Final answer:
The most appropriate management for the 87-year-old female with recent breast cancer diagnosis involves a comprehensive approach that addresses her cancer, the possible need for hormone replacement therapy, and the evaluation of her cognitive changes and suitability for physical activities and nutrition for cancer survivors.
Step-by-step explanation:
The most appropriate management for an 87-year-old female with recent breast cancer diagnosis, energy decline, and appetite loss should be comprehensive and supportive. The doctor should address her physical issues, which may include managing the cancer and considering the use of hormone replacement therapy due to normal decline in hormones with aging. Additionally, it is crucial to assess and manage potential cognitive issues, as her difficulty in paying bills and memory lapses might suggest an underlying problem that extends beyond normal aging effects. An interdisciplinary approach including a geriatric assessment, nutritional advice to ensure proper nutrition, and physical activities tailored to her condition could be beneficial. Considering her cognitive changes and physical symptoms, an evaluation by a geriatrician, oncologist, and potentially a neurologist is appropriate to rule out other conditions, such as dementia or the side effects of cancer treatment, and to create a comprehensive care plan.
Furthermore, it's important to follow general health recommendations post-treatment for cancer survivors, which include maintaining a healthy diet with the recommended intake of vegetables and managing any post-treatment symptoms to prevent complications. An update by Speck et al. (2010) on controlled physical activity trials in cancer survivors emphasizes the importance of physical activity in their ongoing health. Initiating or referring the patient to supportive services, such as home health aides or cognitive therapy, can also address changes in her daily living activities.