Diagnosis of an Old Depressed Patient

Robin Henderson is a 30-year-old married Caucasian woman with no children who lives in a middle-class urban area with her husband. Robin was referred to a clinical psychologist by her psychiatrist. The psychiatrist has been treating Robin for more than 18 months with primarily anti-depressant medication. During this time, Robin has been hospitalized at least 10 times (one hospitalization lasted 6 months) for treatment of suicidal ideation (and one near lethal attempt) and numerous instances of suicidal gestures, including at least 10 instances of drinking Clorox bleach and self-inflicting multiple cuts and burns. Robin was accompanied by her husband to the first meeting with the clinical psychologist. Her husband stated that

Client (AM) is a 20-year-old heterosexual African American female, born in Durham, and currently still resides there. Her primary language is English. She lives with her 13 moth old child (NM) in a one-bedroom apartment. The client is unemployed and currently receives SSI benefits. AM resides in subsidized housing because of her social security income. Client did not finish high school and has no desire to do so.

The client resides with her adult son, aged 20. The client also has two adult daughters that each live over two hours away.

My Chosen client is a seventy seven year old man named Daniel Henderson who lives in a West London care home called St. Vincent’s’ House Care Home. He is married to a woman called Sarah Henderson who is seventy two years old,

The client also has a strong relationship with her children and is involved in their educational needs.

The client is a Hispanic Male age 69, who was born in the Dominican Republic. The client communicates solely in Spanish. He has two daughters who both live in the Bronx. The client suffers from Diabetes, Cholesterol and moderate Dementia. The client has shakiness in the hands as a result of a surgery he endured in the brain. The client lives in a rented room in Inwood Heights. Initially, the clients presenting problem included finding adequate housing however, after completing the intake form I became aware that the client was over income for most housing assistance programs. When the client and I talked more about the reasons he wanted to find housing it became obvious that the client wants to feel valued by his children. Also the client mentioned wanting to overcome feelings of loneliness and isolation. The client copes with feelings of seclusion and solitude by coming everyday to the senior center. He also tends to use the defense mechanism rationalization and tries to rationalize behaviors for others including his daughter’s absence from his life. My interpretation of the clients functioning in the situation is that although the client is experiencing health impairments and sadness the client is very self-sufficient. He is capable and able to take care of his hygiene, he is able to feed himself and he is able to go to doctor’s appointments on his own. I do however; think he is in need of case management and emotional support.

Ms. Cruz informed HS that client last permanent address was 245 Walnut Ave. Trenton, NY 08609. Client stated that they need to move out from the apartment because there was an altercation between the husband and another person who trying to kill him. Family left the apartment for security reasons and they decide to come to the shelter system. Family is currently residing at 220 East 197 St Bronx, NY Unit . Family composition

The patient expressed she has no current suicidal ideation or homicidal ideation. However, she admitted to suicidal ideation in the past, right after her breakup, approximately two months ago. She expressed that she wanted to hurt herself and had a plan on how to do so, but did not think she could go through with it. Her plan was to overdose by taking her mother’s

Family is PA case is fully active. Family is eligible for Food Stamps for the amount of $191 and cash for the amount for $93. Also, family has been certified with SSI with a total amount of $ 1363. Client is not employee at the moment. Client is exempt from work due to diagnosed of Depression. However, client stated that she will start seeking for employment because LLs are asking to the family for a higher income. Client does not have any type of savings, as per client the SSI and FS are not enough. HS reminded Ms. Abdelaal

The client under assessment is a white male individual that goes by the name Mario. Mario is 24 years old and has been married for the last six years. Mario and his wife Candice do not have any kids together. Mario is prior military with six years under his belt serving in the air force. Since leaving the air force he has changed occupation. Mario is currently working at a warehouse as security personnel and his wife works as a nurse. Mario’s relatives are his mother, Cynthia aged 29, his elder sister, and his 2-year-old nephew.

The next client we visited was not as simple of a case. This client was a woman in her 90’s who lived with both of her adult daughters. The daughters were away to work for most of the day and she was left alone. Before coming to the home, it was reported in her file that she suffered from glaucoma and was legally blind, that she had anxiety, and that she often hoard items leaving her home cluttered with very narrow paths to walk. Upon arriving at her home she was very anxious for us to arrive and was alone. She home layout showed concern because of all of the clutter and steep staircases. Her bedroom and bathroom were on the second floor and had not grab bars or adaptive equipment. She had a walker and a commode that she kept in her room away from the bathroom. Although for 90 years old she was very mobile, she had a very high fall risk being legally blind, the homes set up, and the clutter. This woman also was clearly suffering from anxiety and depression and expressed that although she was not suicidal, she wished she would die soon. There were also no leisure activities for her to do while being left alone all day and the television was unplugged on the floor and the audio books she had did not work.

The client has been referred for an assessment by his Primary Care Provider, after describing his feelings of being down, in addition to participating in a sadness rating scale where he rated 10, most sad, on the scale of 1 -10. His wife died of stage 3 breast cancer in 2014. During the session, the client had poor eye contact, frown on his face, he spoke slowly and thoughtfully, had slumped posture, this demeanor continued throughout the interview.

The patient is a 59 year old male who presented to the ED via EMS with suicidal and homicidal ideations.Patient reports conflict a roommate and his nurse as the contributing factors to his distress. The patient reports depressive symptoms as: feelings of isolation, hopelessness, worthlessness, anhedonia, fatigue, irritability, and tearfulness. Patient reports history of bipolar. Patient reports one hospitalization and no attempted harm to self. The patient denies current symptoms of psychosis, however reports experiencing auditory hallucination a month ago.

It would be great if I could get information from those close to the client such as a parent or spouse who may be able to fill in the blanks with information I wasn’t able to get from the client, to get a clearer case history.

2.) Request client's family in law a 48 hours notice before they come and visit the client's family (This includes time, and how many people are visiting).