Francis and Mildred Case Story and Case Study: Background

Francis and Mildred Butler’s Story and Case Studies: A Focus on Geriatric Populations

Francis and Mildred Background

Francis and Mildred Butler are an 82-year-old couple who are living independently. They moved to Colorado 20 years ago when they both retired. The Butlers have been married for 33 years. This is a second marriage for both of them. They both have children by their first marriages. Mildred has two adult children, Harry and Hester, who live out of state. Mildred’s relationship with her children was strained by her divorce from their father and remarriage, and living cross country makes it difficult to foster a close relationship. Francis also had a daughter, Kim, from his first marriage. Kim and her family live in the same community, so Francis and Mildred see Kim, her husband Davis, and their children Mark and Amanda. Francis and Mildred helped out often with childcare and activities when Mark and Amanda were young and continue to have ties to them as young adults.

Francis retired from a career in the Air Force. He is black and was raised in Jackson, Mississippi. He joined the Air Force as one of the few opportunities for education and advancement at that time. He has made a conscious decision to live outside of Mississippi although he has gone back to visit extended family at least once a year. Mildred is a retired school teacher from California. Mildred is white. Francis and Mildred both felt some resistance from their families when they began to date and then married as an interracial couple. Francis was raised in the Pentecostal Tradition and Mildred as a Methodist. They identify as Buddhist when they were married as a conscious decision when they decided to join their lives.

Francis has had a diagnosis of prostate cancer for the last 6 years and it has been well controlled with hormonal therapy. He is able to manage his own activities of daily living (ADL) but he has slowed down some. Mildred has moderately severe congestive heart failure (CHF) and stage IV renal failure. It has been difficult at times to balance the management of CHF and renal failure. Both Francis and Mildred value their independence and autonomy. They have participated in discussions about advance care planning. In addition, they have followed the political and social discussion of Death with Dignity in Oregon and other states. They have signed petitions to support similar laws in their home states. Kim, Davis and their family have heard both Francis and Mildred’s points of view on health, life and interest in the Death with Dignity Movement. They have respected their decisions and have made it clear that they love, support and are more than willing to help them with support as their health declines and that they do not see this as an unwanted burden.

Case Study Participants

Francis and Mildred Butler an 82-year-old couple living in Colorado

Kim Francis’s daughter

Rhonda Phillips is a BSN prepared nurse who works with the outpatient and home-based Hospice and Palliative Care Program.

Julie Tribble is a Chaplain on the Palliative Care Team. She sees patients both in the hospital and also in the Outpatient Palliative Care Clinic.

Harri Walker is an Advance Practice Nurse with the inpatient Palliative Care Team.

Bob Sanderson is the Social Worker on the Palliative Care Team. He sees patients both in the hospital and in the Palliative Care Outpatient Clinic.

Nancy Rodriquez is an advanced practice nurse in the Palliative Care Outpatient Clinic.

Dr. Katie is a physician on the Palliative Care Team. She sees patients primarily in the hospital and works with other members of the IDT.