The assignment deals with the case study of Michael an 82-year old man who have suffered a major stroke which left him physically debilitated. He is mentally alert and lives with his wife Lucia in Gold Coast. His elder son Jared lives in Sydney and prefers his father’s treatment to be started at nursing home. Michael’s daughter Julie lives in Brisbane and was recently diagnosed with an aggressive form of Lupus. Michael is keen to return home and his wife is ready to care for her husband at home instead of rehabilitation. However, his doctors have concluded after the assessment that his condition is critical and that his wife may not be able to provide him with required care. In this context, the paper discusses the post hospital care for Michael as a social worker. The concerning issues related to the case are discussed using the social work assessment framework. Further, the paper highlights the interventions required for client and how the social care responsibilities were delivered considering the professional values and ethics.
In order to help Mr. Michael in his care after transition from extensive rehabilitation to home, it is necessary to assess his condition to enhance optimal functioning and well-being. For this purpose, a multi-dimensional assessment framework is used. This framework helps to explore the socioeconomic context of the current situation of the client. This framework includes social, cultural and structural context (Fillenbaum, 2013).
Age-82 years, gender- male
Michael is mentally alert although physically debilitated due to stroke. His coping strategies are good as long as he is in rehabilitation. There is no history of drug or alcohol abuse. He is dependent on caregiver for his daily life activities.
Michael has social stress as he and his wife left teaching. There is low social connectedness with colleagues and students with no family support except his wife and son. He has good educational network
Michael receives no emotional support from his daughter, as she is ill. His son is also away from home. His wife offers emotional, moral support and is caring. He has good intellectual capacity. However, the source of his stress is his daughter’s condition and his lonely wife. His illness is an added burden on his wife. His wife is the source of his motivation. His other source of stress is his son who is insisting him to continue rehabilitation.
Since Michael and his wife both are retired teachers they are dependent on his son financially. Since, Jared is a sole income earner it adds to structural source of stress
Cultural and spiritual dimensions
There are no cultural source of stress found.
Using the procedural and questioning model during interview the long term and short term concerns are identified (Milner, Myers & O'Byrne, 2015). The procedural model helps to gather information to see if the client fits the criteria of services. The questioning model helps to question and answer the client with active listening to understand the nature of people. While, communicating with client a non-defensive attitude was maintained. Further, active listening, acceptance and empathetic understanding was practiced to identified immediate and long term concerns of Michael (Teater, 2014). Upon reflecting on the assessment and communication with client it appears that Michael and his wife are positive in attitude. The client seems to be in situation where he is contemplating his health issues and is ready to take action to change his behaviour. At this stage, implementing interventions is easy (DiClemente & Wiprovnick, 2017). It is indicative of good self-esteem. However, it is evident from the radical casework and interview that structural factors are influencing the client’s situation (Baldwin, 2016). It would be challenging for Michael to return home where his wife will not be able to give him the health care that he is best receiving at rehabilitation centre. The clinical information received from his doctors indicate his physical condition to be critical. It will be burdensome for Lucia to care for her daughter as well as her husband. He has good image as a teacher and loves travelling. However, his current assessment indicates of poor quality of relational network.
Thus, the immediate source of concern is safety of physical and mental health of Michael, and decision-making in regards to his transition from rehabilitation to home and affordability of services due to financial constraints and psychological support. Therefore, there is a need of helping client and family in decision-making and discuss costs effective services and implications with them. The long-term concerns in this care are social support for Julie, financial support to client’s family and improve relational network.
Arrange for all the care needs at home with the help of community services offered by non-governmental organization. This services will be cost effective and will help in any assistance and equipment required by Michael. The community stroke team consists of healthcare professionals such as psychologists, physiotherapists, community stroke nurses, dieticians and occupational therapists. The team will continue to care and assess the health care needs and monitor the achievement of goals agreed (Walker et al., 2013).
Michael will be provided with the practical help needed in this case. It includes provision of home carers to assist in adaptations for his home after performing the community care assessment (Tourangeau et al., 2014). The assessment will be conducted before Michael leaves rehabilitation.
Michael will be refereed to short-term respite care, which involves short-term stay in care home to give break to his care assistant (Borenstein & McNamara, 2015). In this manner, Michael can enjoy staying at home. It will also satisfy his son’s demand to continue with Michael’s care at nursing home. Simultaneously, it will also help his wife in fulfilling her responsibilities towards her both daughter and husband. Moreover, respite care will help improve social connectedness of Michael as there will be other patients with similar illness. It will help improve his mental wellbeing to some extent and provide various opportunities.
The family will be referred to other home services such as wheel and laundry services. They will be provided necessary equipments to assist Michael in performing activities of daily life. Stroke helpline numbers will be provided in case of any emergency to receive additional support and information. The client’s family will be referred to sources that can offer them financial support.
