When taking Mr. King, an 86-year-old male patient, back to the exam room, you notice a slight odor of stool. While taking his vitals, you see that his nails are unkempt and dirty. The provider wants...

When taking Mr. King, an 86-year-old male patient, back to the exam room, you notice a slight odor of stool. While taking his vitals, you see that his nails are unkempt and dirty. The provider wants an apical pulse so you help remove Mr. King’s shirt and offer him a gown. You notice bruising and tenderness on his back. A weight check shows a loss of 20 pounds since his last checkup six months ago. Mr. King tells you his dog just died and he moved in with his daughter and her four kids one month ago. “Boy, I miss my house and dog. The kids are so noisy but I love them. I think, though, I am in the way because I can’t do much to help my daughter.” As you talk, you notice his dentures are dirty and one stem of his glasses is missing. He sits slumped on the exam table.

 1. What might these observations suggest? Is this abuse? Depression? Support your choices.

2. Discuss how you could relay this information to the provider. Do you think the daughter should be involved in the discussion of care?

 3. Discuss the signs of abuse and depression and how they can be related to each other. What other areas can be explored to evaluate the care that Mr. King requires?