Jaime and Rosa case study

QUESTION

A Central American Immigrant Couple Rosa and Jaime Sanchez immigrated to the United States from a Central American country 18 years ago when they were in their early 60s. A son and a daughter were already living and working in the United States when they arrived. Rosa and Jaime lived with their son, Jorge, his wife, Maria, and two small children in a two-bedroom apartment. To make ends meet, Rosa found work in the laundry of a nearby motel, and Jaime took the night janitor’s position at the local boys’ club. Rosa had hypertension, which she controlled with medications obtained at a nearby community health center. Jaime was an insulin-dependent diabetic and had to pay for most of his medical expenses. Two years after the arrival of her in-laws, Maria gave birth to another child. During the next 6 years or so, Rosa and Jaime learned barely enough English to become U.S. citizens. During this time, Jorge and Maria purchased a modest three-bedroom home, and the parents occupied one of the bedrooms. Rosa and Jaime had to stop working because of old age and declining health. Without a source of income, they qualified for Supplemental Security Income (SSI) and Medicaid. Most of the SSI income was handed over to the son for their room-and-board expenses. Medicaid covered their medical expenses. Starting at age 71, Jaime suffered several ministrokes. His blood sugar had not been well controlled. He also developed glaucoma in one eye and was barely able to see with that eye. The son and his wife both had full-time jobs. Before, Rosa was able to spend a lot of time taking care of her grandchildren, but “now her husband required more attention. He needed assistance with bathing. He also needed insulin injections and blood sugar monitoring three times a day. Their daughter, who lived with her family about 15 miles away, came over and provided help periodically. Jaime is now 77 years old. Two years ago, he fell and injured one of his ears. He has lost 75% of his hearing in that ear. Fortunately, he did not sustain any fractures. He wears a hearing aid in the other ear. Recently, he complained of declining eyesight in the good eye. An eye exam showed signs of macular degeneration. Rosa does not have the level of strength she once had to take care of Jaime. Both Jaime and Rosa use canes for walking because of some limitations in mobility. Jaime and Rosa’s grandchildren are growing up. They need more space in their home and time to devote to their school work. Jorge and Maria show some level of frustration because they are unable to devote the necessary time to take care of Jorge’s elderly parents. The parents don’t have the money to go to an assisted living facility, but perhaps they can qualify for care in a nursing home. Jorge, Maria, and Jorge’s sister have come to realize that the parents need to move out, but they don’t know where to turn. Jorge calls a nursing home located 6 miles from his home and makes an appointment to see the administrator.

Assignment

1. On the basis of the information given in the case, assess Jaime and Rosa’s current long-term care needs.

2. What type of living and care arrangement would you recommend?

ANSWER

Based on the information provided in the case, Jaime and Rosa have several long-term care needs that should be assessed

a) Medical Needs: Jaime has multiple health conditions, including diabetes, hypertension, glaucoma, macular degeneration, and mobility limitations. He requires assistance with daily activities such as bathing, insulin injections, blood sugar monitoring, and management of his hearing impairment. Rosa also has hypertension and may require monitoring and medication management.

b) Social and Emotional Needs: Both Jaime and Rosa have limited social interactions and rely on their family for support. They may benefit from socialization opportunities, companionship, and activities that promote their emotional well-being.

c) Housing Needs: The current living arrangement with their son’s family is becoming challenging as the grandchildren grow up and need more space. Jaime and Rosa require a living arrangement that accommodates their physical limitations and provides a safe and comfortable environment.

d) Caregiver Support: The son and daughter-in-law, Jorge and Maria, are struggling to provide adequate care for Jaime and Rosa while juggling their own responsibilities. They need support in managing the care needs of their elderly parents.

2. Based on their current needs, a recommended living and care arrangement for Jaime and Rosa could be a nursing home or assisted living facility. Considering their health conditions, mobility limitations, and the need for assistance with daily activities, a nursing home may be more appropriate.

Nursing homes provide 24-hour skilled nursing care, assistance with activities of daily living, and a structured environment that can cater to the complex medical and personal care needs of the elderly. They have healthcare professionals available round the clock to monitor and manage their medical conditions, administer medications, assist with mobility, and provide specialized care for conditions like diabetes and hypertension.

A nursing home can also offer social and recreational activities, allowing Jaime and Rosa to interact with other residents and engage in activities that promote their emotional well-being. The nursing home environment can provide the necessary support for their declining health, ensuring their safety and comfort.

To determine the most suitable nursing home, Jorge should visit the facility he contacted and meet with the administrator. During the visit, he can assess the quality of care, the range of services provided, the living conditions, and the level of staff expertise. It is important to ensure that the nursing home has experience in caring for individuals with conditions like diabetes, hypertension, and visual impairments.

Additionally, Jorge should inquire about the cost of care, including whether Medicaid coverage is accepted, as Jaime and Rosa currently rely on Medicaid for their medical expenses. This will help determine the financial feasibility of the nursing home arrangement.

In conclusion, considering Jaime and Rosa’s current long-term care needs, a nursing home appears to be a suitable living and care arrangement. It can provide the necessary medical support, assistance with daily activities, and socialization opportunities while relieving the burden on their family members who are struggling to meet their care needs. It is essential for Jorge to carefully assess the chosen nursing home to ensure it meets their specific requirements and offers a safe and supportive environment for his parents.