Case Study: Identifying Resilience in Families
About the Author
Phyllis Mensh Brostoff CISW, CMC, is the CEO and co-founder of Stowell Associates in Milwaukee, Wisconsin, providing geriatric care management and care managed home care services to the elderly, disabled adults, and their families since 1983. She received her master’s degree in social work from the University of Maryland in 1970, and immediately began working with the elderly. Phyllis is certified by the state of Wisconsin as a Certified Independent Social Worker (CISW), the National Association of Social Workers Academy of Certified Social Workers (ACSW) and the National Academy of Certified Care Managers (CMC). She taught at the University of Wisconsin-Milwaukee School of Social Welfare from 1971-1977. She was a founding member of the NAPGCM and was the President of the National Board in 2009 and President of the Midwest Chapter Board 2006-2008. She has given numerous speeches, workshops, and presentations throughout the country on care management, assessment, ethical issues, the care of the chronically ill, and how to grow a business to social workers, nurses, attorneys, trust officers, financial planners, and the general public.
Phyllis Mensh Brostoff, CISW, CMC
In my Aging Life Care™ / care management practice, I often have identified resilience in families that they did not know they had. By resilience I mean responding to stress and adversity positively, coping well when change is needed rather than disintegrating. These family histories illustrate how an Aging Life Care Professional™ / care manager can assist families in identifying resilience within the families they assist. The care manager can provide a unique point of view by looking at the whole family system, improving the family’s resilience when they come to you driven by that crisis which provides the opening for the family to change.
Ingrid W contacted me because her widowed mother seemed to be experiencing significant memory loss. Mrs. W lived in the family home with Ingrid’s brother, Joe. Joe had been diagnosed with schizophrenia in his early 20s and was 48 when I met him. He spent most days walking to the local library around 9am, having lunch at a nearby McDonalds, and then coming home around 5pm. He had no friends, but mother and he got along well and enjoyed each other’s company. Now Ingrid wanted Joe out of the house because she wanted someone to come in and take care of their mother. I visited the home and found a lovely well cared for home in a suburban village, close to a mall and within walking distance of stores and the library. Mrs. W was in the mid-stage of an Alzheimer’s type dementia, but she appeared to be doing very well in her home, even though she really could no longer safely prepare food or remember to take her medication. Joe managed his own room and laundry and was mild mannered and polite, although hard to engage in conversation. He could comprehend the need to call for help if something happened to his mother and had, in fact, called Ingrid when Mrs. W. had a fall in the home. While on the surface it may have appeared that Joe was a hindrance to the care that his mom needed, my recommendation to Ingrid was to preserve his role in the home. Joe was an asset, providing Mrs. W with continuity in the home and a measure of safety. Since he was gone for most of the day, Ingrid could hire a caregiver to come from 9am to 5pm, cook all of the meals, help her mother with a bath and dressing, take her to any appointments, and do the housework. Joe would be the second and third shift helper. This plan did work for several years and Ingrid and Joe now had a changed relationship.
A similar scenario occurred with the H family. Mr. H had dementia and a stroke. He lived in the family home with his wife and mentally ill adult son, George. George had been in the Navy for 10 years but something happened and he left with a duty disability. George was very handy and lived in the basement of the family home surrounded by tools. Friends and family brought over TVs and other small appliances for him to fix which he then donated to shelters for homeless families. Three days a week he biked over to the Habitat for Humanity building and worked on whatever project they had for him. He sometimes prepared a simple dinner, but mostly Mrs. H cooked and cleaned the home. George helped transfer his father from the bed to the wheelchair, but the two H daughters felt that their father was too much of a burden on their mother and eventually he was moved to a nursing facility close to where daughter Deb lived. The daughters thought that George should find his own apartment, sell the home, and mother should move into the home of daughter Gail about 100 miles from the family home. Mrs. H refused this plan and George and she continued to live together for another 3 years until she went into a residential hospice.