Treating Geriatrics With Despondency Issues

Mr. P is suffering cardiomyopathy, congestive heart failure, 4+ pitting edema, labored breathing, and an inability to stick to a restricted diet or manage his polypharmacy. He is 76-years-old and in a state of declining health. The medical bills are mounting (and indeed have become overwhelming for Mrs. P who has never had to deal with the couple's financial affairs, as they were always taken care of by Mr. P). The couple is depressed/despondent: Mr. P over his inability to understand why God allows him to linger in this condition rather than just take him immediately, Mrs. P over her inability to have a moment of rest outside the home, where she tends to her husband. Life is difficult for the two. This paper will consider the condition of Mr. P, how it affects Mrs. P, and how the situation can be approached so as to provide a high degree of care.

There are two concerns in this situation: first, there is Mr. P whose health is not good and who needs assistance; second, there is Mrs. P who is feeling overwhelmed by the new territory in which she finds herself (bills and treatment of her husband). The medical side of Mr. P can be managed but Mr. P clearly needs assistance with managing it and his wife is not up for the task. Mrs. P also suffers from dealing with the medical bills. So the first place to start is with the couple's living and financial situation. Are they are eligible for Medicare? Are they indigent? Are they open to the idea of assisted living or hospice, which can provide in-home care (Connor, 2009)?

A treatment plan can be devised after answering these questions. The plan should include family therapy so that the despondency that both are experiencing can be eased and a more hopeful and gracious attitude adopted. The treatment plan should include the continuation of Mr. P's polypharmacy and diet restrictions; however, there should be an element of added management since neither he nor Mrs. P appear able to properly manage these treatments. This is where hospice can help or an assisted living situation. Also family therapy, including the use of a spiritual minister (assuming that Mr. P desires a spiritual minister, since he made allusions to God taking him), should be included in the treatment.

The method for providing education should be through should consider the fact that geriatrics likely have experienced alterations in their cognitive processes which require patience and understanding on the physician's part (Barry, 2000). Therefore, one should not push treatments on the elderly but rather assist them in arriving at the conclusions "on their own." Caring for adults in the home can be an effective strategy, but educating the elderly on this option should be an exercise conducted during check-ups and discussed step-by-step.