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Week Five Assignment Scenario

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Your Aunt Phyllis, who is 61 years old and a widow, lives close to you and was diagnosed with breast cancer 3 years ago. Her husband died of a stroke 5 years ago. She has one daughter, but her daughter lives far away, and their relationship is not close. She has undergone surgery, radiation, and chemotherapy treatments, and her cancer is in remission. Her doctors do not recommend further treatment at this time. She still experiences nausea occasionally, possibly conditioned from the time spent undergoing chemotherapy treatments. Problem You have noticed that your aunt’s energy level is reduced and, when you visit, you observe that she doesless to keep her apartment as clean as she used to. Her personal hygiene has also reduced. In speakingwith her, you have noticed that she is very fearful that the cancer will return. She has even expressedconcern that she will soon die. She has a pessimistic attitude toward life. She used to play bridge with agroup of friends, but she has not seen them in over a year. Her social support is very low, and you areone of her few close confidants. You also have some concerns about her short-term memory, as she oftenseems to forget things that have recently happened.Behavioral Health InformationPhyllis has always been slender, but she appears even more frail since her cancer treatments. She wasnever a big eater, but her appetite is reduced further because the chemotherapy made her quitenauseous. Sleep patterns are disturbed by early awakening insomnia. She goes to bed at about 8 PMand usually awakens at 2 AM and cannot get back to sleep. She walks every day for exercise, but herattitude toward exercise is fairly negative, and she states that “I don’t know what this walking is doing forme.” She is a religious person and attends church every week. She confided that she is angry with Godabout her cancer. She believes she has led a good life and cannot understand why she was cursed withthis disease. Her self-efficacy is low, which is a dramatic change from her “old self,” before her husbanddied and she was diagnosed with cancer. She used to be vibrant and active, as you remember her. Shehas never been seen by a psychologist or psychiatrist.