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HEAL13431 Mental Health Issues and Cognitive Impairment Case Study
Josephine Miller
You have been assigned to assist Josephine Miller in her home 2 days a week. She is a 35 year
old female with 2 school age children. Josephine’s husband leaves for work at 6:00 am. Your role
is to assist Josephine get the children ready for school. You are usually in the home for about an
hour each morning and during that time Josephine paces and wrings her hands continually.
Thomas and Josephine have been happily married for the past 10 years. Josephine is a
successful interior decorator; however, has been under considerable stress since her major
client decided to discontinue his contract four months ago.
For the last 6 months, Josephine has been experiencing panic attacks and severe anxiety for
which she had not sought treatment. She has had feelings of dread for no apparent reason,
racing heart rate, nausea and trouble sleeping. Josephine’s anxiety and panic has been steadily
increasing. For the past 4 weeks she has not been able to leave her home or attend work, make
meals or care for herself or her children. Josephine has no past psychiatric illness or other
medical problems.
Thomas, Josephine’s husband, convinced her to go to the emergency department when he
returned from work and found her sitting on the floor in the corner of their bedroom crying and
fearful. Josephine had been too frightened to leave the corner all day. After further assessment
and consultation with Josephine, she has agreed to be voluntarily hospitalized.
Following 3 days of hospitalization Josephine was discharged home, with a prescription of 2-mgtablet of lorazepam twice a day. Josephine has become cooperative with treatment, and is
attending group therapy twice a week and socializes with other clients.QUESTIONS
1. Discuss anxiety and identify 4 symptoms of anxiety/panic that Josephine was experiencing
before her hospitalization.
2. On your first visit Josephine states, ‘I don’t know why you are here. I am perfectly capable
of looking after my family’. Considering therapeutic communication, how would you
respond to this statement?
3. Considering the principles of Mental Health Care, choose 2 principles and describe how
you would apply them in Josephine’s situation.
4. List 3 suggestions you would give to Josephine, within your role as a PSW, to help manage
her anxiety and discuss why it is important for her to know this information.
5. Discuss 2 new things you have learned regarding anxiety and panic disorders and how they
will impact how you provide care?

 

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