Out of the Shadows
Uncovering Substance Use and Elder Abuse
Case Studies ref
The following case studies illustrate the content in Module 3. The Quiz on the next page is based in part on the information in the case studies below. A PDF link at the end of the page allows those taking the Quiz to print out a case study copy to refer to while answering quiz questions.
Case No. 1
Mrs. Z is a retired teacher who is 75. She still occupies the same modest house she lived in while raising her children. Mrs. Z has two sons who do not get along. The eldest son, George, is 40 and lives across the country with his wife and three children. He runs a successful business. Mrs. Z's youngest son, Jeffrey, is 36 and lives alone. Jeffrey has had a string of failed investment ventures. When necessary, Mrs. Z has paid Jeffrey's rent and other expenses because of his financial difficulties.
At her last appointment, Mrs. Z's doctor noticed she appeared to have some memory problems. A specialist confirmed Mrs. Z has cognitive impairments that could be the result of ministrokes. She has stopped seeing friends, stays inside most of the time, and has started sleeping a lot. Sometimes she has difficulty remembering simple directions and finding the right words to express herself. Her ability to handle simple tasks, such as making a grocery list, has decreased. Following this assessment, Mrs. Z's son Jeffrey has assumed more responsibility for her care. However, signs exist that Jeffrey may be taking financial advantage of his mother. Mrs. Z has received several notices of termination of service for unpaid telephone and utility bills. In addition, Jeffrey was recently stopped and ticketed for driving under the influence. When the police stopped him, they discovered he had no insurance on the car.
Jeffrey has become extremely belligerent toward his mother and others involved in her care. He constantly reminds Mrs. Z of his caregiving responsibilities. Mrs. Z excuses her son's behavior and fears losing contact with him completely.
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Case No. 2
Mr. C, 61 years old, is twice divorced and has significant health problems. He lives alone on the second floor of a walk-up apartment building. Mr. C has a history of family violence. He was physically and psychologically abusive toward his first wife and children. His second wife left him because of his frequent drinking binges.
In addition to his health problems, which include recent hospitalization for ulcerative colitis, Mr. C has financial difficulties due to his lifestyle of heavy drinking, which he subsidizes using his pension checks. Mr. C recently had a bad fall that resulted in hospitalization. He frequently refuses to take his pain medication, claiming that it confuses him.
Three of Mr. C's four children refuse to have anything to do with him. As his health condition deteriorates, however, his only daughter, Georgina, has stepped in, saying she will help out with the grocery shopping and driving. Georgina recently discovered her father is able to maintain his liquor supply through home delivery. She and her father have had several shouting matches as a result of this discovery. Following the last shouting match, Georgina locked her father in his room and withheld his dinner until he promised to stop drinking. Despite the fact that Mr. C has no signs of cognitive impairment, Georgina decided to intercept his pension checks to prevent him from using the money to buy alcohol.
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Last Updated: 8/3/04
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