Case Study 4

Gladys, an 84-year-old widow, is close to being discharged from outpatient services after breaking her hip from a fall. She uses alcohol, and tells you that she has been drinking more heavily since her husband passed away more than a year ago to help her cope with grief. She won’t tell you how often or how much she drinks, but admits that she’s lost over 25 pounds in the past year.

Student questions

• How do you establish a therapeutic relationship with Gladys?
• What supports can you provide for Gladys?
• What are some key risk considerations?
• When would you consider a harm reduction approach?
• How do you develop a risk assessment?
• What are the suicide considerations in this scenario?
• What are interventions that would tackle the immediate risks in daily live, such as housing situation or ambulation?
• What are the key medication considerations, especially give her age and alcohol use?
• What other considerations may you have to maintain her safety?
• How would you use a harm reduction approach with Gladys?
• What accommodations at home may she need?

Educator elaborations

Give Gladys an acute scenario, for example, she is in withdrawal from alcohol and experiencing delirium.

Discussion Topics

• Aging and mental illness and addiction
• Coping with grief and loss
• Mental health and illness and addiction; plus concurrent health disorders