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Vignette 2:

Mr. and Mrs. DeGuzman have been married for 54 years. He was recently in a car accident where he hit a parked vehicle. His health was already compromised, and with this recent event, he is now admitted to a hospital and needs a breathing machine. His wife and two grown sons are considering hospice. They reside in a single story home. Mrs. DeGuzman has been a homemaker all of her life.  She was never a joiner and would identify her recently deceased twin sister as her "best and only friend." They live off of social security and a small pension from the Train Operators fund.