Question

You deliver D.Z.'s dietary tray, and he comments how hungry he is. As you leave the room, he is rapidly consuming the mashed potatoes. When you pick up the tray, you notice that he hasn't touched anything else. When you question him, he states, “I don't understand it. I can be so hungry, but when I start to eat, I have trouble breathing and I have to stop.”

One theory for the increased work of breathing is based on carbohydrate (CHO) loading. D.Z.'s wife approaches you in the hallway and says, “I don't know what to do. My husband used to be so active before he retired 6 months ago. Since then he's lost 35 pounds. He is afraid to take a bath, and it takes him hours to dress—that's if he gets dressed at all. He has gone downhill so fast that it scares me. He's afraid to do anything for himself. He wants me in the room with him all the time, but if I try to talk with him, he snarls and does things to irritate me. I have to keep working. His medical bills are draining all of our savings, and I have to be able to support myself when he's gone. You know, sometimes I go to work just to get away from the house and his constant demands. He calls me several times a day asking me to come home, but I can't go home. You may not think I'm much of a wife, but quite honestly, I don't want to come home anymore. I just don't know what to do.”

1) How would you respond to her statement?

2) What education will you provide for this patient and his wife?

Answer 1

The above mentioned symptoms are common in males after retirement. Extreme hunger is a symptom of anxiety in home alone males.D.Z. is developing a dependency on his partner so he wants her to be with him always. It's also because of inferiority complex developed by him Since his wife is working.

1) explain the basic reason why he is so irritating and dependent on her. Ask her to support him to develop a good attitude on his image with positive reinforcement.

She should be asked to maintain the same attitude as it was before retirement.

2) the best solution is engaging him with any work making some money so that he develops a positive attitude on himself.

The partner should support the activities exposing him social relationships and making friends so that he doesn't feel lonely when the wife is working.

Additionally yoga, artwork classes etc. Can be practiced to engage him positively.

At any cost never say or behave in a way which hinders self confidence and self image.

Establishing routine life structure will bring back him a normal life as he was before retirement.