A7SC008: Mrs. Eileen Wilson Brought Her Mother, Sheila Into The Doctor’s Office: Professional Practice Case Study, UCD, Ireland

Mrs. Eileen Wilson (46 years old) brought her mother, Sheila, 75 years old, into the doctor’s office, because Sheila has been experiencing increasing pain in her legs and hands over the last year. She was diagnosed with arthritis about 5 years ago but has been reluctant to go back to the doctor for ongoing treatment. Sheila is caring for both her husband Vincent and her mother, Jane (Eileen’s grandmother) who is 96 and also lives with them. Vincent, who is 77, suffered a severe heart attack a year ago. Although he is still able to do many things for himself, he is becoming more disoriented and confused cognitively.

Jane moved in with Eileen and Sheila over ten years ago. Increasingly frail, she needs Sheila, as her primary caregiver, to help with most of her Activities of Daily Living (ADLs). The doctor referred Eileen and Sheila to talk with social services after prescribing her pain medicine for Sheila’s arthritis.

Eileen had convinced Sheila to see the doctor after numerous tense discussions about how she needed help to manage her pain. Now Eileen is voicing the opinion that Sheila cannot continue to care for Jane in the home. Eileen comes over to help Sheila with her caretaking responsibilities at least twice a week. But lately, Eileen has needed to give more time, since Sheila is not able to meet the needs of both Jane and Vincent. Eileen feels guilty that she’s not able to help as much as Sheila wants her to. However, Eileen has just gone back to college to get a nursing degree and works nights as a nursing aide in the hospital. Eileen thinks Jane needs to move to a skilled nursing facility because no one in the family can provide for all her needs. Sheila is highly resistant to moving her mother to any kind of long-term care facility. Eileen doesn’t like the idea either, but she does not know of any other option.

Eileen’s son, 20 years old, is in college nearby, but is very busy and comes around only about once a month to help his mam. Eileen’s brother Dave, age 55, lives in another county and does not seem to understand or care about the difficulties that Eileen is facing in trying to meet the needs of her parents and grandmother. The family is stressed, overwhelmed, near the breaking point, and does not know how to resolve the issues facing them.