University of Wisconsin–Madison

Reading and Case Study Analysis for Social Work

Professor Betty Kramer, Social Work 821

The purpose of this initial assignment is to demonstrate your understanding of the readings and your ability to apply course content to the mental health challenges faced by an elder and their family.

Instructions:

  1. Review lecture notes from Week 1 and all required readings for Week 1 and Week 2.
  2. Read the attached case study.
  3. Given what you have learned during our first class session and the Week 1 and 2 readings in a 4-5 page double-spaced (12 pt. font; 1” margins) written report, use the following headings to concisely answer these questions:
    1. Preliminary Assessment (Suspicions): Given what Vanessa shares with you, what might you initially suspect is causing her mother’s symptoms and why?  Be specific and provide and cite evidence from the reading to support your preliminary assessment.
    2. Engagement & the Clinical Interview: You will need to do a home visit to initiate the assessment.  What will you do in advance to prepare for the interview? How will you approach Mrs. Johnson?  What will want to accomplish during this home visit?
    3. Assessment: Given the little bit of information Vanessa has given you, what else will you want to know and how will you obtain that information?
      1. Please list the various domains that you believe will be important to investigate as part of the assessment to determine the cause of Mrs. Johnson’s symptoms and the most appropriate care plan. Be sure to list the mental status tests and medical tests that you feel should be completed (see Ch. 4 McKinnis, 2009; Ch. 6 in Zarit & Zarit).  [Note: it is acceptable to provide bulleted list of points in response to these particular questions]
      2. Describe how that data will be collected (and by whom)?
      3. Provide a brief rationale for the assessment domains that will be included.
    4. Possible Recommendations: Assuming your preliminary assessment turns out to be correct, name 2-3 primary recommendations that you might make to Mrs. Johnson and her family? 
  1. Submit paper to Learn@UW dropobox by 9:00 a.m. before week 2 of class.

Daughter Requests Case Manager Consultation for her mother: Mrs. Johnson

Mrs. Johnson (Mrs. J.) is a 78-year-old, African American woman who lives in a small Midwestern city. About a year ago, her husband died suddenly of a stroke, leaving Mrs. J. to live alone in her home of 52 years. It was the home where she had raised her three children, all of whom graduated from college, have professional careers, and now live in other parts of the state. Her family is a source of pride, and her home has numerous pictures of her children and grandchildren.

About 3 months ago, Mrs. J.’s oldest daughter, Vanessa, got a call from one of the neighbors. Vanessa lives a 4-hour drive from her mother—a drive that can often be longer in bad weather. The neighbor stated that Mrs. J. had walked to the neighborhood store in her pajamas and slippers. Because Mrs. J. has lived in the community for several years, people have been watching out for her since her husband died, and someone gave her a ride back home. Mrs. J. doesn’t drive, and the temperature was fairly chilly that day.

As a result of the call, Vanessa went to Mrs. J.’s home for a visit. Although she and her siblings had been calling Mrs. J. regularly, no one had been to the family home in about 7 months. Vanessa was shocked at what she saw. Mrs. J. had been a cook in a school cafeteria earlier in life and always kept her own kitchen spotless. But now the house was in disarray with several dirty pots and pans scattered throughout different rooms. In addition, odd things were in the refrigerator such as a light bulb and several pieces of mail. Many of the food products were out of date, and there was a foul smell in the kitchen. Trash covered the counters and floor.

Vanessa contacted her siblings to ask them if their mother had told any of them that she wasn’t feeling well. Her brother, Anthony, remarked that their mother would often talk about Mr. J. in the present tense—but he thought that it was just her grief about his death. The younger brother, Darius, reported that his wife was typically the one who called their mother—about once a month. He didn’t know if there had been any problems—his wife never said anything about it to him. Vanessa also contacted the pastor of her church, Rev. M. He stated that Mrs. J. had been walking to church on Sundays, as usual, but he did notice that she left early a few times and other times seemed to come to service late. But like the brother, Anthony, he thought that this behavior was probably a grief reaction to the loss of her husband.

A final shock to Vanessa was when she went through her mother’s mail. There were several overdue bills and one urgent notice that the electricity was going to be cut off if the balance wasn’t paid. She owed several hundred dollars in past due heating, electric, and telephone bills.

Vanessa contacted her mother’s primary care physician (Dr. P.) who said that he had last seen Mrs. J. for her regular checkup 6 months earlier and that she had missed her last appointment a week ago. Dr. P. said that her staff had called to make another appointment but that her mother hadn’t called them back yet.  Mrs. J. is being treated with medication for arthritis, hypertension, and gastroesophogeal reflux (GERD). Her weight was stable, and her only complaint was some difficulty staying asleep at night. Dr. P. reported that her mother’s mood was sad but had improved some in the month before the last visit. The doctor asked about memory and concentration, but her mother denied having any problems with memory. Imagine that you a case manager at the local Senior Coalition.  Vanessa is calling you to seek advice about what to do. She would like you to do an assessment to help her determine what is wrong and how she can best help her mother.