Mr. Smith: 85-Year-Old Widower of Indian-German Origin - Research Paper

Introduction

My patient is Mr. Jeremiah Smith. He is an 85-years old right-handed male of Indian and German ethnic origin. He is heterosexual but currently widowed for the last 25 years. He is the father of two daughters both adult females (Susan and Mary). Smith's parents died of medical reason, and he currently has one sibling, a 90-year old brother (in perfectly good health), Mr. Smith was born and raised in the northern suburbs of Seattle city, Washington State. He received only eight years of formal education and later joined his parents in their farm works. Mr. Smith is a retired casual worker where he has worked as a cafeteria server in a local high school and later in local hardware. For the last decade, Mr. Smith has traveled a lot. He started by moving to New Mexico State to be closer to his daughter, Susan, and his grandchildren. Six months ago, he later moved to Colorado State to live with his other daughter, Mary, and her husband when he deemed the conditions he was experiencing while living with Susan were no longer tenable. (Kennedy & Harper, 2014)

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Reason for Referral

Mr. Smith's referral reason was caused by various interrelated referral sources. Proper psychological guidance was therefore warranted for the promotion of Smith's wellness and health. The main problem facing Smith was a return to independently control and manage all his financial matters without interference from Susan (Kennedy & Harper, 2014). Susan has been embezzling his father's funds and auctioning property without his father's consent, an undesirable thing that Smith is aiming to change presently (Kennedy & Harper, 2014). For this reason, I reviewed the reasons for a psychological referral as explained below.

To begin with, Smith shows signs of anxiety called obsessive-compulsive disorder (OCD). OCD can either be in the form of compulsions or obsessions. Obsessions are repetitive impulses, thoughts, or images that a patient shows to be experiencing (Ready & Veague, 2014). Compulsion is recurrent actions, which a patient undertakes as a means to counter the obsessions they are experiencing (Ready & Veague, 2014). The impulses that follow such episodes require psychological assessment. In the assessment, clinical observations of the client's brain, need to be undertaken. Personality, intellectual functioning (IQ), and behavioral assessments are also necessary to ascertain developmental, social, spiritual, and emotional issues that can be associated with this disorder. This can be achieved through cognitive behavioral therapy (CBT).

Another referral source is family issues. The problems underlying in the family should be inspected thoroughly to find out the major symptoms that need to be addressed (Ready & Veague, 2014). Personality and behavioral assessment methods are some of the useful methods to unearth family issues. Personal observation of the clients and their other family members using family therapy sessions will aid in getting rid of the family problems symptoms early before the issue escalate and probably get out of hand and harm the patient.

Nowadays, various health issues are requiring the intervention of psychology, thus becoming a source of referral for numerous psychological assessments. Healthy psychology is aiding in the treatment of pertinent health problems facing human beings today. Research has shown the efficacy of health psychology in helping patients manage lifestyle diseases like hypertension and others (Ready & Veague, 2014). Non-drug interventions and recommendations offered during therapy, like physical activity and sessions that discourage drug intake, are continuously acting as a remedy in controlling and preventing these health problems.

Sessions focusing on fostering patients' wellness are actively solving the concerns that face already sick patients (Ready & Veague, 2014). Other therapy sessions can help aged individuals on how to managing frailty syndrome and perhaps live longer and healthy lives. Additionally, psychological sessions aimed at spiritual issues can also promote the patient-psychotherapist connection and consequently contribute to bettering services the client receives. It is because, the more open a client is to a psychotherapist, the higher the chances of receiving quality recommendations that adequately solves all the issues raised during sessions.

Current Symptoms and Presenting Concerns

Smith suffers from obsessive-compulsive disorder (OCD). He is obsessed with recurrent thoughts, images, and impulses of an imaginary "angel" that is walking in the house and helping him recover from concussion situations he had suffered. Through psychological assessment, this OCD is as a result of his religious beliefs and values cultivated to him by the Indian religion he has grown and lived to follow. Smith requires cognitive-behavioral treatment (CBT) to solve this anxiety issue. (Kennedy & Harper, 2014)

Another referral source is family issues. The underlying family conflict existing between Smith and his daughter, Susan, requires psychological assistance. Mr. Smith demonstrates some form of dissatisfaction from the life he was experiencing while living with Susan. He explains how he encounters the problem of being treated as a child by Susan, where he is not allowed to self-govern most aspects of his life. This, coupled with financial problems where Susan is culpable for misusing his father's funds and property since he was diagnosed with dementia, is warranting a referral for family therapy. (Kennedy & Harper, 2014)

Additionally, healthy issues facing Smith requires a psychological assessment. The syncopal episode he had experienced last year requires a frequent clinical assessment to make sure there are no underlying health concerns. Hypertension issues facing Smith can also be managed with efficiency non-drug interventions like psychological assessments and recommendations aimed at reducing high blood pressure. Moreover, psychological interventions can aid in the promotion of Smith's wellness by actively contributing to managing his medication and frailty syndrome. The psychological assessment aimed at assessing spiritual issues that concur with Smith's Indians' believes will greatly help in promoting his well-being and foster his connection with a psychotherapist. This increased connection will be essential in ensuring that Smith does not hold back any critical information during psychological assessment sessions. It will be an added advantage because it will guarantee optimal psychological assistance, consequently contributing to boosted Smith's health and wellbeing. (Kennedy & Harper, 2014)

Smith's Psychosocial History

Educational History

Mr. Smith performed well in school but received only eight years of formal education because his parents required him to help in their family farm works.

Occupation History

Mr. Smith is currently a retired casual worker. His record shows he has worked for several local institutions. He acted as a server in a local high school cafeteria before retiring and began working for a local hardware store for several years.

Medical History

Mr. Smith is currently managing three health issues (hypertension, hypercholesterolemia, and osteoporosis). He was also diagnosed with dementia issues last year. He also explained an occurrence of a syncopal episode that rendered him unconscious, albeit for an unknown period. He is controlling the health issues superbly with medication. He is undertaking donepezil doses (4mg per day) to treat dementia, alendronate dosage (20mg per day) to treat and manage osteoporosis, and Lipitor dosage (70 mg per week) to manage hypercholesterolemia. He does not partake in alcohol and withdrawn from smoking 50 years ago. He also has no history of use and abuse of recreational drugs.

Psychiatric History

Smith encountered a syncopal episode that should be observed to ensure there are no brain issues. He explains that there are no developmental issues relevant to this assessment. He was born normal and grew without any developmental challenges. His family history shows that his parents died of medical sources (his mother died at the age of 75 due to cardiac complications while his father's course of death at the age of 42 years was recorded as stroke).

Social History

Behavioral and intellectual functioning assessments demonstrate positive behavioral features about Smith. He is a well-groomed man who demonstrated a willingness to keep time. He showed no signs of anger and mood disturbance issues. He also displayed joy and happiness whenever talking about family ties. He also showed a cordial coexistence with his family members.

References

Kennedy, N. & Harper, Y. (2014). College of Health, Ashford University: San Diego, CA.

Ready, R. E., & Veague, H. B. (2014). Training in psychological assessment: Current practices of clinical psychology programs. Professional Psychology: Research and Practice, 45(4), 278-282. doi:10.1037/a0037439