Case 1: Emma is an 85-year-old African American female who was recently widowed. She lives independently in her small home in a large city. She is fairly active in her communityshe likes to attend church, weekly exercise classes, and social outings with her friends. Recently, she has found little interest or joy with leaving her home; this began after a bout of the flu where she was hospitalized for 3 days. She was happy enough with her medical care and was glad to be feeling well enough to return home. However, she finds she has little energy to manage her home, let alone socialize with friends. Her visiting nurse asks her often about her mood, appetite, and sleep patterns. Emma is vague with her responses and says she is "fine." The nurse requests a social worker to speak with Emma to see if any community services would help her recover and get back to her former routine.

1. What condition does Emma likely have and how can you tell?

2. What risk factors does Emma have for this condition?

3. The visiting nurse requested that a social worker meet with Emma to discuss community services. Who else should Emma meet with and why?

Case 2: Mr. Means was referred to the skilled nursing facility rehabilitation center after his primary care physician noted a decline in functioning since his last visit, even though the only medical issue involved was rather minor surgery. While being evaluated, Mr. Means was unable to complete his self-care skills, even though he had no medical or physical reason not to (other than deconditioning). It turned out that his home health aides, provided by his well-intentioned family, had taken over doing everything for him, even the most basic self-care tasks such as dressing.

1. What might be transpiring for Mr. Means and why?

2. What might need to happen to get Mr. Means back on track?