Mrs. G Nutrition Case
I. Identifying and Demographic Information
Mrs. G is an eighty-six year old Caucasian woman of Jewish descent and faith. She is approximately five feet tall and dresses impeccably. She is widowed and currently lives in an assisted living facility. Prior to retirement, Mrs. G worked as a secretary in a law firm for twenty years and experienced an upper-middle class status throughout her life. Mrs. G is articulate and insightful, but speaks slowly and without much inflection.
II.Presenting Problem or Concern
Mrs. G seeks bereavement services following the death of her husband. Mrs. G has a decrease in appetite and has reported losing seventeen pounds since her husband’s death and is currently having her weight monitored by the doctor. She has been diagnosed with ‘temporal arteritis ‘and is …show more content…
deeply concerned about losing her sight due to this. Mrs. G has been prescribed Prednisone for the arteritis and has been experiencing the side effects of thinning of the skin, leading to tears and sores. Mrs. G suffers from osteoarthritis and needs a cane to walk. In 1994, she was hospitalized with sciatica, which continues to be a problem for her.
She has decreased motivation to do the things she used to enjoy and reports having a lack of energy and is having difficulty sleeping, sometimes only managing two hours a night. She emotionally relays how much she misses her husband and is taking Zoloft, which she states is helping “somewhat”.
III. Strengths and Resources
Mrs. G is actively grieving the loss of husband. Her reality testing, judgment, impulsivity and thoughts processes are well- developed and she appears to have a strong sense of reality of herself and of the world. She is aware of the resources available in the community and is particularly familiar with HGS bereavement services.
Mrs. G recounts partaking in many of the rites and ceremonies of the Jewish faith, which she states helped her during her grief of burying her husband. She is supported by the Jewish community in which she resides. She is also supported by her two nephews who live locally and visit frequently. She is financially dependent due to adequate savings.
IV. Background
Mrs. G is the third of seven children. Mrs. G was closest with her oldest sister and lived with her until she married Mr. G at the age of fifty one. Mr. G has three children aged between eleven and fifteen from his previous marriage. Upon marriage, Mrs. G took on the role of wife and mother. During the first session, Mrs. G states that she has a good relationship with her step children, but now they live extremely far from her. In the following session she affirms that past interactions with her step children had been conflictive and that despite relations improving, she remained closest with her two nephews, the sons of her oldest sister.
In the past ten years, Mrs. G has lost four out of her seven siblings. The death of her oldest sister was a particularly tragic event for Mrs. G, where she found her sister unconscious and was unable to say goodbye to her before she died a few hours later. She also relays the death of her mother when she was twenty-two. She affirms that her mother was wonderful, but extremely ill. Early memories involve her mother suffering with terrible migraine headaches and spending frequent periods of time in bed. After the death of her mother, Mrs.G began dating a man who became her husband. The relationship ended as a result of an interaction between the couple, something that Mrs. G is unwilling to disclose.
Mrs. G states that she has a close relationship with another older sister. This sister was soon moving an hour away. Mrs. G expressed concern about being able to see her, since she is no longer able to drive.
V.Biopsychosocial Stressors Mrs. G is dealing with the loss of her husband, a man that she considered her “whole world”. Unresolved losses from Mrs. G’s past appear to be hindering her grieving process. This has been indicated by her frequently asserting that “When you’re younger, you just get over it… You know, you just busy yourself with other things.” Repressed painful emotions and unresolved feelings seem to be intensifying and possibly prolonging Mrs. G’s grieving process. Specifically, the recollection of her mother’s illness extends “as far back” as Mrs. G can remember.
The death of her husband coupled with the death of many significant people to her has reduced her support system. Her Jewish faith is extremely important to her. She was an active member in the local temples, along with her husband. Lack of motivation and desire and inability to drive has resulted in her minimally attending
As well as dealing with the loss of her husband, Mrs. G has had the major adjustment of moving from her marital home into a high-rise assisted living home. Mrs. G reports no concerns or stressors related to financial factors.
VI. Psychological Functioning
Mrs. G appears to have a cohesive self, since she is functioning on her own and maintains a sense of reality which appears to be based in reality.
The symptoms Mrs. G is exhibiting are within the normal limits of the grieving experience. She does; however appear to be at the higher end of the spectrum, where she is experiencing her loss more intensely and for a longer period of time during the period of bereavement.
Mrs.
G seems to idealize those close to her. In contrast, those that do not meet her needs as “bad”. She was recently disappointed by her stepson and has rejected him, claiming that she “can’t count on him for anything.” She has had disagreements with residents, which has resulted in no further interaction with them.
In resisting the impact of her loss, Mrs. G has regressed back to earlier behaviors, such as being overly dependent on her sister and nephews, for daily living needs and transportation.
VII. Health and Biological Factors
Mrs. G has temporal arteritis, osteoarthritis and was previously hospitalized with sciatica. She has been prescribed Prednisone for the arteritis and is taking the antidepressant Zoloft.
Her older age and frail physical condition could be hindering her grieving process. In particular, her sight problems, which gives her doubled and blurred vision has prevented her from being able to drive and thus has limited her ability to be able to visit her family, as well as visiting her husband’s grave which is situated an hour away from her home.
