Mr D and his family, current experience | Mexico

Mr D and his family, current experience | Mexico

14 Jun 2022

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Mr. D lives by himself in a mid-size town since his wife passed away last year. His children have moved to the bigger city to work and can only visit once a month. Over the last few months Mr. D has found it more difficult to look after the house and himself. His son noticed that his father does not seem himself and is worried about him and what people may think if they see his father.

Because he lives alone and far from his children, Mr David depends on his neighbour, who he has known for some years now, to help taking him shopping or to do the shopping for him and who helps with some household chores, after some insistence on part of his neighbour. However, Mr David is worried as his neighbour has accepted a new job and is going to move in the next few months and would not want to ask a stranger to help him. High insecurity in some cities make even this support difficult as not many people want to be potentially exposed to strangers or dangerous situations. In addition, it is not usual for Mr David to ask for help as strong gender roles are usually present in this generation. This prevents him from asking for help, even while acknowledging that he needs it. If neighbours or some other friend do help, this will be the case only where long-time acquaintances have been made.

Mr David has access to social security services, as he worked in a public university and is now retired, so he also receives a small pension. He attends health services at some regular basis for follow-up and management of his high blood pressure, as well as preventive health programmes such as vaccination (i.e., influenza vaccination in November) (funded through his social insurance). In one of his follow-up appointments, the GP notices signs of cognitive impairment, and conducts a brief cognitive screening. He finds initial signs of impairment, so he schedules an appointment in 6 months with the GP and asks him to visit the assigned social worker at the institution. (Would Mr likely follow-up on appointment with social worker? would there be stigma associated?) The social worker will assess his social situation and his household arrangements, as she/he is worried he may soon not be able to manage by himself. The social worker asks if there are any family members that can be contacted, and Mr David refers to the only son that he feels looks after him. The social worker asks Mr David to discuss with him that he should not be alone anymore. Also, the social worker feels that Mr David would benefit from visiting one of the Gerontological centres that the institution has and gives Mr David the contact details of the one that is closer to his home. However, some days later, on considering this as an option, Mr David feels that the centre is too far from his home, he would have to pay for taxis to get to and from there and that he would not feel that comfortable talking to other people that he does not know anyway and decides not to go.

In his next visit, the GP sees signs of Mr David’s rapid cognitive decline and asks the social worker to contact the family member as Mr David should definitively not live alone anymore. The social worker talks to Mr David’s son, who in turn talks to his two sisters who both say they are unable to help him. One is living far away and cannot come back to their hometown and the other one says that she is already feeling overwhelmed with work, taking care of her children and, on top of it, having some marital problems, so she cannot worry with yet another problem; she tells him he is the only one who is still single so he should do this. While Mr David’s son does not feel very comfortable with that, he worries about his father’s condition, what could happen with his neighbours if he gets worse and ultimately, he thinks about what the social worker said about his father being exposed to many risks by living alone (falling, leaving the gas on, not performing personal care tasks, etc.).

Mr David’s son considers moving in with his father but is not realistic to think that he will find a job that is as well paid as his current job in their hometown, so he asks his father to move in with him. His father is reluctant, he does not want to move, that is the apartment he has been living in forever and takes a long time to convince him. Eventually, under the reasoning that it is best for him and his care his father agrees. With his father, he decides to put the apartment up for rent so that with that income and Mr David’s pension, his son can hire some paid (informal) help at home to help him with cleaning, cooking for his father and “watching” him, while he is at work.