Paul Watts is a 65 years old male who has been diagnosed with COPD for last 10 years. He is living at home and receiving care from a PSW twice a week in addition to being cared for by his wife.

Paul Watts is a 65 years old male who has been diagnosed with COPD for last 10 years. He is living at home and receiving care from a PSW twice a week in addition to being cared for by his wife. Despite his health complications and difficulty breathing, Paul continues to smoke a pack of cigarettes a day. Paul is able to participate in some self-care activities but requires assistance with bathing. The assigned PSW is responsible for assisting with medication. Paul tends to self-medicate and takes Ativan and “medicinal” marijuana for anxiety issues. Paul is a quiet introverted person and does not like visitors. He gets extremely agitated when the homecare staff visits

You use the access key and you enter Mr. Watts home. He is sitting in his chair in a bathrobe, his nasal cannula is attached to an oxygen concentrator. The cannula is askew. The home is relatively messy, there are 15-20 medication bottles, some of which are opened and, on the tables, and bed. Some of the medications belong to his wife and are expired. He is a smoker; you see cigarette butts and several different types of puffers. There is a half pack of Cigarettes and a lighter beside it, Mr. Watts is stating he is going out for a smoke. There are empty pizza boxes, donuts on the bed, the windows are closed and laundry everywhere.

You attempt clean Mr. Watt’s table and he starts yelling that you should not touch his belongings. With each turn he is looking at you, he states he does not trust you. He states he also does not trust his wife because she left for the store over an hour ago. He is short of breath and he is refusing to allow you to do anything. It is his shower day; he refuses a shower. He then verbalizes that he has back pain and requested one of the medications off the bedside table. He starts groaning in pain and is hyperventilating.

Answer the following questions:

1. Considering therapeutic communication, what would be your response to Mr.Watts’ refusal of a shower? State what you would say to him.
2. Considering prioritization, what task do you attempt to start with?
3. List 4 health teaching topics you would present to Mr.Watts?
4. What is your role as a PSW in medication administration? Draw on examples from the above case scenario
5. What are some strategies you could take to complete the task scheduled for that day?

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