VIII. Test Results
IX. DSM IV.TR Diagnosis
Axis I Dysthymia
Axis II No
diagnosis
Axis III Temporal Arteritis Osteoarthritis
Axis IV Death of husband Death of close family members Relocation Living Alone Adjustment to life-cycle transition
Axis V (Current) GAF 66
X. Formulation or Conceptualization
Mrs. G is an eighty-six year old Caucasian woman of Jewish descent and faith. She is approximately five feet tall and dresses impeccably. She is widowed and currently lives in an assisted living facility. Prior to retirement, Mrs. G worked as a secretary in a law firm for twenty years and experienced an upper-middle class status throughout her life. Mrs. G is articulate and insightful, but speaks slowly and without much inflection.
II.Presenting Problem or Concern
Mrs. G seeks bereavement services following the death of her husband. Mrs. G has a decrease in appetite and has reported losing seventeen pounds since her husband’s death and is currently having her weight monitored by the doctor. She has been diagnosed with ‘temporal arteritis ‘and is …show more content…
deeply concerned about losing her sight due to this. Mrs. G has been prescribed Prednisone for the arteritis and has been experiencing the side effects of thinning of the skin, leading to tears and sores. Mrs. G suffers from osteoarthritis and needs a cane to walk. In 1994, she was hospitalized with sciatica, which continues to be a problem for her.
She has decreased motivation to do the things she used to enjoy and reports having a lack of energy and is having difficulty sleeping, sometimes only managing two hours a night. She emotionally relays how much she misses her husband and is taking Zoloft, which she states is helping “somewhat”.
III. Strengths and Resources
Mrs. G is actively grieving the loss of husband. Her reality testing, judgment, impulsivity and thoughts processes are well- developed and she appears to have a strong sense of reality of herself and of the world. She is aware of the resources available in the community and is particularly familiar with HGS bereavement services.
Mrs. G recounts partaking in many of the rites and ceremonies of the Jewish faith, which she states helped her during her grief of burying her husband. She is supported by the Jewish community in which she resides. She is also supported by her two nephews who live locally and visit frequently. She is financially dependent due to adequate savings.
IV. Background
Mrs. G is the third of seven children. Mrs. G was closest with her oldest sister and lived with her until she married Mr. G at the age of fifty one. Mr. G has three children aged between eleven and fifteen from his previous marriage. Upon marriage, Mrs. G took on the role of wife and mother. During the first session, Mrs. G states that she has a good relationship with her step children, but now they live extremely far from her. In the following session she affirms that past interactions with her step children had been conflictive and that despite relations improving, she remained closest with her two nephews, the sons of her oldest sister.
In the past ten years, Mrs. G has lost four out of her seven siblings. The death of her oldest sister was a particularly tragic event for Mrs. G, where she found her sister unconscious and was unable to say goodbye to her before she died a few hours later. She also relays the death of her mother when she was twenty-two. She affirms that her mother was wonderful, but extremely ill. Early memories involve her mother suffering with terrible migraine headaches and spending frequent periods of time in bed. After the death of her mother, Mrs.G began dating a man who became her husband. The relationship ended as a result of an interaction between the couple, something that Mrs. G is unwilling to disclose.
Mrs. G states that she has a close relationship with another older sister. This sister was soon moving an hour away. Mrs. G expressed concern about being able to see her, since she is no longer able to drive.
V.Biopsychosocial Stressors Mrs. G is dealing with the loss of her husband, a man that she considered her “whole world”. Unresolved losses from Mrs. G’s past appear to be hindering her grieving process. This has been indicated by her frequently asserting that “When you’re younger, you just get over it… You know, you just busy yourself with other things.” Repressed painful emotions and unresolved feelings seem to be intensifying and possibly prolonging Mrs. G’s grieving process. Specifically, the recollection of her mother’s illness extends “as far back” as Mrs. G can remember.
The death of her husband coupled with the death of many significant people to her has reduced her support system. Her Jewish faith is extremely important to her. She was an active member in the local temples, along with her husband. Lack of motivation and desire and inability to drive has resulted in her minimally attending
As well as dealing with the loss of her husband, Mrs. G has had the major adjustment of moving from her marital home into a high-rise assisted living home. Mrs. G reports no concerns or stressors related to financial factors.
VI. Psychological Functioning
Mrs. G appears to have a cohesive self, since she is functioning on her own and maintains a sense of reality which appears to be based in reality.
The symptoms Mrs. G is exhibiting are within the normal limits of the grieving experience. She does; however appear to be at the higher end of the spectrum, where she is experiencing her loss more intensely and for a longer period of time during the period of bereavement.
Mrs.
G seems to idealize those close to her. In contrast, those that do not meet her needs as “bad”. She was recently disappointed by her stepson and has rejected him, claiming that she “can’t count on him for anything.” She has had disagreements with residents, which has resulted in no further interaction with them.
In resisting the impact of her loss, Mrs. G has regressed back to earlier behaviors, such as being overly dependent on her sister and nephews, for daily living needs and transportation.
VII. Health and Biological Factors
Mrs. G has temporal arteritis, osteoarthritis and was previously hospitalized with sciatica. She has been prescribed Prednisone for the arteritis and is taking the antidepressant Zoloft.
Her older age and frail physical condition could be hindering her grieving process. In particular, her sight problems, which gives her doubled and blurred vision has prevented her from being able to drive and thus has limited her ability to be able to visit her family, as well as visiting her husband’s grave which is situated an hour away from her home.
VIII. Test Results
IX. DSM IV.TR Diagnosis
Axis I Dysthymia
Axis II No
diagnosis
Axis III Temporal Arteritis Osteoarthritis
Axis IV Death of husband Death of close family members Relocation Living Alone Adjustment to life-cycle transition
Axis V (Current) GAF 66
X. Formulation or Conceptualization