An 80-year-old Hispanic widow is on an acute rehabilitation unit in the hospital following a right total knee replacement for osteoarthritis. She is 5 feet 2 inches tall and weighs 175 lb. She has a history of hypertension (since age 16) and non-insulin-dependent diabetes mellitus, hypothyroidism, and coronary artery disease. Her medication list includes Lipitor, metoprolol, glyburide, metformin, Cardizem, lisinopril, chlorthalidone, aspirin, Synthroid, and Tylenol for pain. She also reports that she takes garlic capsules, fish oil capsules, and some Chinese herbs because she has been told that they are effective for her chronic conditions.
She lives alone in the family home in a low socioeconomic area of a large city. Her daughter lives about 1 hour away, and her son lives in a neighboring state. The widow expresses concerns about the large number of medications that she takes, the difficulty in affording the cost of the medications, and the difficulty in managing all of the medications and the schedule for those medications. She also confides that she does not always take the medications “exactly the way they say I should.” When questioned further, she states, “The directions are confusing. I am not a doctor or nurse.” She also does not understand why she has to take multiple medications for the same problem: “Why isn’t one medicine for my diabetes good enough?” She also tells you that the medication schedule interferes with her daily activity schedule: “I can barely find time to go to Mass every day with all of those stupid pills you want me to take.”
Do you think that she is adhering to her medication regimen? Provide your reasoning for your answer.
Discuss two potential reasons for her nonadherence.
For the two reasons for nonadherence that you identified in question 2, provide two interventions to improve her adherence
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