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Review: Diversity in the Workplace, a Case study on Jill by Tony Astro

u09d2 Intervention Strategies After watching the Diversity in the Workplace video, this is how I would  respond to the client, keeping ...

Tuesday, December 9, 2008

Case Study on Elderly (Mrs. Falcone) and Alcoholism

Case Study: Mrs. Falcone
Presenting Complaint
Friar Francis called your office and made an appointment for Mrs. Falcone. He is her priest and has become increasingly concerned about Mrs. Falcone's behavior at church activities, especially if those activities occur in the evenings when there is alcohol served. He has reported to you that he is very concerned that Mrs. Falcone has a drinking problem. She has fallen at home twice and received a gash on her forehead when the last episode occurred. Mrs. Falcone, according to Friar Francis, agreed to come to see you, the counselor, only because he will drive her to the appointment.

Case Overview
Mrs. Falcone is 76 years old, a widow for 2 years, residing in the same home she lived in with her husband of 55 years. She has one daughter who lives 350 miles away and who visits about every 2 months. Mrs. Falcone's health is generally good, with mild hypertension that is managed effectively with medication. She used to be active in her church and with two women friends who are also widows. Financially, Mrs. Falcone is secure and she continues to drive her car. She has a history of cigarette smoking that she continues, but at a reduced rate since recently experiencing shortness of breath. Family history includes a father who was an alcoholic and a sister who died from alcoholism-related medical problems 5 years ago. According to Mrs. Falcone., when you spoke with her over the telephone, "I don't know what Friar Francis is so worked up about. I just have a few drinks in the evening to settle my nerves. My husband and I always had a few drinks in the evening."

In planning for this first session with Mrs. Falcone, review the article, "Chemical Dependency and the Elderly" and formulate an overview of the method you will use to conduct the intake interview.


Subject: Discussion 4: Mrs. Falcone, Alcoholism & Anxiety Disorder Topic: u04d2 Case Study Summary
Author: Tony Astro Date: November 2, 2008 2:51 AM


According to Anxiety Disorders Association of America, until recently, anxiety disorders were believed to decline with age. But now experts are beginning to recognize that aging and anxiety are not mutually exclusive: anxiety is as common in the old as in the young, although how and when it appears is distinctly different in older adults (ADAA Website, 2008).

With anxiety, many resort to alcohol or drugs. Mrs. Falcone, although has a family history of a father who was an alcoholic and a sister who died from alcoholism-related medical problems 5 years ago, counselors must still consider the possibility of Anxiety Disorder. His continuing denial from the alcohol and possibly anxiety post a complication and counselor must open continue its effort to open up Mrs. Falcone and accept the fact that she has the problem. First, since Mrs. Falcone refutes addiction on alcohol, this counselor will pose the following inquiry (both during her sobriety and when not):

1. Are you happy residing in the same home she lived in with her husband of 55 years?
2. When you stop smoking or reduced rate in smoking due to experiencing shortness of breath, will this apply to reducing alcohol if you do drink a good amount of alcohol as Friar Francis alleged
3. Are you afraid or anxious of anything at all?

Recognizing an anxiety disorder in an older person poses several challenges. Aging brings with it a higher prevalence of certain medical conditions, realistic concern about physical problems, and a higher use of prescription medications. As a result, separating a medical condition from physical symptoms of an anxiety disorder is more complicated in the older adult.

Diagnosing anxiety in individuals with dementia can be difficult, too: agitation typical of dementia may be difficult to separate from anxiety; impaired memory may be interpreted as a sign of anxiety or dementia, and fears may be excessive or realistic depending on the person's situation. (ADAA Website, 2008)

If Mrs. Falcone indicates any anxiety, counselor may tackle this issue first and then embark upon the issue on alcoholism. This will flow into a basic issue of anxiety into a possibly more dense issue of alcoholism which could also be genetic due to 2 of her immediate relatives being alcoholic.

According to a study by NIAAA’s (National Institute on Alcohol Abuse) director Enoch Gordis, who stresses that alcohol “gene search is infinitely more difficult than that in a single-gene disease. Alcoholism genes are multiple, they interact in unknown ways, and they have incomplete penetrance, which means you can have the genes but not be an alcoholic,” and he adds that “these genes are for risk, not for destiny.” (Holden). Gordis is claming that alcoholism is genetic, but the carrier of the gene could end up never becoming an alcoholic at all, which strangely should take genetics completely out of the picture, because in the end it’s still all up to choice. Such findings not only leave the reader in doubt, but also leave the reader in complete confusion. (Hue, 2008)

With that in mind about possible genetics and other complications, counselor may shift the spotlight on anxiety disorder and maybe involve Friar Francis who sponsored her towards counseling Mrs. Falcone on misbehaviors every time an alcohol is served.
Identifying elderly persons in need of services can be very difficult because they are often retired, live away from their families, do little or no driving, and participate in few social activities. This lack of coercive forces can make it difficult to determine if chemical dependency problems exist. (ADP, 2008)

References:

Hue, 2008. Alcoholism and Genetics. Retrieved on October 31, 2008 at http://web.pdx.edu/~hue/alcoholism_and_genetics.htm

ADAA Website: Anxiety in the Eldersly. Retrieved on October 31, 2008 from http://www.adaa.org/GettingHelp/AnxietyDisorders/Elderly.asp

ADP Website: Chemical dependency and the elderly. Retrieved on October 31, 2008, from http://www.adp.ca.gov
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