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: JONES, FrancesRank Order:        
Gender:  F 
Race:  Cauc 
Age:  N/R 
Marital Status:  Married 
Time waiting:  18 months 		 Religion:  Protestant 
Employment:  never employed 
Education:  high school; 1941 diploma 
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
husband49machine shop
son18hardware store
daughter1410th grade
son138th grade
Other Members of patient family
relationshipnotes
parentsdeceased 1959 and 1964
sister 
sister 
sister 
brother 
brother 

Comments (top)

  • Husband has service record - Army
  • Other Agencies Contacted: State Kidney Foundation
  • County Dept. of Social Services contacted about Medicaid
  • Family health problems: Husband gouty arthritis -- not incapacitating
  • Spouse income - $7800.year
  • Insurance through husband's machine shop employment

    • 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.

    • Family relationships have not been close and Mrs. Jones will not at her siblings to donate a kidney.
    • Marital relationship appears stable

    Personality Structure of Patient (top)

    Include self-image, stability, focus of life activities, ability to cope with stress, etc.

     Mrs. Jones appears to be of average intelligence and has led a rather simple, uneventful life. Her life activities have focused on being a wife and mother and she seems to have been successful in these areas. She has accepted the various stages of her illness with calmness and hes taken rational steps in making decision (i.e., meeting another transplant patient).

    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

     Mrs. Jones has had renal disease for about 4 years, but was not symptomatice until Feb '71. Mrs. Jones has kept regular clinic appointments and has followed her medication and diet program without difficulty. Mrs. Jones has been ambivalent about treatment choice, initially wantin a related transplant. When a relative donor was not available, she chose home dialysis. Since meeting a successful cadaver transplant patient she has decided upon this method of treatment.

    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.

    Mr. Jones is leaving the treatment decision up to his wife, and seems to have no preference himself. He is quite supportive of Mrs. Jones and is cooperative in carrying out her medical program

    Referral Text (top)

    Recommendations: Accept for cadaver transplant program

    Diagnosis: Chronic Glomerulonephritis; diagnosed 1976, symptomatic Feb 1971

    Course of Treatment:

    • 6-71 - Mrs. Jones and sister seen for initial evaluation
    • 10-71 - Mrs. Jones hospitalized and decision for cadaver transplant made. Mrs. Jones continues to follow medical program without difficulty and is a cooperative, uncomplaining patient.

    Closing summary (9/21/73): Mrs. Jones was referred to the Department of Social Work in June 1971 for evaluation for the renal programs and a history is available in the department records. Mrs. Jones was quite ambivalent about which treatment program to choose and initally work focused on helping her make this decision. Mrs. Jones chose to have a transplant and received a cadaver kidney in February of 1972. She has had no difficulty adjusting to her illness and has been medically stable since the time of the transplant. Currently Mrs. Jones has resumed her roles as wife and mother and is functioning much as she did prior to becoming ill. As Mrs. Jones' condition is stable, there is no indication for additional social work follow-up. Should she develop difficulties, please refer her to the renal social worker.

    Closing summary (1/11/76): Mrs. Jones was referrred to social work because of an irreversible kidney rejection following nearly four years of sufficient renal function. This episode produced a depressive reaction in Mrs. Jones that left her feeling scared, frustrated and worthless. Her thoughts turned to both a fear and a wish for death.

    Social treatment consisted in facilitation of the grieving process which led way to the strenghening of her ego functions. After returning to dialysis, support was given to her problem solving capacities which led to an early discharge and the establishment of an out-patient dialysis schedule.

    A second course of action that was pursued was the implementation toward a legal decision regarding the reception of a kidney from ***, a sister who had been institutionalized for metal retardation many years. Mt.s Jones has obtained the services of a lawyer after the tissue typing (which was sanctioned by the judge of *** county) of the donor revealed excellent compatibility>

    Presently, transfer of Mrs. Jones to *** General Hospital for transient dialysis is planned but cannot be accomplished because their unit is filled to capacity. She will be transferred when an opening occurs.

    Social work involvement is terminated until a legal decision is made and Frances returns for either a related or cadaver transplant


    [signed]
    Clinical Social Worker


    8-76 - Exploring legal aspects still.

    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.