Case Study: Red Yoder is an 80-year-old farmer
1. Patient Profile
• Name: Red Yoder
• Age: 80 years old
• Occupation: Retired farmer (actively helped on the family farm until age 78)
• Living Situation: Lives alone on a small section of his former farm in a rural
Midwestern community. His wife passed away 5 years ago. His son, Mark (55),
lives 20 minutes away and manages the main farm operations.
• Medical History: Hypertension (controlled with lisinopril), mild osteoarthritis in
both knees, benign prostatic hyperplasia (BPH).
• Social History: Lifelong non-smoker, drinks one beer per week. Independent
with all ADLs until recently. Strong-willed, private, and proud of his self-
sufficiency.
2. Presenting Problem
Red is brought to the rural health clinic by his son, Mark, who reports a “slow decline”
over the past 4 months. Mark states:
• Red has lost 18 pounds (unintentional).
• He has stopped attending his weekly card game at the VFW.
• The house looks “disorganized” and mail is piling up unopened.
• Red forgot to take his blood pressure medication for three days last week, and
his BP was 168/92 at a pharmacy screening.
Red dismisses these concerns, stating: “I’m 80 years old. I can’t run a marathon anymore.
Mark worries too much.”
3. Subjective Data (Patient’s Words)
• “I’m fine, just a little tired.”
• “Cooking for one isn’t worth the trouble. A sandwich is plenty.”
• “My knees hurt more now, so I don’t go out as much. The cold is bad for
them.”
, • “I’ve always been a light sleeper – now I’m up 3-4 times a night to use the
bathroom.”
• “Don’t put me in a home. I’ll die first.”
4. Objective Data
Assessment Findings
Vitals BP 150/90 (sitting), HR 88, RR 18, Temp 98.2°F, O2 sat 96%
General Thin, slightly disheveled appearance, strong odor of urine, sunken cheeks
HEENT Mucous membranes dry, poor dentition (two missing molars)
Cardiovascular Regular rate and rhythm, no murmurs
Bilateral knee crepitus, decreased range of motion, steady but slow gait using a cane
Musculoskeletal
found in the barn (not fitted)
Alert and oriented x3 (person, place, time). MMSE score = 24/30 (lost points on recall
Neurological
clock drawing).
Skin Skin turgor poor, bruising on forearms (from bumping into doorframes)
Laboratory Hb 10.2 g/dL (mild anemia), BUN/Cr elevated (dehydration), Vitamin D low
5. Psychosocial Assessment
• Geriatric Depression Scale (short form): Score 6/15 (mild to moderate
depression)
• Social support: Minimal – sees son once weekly, daughter lives in another state,
most farming friends have died or moved.
• Financial: Adequate (Medicare + pension), but reluctant to spend money on
“frills” like prepared meals or home health aides.
• Cognitive: Subtle decline noted – missed a follow-up appointment, couldn’t
recall if he had taken his morning meds.
1. Patient Profile
• Name: Red Yoder
• Age: 80 years old
• Occupation: Retired farmer (actively helped on the family farm until age 78)
• Living Situation: Lives alone on a small section of his former farm in a rural
Midwestern community. His wife passed away 5 years ago. His son, Mark (55),
lives 20 minutes away and manages the main farm operations.
• Medical History: Hypertension (controlled with lisinopril), mild osteoarthritis in
both knees, benign prostatic hyperplasia (BPH).
• Social History: Lifelong non-smoker, drinks one beer per week. Independent
with all ADLs until recently. Strong-willed, private, and proud of his self-
sufficiency.
2. Presenting Problem
Red is brought to the rural health clinic by his son, Mark, who reports a “slow decline”
over the past 4 months. Mark states:
• Red has lost 18 pounds (unintentional).
• He has stopped attending his weekly card game at the VFW.
• The house looks “disorganized” and mail is piling up unopened.
• Red forgot to take his blood pressure medication for three days last week, and
his BP was 168/92 at a pharmacy screening.
Red dismisses these concerns, stating: “I’m 80 years old. I can’t run a marathon anymore.
Mark worries too much.”
3. Subjective Data (Patient’s Words)
• “I’m fine, just a little tired.”
• “Cooking for one isn’t worth the trouble. A sandwich is plenty.”
• “My knees hurt more now, so I don’t go out as much. The cold is bad for
them.”
, • “I’ve always been a light sleeper – now I’m up 3-4 times a night to use the
bathroom.”
• “Don’t put me in a home. I’ll die first.”
4. Objective Data
Assessment Findings
Vitals BP 150/90 (sitting), HR 88, RR 18, Temp 98.2°F, O2 sat 96%
General Thin, slightly disheveled appearance, strong odor of urine, sunken cheeks
HEENT Mucous membranes dry, poor dentition (two missing molars)
Cardiovascular Regular rate and rhythm, no murmurs
Bilateral knee crepitus, decreased range of motion, steady but slow gait using a cane
Musculoskeletal
found in the barn (not fitted)
Alert and oriented x3 (person, place, time). MMSE score = 24/30 (lost points on recall
Neurological
clock drawing).
Skin Skin turgor poor, bruising on forearms (from bumping into doorframes)
Laboratory Hb 10.2 g/dL (mild anemia), BUN/Cr elevated (dehydration), Vitamin D low
5. Psychosocial Assessment
• Geriatric Depression Scale (short form): Score 6/15 (mild to moderate
depression)
• Social support: Minimal – sees son once weekly, daughter lives in another state,
most farming friends have died or moved.
• Financial: Adequate (Medicare + pension), but reluctant to spend money on
“frills” like prepared meals or home health aides.
• Cognitive: Subtle decline noted – missed a follow-up appointment, couldn’t
recall if he had taken his morning meds.
