Case
Mrs. Lopez is an 87-year-old resident at the Sunrise Assisted Living and Continuing Care facility. She moved there four years ago with her husband who was diagnosed with Alzheimer’s disease. They have one daughter who is single with no children. Mrs. Lopez’s husband passed away last year. After his death, Mrs. Lopez’s daughter began to notice a change in her mother’s agility and personality. Mrs. Lopez is no longer interested in participating in daily recreational activities; she refuses to take her medicine; and, she only talks about “seeing her husband again.” Mrs. Lopez’s daughter is concerned that her mother is suffering from depression and may have suicidal ideation. She is in need of a mental status assessment and treatment plan.
Solutions
I would start my conversation with Mrs. Lopez by asking “How has your mood been lately?” The most probable reply to the question would be “I have been feeling depressed lately. Nothing seems to be interesting to me. Talking to people around me including my daughter and participating in every-day activities seems meaningless to me.” Second, I would inquire “What do you think is the reason for your depressive mood?” I assume that Mrs. Lopez would reply “After my husband passed away, it is hard for me to find a reason to exist. It is not that I loved his so much I cannot live without him. It just all my life revolved around taking care of him and now I am too old to find another meaning for my life. Finally, I would ask “What do you think your husband would want you to do?” She would most likely reply “He always wanted me to be happy. He would probably say that he wanted me to go on with my life and take care of my daughter. But how can I take care of my daughter when I am old and locked in this place?”
After asking the open-ended questions, it is beneficial to make a summary for the client for several reasons. Summarizing can help to make links between present past material, serve as a transition to move to another topic, and help the client understand that the service provider has been listening attentively (Miller & Rollnick, 2013). The summary for this conversation could sounds like the following. “So, I have been feeling depressed lately mainly because you do not really have a meaning in life. Previously, all you needed was to take care of your husband, but now, as he passed away, you do not feel you want to find another reason to live. You also believe that your husband would want you to take care of your daughter; however, you do not feel that it is possible.”
Reference
Miller, W., & Rollnick, S. (2013). Motivational interviewing (3rd ed.). The Guilford Press.