Evelyn is a 78-year-old woman who lives alone in her own home. She was referred to a community counselor for drug/alcohol assessment because her Meals-on-Wheels delivery people and her home health aide noticed that she seemed to be out of it’ when they would try to talk with her, and they noticed that she had several prescription medications on her dining room table as well as beer in the refrigerator. You have gone to her home to evaluate her, and you notice the home is quite messy. Evelyn begins to cry shortly after you introduce yourself and ask whether she has any close family or friends in the area. She seems unable to stop crying.

1. How would you help Evelyn begin to trust you with information about herself?

2. Would a messy home make it difficult to do an assessment of Evelyn’s usage?

3. What stereotypes of the elderly do you hold that might make it difficult to hear Evelyn’s life story, including her alcohol/drug history?

4. If an intervention on her usage is necessary, what factors would make it difficult for you to intervene in Evelyn’s life?