Mary’s Wellness Plan

1. Age 18: Adolescence/Young Adulthood

• Well Visit Content:
  • Comprehensive health history: Including family history, social history, and sexual history.
  • Physical examination: Including vital signs, BMI, and a thorough assessment of all systems.
  • Mental health screening: Assess for depression, anxiety, and substance use.
  • Discussion of healthy lifestyle habits: Nutrition, exercise, sleep, and stress management.
  • Counseling on safe sex practices: Including contraception and STI prevention.
• Immunizations:
  • Meningococcal booster (if not previously received).
  • Influenza (annually).
  • HPV vaccine series (if not previously completed).
  • Tdap (if not received within the past 10 years).
• Preventive Screenings:
  • Cervical cancer screening (Pap smear) if sexually active.
  • STI testing (chlamydia, gonorrhea, HIV).
  • Screening for lipid disorders.
  • Screening for depression.
• Education:
  • Education on healthy relationships and consent.
  • Education on the dangers of tobacco, alcohol, and drug use.
  • Education on self breast exams.

2. Age 40: Child-Bearing Years/Middle Adulthood

• Well Visit Content:
  • Update health history: Including management of rheumatoid arthritis, family history, and reproductive history.
  • Physical examination: Including assessment of joint function and pain management.
  • Mental health screening: Assess for depression, anxiety, and stress related to chronic illness.
  • Discussion of family planning and contraception, if applicable.
  • Review of current medications and side effects.
• Immunizations:
  • Influenza (annually).
  • Tdap (if not received within the past 10 years).
  • Pneumococcal vaccine, if indicated due to rheumatoid arthritis.
• Preventive Screenings:
  • Mammogram (annually or biennially, depending on risk).
  • Cervical cancer screening (Pap smear) per guidelines.
  • Colon cancer screening (per guidelines).
  • Lipid panel.
  • Blood glucose screening.
  • Bone density screening (if risk factors are present).
  • Screening for depression.
• Education:
  • Education on rheumatoid arthritis management: Including medication adherence, joint protection, and exercise.
  • Education on managing stress and maintaining healthy relationships.
  • Education on healthy lifestyle, and maintaining a healthy weight.

3. Age 65: Older Adulthood

• Well Visit Content:
  • Comprehensive geriatric assessment: Including functional status, cognitive assessment, and fall risk assessment.
  • Review of all medications: Including potential drug interactions and side effects.
  • Assessment of pain management: Given severe rheumatoid arthritis.
  • Discussion of social support and resources.
  • Assessment of mental health, and any signs of cognitive decline.
• Immunizations:
  • Influenza (annually).
  • Pneumococcal vaccine.
  • Zoster vaccine.
  • Tdap (if not received within the past 10 years).
• Preventive Screenings:
  • Mammogram (per guidelines).
  • Colon cancer screening (per guidelines).
  • Bone density screening.
  • Vision and hearing screening.
  • Cognitive assessment.
  • Screening for depression.
• Additional Concerns and Recommendations:
  • Accessibility assessment of home and environment.
  • Referral to occupational therapy and physical therapy for adaptive equipment and mobility aids.
  • Assessment of caregiver support and respite care.
  • Discussion of advance care planning and end-of-life care.
  • Monitor for signs of polypharmacy.
  • Monitor for signs of social isolation.
• Demonstrating and Advocating for Social Justice and Health Equity:
  • Advocate for accessible healthcare facilities and transportation.
  • Support policies that provide affordable medications and assistive devices.
  • Promote awareness of the needs of disabled women in healthcare settings.
  • Work to reduce stigma associated with disability.
  • Advocate for policies that support home health care, and caregiver support.
  • Provide culturally competent care, and ensure that all of Marys needs are met.

Evidence-Based Sources:

• U.S. Preventive Services Task Force (USPSTF): www.uspreventiveservicestaskforce.org
• Centers for Disease Control and Prevention (CDC): www.cdc.gov
• American College of Obstetricians and Gynecologists (ACOG): www.acog.org
• Arthritis Foundation: www.arthritis.org
• World Health Organization: www.who.int
• National Institute on Aging: www.nia.nih.gov

By implementing this comprehensive wellness plan, Mary can receive the necessary care and support to maintain her health and well-being throughout her lifespan.