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Mrs. A. is an 81-year-old African American who lives with her daughter, Mildred, and teenage great-grandson in a two-bedroom apartment in a large metropolitan area of Ohio. Mildred works as a nursing assistant in a nearby nursing home and often works double shifts. Mrs. A. was born in Alabama and lived there until 20 years ago, when her husband died and she moved in with her daughter (who lived alone at the time). Seven years later, Mildred took on responsibility for raising her infant grandson, who is now 13 years old. Mrs. A. has glaucoma, arthritis, and hypertension, and she had a stroke several years ago: She admits to having "a little problem with my memory," but Mildred says, "She remembers what she wants to remember." Mrs. A. takes an over-the-counter analgesic as needed for her arthritis and has two prescription medications for hypertension. She also uses prescription eye drops twice daily. Mrs. A. has her blood pressure checked by the parish nurse about once monthly; she sees a doctor and nurse practitioner at a neighborhood clinic for checkups about twice yearly. The parish nurse often tells her that her blood pressure is "a little on the high side" and encourages her to see her doctor, but Mrs. A. has difficulty getting appointments because she depends on Mildred to take her there. Mrs. A. is about 30 lb overweight, and she walks very slowly. When they go to church, Mildred provides a supportive hand to assist with steadiness and mobility. Mildred shops for groceries, but Mrs. A. prepares most meals for the family. Questions In what ways, both positively and negatively, might Mrs. A's living arrangements influence her health and functioning? What factors are likely to influence the kind of health care Mrs. A. receives? If you were the parish nurse, what actions would you take to decrease health risks and promote quality of life for Mrs. A.? What additional resources could be used to improve Mrs. A.'s situation?