case study

Chapter 4

Diabetes and Chronic Kidney Disease

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(Students will read the case study and answer 2 questions of their choosing. Please number the question you are answering and restate the question in a sentence. Answers must be at least one paragraph (3 to 5 sentences) and written in complete sentences. Each question is worth 5 points each, for a total of 10 points.)

Case Study

Ms. Consuelo Mendoza is 44 years old and immigrated to the United States from Puerto Rico. Currently, she lives with her sister and her sister’s 13-year-old son. While I her native country, she worked as a flight attendant, received a college education, and subsequently became employed as a language arts middle school teacher. Since arriving in this country, Ms. Mendoza has worked as a secretary, home health aide, and sales person in a women’s dress shop. On a part-time basis for many years, Consuelo taught ESL (English as a second language [English Language Learners]) classes and tutored Spanish-speaking individuals wanting to learn or become proficient in English.

Since late adolescence, Consuelo has had Type II diabetes. At age 40, she was diagnosed with kidney disease. As a result, she is restricted to a maximum of light work, although her treating physician would prefer that she work in a sedentary capacity. In end stage renal failure for the past year, she has been put on a list to receive a kidney transplant. Ms. Mendoza requires dialysis three times a week for approximately four hours each time, which she receives in the evenings and on the weekends. For the year she has been on dialysis, she has worked only part time as an ESL teacher and tutor.

Recently, Consuelo has sought vocational rehabilitation services because her part-time work does not provide her with sufficient income. There have been some months when she earns enough income to meet all her expenses and other times when she does not.


Identify factors significant in assessing rehabilitation potential for this client.
Discuss Type I and II diabetes and the complications that can occur. Relate this to the case study. What may have caused this client to have renal failure?
Describe the two types of dialysis and kidney transplantation. Identify advantages of a transplant over dialysis.
Considering that Ms. Mendoza is on dialysis and may be receiving a kidney transplant within the year, what kinds of rehabilitation services will you provide at the present time and in the future? Are there any considerations needed for Consuelo’s diabetes?
What issues related to diabetes and kidney transplant need to be considered in vocational planning?
Describe issues of reasonable accommodation for clients on dialysis.
Because of strong religious beliefs and her own fears concerning surgery, Ms. Mendoza is conflicted about receiving a transplant. As her rehabilitation counselor, how would you handle these mixed feelings she has shared with you?

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