George Esposito is a 79-year-old male admitted to a medical ward. George was taken to the emergency department by his daughter following a fall at home. George tells the staff it was “nothing but a...

George Esposito is a 79-year-old male admitted to a medical ward. George was taken to the emergency department by his daughter following a fall at home. George tells the staff it was “nothing but a bit of a dizzy spell”.

George lives alone and his daughter, Angela describes him as a very private man who prefers his own company. George owns his own small weatherboard home on a small farm. He has tank water only at the property. He has a vegetable garden, three chickens and his Jack Russel dog, Bella. George and Bella are inseparable.

George enjoys watching sport and news programs on television, loves a good strong cup of black tea with three teaspoons of sugar and chocolate biscuits. He likes to get up early and go to bed early. He does not like the recent hot weather.

Angela visits once a week and has been dropping off his meals, but she reports he says that he has not been eating them recently because he is not hungry, and things seem to get stuck in his throat. She notes her father has lost weight in recent months and there has been a significant decrease in his intake. She has been cleaning the bathroom and vacuuming the house when she visits, which her father has never let her do before but now seems happy to let her.

Angela tells you “Dad just seems to have really slowed down – he has always been such an active man, but he is just not himself”.

George has chronic pain from osteoarthritis and suffers from constipation. Hearing loss is also becoming a significant issue for George. He visits his GP once a year for his influenza vaccination, he takes no prescribed medication. His GP has spoken to George about analgesia and options to manage constipation, but he doesn’t want to ‘rattle with all those pills and potions’. He does take castor oil for his constipation and paracetamol and aspirin for his pain, which he buys from the local supermarket on his weekly trip to the shops. George has not visited the dentist for over 25 years.

George is a tall, thin gentleman (185cm and 53kg), he is pale, and his skin is dry, and you note poor skin turgor.

Question 4.

George reports a long history of constipation. What factors place George at risk of constipation? Provide a justification for your response (maximum 200 words).