As a social worker I have managed to build some rapport with client and his family and establish trust by showing interest and warmth. Therefore, I can help the client to explore their problems and its consequences and make effective decision (Taylor, 2013). I would give them the required psychological support by motivation. I would arrange for free of cost counselling services in Goald coast to address emotional concerns.
My professional values that I would consider in this case are to ensure that Michael and his family access basic information, services and resources. Serious efforts were made to promote the equality of opportunity to the client considering his financial and social dimensions. I attempted to have wholesome engagement with the client. While advocating, warmth and honesty is maintained to build relationships. This helped Michael and his wife to gain confidence and engage in open communication. These professional values guide my every day practice. While providing information personal gains and benefits are avoided. In case of Michael I have tried sincerely to implement cost effective approaches. I ensure to prevent discrimination and oppression of client. My professional value is to empower client while focusing on the priority concerns. This value guided in addressing Michael and his son’s concern.
As a social worker, I tend to put aside personal opinions and views when assessing client’s situation and never merge with the professional views and beliefs. The values were maintained in case of Michael as well. I have set my personal values but it does not interfere with the treatment or services delivered. I believe in offering sensitive and nonjudgmental services. I value honesty in my personal and professional work. I personally believe in marinating authenticity of the information delivered and giving a genuine response to client’s concerns. According to Hepworth et al., (2016) being genuine and authentic helps build rapport with client and trust. I have learnt this value from my profession.
While performing assessment and having discussion with the client, his respect and dignity was maintained. Maintaining worth and dignity of each client is the core value of social work (Miley et al., 2016). While having interview with the clients it is kept in view that each client has unique experiences. Therefore, client’s individuality is respected. Prior to helping clients and their family in decision-making, confidentiality of all the personal information shared is ensured. Precautions are taken to safeguard the information and comply with the ethical principles of social work profession (Parrott, 2014)). No presumptions were made and being judgemental was completely avoided while collecting Michael’s information. It helped to understand the core of the problems and develop rationalised interventions. While developing intervention to improve social connectedness social justice was ensured. These attempts improve relational network individually and collectively (Hepworth et al., 2016). These activities promote respect for value, integrity and competence of the social work profession. The other core values of social work is to volunteer professional skills free of charge through community organisations (Reamer, 2013).
The ethical dilemmas in this case is acceptance of services of community stroke nurse by Michael. This is in regards to personal care offered by nurse such as dressing, bathing and other. Michael may prefer particular course of action, however, the nurse may influence the client with her professional opinion. It may violate the right to determination of client. Further, as the home care assistant will be acquainted with personal life of Michael and household issues there is a risk of breach of confidentiality. Further, improper allocation of fund or resources due to change in administrative policies may give rise to stressful ethical dilemma among the administrators. After terminating contact with the Michael and his family having further contact and to what extent it is appropriate adds to ethical dilemma. It can also give rise to situation where social workers’ moral and internal values conflict with that of Michael or Lucia. The language used by the stroke team members and the services may not met all the cultural factors or needs of the client although the goal is to provide culturally appropriate care (Miley et al., 2016).
Baldwin, M. (2016). Social work, critical reflection and the learning organization. Routledge.
Borenstein, J., & McNamara, P. (2015). Strengthening kinship families: scoping the provision of respite care in Australia. Child & Family Social Work, 20(1), 50-61.
DiClemente, C. C., & Wiprovnick, A. E. (2017). Action as a Stage of Change in Couple and Family Therapy. In Encyclopedia of Couple and Family Therapy (pp. 1-3). Springer International Publishing.
Fillenbaum, G. G. (2013). Multidimensional functional assessment of older adults: The Duke Older Americans Resources and Services procedures. Psychology Press.
Hepworth, D. H., Rooney, R. H., Rooney, G. D., & Strom-Gottfried, K. (2016). Empowerment Series: Direct Social Work Practice: Theory and Skills. Nelson Education.
Kadushin, A., & Harkness, D. (2014). Supervision in social work. Columbia University Press.
Miley, K. K., O'Melia, M. W., & DuBois, B. L. (2016). Generalist social work practice: An empowering approach. Pearson.
Milner, J., Myers, S., & O'Byrne, P. (2015). Assessment in social work. Palgrave Macmillan.
Parrott, L. (2014). Values and ethics in social work practice. Learning Matters.
Reamer, F. G. (2013). Social work values and ethics. Columbia University Press.
Taylor, B. (2013). Professional decision making and risk in social work. Learning Matters.
Teater, B. (2014). An introduction to applying social work theories and methods. McGraw-Hill Education (UK).
Tourangeau, A., Patterson, E., Rowe, A., Saari, M., Thomson, H., MacDonald, G., ... & Squires, M. (2014). Factors influencing home care nurse intention to remain employed. Journal of nursing management, 22(8), 1015-1026.
Walker, M. F., Sunnerhagen, K. S., & Fisher, R. J. (2013). Evidence-based community stroke rehabilitation. Stroke, 44(1), 293-297
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