Note: These "patients" have been constructed for the purpose of this case, and have no basis in reality. Any resemblance to persons living or dead is purely accidental, and a possibly a demonstration that randomness leads to strange coincidences.

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Patient: HOLCOMB, EileenRank Order:        
Gender:  F 
Race:  W 
Age:  N/R 
Marital Status:  Married 
Time waiting:  20 months 		 Religion:  Catholic 
Employment:  N/R 
Education:  N/R 
Family residence status:  N/R 
Insurance:  N/R 
Composite RecordReferral TextCommentsPersonalitySocial HistoryAttitude (patient & others)Family Records

Patient Family Information (top)

Members of patient household
relationshipageempl. or School
husbandN/R***
Other Members of patient family
relationshipnotes
mother-in-law 
parents 
brother 

Comments (top)

N/R

Social History of Patient (top)

Early history, including family and peer relationships, cultural and geographical background, health, economic and other factors which may have effected patient. Include present family situation.

  • ill since age of 9 with diabetes

Personality Structure of Patient (top)

Include self-image, stability, focus of life activities, ability to cope with stress, etc.
  • passive acceptance toward illness
  • agreeable to hearing info. on available treatment plans

Attitudes (top)

Patient's Attitude Toward Illness and Proposed Treatment

Include initial impact of illness, changes in life activities, reactions to and ability to follow medical treatment program, and goals patient sees for self with proposed treatment

 N/R

Attitude of Significant Others

Include attitude toward illness and proposed treatment, ability to participate in proposed treatment, ability to give emotional support to patient, and changes in relationship with patient since onset of illness.

According to patient, they take it calmly w/ concern and questions. They are used to her illness.

Referral Text (top)

7/26/75

23 year old white female R.N with deiabetes and renal failure. Will probably need hemodialysis and transplant

Referral; Mrs. Holcomb was referred for a social evaluation in regards to hemodialysis or transplant possibilities.

Social History: Mrs. Holcomb is a 23 year old general medical RM at *** Hospital in ***. Her husband is a school teacher. the couple have no children and live in a home they are inthe process of buying.

Mrs. Holcomb's parend and brother also live in ***. Her parents, Mr and Mrs. ***, ca be reached at ***. The brother has just recently been married. Mrs. Holcomb's in-laws are located in *** as well.

Mrs. Holcomb has had diabetes since the age of nine and presently must give herself an insulin shot daily. She is covered by two health insurance policies: one is a private *** plan while the other is her husband's *** plan.

Reaction to Illness: Mrs. Holcomb appear to be passively accepting her condition. She says she is used to being sick, so that this new situation is not too alarming for her. It is suspected that this casual attitude harbors a hope that her kidneys will regain normal functioning. At any rate, her first experience won peritoneal dialysis may have broght reality a bit closer, as the experience angered and upset her a great deal. After the experience, she was ready to request a transplant, something she had not actively studied previously,

Mr. Holcomb will be available all summer as he will not be working. He decided he would stay home and care for his wife. this meant turning down a summer school job. Mrs. Holcomb feels her huband, too, is taking her illness in stride as he grew up with knowing of her poor physical condition.

Recommendations: Mrs. Holcomb requests a transplant becuase of her young age. Ager being informed of her alternatives, she decided that she would prefer not to be tied to a machine the rest of her life.

If home training becomes the treatment of choice, I see no social problem to interfere with its implementation.

[signed]
Clinical Social Worker

Note: These "patients" have been constructed for the purpose of this case, and have no basis in reality. Any resemblance to persons living or dead is purely accidental, and a possibly a demonstration that randomness leads to strange coincidences.