Question

William Davis is 62 years old. He was employed as a postal worker until his declining eyesight forced him into early retirement a few months ago. His wife, Mildred, died last year of complications from diabetes after a prolonged and expensive hospitalization. Mr. Davis does not trust the medical community, and because of this distrust, he has not been to a doctor since his wife’s death. Mr. Davis is not considered legally blind, but his presbyopia and an advancing cataract in his right eye are starting to interfere with his ability to take care of himself. He still drives to the market once a week, but other drivers get angry and honk at him. He pays for his groceries with a credit card because he is afraid the cashier will cheat him if he accidentally gives her the wrong bills. He complains that the cleaning lady hides things from him and deliberately leaves the furniture out of place. When she leaves, he can’t find his slippers or an ashtray. Yesterday, he put his lit pipe down in a wooden bowl by accident. His son insists on taking him to see the ophthalmologist who treated his wife’s diabetic retinopathy. Dr. Hsing believes Mr. Davis’s sight can be improved in the right eye by performing cataract surgery. Mr. Davis listens in fear as the doctor explains. “Without this procedure, your sight will only get worse.” Mr. Davis thinks about all the medical procedures that were tried on Mildred, and she died any-way. He doesn’t want to go into the hospital, and he doesn’t want any operations. But his son is talking about taking away his car if he doesn’t do something about his failing sight. “What more can be taken away from me?” he thinks bitterly. “First my wife, then my job, and now my independence.”

1. Discuss why cataract surgery would be scary to Mr. Davis and what Dr. Hsing and his staff could do to ease his apprehension.
2. Mr Davis is a patient in your clinic. What are some ways you would you adjust your usual routine to accommodate his needs?
3. If Mr Davis does not have the surgery, what agencies or resources would be available to him?

Answer 1

Answer A

Cataract surgery or any other medical procedure can be a cause for even normal people to an extend. Here in case of Mr.Davis the association between his wife's death is with the failure of treatment course as he thinks. Even after following expensive and up to date management for the disease his wife had it eventually lead to her demise.The psycological trauma he had was supposedly not managed as needed.

To ease this situation the doctor and health care workers can institute thorough health education and counselling sessions adressing his needs and probably cause of his wife's death in the presence of his son.

Answer 2

To adjust the patient's needs and gain the trust it would be better if we allot specific consultation time to the patient which is comfortable for him. Try to avoid long periods of waiting time. It is better if the patient is allocated with a personal attendant to familiarise and help him with the procedures and routine in the clinic.

Answer 3

If Mr. Davis is not attending the surgery. There is a fat chance he looses his vision gradually. In that case the client can seek help from the associations like

American diabetes association

American foundation of the blind or any other organisation. To seek help with his daily activities the client can appoint a caregiver or can seek help from organisations that help the older people.