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Mr. Jones is a single 70-year-old who has severe joint restrictions in his hips and knee due to arthritis. He walks with a limp and has considerable joint pain.

Mr. Jones is a single 70-year-old who has severe joint restrictions in his hips and knee due to arthritis. He walks with a limp and has considerable joint pain. He has not followed thorough on referrals for physical therapy and has rejected the recommendations for surgery, despite being informed it could decrease his pain and improve his mobility. Although he has been fitted with a cane, he does not use it.

During his visit to the Emergency Department, the nurse asks Mr. Jones why he doesn’t want therapy, surgery, or to use a cane. He responds, “All that seems like it is for old people. Can you image me trying to meet some young woman if I’m hopping around on a cane?” The nurse attempts to describe the benefits of therapy, surgery and cane use but Mr. Jones interrupts him. “Look…I appreciate you trying to help but I’m not ready for old people stuff” he says. “I’m just here to get a stronger prescription for the pain pills I’m taking.”

What could be some of the factors causing Mr. Jones’ views and reactions? What additional information would be useful to know about Mr. Jones to understand his views and assist him in improving his function and comfort level? What would be some effective actions to assist Mr. Jones?

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