Albert is a 70 year old widowed man originally from a European country, who has resided in the United States for the past 45 years. He is able to speak and read English but is not proficient in writing in English as his profession has been in agriculture. He has maintained close ties to his family of origin through trips, letters and phone calls; however, he only has one living sister whom he hopes to visit “one last time.” He has maintained his culture in his home including speaking his native language with his children. Although he has grown used to “American food” he prefers dietary choices and ways of preparing meals that reflect his country of origin.
Albert has experienced extreme osteoarthritis since his early 50’s and has had two knee replacements and a hip replacement. He has been hospitalized for an acute and life threatening infection in his artificial hip, which has resulted in most of his femur and part of his pelvis being removed, in addition to the artificial joint. He is given massive doses of strong antibiotics to save his life, which results in renal failure requiring dialysis. There is a possibility that the renal failure will reverse itself as he recovers sufficiently to be discharged. He has three adult children, who take turns being in the hospital throughout the weeks of treatment. As he begins to recover, family frequently bring in his favorite types of foods to supplant his hospital diet. Hospital personnel do not question this practice.
Albert is to be discharged to a rehabilitation center for occupational and physical therapy so he may return to his home. He does not want to go to the center, because he believes people die in “these places.” He finally agrees to go because his family convinces him he needs the strength to live alone, or he will have to move into one of their homes. This proves to be very motivating. Diet continues to be an issue with him in his new life in the rehab center. He tells the dietitian he likes yogurt and dislikes “green.” He wants foods he is familiar with, but the facility will not allow his children to bring in meals like the hospital did. The dietitian informs him that he needs to get used to the food, because they are likely to order meals-on-wheels for him when he is discharged. Albert reacts by getting depressed, refusing to eat, and has just begun muttering, “maybe I should just die.”
His children contact you, the rehab center’s social worker, because they are worried about his mental state which is affecting his recovery, and to ask you to intervene with the center’s director on Albert’s behalf. They in particular think the dietitian is arbitrary and unreasonable and they are paying good money for his care and he doesn't deserve to be bullied. They also want accommodations made for Albert’s diet, and wonder if Albert could benefit from seeing a psychiatrist. What would you, as the social worker, do in this case?
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