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COPYRIGHT © 2013 Case Management Society of Australia and New Zealand (CMSA)
CASE STUDY 16 – ELENA
Elena is an 83 year old woman from the Baltic region who resides alone in a 3 bedroom home after being widowed 10
years ago. She has increasing memory loss and loves animals. Elena has always housed many pets, including strays,
birds and a little dog “Rex”. Elena speaks very good English but has never learnt to read English. She has 2 supportive
daughters, Natalie and Rebeccah, who visit weekly however both are not local to the area and must travel 1 hour by car
to see their mother. Elena is currently receiving minimal services (fortnightly cleaning).
Both Elena’s daughters independently report of increasing changes to their mothers behaviour and her health. On visiting
they observe there is little to no food in the home and Elena appears to have lost a significant amount of weight in
recent months. Furniture and other items are frequently moved about and/or misplaced. Elena has become suspicious of
visitors, accusing them of stealing her belongings, including her jewellery. Elena no longer answers the telephone nor
understands its purpose, recently pulling it from the wall in her endeavours to investigate what the noise was.
A neighbour has telephoned Natalie concerned that Elena has taken to watering her front garden at all hours of the day
and night wearing only a singlet and underpants. Furthermore, they have disclosed that Elena will often take her dog Rex
for numerous walks during the day and observed her leave one evening, a little after 10.00pm, not returning home until
well after midnight. There have been several incidents in the past 2 months where the same neighbour has called the fire
brigade to the home as Elena, having taken off with Rex, had left a kettle boiling on the electric stove.
You learn that both Natalie and Rebeccah are supportive of Elena’s wish to remain living at home but are increasingly
frustrated and troubled by Elena’s erratic behaviour. On visiting 12 weeks ago Rebeccah arrived to witness her mother
reversing her car straight into the front fence. Rebeccah immediately coaxed her mother to give her the car keys and took
them with her when leaving to prevent Elena from driving. Last week, another neighbour telephoned Natalie requesting
her urgent attendance at the home. Elena was hysterical and inconsolable claiming that her car had been stolen out of
the driveway. Further investigation revealed that Elena had found a spare set of keys and had driven the car to the local
supermarket, before abandoning the car (unlocked) and walking home. Elena has hidden the spare set of keys to the car
and refuses to hand them over to her daughters.
Additional information
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Elena has started to mix up the pet food, feeding the bird’s dog food and Rex the bird seed.
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Soiled clothing is often found placed in the dishwasher by the HACC worker who visits fortnightly for cleaning. The
worker has also found what appears to be medication on the lounge room carpet.
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Elena has not attended her regular hairdressing appointment for several weeks. This is very out of character for her as
she has visited the same hairdresser at the same time each week, for a wash and blow dry, for 20 years. She is often
seen wearing the same items of clothing.
Instructions:
1.
Please answer each of the questions below.
2.
Please complete this activity with reference to the resource materials provided.
3.
Please document and report your findings back to the group.
Questions:
1.
What guidelines from each of the CMSA National Standards of Practice for Case Management would you utilise in
this case?
2.
How does your proposed case management provide evidence of:
A. Facilitating the personal development of Elena?
(i.e. her individual, diverse and special needs, including his aspirations, choices, expectations, motivations,
preferences and values)
B. Advocating for Elena’s rights?
(including developing Elena’s strengths to advocate for herself)
C. Addressing Elena’s needs?
(i.e. purposeful case management)
D. Promoting sustainable solutions for Elena?
(i.e. balances Elena’s needs with the available resources and any of your possible limitations as a case manager)
E. Effective communication?
(i.e. with Elena, her daughters and other Key Stakeholders