Mr. K is a 72-year-old man diagnosed with spinal cord injury due to a fall seven years ago. He has bladder and bowel incontinence, hypertension, and degenerative joint disease in the fingers of both hands. Mr. K's wife died three years ago and his sister, who had become his primary caregiver, died six months ago. Mr. K's daughter is now the caregiver and makes weekly visits.

The daughter reports that her father is very moody and anxious and complains of stomach problems, including nausea and vomiting. She also states that he has problems eating and periods of confusion, which make it difficult for him to remember phone numbers or to pay bills. She has found his garbage can full of beer cans on some of her visits.