Primary Care of the Psychiatric Mental Health Client II

Geriatric Case Study Video Transcript

Midge is a 72-year-old woman who lives with her daughter in a rural community in southern Appalachia. She has been the permanent caregiver for three of her great grandchildren whose parents have lost custody. Her granddaughter is currently in jail for drug charges. Her daughter works two jobs to keep the family afloat and has little time. Midge’s daughter has been noticing a decline in Midge’s ability to care for the three children ages 4 to 9 years and Midge has been sending the kids to school unkempt without any lunch money. The school has called Midge’s daughter several times alerting her to the children’s situation. Her daughter can’t take more time off from work.

Midge was the eldest daughter in a large family of Scots-Irish decent. Her father was killed in a mine at age 45 and her mother was left to care for Midge and her five siblings. Midge left school at 15 to help her mother. Midge worked at a local Kroger store for 25 years until her retirement. Her husband died of lung cancer 10 years ago when she moved in with her daughter.

According to her daughter, Midge has been having hallucinations of a person sleeping on the woodpile in the back of the house. She is terrified that this person might come into the house to hurt the children and has been seen by neighbors walking down the dirt road with the three of them in tow. The other day when it was very warm, the youngest child left the house, wandered into a yard and jumped into an above ground pool. This neighbor found the boy when her dogs starting barking and circling the pool. Midge had lost track of him. Sometimes the person on the woodpile sings old hymns and Midge will sing with them.

Midge has no history of psychiatric illness. Her medical history includes hypertension and appendectomy in 2000. Her daughter thinks she has been missing her blood pressure medication because her BP readings have been erratic. Lately, she has been going out to the woodpile at night to shoo the person away. Midge’s daughter is at her wits end.