Impact of Immigration: Disease Exposure and Health Maintenance

Sandra Sanchez-Reilly and Dulce M. Cruz-Oliver

Clinical Case

Mrs. Flores, a 75 year-old woman from Colombia has decided to move to the United States to help her recently divorced daughter care for her three small children. Mrs. Flores is a retired laboratory technician who was living alone after her divorce. Mrs. Flores has multiple medical conditions that have been well controlled to date, including osteoarthritis, hypertension, and obesity. Mrs. Flores has a small pension from retirement. Few months after arrival to the U.S., Mrs. Flores runs out of medications. Mrs. Flores’ daughter tried to find a Spanish-speaking provider with little success, given the fact that Mrs. Flores does not qualify for medical insurance: she does not qualify for Medicare due to lack of contributing time working. Mrs. Flores receives a physical exam, laboratories ordered and her prescriptions. Follow-up reveals high cholesterol and Mrs. Flores is referred to a dietician for counseling, but she becomes upset and defensive: “All my life I have eaten the same thing, and now I have to change my diet? Exercise? And who is going to pay this crazy bill?” Mrs. Flores has had a hard time adapting to her new life: Her grandchildren do not speak Spanish or like the food she prepares, she misses her family and friends and is starting to think this was a mistake...

S. Sanchez-Reilly, M.D., A.G.S.F., F.A.A.H.P.M. (*)

Division of Geriatrics, Gerontology and Palliative Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA

GEC and GRECC, South Texas Veterans Health Care System,

7703 Floyd Curl Drive MC 7875, San Antonio, TX 78229, USA e-mail: This email address is being protected from spam bots, you need Javascript enabled to view it

D. M. Cruz-Oliver, M.D., C.M.D.

Division of Geriatrics Medicine, Department of Internal Medicine, Saint Louis University, 1402 South Grand Blvd M238, St. Louis, MO 63104, USA e-mail: This email address is being protected from spam bots, you need Javascript enabled to view it

© Springer International Publishing Switzerland 2017 L. Cummings-Vaughn, D.M. Cruz-Oliver (eds.), Ethnogeriatrics, DOI 10.1007/978-3-319-16558-5_4

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