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.

Back to summary list
Patient: COLLINS, JohnRank Order:        
Gender:  M 
Race:  W 
Age:  38 
Marital Status:  N/R 
Time waiting:  19 months 		 Religion:  Roman Catholic 
Employment:  prefessional school 
Education:  self-employed 
Family residence status:  Buying House 
Insurance:  N/R 
Composite RecordReferral TextCommentsPersonalitySocial HistoryAttitude (patient & others)Family Records

Patient Family Information (top)

Members of patient household
relationshipageempl. or School
wifeN/Rnone
9 children, aged 5 to 17N/Rat home - in school

Comments (top)

  • In present house since Dec 1971; Home 1 year old - 2 story; no water softener
  • machine in den
  • No contact with other agencies
  • No military service
  • Golf - 1/week
  • bridge player
  • bowling - 1/week
  • Member, Knights of Columbus
Financial circumstances
  • Income and savings
    • Patient income - $69,000/yr net; $90,000/yr gross; $42,000 after taxes
    • Pension benefits - $800/mo insurance (no benefits yet)
    • Savings - less than $1,000 cash
    • Stocks and bonds - retirement mutual fund holdings of $3000; $4000 US Series E bonds
    • Real property - cottage, preparing to sell;
    • Insurance - $40,000 straight life; $40,000 term life
  • Debts
    • House mortgage $49,000 balance; house estimated worth at $70,000
    • Approximately $2000 credit card debt
    • $7000 home improvement load
  • Plans for financing treatment
  • Sale of cottage - values at $17,000 with $8,000 outstanding mortgage
  • State kidney foundation agreed to purchase equipment because of financial help from bowling group. this group has put one machine in the loan closet and plant to fund raise again this year

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.

Patient has been a strong partner in marital realtionships. Wife has been very dependent-overprotected. Husband sees wife as basically incompetent in roles other than wife-mother.

Personality Structure of Patient (top)

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

Masculine image based on roles of husband-father-bread winner. Depression because of possible loss of roles

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

Depression because of loss of significant roles. Should be no major changes in life activities. Sees treatment as making him "well" perhaps somewhat unrealistic

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.

Wife is frightened about future and possibility of husband's death

Referral Text (top)

Recommendations: OK for training

Medical Diagnosis: Chronic renal failure

Course of Treatment

  • 2-73: Referral from Dr. *** for transplant or dialysis. Initial interview with patiend and wife following which patient was admitted for peritoneal dialysis. Seemed to have made decision for dialysis prior to interview. Wife quite emotional - cries easily
    focus on treatment and future
    accepted for training
  • 3-73: On machine-bored-depressed about not being able to work. Ambivalence about home dialysis. Considering possiblity of son giving kidnet. Working through these feelings.
  • 3-23-73: Training started; concernr re machine. Bowling alley has purchased machine for loan closet
  • 6/11/74 - Hospitalized

Closing Summary (9/19/73): Mr. Collins was referred to the Department of Social Work in February 1973 for evaluation for the renal programs. Initially he was quite interested in having a transplant as he felt this would give him the best chance for leading a normal life. As there were no family donors available, and as Mr. Collins began to understand the risks of transplant he changed his mind and sought instead to enter the home dialysis training program. He has been throughout the course of training quite ambivalent about his decision and periodically has brought up the possibility of transplant in the future.

Mr. Collins and his wife *** successfully completed the dialysis training program in May 1973 and have been at home since that time. Mr. Collins has resumed his (occupation) though on a somewhat more limited basis than prior to the illness

As Mr. Collins continues to have periodic episodes of depression and has not yet fully accepted the limitations of the dialysis program this case will be referred to Mrs. ***, a renal social worker, for continued follow-up.

[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.