Health Promotion: Prevention of Disease
Case Study Module 2
Instructions: Read the following case study and answer the reflective questions. Please provide
rationales for your answers. Make sure to provide a citation for your answers.
Deadline: Due by Sunday at 23:59 p.m.
CASE STUDY: An Older Immigrant Couple: Mr. and Mrs. Arahan
Mr. and Mrs. Arahan, an older couple in their seventies, have been living with their oldest daughter,
her husband of 15 years, and their two children, ages 12 and 14. They all live in a middle-income
neighborhood in a suburb of a metropolitan city. Mr. and Mrs. Arahan are both college educated and
worked full-time while they were in their native country. In addition, Mr. Arahan, the only offspring
of wealthy parents, inherited a substantial amount of money and real estate. Their daughter came to
the United States as a registered nurse and met her husband, a drug company representative. The
older couple moved to the United States when their daughter became a U.S. citizen and petitioned
them as immigrants. Since the couple was facing retirement, they welcomed the opportunity to come
to the United States.
The Arahans found life in the United States different from that in their home country, but their
adjustment was not as difficult because both were healthy and spoke English fluently. Most of their
time was spent taking care of their two grandchildren and the house. As the grandchildren grew older,
the older couple found that they had more spare time. The daughter and her husband advanced in
their careers and spent a great deal more time at their jobs. There were few family dinners during
the week. On weekends, the daughter, her husband, and their children socialized with their own
friends. The couple began to feel isolated and longed for a more active life.
Mr. and Mrs. Arahan began to think that perhaps they should return to the home country, where
they still had relatives and friends. However, political and economic issues would have made it
difficult for them to live there. Besides, they had become accustomed to the way of life in the United
States with all the modern conveniences and abundance of goods that were difficult to obtain in their
country. However, they also became concerned that they might not be able to tolerate the winter
months and that minor health problems might worsen as they aged. They wondered who would take
care of them if they became very frail and where they would live, knowing that their daughter had
only saved money for their grandchildren’s college education. They expressed their sentiments to
their daughter, who became very concerned about how her parents were feeling.
This older couple had been attending church on a regular basis, but had never been active in other
church-related activities. The church bulletin announced the establishment of parish nursing with
two retired registered nurses as volunteers. The couple attended the first opening of the parish clinic.
Here, they met one of the registered nurses, who had a short discussion with them about the services
offered. The registered nurse had spent a great deal of her working years as a community health
nurse. She informed Mr. and Mrs. Arahan of her availability to help them resolve any health-related
issues.
Reflective Questions
1. What strategies could be suggested for this older adult couple to enhance their quality of life?
2. What community resources can they utilize?
3. What can the daughter and her family do to address the feelings of isolation of the older couple?
4. What health promotion activities can ensure a healthy lifestyle for them?
Sample Solution
nds causally on the existence of other beings (e.g., our parents), God’s existence does not depend causally on the existence of any other being. Further, on Malcolm’s view, the existence of an unlimited being is either logically necessary or logically impossible. Here is his argument for this important claim. Either an unlimited being exists at world W or it doesn’t exist at world W; there are no other possibilities. If an unlimited being does not exist in W, then its nonexistence cannot be explained by reference to any causally contingent feature of W; accordingly, there is no contingent feature of W that explains why that being doesn’t exist. Now suppose, per reductio, an unlimited being exists in some other world W’. If so, then it must be some contingent feature f of W’ that explains why that being exists in that world. But this entails that the nonexistence of an unlimited being in W can be explained by the absence of f in W; and this contradicts the claim that its nonexistence in W can’t be explained by reference to any causally contingent feature. Thus, if God doesn’t exist at W, then God doesn’t exist in any logically possible world. A very similar argument can be given for the claim that an unlimited being exists in every logically possible world if it exists in some possible world W; the details are left for the interested reader. Since there are only two possibilities with respect to W and one entails the impossibility of an unlimited being and the other entails the necessity of an unlimited being, it follows that the existence of an unlimited being is either logically necessary or logically impossible. All that is left, then, to complete Malcolm’s elegant version of the proof is the premise that the existence of an unlimited being is not logically impossible – and this seems plausible enough. The existence of an unlimited being is logically impossible only if the concept of an unlimited being is self-contradictory. Since we have no reason, on Malcolm’s view to think the existence of an unlimited being is self-contradictory, it follows that an unlimited being, i.e., God, exists. Here’s the argument reduced to its basic elements: God is, as a conceptual matter (that is, as a matter of definition) an unlimited being. The existence of an unlimited being is either logically necessary or logically impossible. The existence of an unlimited being is not logically impossible. Therefore, the existence of God is logically necessary. Notice that Malcolm’s version of the argument does not turn on the claim that necessary existence is a great-making property. Rather, as we saw above, Malcolm attempts to argue that there are only two possibilities with respect to the existence of an unlimited being: either it is necessary or it is impo