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Adult Health Case-based Modules, Case 4 of 4

Using the Cases in Training (102KB) [download]
Case Four Case and Questions Only (69KB) [download]
Case Four Case and Questions Only (569KB) [download]
Case Four Complete (103KB) [download]
Case Four Complete (754KB) [download]

Briefly describe the activity and its purpose.

Click here for a complete overview of this resource. A basic case description appears below and additional details (continuations, discussion questions, answers, related resources, etc.) can be found in the attached documents.

Ms. Grace Tester is a 63 year old woman with Down Syndrome who lives in a large institutional setting in Ohio. She has an intellectual disability, arthritis, and asthma. She has developed signs of dementia over the past half year. Her only living relative is an 80 year old sister who lives on the east coast and rarely sees her. Ms. Tester turned 18 while living in the institution and her parents never saw the need to pursue guardianship rights. 

On a routine annual examination at the facility where she lives, the physician discovers a small lump in Ms. Tester's left breast. She has a family history of breast cancer with both her mother and a sister dying of the disease. A mammogram confirms a characteristic mass indicative of cancer. The physician would like to have a needle biopsy, followed by surgery and further treatment if cancer is confirmed. He is not sure how to proceed since Ms. Tester does not have a guardian.

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