Reference no: EM133402954

Case Scenario

Vicente is a 35-year-old man who has lived in Florida all his life. He has worked as a retail store manager, and his husband has been a police officer. The couple have two sons, ages five and eight. Vicente and the children waited out Hurricane Ian in their home while his partner worked his shift as a police officer. The couple had considered evacuating, but they did not want to leave Vicente's elderly mother alone, who was immobile but alert and lived in the couple's home

When water began flowing into the house some hours after the storm, Vicente moved his children into the attic, but his mother was too heavy for him to carry alone. He remained with his mother as the room took in more water. The mother's mattress floated in the water, and Vicente treaded water beside it as he held his mother's hand with one hand and the mattress with the other. His mother cried and screamed in fear, and Vicente tried to calm her down, telling her the water would stop or else help would soon arrive. Eventually, when the room was almost entirely submerged, Vicente feared he might drown and left his mother to go to the attic.

Vicente and his children watched in fear as water infiltrated the attic and continued to rise. The children cried and held on to their Dad, who struggled to remain calm even as he realized that his mother had died in the room below them and as he feared that he and his children might drown too. Vicente took a chair in the attic and thrust it toward the roof to create a hole large enough to climb through, just in case the water continued to rise. He and his children eventually had to climb onto the roof, where rushing waters and debris around them had replaced their once-tranquil neighborhood. They waited on the roof for six hours until rescued by volunteers in a helicopter.

Five weeks after the hurricane, Vicente and his children are living in a shelter for homeless families. He does not know if his husband is alive, he never saw him while he briefly stayed at a church awaiting housing. He constantly and vividly remembers his mother's tearful face and agonizing cries - the last scene he had with his mother before ascending to the attic. Vicente cannot sleep well at night, because he has nightmares about the flood and its devastating consequences. During a rainstorm shortly after his arrival in Georgia, Vicente was overcome with fear and could not breathe easily. Similarly, he was scared to shower or bathe because it reminded him of being covered in water in his mother's room. At the homeless shelter, he constantly looks around him to make sure no dangers are present. Even so, when someone approached him, he reacts with such surprise that the person inevitably apologizes. His children hug him and seek comfort from him, but he feels too numb and stressed to be affectionate.

Sensing his distress, social workers tried to talk to Vicente about his situation, but he refused to discuss the flood, the traumatic rescue, his mother's death, or his anguish about his husband's uncertain fate. He feels detached from those around him as if he was looking at them through a thick pane of glass. He cries often, and he is prone to yelling at rescue workers or snapping at his children. When rescue workers tried to talk to him about his future plans - where he would live, how he would support his family, and dealing with his husband's fate - Vicente yelled at them to "shut up". He has difficulty thinking about the future because he felt his experience in the flood taught him that life is fragile and short and that he would soon die.

Communicating a DSM-5-TR Diagnosis

The CLIENT MAP must contain a Principal Diagnosis for the client. (Additional diagnoses may be warranted but you will be graded on the accuracy of the Principal Diagnosis). Write out the name of the disorder. Add any specifiers or subtypes that fit the presentation. Additionally, document the diagnostic code number-use the ICD-10-CM code. Next, do not document the entire criteria set, only the criteria met by the client. You will also illustrate the rationale for each criterion met (indicated by either a subjective account or observation of others) based upon the client's presentation.