Case Study of Mr. Angeli:
Mr. Angeli is an 82-year-old Italian man who was referred to your office by his primary care provider for
treatment of depression. His primary care provider discussed antidepressants with Mr. Angeli, but he was
resistant to this approach.
During your intake assessment, you learn that Mr. Angeli emigrated to America when he was 7 years old. He
worked at a variety of jobs throughout his life and had been divorced twice. He had two children, a son and
daughter. His daughter died in her teens, but Mr. Angeli would not expand on this, and instead focused on his
son with whom he lives. He moved in with his son and his son’s wife about 6 months ago because he was
having difficulty caring for his house. Mr. Angeli informs you that his son said that he could come and live with
him. He has since sold his house and when speaking of its sale, tells you “I’ve been able to help my son out
with some money- he lost his job last year and has been having trouble finding work.”
Mr. Angeli begins to open a bit more and informs you that his two divorces resulted from his “trouble with
drinking” over the years. He explains having lived a very stressful life and talks about some of the challenges
with being marginally educated and his years of struggle to make ends meet. He acknowledges that over the
years he “lost his patience” with his children a few times, to which he adds “I never meant to hurt them, I love
them.”
Mr. Angeli has problems with high blood pressure and what he describes as “liver problems.” He says that he
goes to see his primary care provider once a month for follow up treatment.
Several times during the clinical interview, Mr. Angeli becomes tearful, but fights the tears from coming. He
states that he feels both “helpless” and that “things will only get worse for me.” When you ask him what he
means by this, he pauses and says “well, sometimes when my son has been drinking, he gets a little nasty.”
He further divulges that he “understands” how his son feels as he used to get like that himself. He then admits
that during one of his son’s drinking episodes, he got into an argument with his son & that his glasses got
broken- to which he added with a small smile “thankfully I had this other pair!” as he points to his face. He said
that when his son has been drinking, he often says “some really nasty” things to him. Mr. Angeli explains that
he has been giving his son money from his social security check, and has also been giving him additional
monies from the sale of his house. He also reports that from time to time, he hears his son and his wife
fighting, which frightens him as he says that “it reminds me of the fights I used to get into with my two wives.”
You ask Mr. Angeli if he is afraid of his son and he remains silent…
PART 1:
After reading the above case study, please respond to the following questions:
1. Do you think abuse has occurred? If so, what type of abuse? What additional information is needed to help
you decide?
2. Describe the theoretical orientation that may explain the context of the abuse. The following are the more
Caregiver Stress Theory
Social Learning Theory (Cycle of Violence Model A.K.A. Intergenerational Transmission of Violence Mode)
The Social Exchange Theory
The Background-Situational Theory (Dyadic Discord Theory)
Power and Control Theory
Ecological Model
Biopsychosocial Model
Be sure to provide the rationale for the theory selected- that is, why do you think the theory selected is the best
fit for the situation?
3. What needs to be done immediately in this situation?
PART 2:
Part two of the assignment will require you to research the state where you practice (or plan to practice) and
describe your legal obligation as a psychologist to report elder abuse allegations. After you have researched
this information you will address the following questions:
1. What is your legal obligation to report elder abuse? Be certain to describe how will you address issues of
abuse that were divulged to you in confidence by the patient?
2. What types of abuse/maltreatment are you obligated to report? Discuss the reporting process and what is
involved.
3. What are the timelines for reporting? Specifically, once you become aware of the allegation of abuse or have
reasonable cause to believe that an older adult is being abused, how long do you have to make a report to the
agency responsible for making such reports? NOTE: Some states require you to report to more than one
agency- if this is the case, what are the timelines for reporting to each agency?
4. What are you required (under state law) to do immediately to keep the older adult safe?
5. Imagine that you are going to continue providing care for the individual who is being abused. Describe the
steps you would take to providing care to the abuse victim.
Assignment Outcomes
Identify legal and ethical issues relevant to older adults including elderly abuse reporting.