Case Study - Janice, Recognizing her Risks

Mike's 48-year-old daughter, Janice, has been the sole support mother of two (now adult) sons. She works as a transport driver which involves long hours of inactivity and means heavy meals at truck stops. She says she would love to find other work but feels limited by her grade 11 education. She recognizes that she is overweight and not active enough, but at this time sees no way to change. She is physically exhausted when she returns home and says she has no energy to exercise. She is a heavy smoker. Janice lives alone and finds her work schedule leaves her little time or energy for socializing.

Last year Janice's family doctor retired and she is currently without a primary care practitioner. She has been on a waiting list for over 10 months. She is unaware of the major signs and symptoms of stroke or heart disease. She is outside of her community during the daytime.

Janice is grateful that her brother Robert was able to help their parents after her father's stroke and is proud that he has been able to quit smoking and lose weight. She is worried that he is currently unemployed, and living with their parents, and she fears that Robert might have a stroke like their father. She does not see herself at risk.

PRIMARY PREVENTION ISSUES FOR JANICE

Long-term goal:

Prevent Janice from having a first stroke.

Short-term goals:

1. Help Janice become aware of her risk for stroke. (excellent information is available on the Heart and Stroke website)
2. Provide continuing education and support to modify her risk factors for stroke.

Janice's risk factors for stroke:

• Janice has an unhealthy lifestyle, which includes smoking, unhealthy eating and inactivity. Because she works irregular hours outside of her community, making positive lifestyle changes is particularly challenging.
• Also because she works outside of her community during the day, she may lack a social support network.
• She lacks an understanding about stroke risk factors and the warning signs of stroke and cardiovascular disease especially given her strong family history for stroke and heart disease.
• Janice is currently overweight and inactive and at higher risk for medical problems such as hypertension, Type II diabetes and high cholesterol.
• She has no primary care physician to coordinate her health care and prevention especially regular physicals with thorough screening for cardiovascular and stroke risk factors (hypertension, diabetes, high cholesterol).

PRIMARY PREVENTION CHECKLIST

Goal for Janice: To raise awareness of risk for stroke, and provide continuing education and support to modify risk factors for stroke.