Guest Contributor and author, Carol J. Farran, PhD, RN, MSN, FAAN, has served as Professor, Researcher, and Principal Investigator at Rush University Alzheimer’s Disease Center. Based upon her contribution to Alzheimer’s Disease research, she is included as our first Influencer in ABeautifulVoice.org. As a personal friend, she had influenced my thinking about “Hope and Hopelessness,” the title of her book, a decade prior to Mother’s diagnosis. Additional information about her background, professional accomplishments, awards and recognition can be found here on our Influencers’ page.
Andrew and Susanna were European immigrants who came to a large urban area in the United States after World War II. They had no children and no relatives remaining in Europe. Following many years of marriage, when Andrew was hospitalized on a Geropsychiatric unit, he was very depressed and took little initiative in his own self-care.
Stretching the Boundaries – Caring for Andrew
Susanna’s own depressive symptoms became more obvious as she was encouraged to become involved in Andrew’s care, including personal care, ambulating and other support. On further evaluation, the Unit Geropsychiatrist determined that Susanna was so depressed herself that she had difficulty fully engaging in Andrew’s personal care and symptom management.
Caring for Susanna
She enjoyed the evening polka dances held on the Geropsychiatric Unit, but had difficulty engaging in the physical and mental healthcare needed by her husband.
The Geropsychiatrist determined that, given her own level of energy, Susanna was incapable of responding to her husband’s medical and mental health needs, and that Susanna’s own mental health needs required that she receive some personal attention to her self-care-related needs. 
Susanna was subsequently also admitted to the Geropsychiatric Inpatient unit. Her admission to the unit authorized her own mental health treatment. Given limited social support in Andrew and Susanna’s community network, it also alleviated staff concerns about Susanna needing to take a bus or train ride home by herself each evening after visiting Andrew, and returning to their empty apartment alone.
Individualizing the Treatment for Depression
Surprisingly, Susanna readily agreed to being formally admitted to the In-patient Geropsychiatric Unit, so both she and Andrew could be treated as a dyad for depressive symptoms. She continued to stay on the Inpatient Unit until after Andrew’s death and benefitted from her own individualized treatment for depression.
Moving Forward in Her Healing
After Andrew’s death, Susanna was able to mobilize and care for herself and attentively respond to her own ongoing mental and physical health needs. The unit Social Worker assisted Susanna in finding a congregate living situation near her home that provided her with greater social support and the feeling of community. The Geropsychiatrist’s appropriate assessment enabled Susanna to better care for herself, and helped her to begin moving forward in her own healing.
Author: Carol J. Farran, PhD, RN, MSN, FAAN, has served as Professor, Researcher, and Principal Investigator at Rush University Alzheimer’s Disease Center. For more about Carol, see this page.
Notes: Based on a true story, the names have been changed. Images are from stock files.
