Case Study 1: John and Telua
Telua’s brother John started using drugs and alcohol to drown his sorrow after their dad left their mother. The local suburban high school had its share of dealers and John had no willpower to say no. While weed (cannabis, marijuana, pot) was John’s initial drug of choice, his substance use later led him to having an methamphetamine (ice) addiction. Now out of the closet as a gay man, John also was introduced to the club/party drugs of ecstasy and crystal meth. It breaks Telua’s and her mother’s heart to watch John maintain his addiction despite some brief stints in drug rehab and attendance at local AA meetings. Coming from a Filipino background, John’s father feels animosity towards his son about his sexuality, whereas Telua and her mother are more concerned about his use of illicit drugs. John’s social worker uses tough love—a mix of encouragement and challenge—to help John stay on his path to and through recovery.
Case Study 2: Jenny
Jenny was a very bright young woman. During high school and college she excelled at computer science and exhibited a love and flair for fashion. The summer that she contemplated returning to graduate school, Jackie’s parents noticed she was exhibiting some bizarre behaviors. She claimed to hear voices and see things that were not there. In addition, Jenny’s hygiene became less important to her and she obsessed about colours and Princess Diana.
After a complete biopsychosocial assessment with the family’s doctor and a recommended local mental health specialist, Jenny was deemed to have a mental illness that was labeled as both a disability and schizophrenia. Soon thereafter, to occupy her days, Jenny became active in NEAMI, and was on NEAMI’s Speaker’s roster. Jenny also enjoyed making crafts for her nieces and nephew. She also capably managed the fundraising coordination at her family’s local church.
Case study 3: Suzanne and Tom
Suzanne was 43 when she received the surprise news that she was pregnant again. While she as glad to finally have a son, along with her 23-year-old twin daughters Jessica and Megan, Suzanne felt a sense of loss when she learned that Joel had an intellectual disability (ID). Joe’s dad Tom was proud of his daughters’ academic and athletic accomplishments but felt uneasy relating to Joel. Tom kept quiet as his wife Suzanne disclosed her anxiety about helping Joel navigate through life. Somehow envisioning Joel participating in Special Olympics in the future, rather than high school and college sports, left a hole in Suzanne and Tom’s hearts. Tom is also concerned about how Joel will be treated in their predominantly White town, as Tom’s father is Aboriginal. Tom has had several difficult encounters when his work colleagues found out about his background, and has been racially vilified and discriminated against in the past.
To prepare for an inevitable future, Suzanne decided to volunteer at a local sheltered workshop and day program where she observed other children with intellectual disabilities enjoy horseback riding and work with their hands. One day Suzanne overheard parents of two 23-year-old young adults with ID discuss how their children wanted to get married and have children. This conversation made Suzanne feel very uncomfortable and she doesn’t know how to broach this subject with Tom.
Case Study 4: Kim
Kim had never planned to live anywhere except his family home in Sydney, Australia, where he raised his three children and enjoyed the great outdoors. Last month when he was hospitalized and subsequently discharged to a nursing home, Kim could only think about the current fishing season and the camaraderie he was missing from his fellow angler Club members. Fishing was a great source of joy for Kim, as it reminded him of his childhood in a quiet seaside town in northern Busan, South Korea.
Since becoming a widower, when his high school sweetheart and spouse Ruth died 10 years ago, Kim had put on too much weight and neglected regular doctor’s appointments. His two daughters, who reside in other states, contact him regularly by phone. Kenichi’s now retired only son lives nearby and works the family farm but he is out of touch concerning his dad’s health and health care needs. The shock of learning about his worsening diabetes and metastasized cancer is causing Kim and his family much emotional distress. Kim doesn’t understand the words all the physicians and nurses are using—palliative care, slow medicine, and advanced directives—and he can no longer bear weight, transfer independently, or take steps. It appears that Kim might be released to the home of his oldest daughter, a retired nurse, and hospice care will be put in place if he can show improvement in his activities with the physical therapists.

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