Intake Information
You are the worker “on call” at the Goodheart Mental Health Center, which is located in a Southern town. You receive a call from local law enforcement that they are bringing an elderly African-American female in for evaluation. They had been contacted by personnel from the Greyhound bus station after they became concerned about her apparent confusion and continued presence for the past 36 hours.
Initial Contact
The client appears quite elderly and frail. She is dressed neatly in a checked dress with comfortable shoes. She seems rather alarmed and confused. She is clutching a small handbag. “Good morning, ma’am. What can I call you?” you begin. “My name is Olivia Joyner,” she responds. “I work here at the clinic and hope I can help you out today,” you say. “That’s okay, honey. I just can’t find the el. These police are scaring me some,” she whispers. “You can’t be too careful, you know. White people can be real mean.” “I don’t think he needs to stay if he’s bothering you. Do you think I could look in your purse before he goes?” you ask. “What purse?” she responds, but she allows you to take her bag and hand it over to the officer. The officer finds an identification card in her purse indicating that she is 93 years old and resides in Gary, Indiana. The officer tells you he will try to get more information about her and leaves. “Well, Mrs. Joyner, would you tell me what you’ve been doing at the Greyhound station the last few days?” “Just call me Olivia, sweetie. Where’s the el?” she responds. “I been wanting to do some real important shopping but then there’s the weather. Can’t fight city hall, you know.” You recognize that the “el” is a mass transit system in Chicago (not far from Gary, Indiana). “Okay, Olivia, where are you trying to get to?” The client seems to have lost track of the conversation and is looking anxiously around the interview room. “Have you seen my bag?” she asks. “I got to keep my things together. People can take advantage of you when you get old. Do you know what time it is?” When you return her handbag, she empties it and begins looking through its contents. “Olivia, have you eaten recently? Can I get you something to eat or drink?” you ask. She looks at you expectantly and then returns to her inspection of her handbag. “Strawberry shortcake is the best, don’t you think?”
1. What diagnoses are you considering at this point?
Q