Case studies
CALD Older People Resource
eCALD Supplementary Resources
Case Study 1: Mr Nguyen (adapted from Tran & Hinton, 2010)
Mr Nguyen is a 74-year-old South Vietnamese former army officer who was imprisoned by the Socialist Republic of Vietnam. He was physically and emotionally tortured with stories of family members being killed or imprisoned in other re-education camps*.
Mr Nguyen felt lucky to be alive as so many people died in Vietnam’s re-education camps. He came to New Zealand in 1989 and had nightmares every night for the first couple of years. He felt estranged from his family as he was imprisoned for 12 years and his family had since become westernised strangers to him. His doctor said that he suffered Post-Traumatic Stress Disorder from his long imprisonment and from the torture he suffered.
Mr Nguyen still has nightmares when he feels stressed. He deals with his stress by smoking four packs of cigarettes a day and drinking beer. He has a hoarse cough and sometimes coughs up blood. His family has brought him the see the GP because his herbal medicines do not work on his cough anymore and he cannot get to sleep at night.
*The Reeducation camps were the prison camps operated by the Government of Vietnam following the end of the Vietnam War. In such "reeducation camps" the government imprisoned several hundred thousand former military officers and government workers from the former regime of South Vietnam. Reeducation was seen as a means of repression and indoctrination which developed for several years in the North and was extended to the South following the 1975 Fall of Saigon. An estimated 1-2.5 million people were imprisoned with no formal charges or trials. Approximately, 165,000 people died in the Socialist Republic of Vietnam's re-education camps. Thousands were tortured or abused. Prisoners were incarcerated for as long as 17 years, with most terms ranging from three to 10 years.
What would be the key issues for the clinician to consider?
How could an understanding of Mr Nguyen’s cultural health beliefs and practices and his refugee experiences assist health providers in providing effective care?
What kind of treatment, management, or referrals might the GP consider?
Case Study 2: Mrs Mansoor
Mrs Mansoor is a 70-year-old Iraqi woman from Bhagdad. She was sponsored by her son to come to New Zealand in 2007.
In 2012, Mrs Mansoor’s son moved to Australia because he had a good job offer. He initially took his mother with him but realised she was ineligible for social support so sent her back to New Zealand alone. Mrs Mansoor does not speak any English. She has no relatives in New Zealand. An Iraqi family who have limited means and four children give Mrs Mansoor a room in the basement of the house they rent. They are kind to Mrs Mansoor but have little knowledge of the services available and few resources as they are newcomers themselves.
Mrs Mansoor is sleeping on a mattress on the floor and the basement is cold and dark. Mrs Mansoor is frail, confused and extremely distressed. She eats very little and has an ongoing chest infection. The family contact a local Muslim women’s support group who make a referral for pensioner housing for Mrs Mansoor. They also refer Mrs Mansoor to an Arabic speaking female GP who admits Mrs Mansoor for bilateral pneumonia.
Mrs Mansoor makes a good physical recovery but remains confused and distressed. She is referred by the medical team to the Mental Health Services for Older Adults (MHSOA) service as an inpatient for assessment, treatment and support.