Case/Story

This case focuses on a family living in an urban community. As you read through this story, pay special attention to the various social, cultural and emotional factors that influence the child’s treatment.

The Case of Lanesha Johnson

Lanesha Johnson is a 12-year-old firestorm—teetering on that edge between childhood and adolescence. Her temper, much like her asthma, is persistent. When Lanesha blows into clinic, it’s like she’s dragging her Grandma Marietta along, even though it’s the other way around. Marietta tries her best as Lanesha’s legal guardian, but she’s got a lot on her hands: she’s also raising her 10-year-old grandson Marcus and caring for her aging mother, Lillian.

Lanesha is a fourth grader in a predominately African-American school where her desk often sits empty. She’s been out of school with asthma 14 days this year, many of which coincide with Lanesha’s serious seasonal allergy problems. She spends at least one night a week awake with a nighttime cough and has wheezing and coughing fits about 4 days out of the week. All this distraction probably doesn’t help with Lanesha’s grades, and she’s failing half of her classes.

Lanesha shows up in clinic regularly with empty medicines (her daily controller and quick relief asthma meds) and complains about her Grandma Marietta’s lack of responsibility in refilling them. Marietta doesn’t have a financial problem buying medicine—all costs are paid by Medicaid—but she never can explain why she doesn’t get refills. She just says that it’s Lanesha’s responsibility anyway.

Things to consider about this case

There are several issues to consider about this case. You will explore these issues more fully in the learning activities.

• Is it unusual that Grandmother Marietta is the primary caregiver?
• What responsibilities do health care providers have in this situation?
• How does Lanesha's temperament affect the situation?
  

What to do next

Now that you have read the case, go to the Lecture section to gain a better conceptual understanding of the social, emotional and cultural factors in this case.