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Dementia: the case of Alex

Dementia: the case of Alex
Mary Jo has been contacted by her maternal grandmother and asked to
come and visit so that they can talk about her grandmother’s concerns
about her second husband, Alex.
Mary Jo is a little apprehensive as Grandma has asked her at this stage not
to mention anything to her mother or to her two older brothers and their
wives.
[David, 33 years old, is the elder of Mary Jo’s two brothers; his wife is
Maria; they have two children: Jimmy, six years old, and Thomas, four
years old. Barry, the younger brother, is married to Anna; both are 30 and
they have only one child, Leah, three years old. Sadly Anna miscarried last
year but they are optimistic about having more children.]
Mary Jo is also aware that her own mother has not really accepted her
mother’s (Grandma’s) decision to marry Alex, a Mediterranean man, 12
years ago now, and eight years after her grandfather had died suddenly due
to an aortic aneurism. Mary Jo has always liked Alex as he is a jovial person
who clearly loves and respects her grandmother, often buying her jewellery
and other presents and very often fresh flowers. Mary Jo assumed that her
mum was grieving for her own father and that that got in the way of her
accepting her mother’s second marriage. Mary Jo’s mother had emphasised
how different the personalities of the two men were and explained that as
an only child she had always been her father’s ‘princess’. These thoughts
and more were going through Mary Jo’s mind as she travelled by train to
her grandmother’s home to stay overnight. She knew something was wrong
because Grandma had said, ‘You will understand because you are a nurse.’
Mary Jo was concerned that Alex’s ‘memory problems’ were getting worse
and was worried about how she could best help her grandmother.
Grandma met Mary Jo at the door; she was wearing a brace on her left arm
and clearly sporting a healing right ‘black eye’. Mary Jo couldn’t contain
herself and started quizzing her grandmother about what had happened.
Had Alex hit her? This was no good; how could she live with domestic
violence? Something had to be done! Mary Jo stopped when she realised
that her grandmother was just sitting softly weeping while she had gone on
and on.
Mary Jo suddenly saw herself as attacking and criticising the woman she
had come to help. She drew her breath and said, ‘Oh Grandma, I am so
sorry for how I have just behaved! I can see that you’ve been hurt, and
that has upset me because I love you. I’ll put my bag in the spare room,
check on Alex and we’ll meet in the kitchen and have a cuppa. Is that OK?’
Mary Jo’s grandmother nodded and took a few breaths to steady her crying.
Mary Jo was cross with herself for being so… She couldn’t find the words
but knew she would not have behaved that way if she had been at work.
Prompting questions, set 1
• Can you record a genogram for Mary Jo from the above information?
If you have been able to do this, share its elements with your fellow
students in the discussion forum.
page 1
What other information would be informative? What are the benefits of a
genogram in aged care?