Group Case Study

An 87­year­old woman, Ms. V, was diagnosed with stage 4 Breast Cancer and consented to 6 months of aggressive
chemotherapy treatment. During the first three months of treatment, Ms. V began to experience weekly hospitalizations as
a result of chemotherapy side effects. Eventually blood transfusions and iron treatments were required. Ms. V thereafter
began to experience edema, breathing difficulties, and cardiac heart failure.
The attending oncologist did not completely disclose prognosis to Ms. V and her family. Throughout the treatment process
did not clearly address the quality of life for Ms. V. Shortly after four weeks’ the chemotherapy treatment was suspended
because the harsh side effects deathly weakened Ms.V. She became incontinent, lost physical strength and was limited in
providing self­care.
In order to administer additional chemotherapy treatments, the oncologist stated the Ms. V would need cardiologist
consent to continue the aggressive treatment phase. Consent would not be given until additional cardiac exams were
Ms. V had not seen a cardiologist in years and felt reluctant in meeting with someone who did not know her medical
history. The appointment was scheduled and Ms. V was seen by the cardiologist, who determined she was, in fact, too
weak to continue chemotherapy treatment and discovered an aneurism in her aorta. Ms. V would continue to be
monitored by the cardiologist until it was determined she could resume aggressive chemotherapy treatment.
Ms. V lived with her older 47 year old son, Mr. T, who was divorced with two grown children. They had a strained
relationship for many years, yet Ms. V, for many years, provided a home, financial support by paying annual property
taxes, electric, water, and phone bills. Mr. T wanted to be supportive of his mother, but became extremely irritated as Ms.
V’s illness progressed and she required more attention and assistance. Due to the inability to effectively communicate
with each other, Mr. T became distant and less attentive to his mother’s daily needs. Ms. V began to feel isolated and
struggled with accepting her current situation. She wondered if she had been an unsupportive mother.
During an appointment with the cardiologist, Ms. V mentioned that she was not eating, sleeping, and able to bathe herself
well. The cardiologist sensed that neglect was occurring, since her medication regimen was not being followed as needed,
her weight dropped significantly and she appeared disheveled during the last three appointments. This assessment
prompted a call to APS and the family was under investigation.
Mr. T stated during the investigation that he never had a close relationship with his mother compared to his siblings and
often felt he was treated “differently and unfair”. Now that his mother was ill, he did not want the caregiving responsibility.
Mostly, Mr. T felt this way because he did not how to physically care for his mother. He wanted the other two siblings to
assist in the responsibility in taking their mother to doctor appointments, treatments, and attending to her needs during the
week. Mr. T felt he did not have the support of his siblings. They often had excuses about why they could not help.