bundhoo is a 42-year-old car driver from Triolet. He lives in a private apartment, with his partner, Jane, and their 25-year-old son, George. Jason left school at the age of fifteen and undertook several occupations before taking up Grab car driving.
His father died at the age of 67 due to cardiac complications following a transurethral resection of the prostate (TURP) surgery. His mother died at the age of 51 from metastatic ovarian cancer. After his parents’ deaths, Jason had to take out a substantial mortgage to buy out his sister from her share of their parents’ apartment.
Jane has been working as an accountant in a large firm. Unfortunately, she was made redundant last year when the company’s income declined. She has been unable to find another job until now. Jane has been diagnosed with depression by their local doctor and is taking medications for this.
Jason recently suffered a Transient Ischaemic Attack (TIA) and has been discharged home from the large acute hospital. He said that during this hospitalization, he was found to have an undiagnosed ongoing irregular rhythm of the upper chambers of his heart and so he was started on Digoxin tablets. He weighs 115 kg and his height is 1.65 meters.
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He smokes two (2) packs of cigarettes each day, drinks alcohol (usually between 2 to 3 cans of Phoenix beer) daily and only takes his maintenance medications for hypertension sporadically. He has been previously referred to pulmonary rehabilitation because of his increased production of thick phlegm from repeated ongoing inflammation of his airways.
He has only attended once and never came back because he had to work. He also self-medicates with Ibuprofen at the end of long days of driving to manage an ongoing right knee pain. He states the local doctor had once told him that this is from the “wear and tear” of his knees related to his weight and playing too much soccer in his younger years.
Jason reported that the TIA occurred during a heated argument with Jane. He initially blamed her for all of his problems, and it has been reported he initially was withdrawn and refused to cooperate with hospital staff. However, when he found out during the hospitalization that it was caused by the partial blocking of one of the arteries in the brain due to a blood clot, he started re-engaging with his treating team.
Although he agrees that he would benefit from a rehabilitation program, he openly declares that he would be unlikely to comply. He says that he really needs to be able to earn a living himself because he does not think Jane will get a job anytime soon and he feels that it is unfair to impose such a big responsibility on his son.
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