I went to see Mr. D. recently.
The home is in a nice neighborhood but the grass was about 2 feet high.
A middle aged woman, who was holding a cup of coffee, answered the door.
I said, "hello, are you with Mr. D?"
"I guess you could say that, he's in the kitchen," she said as she turned around and walked away.
Mr. D. was sitting in his motorized scooter, in the cigarette smoke filled kitchen, with the lights off.
As I was starting to sit down another middle aged man appeared.
He said "hey," as he turned on the lights, got a cup of coffee from the coffee maker and walked away.
I could see another middle aged man sitting on the back porch, presumably drinking coffee.
A short time later another middle aged woman appeared from a back bedroom. She saw me, did not answer when I said "hello", got a cup of coffee, turned, walked back into her room and closed the door.
A short time later another younger woman appeared and said "hey" as she also got a cup of coffee from the coffee maker, put in about 4 tablespoons of sugar and walked away.
"That's my daughter," said Mr. D.
It was all a little strange but we still had a good visit.
I noticed both the den and the dinning room had bunk beds but didn't inquire.
I said goodbye and walked to the door.
The first man who had appeared in the kitchen, other than my patient, walked me outside.
"How are you doing?" I asked.
"Hanging in there," he said.
"It seems like you have a pretty busy household here."
He then proceeded to connect all the dots. "The woman who opened the door is my wife. She's pretty stressed out right now. She and I have owned this house for about 15 years. Things were fine when it was just the two of us. The other woman you saw, who probably didn't talk, is my wife's sister. She had a breakdown a few years ago and she and her husband, who hasn't worked for years (the man on the back porch), would have been homeless if they hadn't moved in with us. The younger girl is Mr. D.'s daughter. She's married to my son who's in jail for selling crack. She also has a problem with drugs but seems to be keeping clean lately. They lost their home so she and their 4 children moved in with us also. The 2 girls sleep in the den and the two boys sleep in the dinning room. They started back in school this week. When Mr. D. got sick, he pretty much lost everything and after his wife died of breast cancer, he tried to commit suicide. We told him he could move in with us. It's helped him a lot being around his grand kids. I've just about lost all my savings because I got laid off from my trucking job last year and no one is looking to hire a 56 year old long distance truck driver with a screwed up back. So we've got 10 of us living in this house and no-one is currently working. When our son gets out of jail next month we will be back up to eleven."
I thanked him for filling me in and wished him all the best. I wasn't able to begin to problem solve after such a rapid fire revelation but will contact a social worker for assistance as soon as I get my thoughts together.