Case Study 1: Mr. S

Case Study 1: Mr. S

Mr. S is a 72-year-old retired African American man who lives with his 70-year-old common-law wife in a small, two-bedroom apartment in a public housing development. He is the primary caregiver for Mrs. S who is exhibiting cognitive deficits and behavioral changes consistent with a progressive degenerative neurological process. The interviews on which this cultural formulation is based were held with him.

History of Present Illness

Mr. S and his family noticed for several months that Mrs. S was experiencing increasing memory deficits, coordination difficulties and personality changes. During her work as a beautician, she was finding it difficult to hold the curling iron and remember how to “put chemicals into people’s hair.” After she retired, she became uncharacteristically irritable and angry and demonstrated more memory difficulties. Initially the family attributed her difficulties to her longstanding hypertension which they called her “pressure.’ When she was finally brought to her doctor, Mr. S was told that her blood pressure was very high, that she had suffered a stroke and had Alzheimer’s disease.

Psychiatric History and Previous Treatment

Mr. S had never previously sought psychiatric treatment.

Social and Developmental History

Mr. S was originally born in Ohio but moved to Boston at an early age. He is a World War II veteran and a retired construction worker. He and Mrs. S have known each other socially for many years. Their courtship began after his divorce from his first wife and the death of Mrs. S’s previous husband. They have been together for the past forty years.