Course and Outcome

Case Study 1: Mr. S

Course and Outcome

Mr. S reports that he must assist his wife with the most basic self-care activities including bathing, eating, dressing and using the bathroom. Mr. S describes an average day, “…she gets up in the morning, and then I make her go to the bathroom so she can relieve herself. After that, is to make her get up and get in the tub. She won’t get in the tub. I have to reach down and take one foot, take it up and set it in the tub. After I do that, then she’ll take the other foot and go in. If I don’t do that, she isn’t going to get in the tub. She can wash herself…But I do that because I can get it done quicker that what she would get it done.” Because she is often incontinent, she wears diapers and must be changed regularly. She does not do any chores around the house. She never goes outside alone. He also notes that his frustration and sense of confinement associated with caregiving has been further aggravated by the inefficient and inadequate formal services available in his area. “Well, I’m like, you might say, I’m locked in jail. And the only outlet that I have is when she goes to Kit Clark. But now we’ve been having trouble with The Ride. They put her on standby.” Though Mrs. S is supposed to be transported to an adult day health program each day, often “The Ride” does not come at all. An addition obstacle is that Mrs. S’s eligibility for these services seems to be in doubt due to changing rules and regulations that restrict eligibility.

Diagnostic Formulation


Axis I

300.4 Dysthymic Disorder

Axis II

No diagnosis

Axis III

No diagnosis

Axis IV

Problems with caring for his wife who has dementia

Problems with primary support group (critical of wife’s children)

Axis V

GAF=58 (Current)