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COPYRIGHT © 2013 Case Management Society of Australia and New Zealand (CMSA)
CASE STUDY 3 – MARY
Mary has been referred to your service under the National Respite for Carers Program. Mary’s mother Clare has a formal
diagnosis of dementia and Mary has been her primary carer for the past 3 years.
Mary has full time employment as a legal secretary and her workplace is situated close to home. This is the first time she
has accessed any services, is quite fearful of accepting help and tells you this at your first meeting. Clare has had a recent
psychogeriatric assessment and this reveals a moderate to severe dementia with the likelihood that the symptoms will
start to escalate.
Clare has just started to become incontinent and Mary has bought some ‘nappies’ at Aldi for her mum to wear. She was
referred by the Dementia Advisory Service who have been visiting for about a month. Mary states she was very fond of
Kathy who works there. Mary informs you that under no circumstances will she admit her mother into care as she has
promised her mother she will care for her at home until she dies.
During your visit you notice that Mary answers all the questions that are directed to Clare and that Mary presents as
agitated and stoic.
Additional Information:
►►
Mary has not told anyone at her work that her mother has developed dementia.
►►
Mary has a mortgage on the unit and cannot afford to cease her paid employment.
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Mary leaves Clare unsupervised at home five days a week in order to continue her employment, returning home
during her morning tea, lunch and afternoon tea break to check on her mother. During Mary’s absence, Clare is
restrained in a lounge chair with a sheet tied loosely twice around her waist, wears an incontinence pad and can
access food and reading materials on a table positioned close to the lounge chair.
►►
Mary no longer dates nor socialises with her friends, or work colleagues, as she is either too tired or broke to do so.
She goes to extreme lengths to keep her mother’s medical condition hidden from everyone, fearful of the shame and
embarrassment this may cause her and her mother.
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Mary cannot afford to pay for any home care services as she has reached the maximum limit of her income and credit.
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 Mary?
(i.e. her individual, diverse and special needs, including her aspirations, choices, expectations, motivations,
preferences and values)
B. Advocating for Mary’s rights?
(including developing Mary’s strengths to advocate for herself)
C. Addressing Mary’s needs?
(i.e. purposeful case management)
D. Promoting sustainable solutions for Mary?
(i.e. balances Mary’s needs with the available resources and any of your possible limitations as a case manager)
E. Effective communication?
(i.e. with Mary, Clare and other Key Stakeholders)