Mary Smith is a 60-year-old woman. She

Mary Smith is a 60-year-old woman. She has COPD, diabetes, and high blood pressure. Mary worked as an hourly employee at a large retailer. She lost her job and her employer-based insurance after experiencing a debilitating episode of clinical depression and anxiety. Mary felt very fortunate that she was able to sign up for ObamaCare. She even qualified for a lower rate because of her limited income. Mary has difficulty managing her chronic physical health conditions because of recurrent bouts of depression and anxiety. She smokes a pack of cigarettes each day to help “calm her nerves.” She knows smoking is bad for her health, so she tried to quit several times but always ended up smoking again. Currently, Mary sees a primary care provider who prescribes medications for her depression, anxiety, blood pressure, COPD, and diabetes. She has never seen a mental health provider. Mary lives with her 80-year-old mother who has dementia and needs help with meals and personal care. The dementia has gotten worse and now her mother cannot be left alone. Mary’s mother receives Medicare and Medicaid. Mary is totally overwhelmed. She would like to get some counseling for her depression and anxiety and to help her quit smoking but she does not know who to contact. If she loses her health insurance through the ACA, she will no longer be able to see her primary care provider. And she has no one to help her with her mom. She doesn’t know where to turn for help. Question: 1. Identify at least three (3) additional topics of information would you need about their situation to plan their care? 2. Mary appeared to have previously learned to manage and live with diabetes, COPD and hypertension. But Mary has now also been diagnosed with two more chronic conditions- depression and anxiety. Put yourself in Mary’s shoes. Explain at least three (3) ways that Mary’s current illness experience differs compared to before she lost her job.

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