Mr. Issler is an old aged patient who has been suffering from trauma and abuse. This has caused many problems for Mr. Issler. Currently he is in the emergency room of a hospital and is pale. He is taking thyroid medications since a number of years. He is suffering from a lot of problems and it can be said that all the diseases combined and the medications are causing serious problems for him. I, as a counselor have followed a proper plan of care of him which will be discussed in this paper.