Life course

retired person


Chronic conditions and / or social needs


broadband, smart phone
Matilde is 60 years old, lives alone in a small apartment sites in a working-class area of the city with no family living nearby. She is already retired because she is unable to work since two years as janitor because she is overweight. She practiced sport in her childhood but during adolescence she was abused by her mother´s new partner. Starting from this episode she fell in a state of depression and she felt better only eating in uncontrollably way and in few years she was overweight. She tried to react moving in another city at 26 years old to find a job but her unhealthy lifestyle got worse because she was completely alone. She fell in love with Andrea, a bricklayer, who tried to help her. Unfortunately after 10 years of relationship Andrea died for an untreated pneumonia and Matilde falls in a deep state of depression which affected again her weight. She is no longer able to take care of herself as to dress or bathe. Matilda would like to be self-sufficient, to be able to return to her family and take part to city´s activities as guided tour in museum, local festival, or social event organized to help other young people with similar problems. She would like to move in new apartment nearby the centre of the city.

Internet usage

Mobile device skills

Affinity to new tech

Digital Health Literacy

Assistance (ICT use)

What's important to Matilde

– Staying in good health
– Being active and come back e to walk by the sea or in a park
– Staying in touch online with her family and going to visit them.
– Being able to be auto-sufficient
– Being able to be part of social events, guided tour in museum, local festival
– Being not anymore depressed.
– Find a new comfortable apartment nearby the centre of the city

Health concerns

– Obesity
– Depression and panic disorder
– Mild Sleep apnea syndrome (SAS)
– Risk of heart failure and stroke
– Muscle and bone pains, skin rash
– Polycystic ovary syndrome (PCOS)

Daily living

– She eats ready meals several time in a week
– She sleeps badly and has shortness of breath
– She can’t manage to dress or bathe by herself
– She has muscle and bone pains when she tries to move
– She spend many hours of the day watching tv series in bed

Health tests

– Monthly routine tests: Blood cells count, lipid profile, glucose, renal and hepatic function, hormonal levels (PG, estrogen, PRL, total testosterone and androgens)
– Vitamin levels: Vitamin E, C, B12, D every six months
– Blood pressure every week
– Test for body weight every 3 months
– Evaluation of Bone mineral Density (BMD) with MOC DEXA every three years
– ECG every six months

Events, issues & personal concerns

– Unable to take care of herself
– She is depressed for her past and because she´s alone and warried about her recurring panic attack
– Feeling stressed about your health and scared to be not able to change her lifestyle
– Daily muscles and articular pains

Treatment: medications, therapies, etc.

– 1 pill three times week of Calcium supplements
– 50000U.l./5ml once a month of Vitamin D supplements
– 1 contraceptive pill/day for 28 days each month
– Psychotherapy meeting once a week and anti-depressive once a day
– Physiotherapy 3 times a week
– Improve her personal hygiene to reduce skin rush and apply a cream twice a day
– Try to be more active as starting to walk around the house more often
– She needs to change her lifestyle and follow a healthy diet

Own resources & assets / support

– Small apartment in suburbs;
– Support from family, but it isn´t enough because they live far away.
– Lucia, her neighbour, tries to help and bring her to all the appointment with own car

Care professional concerns

– Matilde sometimes skips medical appointments with specialist because Lucia cannot be with her
– She is unable to follow her diet because she is not very good at cooking and she has a poor motivation


– Matilda cannot manage to lose weight due to the lack of motivation and understanding of her health risks
– Matilda is having more difficult to take care of herself (cooking, hygiene, looking after her apartment)
– Matilda would like to access nutritional and psychological programs or other types of support that can help her

Developed by

Roberta Patalano, Maddalena Illario and her team, A.O.U Policlinico II of Napoli