Reference no: EM133319191

Case Study: You are employed full time as a rehab specialist in a hospital. You have been given the following patient on your caseload and need to help in the discharge plan. Even though your responsibilities revolve around Ruby, there are other significant factors that need to be considered in order for any plans surrounding Ruby to be successful.

Ruby is a 59-year old Hispanic woman diagnosed with paranoid schizophrenia and takes medications to help control hallucinations and delusions. She is also diagnosed with diabetes and needs to take insulin. She is morbidly obese.

It has been many years since she was last employed. She attended high school through the 10th grade and can write and read at basic levels only. Due to her financial situation and her documented mental illness she receives Social Security (SSI) benefits as a disabled person, has Medicaid coverage for her medical and mental health needs, and qualifies for several low-income programs, such as housing and food assistance.

Ruby was admitted to an inpatient psychiatric unit at a local hospital after her daughters took her to the emergency room saying she was "acting crazy" and that she shouldn't be allowed to return to the apartment because "she can't take care of herself." Ruby was expressing thoughts of suicide at the time of her admission to the hospital seven days ago but is no longer expressing these thoughts and seems ready for discharge back to the community.

Ruby reports that she does not know where she will live when she is discharged from the hospital because her landlord is evicting her from the apartment. The lease is terminating at the end of the month (15 days) and her landlord has given her notice that he will not renew the lease with her. It is a one bedroom apartment with rent subsidized by the government. She needs to vacate the apartment in 15 days or eviction proceedings will commence.

Ruby has two unmarried adult daughters. Her daughters are both homeless and they each have two children. The children range in age from 1.5 to 4 years old. It appears that the daughters and children have been living with Ruby on and off for the past several months.

The neighbors have been complaining to the landlord about the children running unsupervised around the apartment building and about visitors coming and going from the building at all hours of the day and night. Her neighbors also say they suspect that the daughters are involved with illegal drug use and dealing.

It is unclear if Ruby would be able to renew her lease if her daughters were not staying with her. Ruby, however, maintains that her family is very important to her and that she intends to help them in any way she can and wants to find a place to live where she can stay close with her children and grandchildren.

Question: As Ruby's rehab specialist in the inpatient psychiatric unit of the hospital, what components of Ruby's culture would you want to remain mindful of in assessing her needs related to Independent living?