Mr. Perez is a 76-year-old Mexican American who was recently diagnosed with a slow heartbeat requiring an implanted pace

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Mr. Perez is a 76-year-old Mexican American who was recentlydiagnosed with a slow heartbeat requiring an implanted pacemaker.Mr. Perez has been married for 51 years and has 6 adult children(three daughters aged 50, 48, and 42; three sons aged 47, 45, and36), 11 grandchildren; and 2 great grandchildren. The youngest boylives three houses down from Mr. and Mrs. Perez. The otherchildren, except the second-oldest daughter, live within 3 to 10miles from their parents. The second-oldest daughter is aregistered nurse and lives out of state. All members of the familyexcept for Mr. Perez were born in the United States. He was born inMonterrey, Mexico, and immigrated to the United States at the ageof 18 in order to work and send money back to the family in Mexico.Mr. Perez has returned to Mexico throughout the years to visit andhas lived in Texas ever since. He is retired from work in a machineshop.
Mr. Perez has one living older brother who lives within 5 miles.All members of the family speak Spanish and English fluently. ThePerez family is Catholic, as evidenced by the religious itemshanging on the wall and prayer books and rosary on the coffeetable. Statues of St. Jude and Our Lady of Guadalupe are on theliving room table. Mr. and Mrs. Perez have made many mandas(bequests) to pray for the health of the family, including one tothank God for the healthy birth of all the children, especiallyafter the doctor had discouraged them from having any more childrenafter the complicated birth of their first child. The familyattends Mass together every Sunday morning and then meets forbreakfast chorizo at a local restaurant frequented by many of theirchurch’s other parishioner families. Mr. Perez believes his healthand the health of his family are in the hands of God.
The Perez family lives in a modest four-bedroom ranch homethat they bought 22 years ago. The home is in a predominantlyMexican American neighborhood located in the La Loma section oftown. Mr. and Mrs. Perez are active in the church and neighborhoodcommunity. The Perez home is usually occupied by many people andhas always been the gathering place for the family. During hisyears of employment, Mr. Perez was the sole provider for the familyand now receives social security checks and a pension. Mrs. Perezis also retired and receives a small pension for a short workperiod as a teacher’s aide. Mr. and Mrs. Perez count on their nursedaughter to guide them and advise on their health care.
Mr. Perez visits a curandero for medicinal folk remedies.Mrs. Perez is the provider of spiritual, physical, and emotionalcare for the family. In addition, their nurse daughter is alwayspresent during any major surgeries or procedures. Mrs. Perez andher daughter the nurse will be caring for Mr. Perez during hisprocedure for a pacemaker.