10 Older Adults 283Case Presentation
Relevant HistoryWesley Long was a 92-year old retired car mechanic and gas station owner.
He has lived with his wife, Betty, now a retired nurse, for nearly 65 years on
the family farm. They met right after World War II where Wesley served in
the Army as an airplane mechanic. While in the army, he lost his pinky^ finger
while working on an engine. He never spoke of the cause of the injury to
his hand or of his military experience really at all. He preferred to immerse
himself in his work. Beyond the hand injury, he had enjoyed good health
until he was 58 when he developed diabetes and hypertension. The condi-
tions worsened in his later years as he developed kidney disease. He became
dependent on dialysis due to advanced kidney disease. He never complained
about his condition although the doctors reported that the neuropathic pain
can be considerable. Wesley faced the amputation of his leg because of the
progression of his disease, was on dialysis, wheelchair dependent, and had
declining vision; his prognosis was bleak. The doctors felt he really did not
have much time left. Betty, ever the nurse, was glad to take on the role of care-
giver to assist Wesley, but Wesley became withdrawn and spoke only when
asked a question.
Meeting WesleyThe work with Wesley began at his home where I met him with his wife. They
had seven children. Four lived within the state; one lived on the same farm but
about a half-mile away. The other three children died in childhood and early
adulthood; one died in a car accident and the other two died from congenital
medical conditions. I immediately sensed the stoicism in Wesley. His bright
blue eyes focused on me when he respectfully answered my questions, but it
was clear he did not like being questioned and he quickly averted his gaze.
Betty felt the heaviness in the air and excused herself to make us tea and give
Wesley and me chance to speak alone. Generally, Betty seemed to prefer to
remain in the kitchen when we spoke to give us privacy, but was clear that she
needed attention as well to help her cope with her husband’s condition. This
would be addressed after I started to work with Wesley.
I opened the interview with simple chatting as I slowly engaged with
Wesley to add to the psychosocial interview that the nurse had started. Given
his age, the home health agency encouraged us to address questions about
military service with these clients: it seemed most appropriate when I saw the
service medal framed on his living room wall. Although it was not in that first
visit, but rather late in the third visit, I asked again about his military expe-
rience when he seemed more ready to talk. This time, he paused for a long
period before he began to talk about his experience. Gentle tears began to flow
as he reminisced about his military service and finally shared how his best
friend died in the war. Bob was shot down in his plane and subsequently died.
Wesley quietly said, “I saw the plane crash. It was then I caught my finger in
the engine I was working on and amputated my pinky finger.” Wesley’s face