Dr. Danilo Ocampo is a 74-year-old retired pathologist. He lives in his home with Lydia, his wife of 51 years. Their only child, a son, was killed at age 22 in an automobile accident. Danilo was born and raised in the Philippines and came to the United States when he was 23. Danilo is the last living member of his immediate family. He has a few nephews and nieces in the Philippines, but no relatives live nearby.

Dr. Ocampo’s health has been declining for the past few years. He has a medical history that includes hypertension, myocardial infarction, angina, and class 2 heart failure. Because of these cardiovascular disorders, he takes multiple medications, including metroprolol, lisinopril, aldactone, furosemide off and on, K+ when taking furosemide, aspirin, isosorbide dinitrate, and nitroglycerin. He has a good understanding of the pharmaceutical properties of the medications. At times, he is not sure he gets good health care because of all the medications he takes – he often does not believe they are helpful because he experiences many side effects, and he has required multiple admissions to the hospital. He usually feels better after a few days in the hospital but typically checks himself out of the hospital before his physicians are ready to discharge him.

Because Lydia has dementia, most of Danilo’s time and energy are spent managing their household and taking care of her. He has been resistant to outside help, believing he can care for her better than anyone else does. He maintains a very consistent schedule, and they get along quite well. Although at one time in their lives they were very socially active, at this point, they rarely go out.