13: Multiple Conditions - Case 2: Mina
Meet Mina. She is an 85 year old lady who recently developed symptoms associated with heart failure. Investigations showed that she had severe aortic stenosis, moderate left ventricular systolic dysfunction, mitral valve regurgitation and pulmonary hypertension. (If you feel that you would like to review your knowledge of heart failure, please visit the heart failure module.) Mina also has a past medical history of chronic obstructive pulmonary disease and depression.
Mina lives with her husband, Joe, in a cottage several miles from the nearest village. Joe has dementia and Mina is his sole carer. Since Joe became unable to drive, the couple have lost their only means of independent transport. Joe has mobility problems and walks with the aid of a zimmer. The couple have one son, aged 63, who lives and works in the city. He would like to visit his parents more often but works long hours and is unable to reduce them or take early retirement, due to financial commitments.
Older people doing most of the care for their spouse are more likely to have poor physical and mental health themselves (Long Term Conditions Alliance Scotland, 2014). A survey of 3,400 carers in the UK found that 83% of them felt that caring had a negative impact on their physical health and 87% of them felt that caring had a negative impact on their emotional health (Carers UK, 2012).